The Importance of Planning

To borrow from the motto of the Boy Scouts of America (2011), “Be prepared!” There is no possible way to fully predict with perfect accuracy when and where a crisis will develop. However, with some foresight, the adoption of a comprehensive crisis communication plan will allow an immediate response to any emergency, disaster, or other crisis that might arise. Gray (2008) discusses how JetBlue might have benefited from such a plan. JetBlue, if they had focused on developing a crisis communication plan, might have uncovered the not unlikely possibility of a major storm grounding many of its passengers. In this case, JetBlue would have been in a more proactive position to mitigate the effects such a storm might produce on passengers and their east coast operations. According to Fearn-Banks (2011), the impending storm prediction would have been a warning sign, or prodrome, that JetBlue could have responded to in order to prevent the crisis. Had JetBlue contacted the passengers prior to their arrival at the airports, they might have been able to secure better and more comfortable accommodations than the airports had to offer. Additionally, the company would have presented themselves proactively instead of taking the defensive posture noted by Gray.

In December 1984, Union Carbide, a pesticide production company, was the subject of the worst industrial accident in history. At their plant in Bhopal, India, an employee purposefully allowed water into large tanks of a chemical called methyl isocyanate (MICN) which caused a chemical reaction (according to Union Carbide management), bursting the tanks and releasing MICN gas into the environment killing more than 3,000 people (some estimates exceed 25,000 dead) and injuring 100 times that amount (Venkatasubramanian, 2011). According to Muller (2001), MICN was stored in large above ground tanks, a water valve was connected to the tanks, and employees had largely unrestricted access to these tanks and valves. When liquid MICN and water are mixed, MICN rapidly expands to a gaseous state and can quickly overwhelm holding tanks. Had Union Carbide conducted an investigation of potential crises while constructing a crisis communication plan, these circumstances might have been uncovered and considered prior to the accident, allowing company officials the opportunity to mitigate the potentially deadly situation and avoid the catastrophe in 1984. Additionally, had this crisis occurred regardless of mitigation, the company would have been poised to provide helpful instructions and recommendations to public safety officials and the public to minimize the loss of life. Union Carbide was eventually sued for billions of dollars, which it has never paid.

Another incident that might have benefited from a crisis communication plan is the Massey Energy Upper Big Branch mine explosion that occurred in West Virginia on April 5, 2010. Venkatasubramanian (2011) describes this explosion as the worst mining accident in four decades, killing 29 people. Like the Union Carbide example above, Massey Energy initially tried passing the blame to employees and single system failures, but eventually the company closed its Kentucky Freedom Energy Mine #1, and the CEO, Don Blankenship, stepped down. This after being confronted with the over 600 safety violations in 2009 and 2010. Again, the implementation of a crisis communication plan would have focused on potential accidents and allowed a window for mitigation and prevention. Upon completion of the effort, when the accident occurred, there would have been clear directives on how to proceed, which might have helped to save the company’s reputation; although, in this case, that is unclear.

Only when a company’s management realizes that safety is important and that crises do occur can they set forth means of mitigating their risk. One important way to mitigate risk is to consider that no matter the attempts at prevention, errors and failures can always occur and it is best to be prepared for the worst-case scenarios in hopes that they never do occur. By being prepared for the worst case scenarios, mainly by having drafted crisis communication plans along with incident action plans, the company representative has focus and direction on how to proceed with response efforts both publicly and internally. The benefits are appearing with a unified message of adequately responding and recovering from the crisis, and bringing a sense of strength and direction to that effort that the public, employees, and shareholders alike can appreciate and find faith. It is always best to be prepared.


Boy Scouts of America. (2011, March). Overview of Boy Scouts of America. Retrieved from

Fearn-Banks, K. (2011). Crisis communications: a casebook approach (4th ed.). New York, NY: Routledge.

Gray, S. (2008). Without crisis plan, your reputation could be at risk. Las Vegas Business Press, 25(8), 22. Retrieved from

Muller, R. (2001). A significant toxic event: The Union Carbide pesticide plant disaster in Bhopal, India, 1984. Rural and Remote Environmental Health, 1(10). Retrieved from

Venkatasubramanian, V. (2011). Systemic failures: Challenges and opportunities in risk management in complex systems. AIChE Journal, 57(1), 2-9. doi:10.1002/aic.12495

Roles and Perceptions in Victimology

Victimology, or the biopsychosociological study of crimes and their impacts on victims, was introduced almost 65 years ago, in 1947, by Beniamin Mendelsohn during a presentation given in Romania (Jaishankar, 2008; Kirchhoff, 2006). Then, in the following two years, Frederick Wertham (1948; as cited in Kirchhoff, 2006) and Hans von Hentig (1949; as cited in Kirchhoff, 2006) both wrote comprehensive books on the subject, based on work of the last 10 years (see footnotes 1 & 2). However, it seems that even many contemporary social scientists and criminologists still regard the science of victimology with less than full credit (Jaishankar, 2008). To understand the validity of a particular science, one should consider the impact of the scientific theories on its subjects. According to Jaishanker (2008), proponents of victimology have struggled to develop theories particular to victimology; the theories being based in sociology and criminology. Victimology, according to Elias (as cited in Jaishanker, 2008) and Fattah (as cited in Jaishanker, 2008), being steeped in application, “has lost its scientific rigour” (p. 2).

Kirchhoff (2006) disagrees with Jaishanker and posits that victimology is a truly interdisciplinary science made up of a number of differing perspectives (e.g. law, sociology, social work, psychology, philosophy and ethics, medicine, nursing, political science, and community organization). Victimology is the professional and scientific consideration of a crime from the perspective of the victim, instead of the criminal or society in general, and though this view is not new, the focus within our criminal justice system is.

What is a victim? Many philosophers, religious and agnostic alike, agree that as individual members of a society, we have rights. Whether these rights originate from a higher power or by virtue of a social contract, these rights have primacy and must be protected by the individuals themselves and by society: the criminal justice system (Kirchhoff, 2006). One way of protecting these rights is retroactive in the form of indemnification, or restitution. Aside from the consideration of the victim during sentencing of the offender, indemnification became the primary means of making reparations to victims “for the damage caused by crimes which [the state] has not been able to prevent” (Kirchhoff, 2006, p. 17). This has been the normative practice throughout much of the world over the last century or so.

In the last 50 years, since Mendelsohn, Hentig, and Wertham provided a renewed focus of victimology, the role of victim has changed significantly, specifically over the last 20 years. The criminal justice system now seeks to include the victim in an active role in the system, offering compassion and dignity in the process (Voogd, 2010). This process, including the provision of victim services, increases the likelihood of positive outcomes, greater benefit, and satisfaction of the victim, as well as maximizing the potential of interfering in the cycle of violence (Hotaling & Buzawa, 2003a, 2003b; Zweig, Burt, & Van Ness, 2003). Referred commonly as restorative justice, a new paradigm of criminal justice is now being offered in areas of Canada and the United Kingdom (Voogd, 2010; Walsh, 2010). According to Walsh (2010), Norfolk Constabulary in the United Kingdom is hoping to be the first fully restorative justice county by 2015. Restorative justice is a means of settling disputes between victims and offenders by bringing them together to discuss ways of dissuading the offender from reoffending, providing adequate reparations to the victim, and reintegrating the offender as a contributing member of the community, all outside of the court system. Walsh describes the benefits, effectiveness, and almost universal acceptance of the system within the county. Restorative justice relies on special training of police officers to handle minor incidents and infractions of the law (both, civil and criminal) as well as managing people exhibiting antisocial behavior. Restorative justice allows police officers to act as intermediaries to the victim(s) and offenders when deciding on a proper course of action.

Restorative justice is nothing new. In the United States, many juvenile delinquents were merely transported home to their parents and handed over with some advice, including suggestions on how to have the child make restitution to the victim. Times have changed, though, and we do not see this type of policing anymore. If this new paradigm promotes the virtues of community, we might see more implementation in the years to come. Victimology, again, may provide a target for resentment by some, but by focusing on the victim over the last few years, the application of victimology on society has produced some very promising results that cannot be argued against.


Hotaling, G. T. & Buzawa, E. S. (2003a). Forgoing criminal justice assistance: The non-reporting of new incidents of abuse in a court sample of domestic violence victims (NCJ# 195667). Retrieved from

Hotaling, G. T. & Buzawa, E. S. (2003b). Victim satisfaction with criminal justice case processing in a model court setting (NCJ# 195668). Retrieved from

Jaishankar, K. (2008). What ails victimology? [Editorial]. International Journal of Criminal Justice Sciences, 3(1), 1-7. Retrieved from

Kirchhoff, G. F. (2006). Perspectives on victimology: the science, the historical context, the present. Journal of the Tokiwa University Mito, College of International Studies, 1, 2-18. Retrieved from Version History of Victimology.doc

Voogd, H. (2010, April 23). A justice system that focuses on the victim, as well as the offender. Edmonton Journal. Retrieved from

Walsh, P. (2011, October 19). Pioneer justice scheme is working in Norfolk. Eastern Daily Press. Retrieved from

Zweig, J., Burt, M. R., & Van Ness, A. (2003). Effects on victims of victim service programs funded by the STOP Formula Grants program (NCJ# 202903). Retrieved from

1 von Hentig, H. (1948). The criminal and his victim: Studies in the sociology of crime. New Haven, CT: Yale University Press.
2 Wertham, F. (1949). The show of violence. Garden City, NY: Doubleday.

Effects of Victimization

Selye (as cited in Roberts & Yeager, 2009) presents stress as natural component of life. Feelings of anxiety or memories of that anxiety are what drive us to fulfill our needs. This is where stress is important to the natural development. As we develop, we face many discomforting scenarios that we learn to avoid (e.g. hunger, cold, burns, pain; and later, losses of loved ones, debt, material losses, et al.). These stressors are learned and we live life trying to avoid them for the most part, and, according to Roberts and Yeager (2009), healthy stressors exist also, such as buying a home, the birth of a child, and others.

It is when stressful situations are too overwhelming to cope with that stress becomes a problem. Overwhelming stress can lead to crisis, acute stress disorder, or post-traumatic stress disorder (Roberts & Yeager, 2009). The key to dealing with stress is to have a positive outlet or sense of control over the stressors.

A study by Taylor (1995) shows that increases in crime, or at least the perception of crime, in a community leads to community decline; however, as this decline manifests, community participation grows to help to stop or slow the decline. This is possibly more akin to piling trash in the corner, then realizing one day that it is time to bring it all to the dump. The stress of living in a declining community is compounding until the community member finds a healthy outlet to alleviate the stress (help with clean-up efforts) or finds a negative outlet, contributing to the decline of the community. Positive outlets within a declining community allow the community members to take responsibility, once again, for the state of their environment, and thereby, relieving the stress of living amongst a declining community.

But, what happens when a person feels no control or ability to control their environment, such as a child? Kilpatrick, Saunders, and Smith (2003) explored the impact of violence and victimization on adolescents across the nation. Unlike adults who might have more opportunity to feel safe in the face of violence and have more options to redirect the stress, children are limited in their ability to react. They have yet to learn strategic coping mechanisms required to deal with stress productively. Kilpatrick, Saunders, and Smith show that “victimization in early childhood and adolescent years is the root of many problems [, such as PTSD, substance abuse, and delinquent behavior,] later in life” (p. 1). What is unclear, however, is the proximate cause of the cyclic phenomenon of violence.

As the studies suggest, violence (within the environment) begets violence (in the individual, especially children and adolescents). As children of violence mature through their environment and as they tend toward violence, they contribute to the environment of others by fulfilling what some might deem as their destiny. This, though, is shown to be untrue in many as not only can an individual contribute negatively to an environment, but many, even those touched by violence, find means of contributing positively, even if as an outlet for the stressors of such an environment. Being a product of one’s own environment does not dismiss the notions of self-reliance and personal responsibility. These ideals are the cornerstone of social change.


Kilpatrick, D. G., Saunders, B. E., & Smith, D. W. (2003, April). Youth victimization: prevalence and implications. Retrieved from

Roberts, A. R. & Yeager, K. R. (2009). Pocket guide to crisis intervention. New York, NY: Oxford University Press.

Taylor, R. B. (1995). The impact of crime on communities. Annals of the American Academy of Political and Social Science, 539(1), 28-45. doi:10.1177/0002716295539001003

Defining Crisis

A crisis is any problem that has a significant impact. Most simply, a crisis is a decision-point of change, for better or worse. For example, a new father seeing his child for the first time might have a crisis of faith. A beautiful and healthy child may trigger thoughts of awe and trigger a divine revelation; whereas, a seriously ill child may bring feelings of doubt and religious contempt. In the field of crisis management, Coombs (2012) defines crisis as “the perception of an unpredictable event that threatens important expectancies of stakeholders and can seriously impact an organization’s performance and generate negative outcomes” (p. 2). In this definition, Coombs suggests that crises are both negative and unpredictable events that effect others. While I agree with the scope of the definition, as I stated above, crises do not necessarily have to be negative events, and frequently, they can be predicted. Predictable negative crises are usually caused by negligent management, such as economic crises (Berg & Pattillo, 1998; Compagnon, 2011; Feldstein, 2010; Roubini, 2010).

A crisis usually develops from a less significant issue and, if understood and contemplated, can be mitigated early (Coombs, 2012). A crisis stemming from an issue finds a causal relationship with risk. Risk can be categorized by human, systematic, and process or random (Youndt, Snell, Dean, & Lepak, 1996). Human and systematic risk can be mitigated easily; however, process risk is inherent and requires substantial process change to minimize.

The British Petroleum Deepwater Horizon event, which occurred on April 20, 2010, was said to have been fraught with risk of all three types. A New York Times article by Barstow, Rohde, and Saul (2010) describes the event and attempts to elucidate what went wrong. Initially, according to the article, there was a blowout of the Macondo Prospect well, a risk that is inherent to drilling, especially in deep water. Next, every single “formidable and redundant defenses against even the worst blowout” (para. 10) failed. This was certainly a failure of process errors (geological “bursts” causing the well blowout), systematic errors (“One emergency system alone was controlled by 30 buttons” [para. 18]), and human errors (“members of the crew hesitated and did not take the decisive steps needed. Communications fell apart, warning signs were missed and crew members in critical areas failed to coordinate a response” [para. 15]).

On a micro-organizational level (the rig), these failures are evident and allowed risk to develop into an issue, which developed into a crisis. On a macro-organizational level, however, the response seemed to be swift, but the focal response to the incident and the public relations response appeared very disjointed, which was compounded by both the media and the federal government, that is, until the U.S. Coast Guard took control. It was apparent very early that both British Petroleum and the federal government were concerned with reputation over response and recovery from the focal incident. This translated to poor support for both by the public. I believe the U.S. Coast Guard is the only managing entity involved in the response to have managed to maintain dignity throughout the effort.

Crisis management is promoted as a multifaceted approach to mitigate, alleviate, respond to, and recover from crises of different types and scope. Although there are many aspects to organizations that require attention during these efforts, it needs to be understood that some have higher priorities than others, and reputation is a culmination of all of these.


Barstow, D., Rohde, D., & Saul, S. (2010, December 25). Deepwater Horizon’s final hours. New York Times. Retrieved from

Berg, A. & Pattillo, C. (1998). Are currency crises predictable: a test (Working paper #98/154). International Monetary Fund. Retrieved from

Compagnon, D. (2011). A predictable tragedy: Robert Mugabe and the collapse of Zimbabwe. Philadelphia, PA: University of Pennsylvania Press.

Coombs, W. T. (2012). Ongoing crisis communications: planning, managing, and responding (3rd ed.). Thousand Oaks, CA: Sage.

Feldstein, M. (2010, June 14). A predictable crisis: Europe’s single currency was bound to break down. The Weekly Standard, 15(37), 1-3. Retrieved from

Roubini, N. (2010, May 17). All crises are predictable: Contrary to beliefs, history shows there’s nothing new in debt or inflation. Gulf News. Retrieved from

Youndt, M. A., Snell, S. A., Dean, J. W., & Lepak, D. P. (1996). Human resources management, manufacturing strategy, and firm performance. The Academy of Management Journal, 39(4), 836-866. doi:10.2307/256714

Impact and Prevalence of Crime

In researching the crime rates of Connecticut and other states, I see that there has been a significant rise in crime during the ’70s, ’80s, and ’90s (The Disaster Center, 2011). Luckily, last year, we have been able to see crime rates reduced to those not seen since 1967.

The probability of being involved in a murder or assault, whether victim or perpetrator, is characterized by a propensity for violence; therefore, the advances in medicine, especially those of the emergency medical services, contribute by allowing these people to survive an initial act allowing them to reoffend (Wilson & Herrnstein, 1998). But what was contributing to the base increase in violent turpitude in the first place? Wilson and Herrnstein (1998) posit that changes in child-rearing focii (from moral development towards personality development) have changed dramatically from the late 19th century to the mid 20th century. No more are lessons in character, but more attention is now paid on enjoyment.

Luckily, my community is far removed from crime. Woodstock, Connecticut, has one of the lowest crime rates in the state; however, Connecticut, itself, does have problem areas, which are the typical urban centers. According to the Connecticut State Police Crime Analysis Unit (2010) Uniform Crime Reports database query tool, Woodstock, during 2009, has had only 25 index crimes (e.g. murder, rape, robbery, aggravated assault, burglary, larceny, motor vehicle theft) with only two violent crimes (aggravated assault and robbery). The remainder 23 crimes were burglary (11), larceny (10), and motor vehicle theft (2). A website by CLRChoice, Inc. (2010) that details crime risk shows the following indices compared to the national risk average (100): total crime risk (Woodstock: 2, Connecticut: 64), murder risk (Woodstock: 5, Connecticut: 49), rape risk (Woodstock: 8, Connecticut: 63), robbery risk (Woodstock: 4, Connecticut: 77), assault risk (Woodstock: 2, Connecticut: 49), burglary risk (Woodstock: 1, Connecticut: 51), larceny risk (Woodstock: 2, Connecticut: 74), and motor vehicle theft risk (Woodstock: 2, Connecticut: 71).

Considering the above statistics, I find the crime to have the most impact on my community is burglary. The psychological impacts of burglary are not unlike those related to other violent crimes, such as rape or assault, and can last up to 10 weeks after the initial incident (Blanco, 2010; Maguire, 1980). For the residents of Woodstock, the personal impact would be significant. Woodstock is still considered by many a sleepy community where door locks are optional. Whenever there is a burglary in the area, however, residents tend to be more vigilant. Incidently, my personal observation is that there are more firearms per capita in Woodstock than in most other areas of Connecticut. This could potentially create an issue, but so far it has not.

Woodstock does not have a police department and is patrolled solely by the Connecticut State Police. Whenever a crime of significance occurs in Woodstock, the police must take resources away from other areas of the state in order to respond and investigate the crime. This puts a burden on law enforcement in the community and surrounding communities.

Crimes of all types can have serious consequences not only for the involved parties but those fairly removed from the crimes (family, friends, etc.); however, burglary, unlike murder or assault that tend to be focused on a specific victim, impacts whole communities and can have far reaching effects that begin to harm the fabric of those communities.


Blanco, A. (2010, February 5). The psychological effects of home burglary. Security World News. Retrieved on October 18, 2011, from

CLRChoice, Inc. (2010). Woodstock crime rates indexes. Retrieved on October 18, 2011, from

Connecticut State Police, Crime Analysis Unit. (2010). Connecticut Uniform Crime Reports [Data]. Retrieved on October 18, 2011, from

The Disaster Center. (2011). U.S. crime statistics: total and by state (1960-2007). Retrieved from

Maguire, M. (1980). The impact of burglary upon victims. British Journal of Criminology, 20(3), 261-275. Retrieved from

Wilson, J. Q. & Herrnstein, R. J. (1998). Crime & human nature: The definitive study of the causes of crime (First Free Press paperback ed.). New York, NY: The Free Press.

Human Resources & Challenges in Health Care

The function of human resources is not without its challenges and difficulties. No matter the industry or organization, acquiring and managing a pool of employees can be overwhelming (Thompson, 2012). Human resources managers in health care organizations seem to face more challenges than most. From nursing and physician shortages to attracting innovative and contemporary researchers, health care organizations seem to search within thinning pools of prospective employees, yet still demand the best and brightest (Keenan, 2003; Lewis, 2010; Thompson, 2012).

One of the most challenging issues to health care over the last few decades has been a significant nationwide nursing shortage (Keenan, 2003; Lewis, 2010). Thompson (2012) outlines both a declining skilled workforce and an increasing population contributing to the problem. Both Keenan (2003) and Lewis (2010) cite the aging babyboomer population adding to the increased need for nurses through 2020 and beyond. Novel human resources strategies can result in an augmented workforce designed to meet the continually growing impact these forces have on health care organizations, specifically those with emergency departments.

One novel strategy includes consideration of other highly-skilled clinicians that do not traditionally work in hospitals. As Oglesby (2007) considers the possibility, paramedics are, by far, one of the best examples. By introducing paramedics into the emergency department, a hospital can redistribute the nurses to clinical areas more suited towards their training, decrease the patient-to-nurse ratios (thereby increasing patient safety and maximizing outcomes), and tap into a new pool of prospective employees that are well-suited to rise to the stressful demands of the emergency department (Keenan, 2003; Swain, Hoyle, & Long, 2010). Additionally, organizations employing paramedics can augment both their emergency department operations and home health care operations by sending paramedics to certain patients to mitigate their complaints and minimize the number of inappropriate patient transports to the emergency department (Swain, Hoyle, & Long, 2010). This alone would decrease emergency department overcrowding and maximize revenue and efficiency in the delivery of care. Additionally, turn-over rates should be significantly lower with a more productive work environment where stress is managed, outcomes are met, and patients are care for more effectively.

In conclusion, intelligent and novel planning of the workforce can, itself, lead to increases in recruitment and retention; however, efforts still need to focus on each individually in order to attract, maintain, and develop a first-class workforce (Thompson, 2012).


Keenan, P. (2003). The nursing workforce shortage: causes, consequences, proposed solutions (Issue brief #619). The Commonwealth Fund. Retrieved from

Lewis, L. (2010). Oregon takes the lead in addressing the nursing shortage: A collaborative effort to recruit and educate nurses. American Journal of Nursing, 110(3), 51-54. doi:10.1097/01.NAJ.0000368955.26377.e1

Oglesby, R. (2007). Recruitment and retention benefits of EMT—Paramedic utilization during ED nursing shortages. Journal of Emergency Nursing, 33(1), 21-25. doi:10.1016/j.jen.2006.10.009

Swain, A. H., Hoyle, S. R., & Long, A. W. (2010). The changing face of prehospital care in New Zealand: the role of extended care paramedics. Journal of the New Zealand Medical Association, 123(1309), 11-14. Retrieved from

Thompson, J. M. (2012). The strategic management of human resources. In S. B. Buckbinder & N. H. Shanks, Introduction to Healthcare Management (Custom ed.; pp. 81-118). Sudbury, MA: Jones & Bartlett.

Practical Use of Strategic Planning

 In this writing, I will describe the similarities and differences of planning versus strategic planning, and I will use these concepts to compare and contrast two very different strategic organizational plans within the health care industry. In my view, strategic planning should be bold, effective, prescient, and ethical, and the reader should keep these attributes in mind when considering the plans for themselves.

Planning is described as the directed implementation of the “blueprint for the future” (McConnell, 2012), or the means of expressing the organizational vision in order to achieve the organizational goals; whereas, strategic planning institutes planning with a consideration and focus towards the forces, whether or not controllable, that might both help and hinder the desired outcomes (Casciani, 2012). One example of an uncontrollable force, especially in health care, are the expectations of the patient or client. Crawford et al. (2002) provides a discussion on the increased propensity to involve patient views in the strategic planning of health care organizations, though at the time of the writing, there was no evidence as to the effect that the involvement of these views provided. Caution must be exercised when eliciting input from the client or patient. For instance, many patients complain about the amount of time that it takes at emergency departments for test results to be returned. As impressive as it would be to have test results returned within just a few minutes, this should not be attempted to the detriment of the accuracy of the tests. Perhaps, in this instance, considering the role of point-of-care testing might be more beneficial than attempting a costly overhaul of the laboratory processes. Approaching problems as they apply to an open system, looking from outside in, provides a better perspective than regarding the organization as an isolated microcosm.

To be effective, strategic planning must be all-encompassing and address the goals of each functional unit, or microsystem, to bring them into alignment with the plans of the macro organization (Kosnik & Espinosa, 2003). To wit, as an organization can only be measured by the outcomes of the integrated microsystems, an analysis of each or any functional unit can tell much about the goals and visions guiding the organization.

Children’s Hospital and Regional Medical Center

The Children’s Hospital and Regional Medical Center (Children’s; 2006), located in Seattle Washington, provides the first of two strategic plans I will review. On the opening pages, as with most strategic plans, the organization defines its mission and vision, and they are certainly bold statements including the elimination of pediatric disease and being the best children’s specialty care center. The only thing that I wish was stated on these first pages is some sort of organizational value statement. The value statement does much to intertwine an ethical approach to the mission and vision. However, I do not doubt the ethical approach Children’s relies on, which is evident by the whole of the plan.

Children’s (2006) is a true regional medical center that serves much of the northwest portion of the United States, including Alaska. An argument could be made that Children’s serves such a vital role to the region that it is too important to fail, yet the organization still seeks to ensure financial stability and “secure Children’s financial future” (p. 5). In health care, especially in today’s political climate, the future of funding sources are unclear, and the most ethical approach to the organizational delivery of health care is to provide it without burden to the community it serves. Children’s exemplifies this approach by maintaining charitable foundation to “expand philanthropy to the community” (p. 16), as well as ensuring sound and responsible investments and maximizing efficiency under cost controls while still ensuring quality and safety improvements.

Additionally, Children’s (2006) focuses its efforts at being the best, which means attracting the best clinicians, performing cutting-edge research, and providing the best care to achieve the best outcomes possible setting the standard for health care across the nation. Children’s holds a bold, effective, prescient, and ethical strategic plan that outlines some goals of many of the microsystems within the organization.

U.C. Davis Health System

The U.C. Davis Health System (2011) strategic plan, unlike the Children’s (2006) plan, immediately outlines the values, or “guiding principles” (p. 3), of the organization. Financially, however, U.C. Davis Health Systems seems less focused on self-reliance, financial security, and community involvement than Children’s and more focused on their stated goal of socially responsible environmental stewardship.

Although the U.C. Davis Health System (2011) strategic plan uses the word bold on the front cover, I find it to be less so and without many specifics and, instead, relying on generalized language that might promote the vision but does nothing to engage it.

It is apparent in the U.C. Davis Health System (2011) strategic plan that they wish to become a leader in many different areas while attracting the best workforce. This is a commendable, bold, and ethical position that helps to ensure quality and safety in the delivery of health care at U.C. Davis Health Systems.


Many different variables drive the production of strategic plans, including politics, community, workforce, investments, geography, and the current status quo of health care delivery. Many of these differences can be seen immediately when comparing various strategic plans, yet by virtue of being a health care organization, many of the stated goals will be similar. Without being informed as to the climate of the organizational operation, it is difficult to appreciate the potential each plan has in regard to success or failure.

As a health care manager, the strategic plan is an obvious resource when deciding on possible employment. As a potential administrator, the strategic plan offers a view into how the administration seeks to direct the operation of the organization. Being responsible to help implement these plans, one must consider the alignment of his or her personal values with those of the organization. A manager might find it difficult to lead in an environment that demonstrates and promotes a different value system.

Strategic plans offer a significant advantage to organizations during their growth providing a clearly written prescription as to what is important to the organization so that it may guide decision-makers to develop and enhance programs to provide a cohesive effort towards future prosperity and relevance.


Casciani, S. J. (2012). Strategic planning. In S. B. Buchbinder & N. H. Shanks, Introduction to healthcare management (Laureate Education, Inc., Custom ed.; pp. 3-23). Sudbury, MA: Jones and Bartlett.

Children’s Hospital and Regional Medical Center. (2006). Our children deserve the best: Laying the foundation for the next 100 years (Strategic plan overview). Retrieved from

Crawford, M. J., Rutter, D., Manley, C., Weaver, T., Bhui, K., Fulop, N., & Tyrer, P. (2002). Systematic review of involving patients in the planning and development of health care. British Medical Journal, 325(7375), 1263-1267. doi:10.1136/bmj.325.7375.1263

Kosnik, L. K. & Espinosa, J. A. (2003). Microsystems in health care: Part 7. The microsystem as a platform for merging strategic planning and operations. Joint Commission Journal on Quality and Safety, 29(9), 452-459.

McConnell, C. R. (2012). Planning. In S. B. Buchbinder & N. H. Shanks, Introduction to healthcare management (Laureate Education, Inc., Custom ed.; pp. 131-139). Sudbury, MA: Jones and Bartlett.

University of California, Davis Health System. (2011). 2011-2016 strategic plan: Creating a healthier world through bold innovation. Retrieved from strategicplan/2011StrategicPlan.pdf

Prior Proper Planning …

… Prevents Poor Performance

I am in the midst of planning an ad hoc merger of a number of local emergency medical service agencies into a single regional provider to reduce overall costs while maximizing revenue, improve training and the delivery of care, and to streamline the operational processes that support our providers in the field. Unfortunately, I have found that there are many obstacles that need to be dealt with at every step before moving on to the next. My research has certainly opened my eyes to developing a useful approach to these problems.

Planning “[provides] the appropriate focus and direction for … organizations” (Zuckerman, 2006, p. 3). Without planning, organizations risk stagnation and obsolescence. For any organization to succeed (and continue to do so), the strategy needs to focus both on the contemporary traditional needs as well as those anticipated in the future, but this focus needs to be comprehensive. Bartling (1997) writes of 25 different pitfalls any health care organization might face when considering strategic planning. These 25 pitfalls are just some of the issues I hope to avoid.

One of the largest difficulties in planning for emergency medical systems, however, is the sense of ‘fiefdom’, or an assertion of organizational ownership — in a truly feudal sense. A fiefdom is a literal power trip. In this area, there are 10 towns with an average of two ambulances each, and each department’s administration will fight tooth and nail to keep the organization from outgrowing them. What is interesting about the area is that many of the members of one department work for at least two of the other departments, also. This is because the pay is so meager they have to work as many hours as possible, and there is no chance of working more than 32 hours at any one service in any given week. The pay is low as is the quality of care. This needs to change, but how do I create an amalgumated organization from the bits and pieces that I have to work with? Add to that my lack of formal authority in this process. My vision is to reduce the number of ambulances by staffing eight ambulances at all times and tactically positioning them around the region. This alone would create 48 well-paid jobs, using the same 40 people who currently job share across organizational lines.

In reviewing the available resources, I have learned that there is no particular process or flow-chart pathway to effective planning (Bartling, 1997; Begun & Kaissi, 2005; Zuckerman, 2006). Critical forward thinking is needed, instead. Some of the particular issues that Bartling (1997) discusses and I foresee might be particular to my planning process are: inadequate planning, short-sightedness, underestimating the complexity of the process, post-merger angst, analysis paralysis, and lack of evaluative criteria, to name a few. Politics plays a large role in many of these issues I mention.

Inadequate planning, short-sightedness, and a lack of evaluative criteria are closely related. I see in the present that the system does not work as well as it should (short-sightedness), and I want to develop a plan that can be implemented immediately (probably suffering inadequate planning). This would leave me with a fragmented system devoid of vision and, therefore, crippled from improving (lacking that evaluative criteria). These are pitfalls that I need to avoid. These issues would give rise to the others dooming my effort to failure and, possibly, leaving the system in even worse shape than it began.

Perhaps, my only chance of fulfilling this process is to first perform a limited situational assessment by identifying the mission, vision, and values of all of the stakeholders and show how a streamlined process can better fulfill their visions (Casciani, 2012). By gaining stakeholder support, I might better leverage my idea against those who fear change.


Bartling, A. (1997). 25 pitfalls of strategic planning. Healthcare Executive, 12(5), 20–23.

Begun, J. & Kaissi, A. (2005). An exploratory study of healthcare strategic planning in two metropolitan areas. Journal of Healthcare Management, 50(4), 264–274.

Casciani, S. J. (2012). Strategic planning. In S. B. Buckbinder & N. H. Shanks (Eds.), Introduction to healthcare management (Custom ed.; pp. 3-23). Sudbury, MA: Jones & Bartlett.

Zuckerman, A. (2006). Advancing the state of the art in healthcare strategic planning. Frontiers of Health Services Management, 23(2), 3–15.