MetroHealth – AI Strategic Planning

January – February 2003 — Cleveland, OH

The goal of this project was to facilitate a strategic planning process for the MetroHealth Department of Medicine, focused on 1) discovering the department’s core strengths, values, and internal best practices; 2) co-creating a shared vision and strategies for the department; and 3) designing initiatives, structures, and processes to realize the achievement of the visions and strategies.

Prior to the Summit – Definition and Discovery:
From the beginning of the project we had a number of key decisions to make regarding the “form of engagement” and “inquiry strategy” (Whitney & Trosten-Bloom, 2003). One such choice raised the question, do we engage in the primary discovery prior to, or during the summit? Based on the facts that the summit was to be two days in duration and the client was hoping to utilize that time to lay out a foundation for ongoing strategic planning, select key strategies, and propose a structure for implementation, the form of engagement chosen was a core-group inquiry (cascading interviews), followed by an AI summit. The time frame for this project was seven weeks – from definition through summit completion. To say the least, it was a very compressed timeframe to carry out an AI process, especially to include interviews of 100 very busy physicians.

We established a client planning/sponsor team (approximately 12 physicians and administrators) to guide the design and implementation of the overall strategic planning process and summit. This team articulated additional hopes for the project, including:
* Shared understanding of what is desired – vision, strategy, goals, success indicators and performance measures
* Discovery of department strengths, best practices, and what is valued most
* Active department involvement, collaboration, and participation in the planning, visioning, and interviewing process
* Active commitment and support for co-constructed vision, strategy, structures, and processes
* Increased ownership in the success of the department
* A roadmap for successfully achieving stated goals, objectives, and activities

Key to launching the core group inquiry was two, half-day planning team sessions. The first session included an introduction to AI theory and process, generic AI interviews, followed by topic selection, question creation, and concluding with the development of a draft interview protocol. Approximately one week later, the second planning team session was held to pilot the interview protocol and to develop the inquiry strategy. This session included the original planning team and 30 additional physicians who agreed to participate as interviewers. The topics chosen for the inquiry were:
1. Uplifting and Balancing Excellence in Patient Care, Education, and Research
2. Collaborative Innovation
3. Supporting our Mission through Fiscal Responsibility

As a result of the planning session, it was determined that 100% department participation for the interviews and summit was desired. The interviews would be conducted over a two-week period – an ambitious goal. In addition, the summit would be planned during weekend hours to enable maximum participation by staff. Thanks to a very dedicated group of physicians, tremendous support by an effective team of secretaries and administrative personnel, the interviews were conducted, summarized, and collated within a two-week period.

During the Summit:
The Summit was held over a two-day period. Participation on each day was dependent on staff schedules and workload, however, approximately 80 participants attended the first day, and 65 attended on the second day. Each participant received a folder with a hard copy of all the interview responses, a description of “What is an AI Summit”, and a handout describing group self-management roles.

Discovery and Dream:
Day one of the summit was focused on the Discovery and Dream phases, and the goal was to bring into the summit all of the rich data from the interviews, to make collective meaning of the results, and to create bold visions for the future of the department.

The session started out by having participants connect with some of the quotable quotes that came out of the interviews – specifically asking participants to choose quotes they perceived most important to the department’s history and future. This was followed by sharing and discussing highpoint moments of success and what is valued most – the stories from the interviews. As a result, participants were asked to share a particularly compelling story and their identified positive core elements. Many examples of service to the community, patients, teamwork, and significant moments in teaching emerged. These themes of commitment, dedication, and love of patients were repeated throughout the day.

Moving into the Dream phase, participants carried out a Headline News activity. They were asked to imagine that it is 2005 and CNN Headline News is highlighting the great work that the department of medicine is doing. The groups created headlines and supporting lead-in stories, which captured their bold visions for the future of the department. Excellence, commitment, compassion, and leading education and research appeared in each report out.

Design and Destiny:
The focus of day two was on Design and Destiny. Six Headlines from day one were chosen to move forward and bring to life through design. In small groups, participants worked to bring the visions to life – answering questions such as:
* What strategic initiatives should we consider to achieve our visions? Who is impacted, affected, or needs to be involved?
* What principles should guide the design of these activities and initiatives?
* And, what are the key measures of success which will indicate progress toward our goals?

A facilitated whole group conversation assisted in prioritizing strategies that would support such bold visions. Rich dialog between seasoned physicians, newly practicing physicians, researchers, educators, and administrators enabled the following key focus areas to emerge:
* Patient Centered Care – Operating Model
* Resident Education
* Faculty Development
* Fiscal Innovation
* Translational Research
* Communication of the good work to the community

Participants were asked to choose one of the above areas, based on their interest, to identify and develop specific strategies and actions to move these key initiatives forward. Lastly, to support both expansive and generative possibilities, participants were asked to rotate to each of the other areas – to appreciate the group’s work and contribute additional ideas and suggestions. The final output included a roadmap of key initiatives, supporting strategies, timing, and actions – which were posted on the wall, to visually represent the plan the department had created.

Summit Outcomes:
As mentioned above, some of the key outputs from the summit included the positive core, headline vision statements, and six key strategic initiatives with supporting implementation roadmaps. Following the summit, a communication was sent out to the department – highlighting what had happened during the summit, some of the key decisions and outcomes, as well as an invitation to join a strategic area working group.

Approximately 40 department staff volunteered to move these strategic initiatives forward, with two co-leaders identified and assigned for each initiative. Most groups have met at least once, with the greatest interest and progress stemming out of the residency education redesign effort. Future AI summits are likely to occur – primarily to reconnect and reenergize, share progress made, to look at emerging trends and opportunities, and to sustain the momentum and energy created during the first strategic planning summit.
Submitted by: Tony Silbert