Planning and the Future of Health Care

In the next several weeks, the CHRISTUS Health FY09 budget will be in its final stages of preparation. As we are traveling toward our tenth year, I am reminded of our commitment in 1999 to our three-dimensional integration process, which demanded that we incorporate into our operational and capital budgets all the strategies which we hope to accomplish in the upcoming fiscal year.

As I indicated in a previous post, this fiscal year is always looked at two prior times before it becomes the fiscal year in which we are operating. With our three-year rolling planning process, we call the third year out our “quicksand year,” where we are making educated decisions based on the best data we have available. These decisions are then again reviewed as the year becomes the second year out, which we call our “wet cement year,” which even further solidifies the decisions that we anticipated in the year before, and gives us an opportunity to refine any of those decisions based on the most current and updated data. Then, as this year becomes the fiscal year of operations, we call it our “hard cement year,” where all the decisions have either been finalized or removed from the strategic process.

However, in many health care systems, strategic planning is often a “book process” and once completed, lives out its remaining days in a notebook on a bookshelf in the leadership teams’ office. The major reason why these plans never become a reality is that they are not funded in both the operational and capital budgets. Therefore, our three-dimensional model mandated that as we create our annual budgets, we must work diligently to ensure that each of the strategies that are essential on our Journey to Excellence have designated line items both in our operational and capital budgets.

In addition to our three-year rolling strategic planning process, which is the core driver of our annual budgets, we have mentioned before that we also do future planning. As we speak, CHRISTUS is halfway through Futures Task Force II. Although many people would say that one cannot look out beyond a year or two because of the complexity and challenges in health care, we firmly believe that looking a decade into the future to predict the most likely outcomes is essential for an innovative and cutting-edge health care delivery system.

We are the first to admit that the recommendations resulting from future planning must be studied continuously to make sure that they are correct. But we are also so comfortable with the ongoing accumulation of data that we believe these recommendations can either be fully accepted, modified or eliminated in sufficient time to be incorporated into our sophisticated three-year strategic planning process. Our comfort level has only been enhanced by the fact that all or a significant portion of the 19 recommendations made by Futures Task Force I have become a reality as we prepare our budget for FY09, and either have been fully or partially implemented over the last eight years since they were formulated at the conclusion of Futures Task Force I in June of 2001.

Because of our success with the first Futures Task Force which was driven by scenario planning, and because most of the recommendations have been fully implemented, we commissioned Futures Task Force II at the end of 2007. We expect this process will come forth with another set of robust recommendations as we celebrate our tenth anniversary in February of 2009.

These recommendations will be reported at our fourth governance conference, which is held every three years to make sure that the governance boards and leadership of all our regions and business units are on the same page as to where we have been, where we are and most importantly, where we are going. Although we will have a complete blog post on the outcomes of Futures Task Force II after their work is completed, is important now to understand that in addition to scenario planning, which we learned how to execute in the Futures Task Force I process, we are utilizing “learning journeys” for our Futures Task Force II process.

These learning journeys are taking us to several key locations in the world where we might experience the most significant changes that are occurring in technology, care of the poor, responses to disaster, cutting edge information management, universal health care and the characteristics of innovative cultures. These journeys have included visitations to New Orleans, India, Canada, Boston, Seattle and San Francisco. In addition, as was the case with the first process, many books and articles have been reviewed by the planning team which includes not only the senior leadership team, but select members of our international board of directors as well as several outside people who bring significant areas of expertise to this planning process.

We all know it is critical to make sure that today, health care is working as efficiently and as effectively as possible. But because health care is so technologically, environmentally and informationally driven, a health care system that is moving forward without a clear vision for the future, undergirded by a solid planning process which is fully integrated with the operational and capital budgeting process will most likely be unsuccessful in any journey they are taking, particularly a Journey to Excellence.