Health Matters: Benefits of System-Wide Strategic Planning

Kurt Spiering, AIA, and Paul Widlarz, AIA


The healthcare industry is undergoing rapid changes as it looks for more efficient processes to deliver services, prompting many healthcare organizations to reassess their current operations to remain profitable. Yet change offers real opportunities. By conducting a system-wide strategic planning process that addresses change, healthcare organizations can provide a solid foundation for future growth.

Below are several steps organizations can take to develop a system-wide strategic plan.

Strategic Visioning

By aligning stakeholders around a strategic vision, healthcare organizations can develop system-wide goals that define where you are and where you need to be. Strategic planning often begins with imagining what your ideal system would look like if you started from scratch. Organizations should perform a market assessment and financial analysis in coordination with facility assessment. This involves identifying competition and market base, and then exploring how you would address that market base--through operations, services, facilities, and locations. Does your market have a large aging population or a lot of young families with children? Is this an urban, suburban or rural market? How is the population currently obtaining health services?

Through strategic visioning, organizations are doing more than constructing or renovating buildings, they are creating access points within an integrated care system to manage population health and enhance operational performance.

For instance, HGA recently conducted a strategic plan for a multihospital system in the South to evaluate current operations after a recent acquisition. With the goal of upgrading, replacing and repurposing, the strategic plan took a macro to micro approach, first looking at geographic market potential, then analyzing system-wide effectiveness within that market, and finally conducting a facility assessment on each campus.

The strategic plan concluded that the hospitals were geographically well placed and should remain open for the time being, but eventually should consolidate to streamline resources and services. Phase two of the strategic plan now involves master planning each hospital to determine best uses.

Lean Planning

By identifying resources from the system level to the individual building level, healthcare organizations can then move confidently through the programming and predesign stages to determine how each building should operate.

"Lean" planning essentially creates efficient workflows and movement of people, processes, and products. Using multiple tools and techniques, Lean assesses workplace operations to understand how care is delivered and determine if people, spaces and technology are enabling or inhibiting efficiency. By using Lean benchmarks, organizations can identify areas for improvement around service lines.

At the recently opened Northeast Georgia Medical Center (NGMC) Braselton, for instance, HGA worked with Northeast Georgia Health System's Six Sigma team to develop a series of guiding principles around three measurable performance metrics: staffing and operations, sustainable concepts and lifecycle-cost savings, and improved patient outcomes and safety. With these benchmarks, the planning team essentially approached the project as clinical consultants, basing every decision on a research-based Lean approach.

Facility Design

The final step in the system-wide strategic planning process is facility master planning and design, in which the building takes form by integrating benchmarked data from the Lean planning processes. Different design tools--such as Extreme Schemes that focus on strengths and weaknesses of a single attribute, and Critical-to-Quality (CtQ) categories that convert predesign data into tangible design formats--can be used as decision-making tools.

Again at NGMC Braselton, the design team conducted a series of predesign workshops with community members to identify service lines and "keystone experiences" that resonate with patients, family, and staff. These keystone experiences translated into tangible solutions, such as use of local stone and natural wood in the entry rotunda, multiple access points to outdoor gardens, and clear wayfinding--design choices that promote a positive patient experience.

By combining all aspects of strategic planning, organizations can design facilities that best support overall goals.


A system-wide strategic plan allows healthcare leaders to effectively plan for growth by evaluating operational processes and market potential. While each organization is different and requires a tailored approach, several takeaways apply:

  • Establish a clear vison for how you want to serve your community.
  • Understand the local market, national trends, and how your facilities serve that market.
  • Identify your current and future operational state.
  • Develop a strategic plan (or road map) to replace and upgrade facilities over time.
  • Update that plan every five years to address evolving market changes.