Strategic Planning and Organizing Patient Care
Chapter 9
Amy Androwich O’Malley, RN, MSN
Ida M. Androwich, PhD, RNC, FAAN


There is a predominant need to have the voice of the nursing profession involved in organizational strategic planning. In order to integrate into the process, nurses need to understand how organizations are structured and how they function. Additionally, aligning the strategic vision with the mission of an organization and relating it to the goals and values of the communities serviced is essential.

Typically, organizations define their purpose and guiding philosophy through developing a formal mission statement. These statements express the reason for the organizational existence. The philosophy, often embedded in the mission, articulates the value statement of the principles and beliefs that direct organizational behavior. Strategic planning builds upon these essentials so that organizations can project growth and renewal. The planning is an ongoing process involving an environmental analysis, establishment of goals, and strategy development. Strategic planning helps develop a vision for where the organization is headed and ensures that resources are identified to carry out the initiatives in a clear plan of action. The steps in the planning process are similar to the nursing process.

The authors review multiple tools that are helpful while conducting an environmental or situational assessment including a SWOT analysis which identifies internal Strengths and Weaknesses and Opportunities and Threats in the external environment. A stakeholder assessment is also used to gather information about those who have or have potential to develop a vested interest in the organization. Other methods such as: surveys, questionnaires, focus groups, interviews, advisory board’s assessments, and reviews of the literature are also highlighted.

The next steps involve identifying a plan with goals and objectives while ensuring congruence with the organization’s mission. Resources are determined, followed by the development of a priority list. Timelines, roles, and responsibilities are further defined. Marketing and communication plans follow the written plan, ending with an evaluation after the plan has been executed.

There are different organizational structures that, by design, allow for facilitation of strategic plans in a variety of ways. Structure types are reviewed including: authoritarian, democratic, matrix, flat, tall, decentralized, and centralized.