Indeed, the strategic plan is an intrinsic survival tool for health service organizations (HSOs) to use during the present economic crisis. A good strategic plan outlines the HSO's directional strategies (ie mission, vision and values) as well as its competitive position. This may involve a SWOTs to distinguish service lines from the competition, or a SPACE analysis, and financial statements along with key operational metrics/ratios. In addition, it will include marketing collateral, market strategy, and market share, and it will define its health service area(s).

Agreed that we are not just facing challenging times but are already in them. There is a great article available in the ACHE website from the Journal of Healthcare Management which deals directly with these issues and of how several organizations successfully used strategic planning and quality improvement as a mean to improve processes, outcomes and as guide for their systems. The article is titled "The Revolution in Hospital Management" and was published in May/June of 2005. It is an excellent piece. Just go to the ACHE website and type in "revolution" in the search engine and it will pop-up.

Strategic planning should be able to account for external challenges. Sometimes those challenges, however, can be unexpected and contingencies may be necessary. For example, given the state of the auto bailout proposal, a hospital in Detroit may anticipate a change in its payor mix -- surely if the bailout doesn't pass or is limited, unemployment will rise and/or health benefits will fall. This is likely to affect the bottom line of regional HSOs.