STRATEGIC PLANNING

Engaging the End User in Strategic Planning 
 
When St. Joseph’s Health, a large safety-net medical center located in northern New Jersey, set out to conduct fresh strategic planning for the organization, it turned to innovative approaches such as human-centered design in order to engage internal stakeholders and the community at large. In doing so, they developed a nimble, nuanced approach that engages end users and allows for frequent updates to strategic goals to best address needs during a time of great change in the health care field.  

"Making sure we can continue to address the poor, the vulnerable and the underserved is always top of line for this organization,” which has been in the community for 155 years, notes Lisa Brady, the senior vice president and chief strategy officer at St. Joseph’s Health. "At the same time, no margin, no mission—so we have to find a balance and find creative ways to be able to meet the needs of that community while also having the margin to be able to fund it. We have a long history of finding ways to meet the needs and being creative, but we didn’t really have a formalized approach to innovation across the organization.”

In late 2015 and early 2016, Kevin J. Slavin, the president and CEO of St. Joseph’s, challenged the organization to find a way to evenly spread innovation throughout the system. In response, Ms. Brady and her colleagues led the creation of a Center for Innovation, which began an exploration phase in 2017 built upon collaboration between a diverse group of members that focused on understanding the charge, being intentional about the participants and environment, and exploring possibilities for innovation. Engaging end users in the planning process was also key.

"There is a tendency to want to jump to solutions rather than truly understand the needs of end users,” Ms. Brady explains. "With the Center for Innovation, we aimed to address this.” 

However, she acknowledges that often the biggest challenge when tackling a project is properly defining the problem. In addressing this, the team developed a framework that was focused first on defining what was trying to be addressed and identifying the core problems that currently curbed success.  From there, the learning began, focused at each step on engaging end-user attitudes and beliefs.  

"Most of us, in the way we approach work, you want to have some level of understanding, but when you are doing human-centered design, the nature of this exploration and learning is different,” Ms. Brady says. "You are exploring and have a scope of what you want to talk about, but you let the end user—the participant—drive where the conversation goes.” 

One example at St. Joseph’s involved bringing in mothers from the community and surveying them regarding their experiences accessing perinatal care. Then, the health system worked with them to come up with ideas of how to address the issues they voiced.  

In a broader corporate sense, this same approach was used to update the organization’s strategic plan during 2020. While some hallmarks of the traditional strategic planning process were included, such as reviewing market share, volumes and demographics, a focus on design thinking and human-centered design was included. This consisted of collecting broad input from trustees, executives, management, front-line workers and community members. Eventually, more than 800 data points of input were gathered, all of which were used to develop innovations by way of shaking up the status quo, as requested by the organization’s CEO. 

"We’re not just planning from a provider’s perspective,” Ms. Brady says. "We’re looking at all perspectives. At every step we broadened it up, saying, ‘If this is the scope we have from our board on strategic direction, now let’s look at how broad the framework can be.’ Once we had the priorities, we questioned what our goals would look like.”  

At one point in the process, end users would be reengaged to provide feedback as the plan was polished. The key was keeping focus on serving the vulnerable community, which has been a top priority for the organization since its inception. Additional focus was placed on delivering care outside of the facility at home or in remote locations, and meeting the needs of a diverse and aging patient population.  

"We want to make sure we are moving outside of just being a provider and going upstream to look at social determinants of health,” including specifically querying users’ barriers to access, Ms. Brady explains. "We all know the social determinants of health, but we can’t assume that tells the whole story.” 

Throughout the process, the team found that methods of innovation and human-centered design were useful tools when developing a strategic plan. They also found that consistently engaging a broad spectrum of voices from the organization and community led to broader ownership of the plan.  

"We now have so many community partners who are fully engaged in our health equity strategy, we have people excited about what we are doing because they have been more engaged in the development of the plan,” Ms. Brady says. "We are going to continue to evolve this strategy, and we’ll need to keep getting input. While annual goals exist, we are making adjustments monthly based upon feedback we are receiving.”