Healthcare Strategic Management 4 Assignment Espoused Reality vs Actuality


Espoused Reality vs Actuality

In the first lecture for the week, the idea of espoused reality versus actuality was discussed.

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Write a 2 page paper addressing the following elements in your paper:

  • Explain how a manager would avoid having espoused reality enter into his or her department.
  • Include a discussion on the tools they could use, would department meetings help – please be sure to support your position with peer reviewed references.

Include a title page and 3-5 references. Only one reference may be from the internet (not Wikipedia). The other references must be from the Grantham University online library. Please adhere to the Publication Manual of the American Psychological Association (APA), (6th ed. 2nd printing) when writing and submitting assignments and papers.

Developing a Strategic PlanLet’s quickly review where we are with our knowledge base as it relates to strategic management. In week 1 we introduced the history and development of strategic management. In week 2, we turned our attention to the various models of strategic management; analytical and emergent. We realized that for most healthcare organizations it would be nearly impossible to adhere to just one in its pure form. In healthcare, there are too many situations and variables which demand a blend of both models. Last week, we discussed the differences in the level of strategy formation. At this time, we are ready to delve into the strategic plan. In this lecture, we will review the components and development of the strategic plan and how to implement it effectively.

Returning to our example of a hospital, let’s assume that we are managing a current department that has recently experienced some financial and staffing difficulties. The first step, and this is probably the hardest step of the process, is to have an accurate and honest assessment of current performance. In any given environment, there is a difference between espoused reality and factual reality. Espoused reality is what we report to the outside world and sometimes to our direct managers. Many of us have probably been guilty of this to some extent. We might be in the middle of a minor crisis and when the home office calls to “check-in” and ask how everything is going, many times our initial response is “things are great.” This is espoused reality. We want it to be great and maybe if we say it enough times, it will be.

Espoused reality is our own worst enemy. If we report to the home office that everything is fine, we might lose the opportunity for some much needed resources and support. Many managers, especially new ones, will report only the espoused reality for fear that their own performance will be placed under the microscope. Nevertheless, step one is an honest assessment of where the organization is at currently. The second step is to identify where we want to be. As mentioned in earlier lectures, this might already be available to us in the form of a mission or vision statements. Once we have a clear understanding of where we want to be, we can then develop our strategic plan of how to get there.

There are several methods to help us determine the objectives and/or actionable steps necessary to get us to our end goal. One method that is gaining popularity is referred to as reverse planning. In reverse planning, we basically jump straight to the end goal and then turn around and look at where we started. We ask ourselves questions such as, how did we get here? What were the obstacles that we faced? How much time did it take us to get here, etc. This method is useful if we have a clear understanding of our environment and a highly functional team.

Another method is the analogy of a road map. In week 2, we likened the idea of strategic management as to a road map. Let’s look at a quick example. If you wanted to drive from Salt Lake City, UT to Denver, CO, you would certainly have a road map available. The road map allows for flexibility. In the event that a major road was closed, you would have the tools available to plan a way around the obstacle. If you didn’t have a road map and came upon a closure, you would have no way to plan around the obstacle. Simply put, you might be forced to return home. Such is the case with strategic plans. If our organization makes the plan too rigid, as we mentioned in week 2, we run the risk of hitting road blocks with no way around them. Conversely, if we held the plan too loose, we would never know which road to start down in the first place.

At this point, we know where we want to be and we have identified objectives to help us reach our end destination. The next steps are identifying who is responsible for what, what resources will be required, and how do we go about implementing our plan. These will be addressed in lecture 2.


Developing and Implementing a Strategic Plan

At this point, we have identified our end goal and have established some objectives to help us reach our destination. What is needed now is a clear understanding of who is responsible for what and what resources do we have at our disposal. It should be mentioned that all of these steps in the strategic plan are normally occurring simultaneously. In other words, we wouldn’t be developing a plan fully knowing that there is no possible way to afford it. As an example, the current healthcare crisis in the United States could be solved by simply offering everyone coverage. The problem is funding; there is no feasible way to pay for such services without drastically increasing taxes. We could draft the best strategic plan anyone has ever seen, but without resources, it will collect dust in a forgotten corner.

Returning to our plan, it is imperative that there is both an understanding of who is responsible for what as well as an agreement of these duties. We might be forced to ask ourselves, do our existing job descriptions support what we are proposing? If not, do we need to create a temporary position or simply recreate the job description? Will these extra duties warrant an increase in pay, overtime approval, etc. At this juncture, we have our end goal, we have our objectives, and we have identified who is responsible for what. The next step is to ensure that we have adequate resources.

As mentioned above, imagine what we could do if we had an unlimited supply of revenue. Unfortunately, most of us live in a finite world with budgets and limitations. Money is not the only resource that we need to factor in when we are developing our strategic plan. Do we have enough employees to carry out our plan? What about physical space; will that play a factor in our plan? Lastly, do we have enough time? It has been said that time is the most precious commodity we have. What happens to our plan if some of our main distributors experience labor issues such as a strike or staffing shortage? What would happen if regulations changed mid-stride forcing us to adjust the timing? All of these factors must be considered when placing the finishing touches on the plan.

Now that we have our finished strategic plan, it is time to implement it within our organization. This lecture purposefully glossed over quite a few of the smaller steps, however, they are present in the readings for the week. As such, it is time to implement our plan and convey it to all employees. We must be cognizant of the implementation dip and understand its potential of derailing our efforts. By sheer necessity of development, we know that there is something not quite right in the organization or we might be headed down the wrong path. Regardless of the cause for creation, a plan inevitably means change. Some employees are change agents and will love an opportunity to take on new challenges. Others fear or even despise change and feel vulnerable when a plan is presented.

As a manager, one of the most critical things to understand is the implementation dip. A fully loaded oil barge traveling at 25 miles per hour takes a staggering 4 hours to come to a complete stop. Its forward momentum carries it a significant distance before the ship comes to a standstill. Also, imagine if we were the ship captain of this oil barge and we realize that there is an obstacle in front of us. By the time we pick up the radio to call the engine room, we have traveled closer to the obstacle. When the engineer gives more power to one engine and decreases the other in order to turn the ship, again, we have traveled closer to our obstacle. Through the forward momentum and drift, before we can perceive any change in our direction, we have traveled closer to that which we are trying to avoid. You are probably scratching your head wondering, why in the world are you getting a basic lesson in maritime navigation? Because it makes a great analogy to organizations.

All organizations are in motion. Even those that appear to be stagnant are being moved by a changing demographic, changing oversight, smarter consumers, etc. The larger the organization, the more drift it will experience before it can change directions. As a manager of our hospital, imagine that you do not know about this implementation dip and organizational drift. With the best intentions, you stand up in front of everyone at a large employee meeting and announce your new strategic plan and how great it is going to be in the long run. You retire to your office and applaud your ability to lead such a large entity.

As was the case with the ship on the ocean, an organization is constantly moving. We developed the plan because we could see obstacles in our path. By the time we get the action plan rolling (new policies, new resources, new directions), we have traveled closer to the obstacle. Those individuals who hate change, the “nay-sayers”, will be the first to shout “it’s getting worse – management’s new plan is going to be our ruin!” While not trying to oversimplify, it always gets worse before it gets better. In essence, the nay-sayers would be correct – it is indeed getting worse. The problem is, no one bothered to convey the simple fact that it takes time to change course. Countless change efforts have failed as a result of this.

Now, let’s revisit your announcement at the staff meeting. Let’s assume that you took this course from Grantham and know all about the implementation dip. You mention to all employees that it is in fact going to get a little darker before we begin to see the fruits of our efforts. You might even give the team the oil barge analogy. In this scenario, imagine the nay-sayers pointing out the fact that it is getting worse. No one is surprised and in fact, since we took the time to let them know this would happen and when in fact it does occur, it actually builds trust with the employees and the nay-sayers are deflated. In this example, our strategic plan can go forward without too much resistance. Next week, we will more fully examine competitors and their role in strategic management.

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