Organizational structure and design principles

Organizational Structure
Mission, Vision and Key Values
This organization will be a new healthcare organization / group home for veterans. The mission is to provide a safe and stable environment for veterans to recover from injury, surgery or trauma. The vision is an America where veterans feel valued, and where their service is repaid with the highest honor. The key external values of the organization are going to be healing, compassion, and empathy, and key internal values will be hard work, caring, and attention to detail.
Framework of the Strategic Plan
The strategic plan will involve positioning – we are targeting veterans who are able to afford private care, although some will be funded through government payer sources. To deliver a premium standard of care that is greater than available at a typical VA facility, we will focus on hiring and retaining the best talent, and investing in our facilities. We seek to serve those who serve, and this investment in people and facilities is how we will execute this plan. The most modern health care tools will be utilized, which is a key point of differentiation for our facility – and comes with it certain requirements for hiring and training of nurses, physicians and other medical staff.
Strategic Planning Model & Relationship with Mission, Vision and Key Values
Of the main strategic planning models, the Basic model is the one that best describes how the organization will approach strategic planning (ExecuteStrategy.net, 2018). This model is based on a pathway of vision ? goals ? approach ? action (Ibid.). The organization has a vision and is in the process of setting critical goals. The approach is largely driven by the vision in this instance, especially where investment and organizational structure are concerned. In the basic model, the vision serves as the basis for the development of strategy. The vision is a high level concept, and the mission is more of an operational level interpretation of the vision, with the key values being the "how" part of translating the vision into action. Thus, vision is the guiding force behind strategy, with mission and key values being strong influencers.
Organizational Structure
In order to deliver high-value service that is superior to other competitors, we are adapting the more traditional hierarchical structure of a normal health care organization into a patient-centric structure. Patients will be assigned teams of caregivers, and these teams will be managed by individual leaders who guide patient care. This structure is how we envision breaking down the communication silos that often exist in health care organizations and increasing teamwork. We feel that if the caregivers work together with each patient – very much possible in a group home setting where patients are typically long-term – that the overall patient outcomes will be superior. Within the structure, the normal roles are going to be much the same, but with a greater emphasis on communication between the different caregivers, and a specific dedication to individual patient needs and caregiver continuity. Outside of this, the organization will have a functional structure – units such a Finance, Operations, etc., but the Patient Care department will supersede more traditional departments based on healthcare role (doctors, nurses, etc. in different departments).
Key Leaders
The organization will be headed by an experienced management team of healthcare professionals. Our head of Patient Care has a diverse range of experience, having started as a nurse, before going back to school to become a physician, and ultimately moving into healthcare administration. The other leadership roles are staffed by experienced professionals who are experts in their fields.
Change Management Model
As a new organization, organizational change is not top of mind, but there are plans to adopt a unique change management model based on iterative change – an organization that is constantly adapting as best practices evolve. This model is borrowed from other industries with a high pace of change, but reflects that the increasing role of technology in health care will bring about more rapid pace of change in our profession as well. To align this approach with the Basic strategic planning model, the change model outlined by Lukas, Holmes, et al (2007) is utilized. This model emphasizes leadership commitment to quality, improvement initiatives, alignment and integration.
In anticipation of this model of change, staff will be recruited in part for their adaptability, and a culture built from the ground up that encourages employees to embrace an environment where jobs might look different from week to week, based on organizational learning and adoption of new techniques and technologies.
Impact of Governance
Governance plays a critical role in ensuring that strategies succeed. Performance evaluation models are vital – who is evaluated on what measures determine which activities people will prioritize in their work. Governance is going to be a top-down exercise in which senior managers set specific targets relating to patient outcomes, and challenge their workers to improve on those outcomes routinely. At the higher levels, governance will focus on more of a balanced scorecard approach – this will place pressure on senior leaders to deliver a more balanced set of outcomes, where the front line employees will focus primarily on patient care outcomes. Creating this alignment, but working within the confines of individual role skills sets, is an important part of achieving consistent success in health care delivery (Nuti, et al, 2016).
Role of Board of Directors
The Board will provide guidance on strategic matters. Ultimately, strategic decision-making decisions will be made by the executive team, utilizing the advice and guidance of the Board. The Board's main role will be in the governance function – ensuring that the right leaders in place to develop and execute strategy, and that they are performing this function well.
Value Chain
The value chain outlines where value is derived in organizational activities. The location will be in a large urban center with a lot of veterans. The target market is specifically going to be veterans (and their families), who have some financial means to pay for differentiated care above what the government will cover. The main program will be a group home, delivering longer-term care for veterans with complex needs, but for whom rehabilitation is possible. This includes injured veterans and those with certain forms of PTSD or other trauma. The clinical operations will focus on a comprehensive care delivery platform, one that includes medical and psychiatric care, nursing and more.
Marketing will focus on developing relationships with veteran's organizations, and with other health care practitioners and facilities that work with large numbers of veterans. The interpersonal aspects of marketing will be emphasized, as relationships are critical to identifying veterans who are the right fit for our facility. Billing will be run basically as in any other health care organization – it is expected to be a mix of government paid, insurance and out of pocket. Follow-up will be done via an individual hired specifically for the job, who is part of the care team for any individual patient.
Organizational culture has been discussed in brief, but will focus on high-quality care delivery, and the ability to be flexible. Adaptability is one element of organizational culture that will be relatively unique to our facility.
Strategic resources are going to include the executive team and the Board, as well as significant up front funding in order to execute the strategy – money for facilities and services, for example. All told, the value chain helps to identify the areas where the organization can ensure delivery of the strategic plan. Each area of the value chain makes a contribution, but this analysis shows that some areas will definitely make a larger contribution than others.
References
ExecuteStrategy.net (2018) Strategic planning models vs frameworks. Execute Strategy.net. Retrieved November 12, 2018 from https://www.executestrategy.net/blog/strategy-planning-models/
Lukas, C., Holmes, S., Cohen, A., Restruccia, J., Cramer, I., Shwartz, M. & Charns, M. (2007) Transformational change in healthcare systems: An organizational model. Health Care Management Review. Vol. 32 (4) 309-320.
Nuti, S., Vola, F., Bonini, A. & Vainieri, M. (2016). Making governance work in the health care sector: Evidence from a natural experiment in Italy. Health Economics, Policy & Law. Vol. 11 (2016) 17-38.