Strategic planning, performance improvement, and information systems are each essential components of an effective organization. They are especially important in the context of healthcare because of the stakes involved—the life-and-death decisions that are inherent in the provision of medical care to the seriously ill. They are also interrelated precisely because the technological element represented by a healthcare facility’s information system is central to the ability of the other two elements to function efficiently.
Strategic planning is, as the name suggests, a long-range process of assessing a healthcare organization’s future requirement and preparing to meet challenges and expectations through personnel policies and improvements to or recapitalization of the organization’s existing information systems. Information systems are constantly reviewed and assessed for weaknesses (e.g., vulnerabilities to hacking and/or to systemic disruptions caused by power outages or other problems) and for deficiencies with respect to each department’s ability to communicate within and between the broader organization. Performance improvement is, as with strategic planning, largely self-explanatory and applies both to individual performance and to unit performance (e.g., surgical teams, catheter lab units, etc.). Perfection being impossible to achieve, there is, by definition, always room for improvement, especially when one or more deficiencies is identified. In the realm of healthcare, the identification of deficiencies may be made under the most inopportune conditions—errors that compromise patient well-being.
These three components are interrelated in that a weakness in any one of the legs to the triangle will invariably adversely affect the other two components. A hospital cannot function if its ability to communicate internally is disrupted for any reason. Breakdown in the pneumatic tube system upon which emergency room teams depend (these tube systems are routinely used to move documents and specimens between the emergency room and the labs that analyze blood and urine samples) requires manual transportation of items, thereby slowing a process heavily dependent upon speed. A disruption to the information systems used in the process of registering patients similarly slows down, often significantly, the healthcare system, as a patient’s medical history cannot be quickly accessed. This is a serious problem in the expeditious treatment of trauma and other emergency patients. Strategic planning must include assessments of the organization’s future requirements in this regard. The process of updating or replacing existing software programs can take weeks and involve disruptions to operations. Long-range planning, therefore, must determine the optimal time to schedule such upgrades (e.g., during night shifts and periods of historically slow operations, like major holidays, when elective procedures are less likely to be scheduled).
Performance improvement involves training in the use of new information systems for the obvious reason that employees must be conversant with new software programs. Healthcare workers, including those in support services, are usually required to pass a series of tests covering myriad areas of healthcare organizations, including handling of contaminated liquids (e.g., blood, urine, feces), proper attitudes toward patients (nurses and other professionals sometimes develop a callousness toward patients which impedes job performance), safety procedures in case of emergencies, and many other subjects relevant to the organization. Strategic planning incorporates emerging areas of concern and projections of possible developments in healthcare and threats to the integrity of the organization and establishes policies intended to ensure that individuals and units are prepared for those future contingencies. All of this involves use of information systems that must keep pace with developments and requirements identified as part of strategic planning.
In conclusion, strategic planning, performance improvement, and information systems are interrelated in that one cannot survive without the others.