Running head: STRATEGIC PLANNING 1

Strategic Planning Process Map

Amy Breen-Lema

University of San Diego

ENLC 557 Strategic Planning and Management of Health Systems

Cheri Pope, MBA, MHA

April 30, 2018

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Salinas Valley Memorial Hospital is a public district hospital which is part of the

Salinas Valley Memorial Healthcare System (SVMHS) in Salinas, California. The

hospital is one of four operating in Monterey County. The healthcare system opened in

1953 and has become an integrated network of health care programs, services, and

facilities. At the core of the system is a 269-bed acute care hospital with several distinct

specializations and programs. Specialized facilities and programs include the Regional

Heart Program, the Comprehensive Cancer Center, Joint Replacement Center,

Regional Spine Center, Women and Children, Regional Wound Healing Center, an

Emergency Department and a Level III Neonatal Intensive Care Unit (NICU). In the

early 1940s when the Salinas Community Hospital Association was formed, local land

and business owner Bruce Church, a group of local businessmen, and more than 175

civic leaders embarked on a major fundraising campaign to build the city’s first hospital.

In 1947, the California State Legislature passed an act allowing communities to

establish taxation districts to build hospitals and area voters approved the Salinas

Valley Memorial Hospital District (SVMHS, n.d.-b).

SVMHS’s Executive Management team consists of: (a) Pete Delgado,

President/CEO, (b) Augustine Lopez, Chief Financial Officer, (c) Henry Ornelas, Chief

Operating Officer, (d) Allen Radner, M.D., Chief Medical Officer, (e) Christie Gonder,

RN, BSN, MBA, Chief Nursing Officer, (f) Adrienne Laurent, Chief Strategic

Communications Officer, and (g) Michelle Childs, Chief Human Resources Officer.

SVMHS has a five-member, publicly-elected Board of Directors consisting of Chris

Orman, President, Margaret D’Arrigo-Martin, Vice President, Carmen Gil, MPA,

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Secretary, Alfred Diaz-Infante, Treasurer, and Carissa Purnell, EdD, Assistant

Treasurer (SVMHS, n.d.-a).

As a comprehensive and integrated healthcare system, SVMHS’ purpose is to be

quality provider of healthcare services for Monterey County. The healthcare system

values committed and compassionate health care professionals who want to work in an

environment with advanced technology and are committed to maintaining nationally

recognized clinical care and superior medical outcomes. It is the mission of Salinas

Valley Memorial Healthcare System to provide quality healthcare to our patients and to

improve the health and well-being of our community (SVMHS, n.d.-b). The vision of

SVMHS is to be a center of excellence where an inspired team delivers compassionate

and culturally sensitive care, outstanding quality, and an exceptional patient experience

(SVMHS, n.d.-b).

The strategic planning process team consists of the members of the Executive

Management team, three (3) board members, the Chief Information Technology Officer,

the Nursing Union Representative, Departmental Directors and Team Leaders. The

team is expected to actively participate in the strategic planning meetings and work

collaboratively to carry out the identified goals and objectives. After the initial planning

meetings, monthly accountability timelines at three, six, nine, and twelve months will be

established (Ebener & Smith, 2015). The resources available to the team include

financial, geographic, demographic, and hospital statistics and data; results of the 2017

Community Health Needs Assessment Survey; patient, customer, and employee

surveys data; and personal interview opportunities. The planning assumptions are that

the group consists of local stakeholders with common interests to improve health care
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services and access for the community in a manner that is financially-responsible and in

alignment with the SVMHS’s mission and vision statements. The planning mandates

compliance with regulatory agencies including local, state, and federal laws, Medicare,

Medi-Cal, and the Joint Commission. For this strategic planning project, the

organizational decision makers are the members of the Executive Team and the Board

of Directors.

Organizational Impressions

The general impressions about the Salinas Valley Memorial Healthcare System

are that it is strategically and financially positioned the organization through multiple

service lines, locations, partnerships and affiliations to provide a broad range of health

care services for the communities across the Central Coast region. Some strengths of

the organization include its long-standing relationships and affiliate partnerships with

area health care facilities that allow the community to have access to a higher level of

care close to home. In addition, when critically ill newborns from within or outside of

Monterey County need a higher level of care, the patients and their families benefit from

the hospital’s affiliate relationship with Stanford University’s Lucille Packard Children’s

Hospital. Furthermore, SVMHS offers its providers, staff, and patients the benefit of a

single, electronic health record system (SVMH, n.d.-c). Lastly, in review of the

organization’s balance sheet for fiscal year ending 2017, the organization continues to

experience excellent financial health, which strengthens negotiating, buying, and

acquisition power for future endeavors (SVMHS, 2017).

The following SWOT analysis diagram demonstrates the current internal and

external strengths, weaknesses, opportunities, and threats experienced by SVMHS.

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Internal External
 Current contracted Physicians  Current affiliations
 Employees  Current vendors
 Financial health  Third-party payors

Positive Strength Opportunities

 Financial health
 Long-standing affiliations
 Multiple service locations/access
 Mental health services
 Expand market share in
Monterey County
 Partnerships outside of
Monterey County

Negative Weaknesses Threats

 Limited mental health services  Neighboring hospitals
 Limited cancer services  Changes in payer
 Primary care shortages reimbursements
 Access to care

Some improvements that can be made to the organization include expanded

access and programs for indigent patients, cancer treatment services, and continued

affiliations outside of the immediate service area. Since the organization has

experienced consistent financial health and growth, there are no recommendations for

discontinuation of services at this time. Current threats to the organization include three

neighboring hospitals within the county, possible changes in payer reimbursements, and

providing access to affordable care. As the Salinas Valley Memorial Healthcare System

looks to the future, it should continue to look for opportunities to further expand and

diversify healthcare offerings and access both within and outside of the community,

while maintaining its financial stewardship. SVMHS can levy its experience with

successfully maintaining strategic relationships with local healthcare providers by

exploring growth, expansion, and partnership opportunities neighboring hospitals and

medical groups, while continuing its efforts to improve access care for all residents of

Monterey County.
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Salinas Valley Memorial Healthcare System Stakeholder Map

County of
Monterey Board of
HRSA
City of Salinas
Directors
Central Coast Alliance
for Health Hospital
EMS
Communit Leadership
Veterans' y Hospital
Administration of the
Law
Uninsured/Indigent Monterey
Peninsula enforcement
patients

Third-party
State of CA payors
(Medi-Cal)
Hazel Hawkins
Federal Memorial Hospital
Medicare
Hospital

Trade
unions Current
SVMHS Foundation

Donors

vendors
Pharmacies

Federal, state &

local regulators Natividad
Medical Center
Local unaffiliated
Physicians

Local News
Employees Area Media
Current Employers Hospital Attorneys
contracted
Physicians
California State University
Monterey Bay Local Rehabilitation The Joint
Centers Commission

A stakeholder map is an important step in strategic plan where an organization

identifies internal, interface, or external individuals or organizations with whom their

future is most closely intertwined and determine which dependencies that are most

critical (Ginter, Duncan, & Swayne, 2013). In healthcare organizations, external

stakeholders include suppliers, third-party payers, competitors, regulatory agencies, the

media, and the local and surrounding communities (Ginter et al, 2013). Stakeholders

have varying degrees of influence and a potential say in how the focus and aims of the

business are decided, so it is important to garner opinions, support, and resources as

early as possible in the process. For the Salinas Valley Memorial Healthcare System,

the map below identifies the internal, interface, and external stakeholders. This group

represents the organization’s current and potential strengths, weaknesses,

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opportunities, and threats, so it is important to consider the individual and collective

relationships to and with the organization as a fundamental part of any strategic

planning endeavor.

Organizational Culture

Salinas Valley Memorial Healthcare System is an integrated network of health

care programs, services, affiliations, and facilities located in Salinas, California. The

organization’s mission statement and core values speak to the overall purpose and

business plan by committing to the continuous improvement of healthcare for the

community. The mission of Salinas Valley Memorial Healthcare System is to provide

compassionate, quality healthcare to its patients and to improve the health and well-

being of the community (SVMHS, n.d.-b). The vision of SVMHS is to be a center of

excellence where an inspired team delivers compassionate and culturally sensitive care,

outstanding quality, and an exceptional patient experience (SVMHS, n.d.-b). Each day,

the organization’s purpose is to deliver exceptional, compassionate, and culturally-

sensitive care using the latest medical techniques with state-of-the-art technology that

improves the health and well-being of the community (SVMHS, n.d.-c). Salinas Valley

Memorial Healthcare System values are dedicated to providing high quality and safe

care for its patients, and also providing employees a safe and productive workplace.

Strategic Concerns

The top three strategic areas of concerns for Salinas Valley Memorial Healthcare

System (SVMHS) are: a) limited mental health services, b) limited cancer services, and

c) a shortage of primary care providers. These strategic areas encompass the

organization’s current service area and will address critical needs within the community.
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Furthermore, SVMHS has the resources and the will to positively change the provision

of these comprehensive service offerings. SVMHS will need to invest significant human

and financial resources in addressing the needs, but the organization is in a strong

position to make a difference. The provision of mental health services is critically

lacking in many communities, and Monterey County is no exception. The need for

mental health services knows no racial, gender, socio-economic, or age boundaries,

and many people go without treatment every day. There is a growing and critical need

for expanded mental health services. SVMHS has many resources and existing

community relationships to expand current offerings and improve access to mental

health services in Monterey County. From an internal control perspective, responsive,

empowered, and capable administrative and clinical staff must be in place to run a

successful and efficient program. From an external control perspective, SVMHS, its

community resources and partners will be responsible for educating the public about the

available resources for maximum outreach and community benefit. Much like for mental

health services, cancer services, specifically pediatric cancer treatment services are in

demand, but not currently met within the SVMHS. While three neighboring hospital

offer a variety of adult cancer services, the closest hospital offering comprehensive

pediatric cancer services is greater than eighty-two miles away. For a rural community

with a growing migrant and underinsured population, critical treatment might be out of

reach for many. With the University of San Francisco’s current pediatric affiliation with

neighboring hospital Natividad Medical Center, it is recommended SVMHS pursue a

partnership opportunity for the expansion of pediatric cancer treatment services. Lastly,

for the shortage of primary care providers, it is recommended that SVMHS engage in a
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nationwide multi-provider retained primary care provider recruitment search. SVMHS

has the ability to offer an exceptionally competitive and comprehensive recruitment

package, which will aid in recruiting and retaining qualified primary care providers to the

community.

Strategic Areas of Focus

There are three strategic areas of focus for SVMHS. The following action steps

provide the framework by which the organization or its representatives will carry out the

identified strategic goals.

Strategic Area #1: Mental health services

Strategy: Expand mental health services for adults in Monterey County

Action Step #1: Collaborate with Community Hospital of the Monterey to

explore partnering on mental health service offerings in Monterey County

Action Step #2: Initiate nationwide retained recruitment searches for an

experienced Behavioral Health Physician/Medical Director and Advanced

Practice Provider (APP)

Action Step #3: Establish a Community Mental Health Care Coordination Team

Strategic Area #2: Pediatric cancer services

Strategy: Expand pediatric cancer services

Action Step #1: Issue Request for Proposal to UCSF for satellite Pediatric

Oncology services

Action Step #2: Issue Request for Proposal to Stanford for referral affiliation

pathway
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Action Step #3: Issue Request for Proposal to St. Jude’s Children’s Research

Hospital for affiliate partnership opportunity

Strategic Area #3: Shortage of Primary Care providers

Strategy: Add 5 Primary Care providers

Action Step #1: Initiate nationwide retained multi-provider recruitment search

Action Step #2: Develop provider recruitment print ad campaign

Action Step #3: Launch “Grow with Us,” a refer-a-colleague campaign

Vision

Salinas Valley Memorial Healthcare System will be recognized for excellence

and innovation in clinical care, and a trusted community partner of quality healthcare

services. As a leading healthcare system, we will provide an enriching environment for

our employees and an exceptional health care experience for the patients, families, and

growing communities we serve.

Over the next 5-10 years, SVMHS will continue to expand partnership, affiliation,

and community outreach efforts to further its commitment to providing comprehensive,

affordable, and accessible health care for the Central Coast region.

Action and Accountability Plans

An effective action plan consists of identified objectives that specify who will

participate, what actions will be required and within what timeframe, the persons

responsible for the actions, the resources required, and how the results will be

measured (Ginter et al, 2013). The following objectives are established to guide

SVMHS through the achievement of identified and attainable goals. The organization
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will be required to have human, financial, and legal resources available to facilitate

progress throughout these processes.

Action Step #1: SVMHS CEO Peter Delgado to contact Community Hospital of
the Monterey Peninsula CEO Steven J. Packer to explore the opportunity for
partnering on mental health service offerings in Monterey County. Contact will
be initiated no later than July 1, 2018, and if interested, strategic planning
activities will start no later than September 2018. Existing SVMHS-owned
office space is available for immediate occupancy. SVMHS Board of Directors
request to limit initial service expansion activities to outpatient services to allow
for proper establishment of internal and external referral support systems and
full-cycle revenue audits.

Action Step #2: Human Resources to initiate nationwide retained recruitment

searches for an experienced Behavioral Health Physician/Medical Director and
Advanced Practice Provider (APP) by June 1, 2018. Target start date of Fall
2018. Requirements include Board-Certification, grant writing, and leadership
experience, and previous experience with underserved populations. SVMHS
Board of Directors have authorized Human Resources to offer signing bonuses
of up to $85,000 for Physician/Medical Director and up to $30,000 for the APP.
In addition, and an annual retention bonuses of $25,000 for Physician/Medical
Director and $15,000 for the APP.

Action Step #3: SVMHS Executive Team to form four-member Community

Mental Health Care Coordination Team for community education, outreach, and
referrals management support no later than July 1, 2018. The assembled team
will present 2017-18 strategic goals at the September 1, 2018 Hospital Board
Meeting. In conjunction with the results from the SVMHS 2017 Community
Health Needs Assessment, the Team’s activities will be limited to making
recommendations to the Board of Directors and Executive Team. The Team
will not hold authorization for any financial or contractual decisions on behalf of
the SVMHS and are serving in a community advisory board capacity only.

Strategic Area #2: Pediatric cancer services

Strategy: Expand pediatric cancer services

Action Step #1: SVMHS Chief Medical Officer Dr. Steven Radner and CEO
Peter Delgado to contact UCSF Regional Medical Director and submit Request
for Proposal (RFP) for satellite Pediatric Oncology Center at Salinas Valley
Memorial Hospital or referral affiliation pathway no later than June 1, 2018.
Status update scheduled for June and July 2018 Hospital Board Meetings.

Action Step #2: SVMHS Chief Medical Officer Dr. Steven Radner and CEO
Peter Delgado to contact Stanford Healthcare’s Medical Director Dr. Norman
Rizk and Jane Shannahan, Vice President, Business Development and submit
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Request for Proposal (RFP) for referral affiliation pathway no later than June 1,
2018. Status update scheduled for June and July 2018 Hospital Board
Meetings.

Action Step #3: SVMHS Chief Medical Officer and CEO Peter Delgado will
initiate contact with St. Jude’s Children’s Research Hospital and submit
Request for Proposal (RFP) for affiliate partnership opportunity no later than
June 1, 2018. Status updated scheduled for June and July 2018 Hospital
Board Meetings.

Strategic Area #3: Primary care providers

Strategy: Initiate nationwide retained multi-provider recruitment search

Action Step #1: Director, Physician Services to solicit bids for 2 Primary
Care/Family Medicine Physicians and 3 Physician Assistants or Nurse
Practitioners no later than June 15, 2018. Target start date, Fall 2018. Status
reports scheduled for July, October, and December 2018 Hospital Board
Meetings.

Action Step #2: HR/Medical Staff Services/Marketing Directors initiate

recruitment print ad campaign targeting all Family Medicine Residency and
Fellowship Programs by June 15, 2018. Status update report scheduled for
June, July & August 2018 Board Meetings.

Action Step #3: Marketing/Director, Physician Services to initiate “Grow with

Us,” a refer-a-colleague campaign targeting all current contracted/affiliated
providers and offering a $25,000 referral/finder’s fee if the referred candidate is
hired by SVMHS. Campaign begins June 1 and runs through September 30,
2018. Status reports scheduled for July and October 2018 Hospital Board
Meetings.

To assure continuous progress with established objectives and to maintain

responsiveness and flexibility with any unanticipated results, status reports for each

action step are scheduled to be presented on a rotating basis at the monthly Hospital

Board Meetings. In addition, the Strategic Committee will meet at 3-month intervals to

evaluate progress and results.

Conclusion

Salinas Valley Memorial Healthcare System has been and is operating with a

clear intention of being a trusted and beneficial community healthcare resource.

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Through continued strategic and collaborative efforts, SVMHS will be a change agent

that brings world-class healthcare innovations and outcomes to the Central Coast

region and enhances the lives of patients, families, and the community as a whole.
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References

Ebener, D. and Smith, F. (2015). Strategic Planning: An Interactive Process for

Leaders. Paulist Press: New York.

Ginter, P., Duncan, W., & Swayne, L. (2013). Strategic Management of Health Care

Organizations (7th ed). San Francisco, CA: Jossey-Bass.

Natividad Medical Center. (n.d.). About Us, NMC Profile. Retrieved from

http://www.natividad.com/about-us/nmc-profile

Salinas Valley Memorial Healthcare System (SVMHS). (n.d.-a). Executive

Management. Retrieved from https://www.svmh.com/About-Us/Healthcare-

District-Information-Reports/Executive-Management.aspx

Salinas Valley Memorial Healthcare System (SVMHS). (n.d.-b). Our Mission and Vision.

Retrieved from https://www.svmh.com/About-Us/Mission-Vision.aspx

Salinas Valley Memorial Healthcare System (SVMHS). (n.d.-c). About Salinas Valley

Memorial Hospital. Retrieved from https://www.svmh.com/About-Us.aspx

Salinas Valley Memorial Healthcare System (SVMHS). (June, 2017). Financial

Disclosures. Retrieved from https://www.svmh.com/documents/financial-

disclosures/2017_6-Summary-Financials.pdf

Stanford Healthcare (2017). About Us: Leadership. Retrieved from

https://stanfordhealthcare.org/about-us/leadership.html