Strategic Planning: Strategies & Tactics

Seattle Children’s Hospital (2011, n.d.) was the first pediatric specialty care hospital founded west of the Mississippi River. Seattle Children’s Hospital, supported by the philanthropic efforts of the community, performs at the cutting-edge of pediatric medicine and research. With nearly 60 pediatric specialties and award-winning research faculty, Seattle Children’s Hospital presents expertise in the field of pediatric medicine.


Seattle Children’s Hospital (n.d.) is a pediatric specialty care center associated with the University of Washington to provide medical and surgical residents with the hands-on practical experience and education needed to succeed in the medical profession.

The hospital (Seattle Children’s Hospital, n.d.) has many specialized programs, or sub-specialties, within its pediatric specialty, including urgent and emergency care, oncology and hematology, craniofacial, orthopedic and sports medicine, a heart and transplant center, neonatology, neurosurgery, and general and thoracic surgery.

Seattle Children’s Hospital (n.d.) also boasts an award-winning research facility dedicated to treating and eliminating pediatric disease.

Strategic Planning

The strategic plan of Seattle Children’s Hospital (2011) focuses on the hospital’s vision and four specific goals:

  1. provide the safest, most effective care possible,

  2. control and reduce the cost of providing care,

  3. find cures and educate clinicians and researchers, and

  4. grow responsibly and provide access to every child who needs us (p. 2).

In order to succeed in reaching these goals, the hospital’s plan must have directives that outline the strategies and tactics useful in attaining the goals.


Strategy is the broad means directed towards attaining strategic goals. As Seattle Children’s Hospital’s (2011) strategic plan demonstrates, in order to achieve the means of providing the safest, most effective care possible, “[the hospital] will standardize our care processes and strengthen our systems to prevent and respond rapidly to medical errors” (p. 5). This strategy is broadly stated, provides direction, and acknowledges that failures may still occur, which allows for the provision of a secondary, or backup, strategy for response to these failures.


Tactics are the individual steps made within a strategy towards attaining a specific goal. Tactics should be moral, safe, efficient and effective towards the strategic goals. For instance, the strategy of “[standardizing] our care processes and [strengthening] our systems to prevent and respond rapidly to medical errors” (Seattle Children’s Hospital, 2011, p. 5) is well-stated, yet broad. In order to employ this strategy, tactics must be employed that are specific to meeting the described goal. In this case, Seattle Children’s Hospital (2011) has identified that “[completing] the transition to an electronic medical record system” (p. 5) is a specific means that can be used to help fulfill this particular strategy and meet the described goal.

Another tactic not presented in Seattle Children’s Hospital’s (2011) strategic plan but helpful in attaining the goal of improved patient safety and drawn from the strategy of “[standardizing] … care processes and [strengthening] … systems” (p. 5) would be the formation of an anonymous, voluntary self-reporting system in which a nurse or physician submits a card detailing a medical or surgical error in the spirit of identifying processes and systems in need of improvement.


Strategic plans are guided by strategic goals, and strategic goals can have many strategies that are employed and useful in meeting the stated goals. It is also true that a plethora of tactics can be employed for each strategy.

Strategic plans are often based on lofty, yet attainable, goals. In order to meet these goals, one must only ask a simple question: How? With each broad answer, a continuous and recursive series of How? can be used to work the strategy into a number of manageable tactics to use to reach that lofty goal.


Seattle Children’s Hospital. (2011). Shaping the future of pediatric healthcare: Strategic plan 2012 to 2016. Retrieved from

Seattle Children’s Hospital. (n.d.). About Seattle Children’s. Retrieved from

SWOT Analysis: Day Kimball Healthcare

Day Kimball Healthcare (DKH) is a non-profit health care organization serving the northeastern Connecticut, southcentral Massachusetts and northwestern Rhode Island communities. The mission of DKH (2011) is “to meet the health needs of our community through our core values of clinical quality, customer service, fiscal responsibility and local control” (para. 4). A comprehensive health care system, DKH offers primary care and a multitude of medical and surgical specialties along with sophisticated diagnostics by offering a comprehensive network of more than 1,000 employees including more than 200 physicians, surgeons and specialists. DKH is comprised of Day Kimball Hospital, four community health care centers, Day Kimball HomeCare, Day Kimball Hospice & Palliative Care of Northeastern Connecticut, Day Kimball HomeMakers, and Physician Services of Northeast CT, LLC.


DKH provides a host of services to the community, including:

  • primary medical care,

  • emergency medical care,

  • surgical care,

  • palliative and hospice care,

  • home health care, and

  • social services

DKH appears to strive towards providing a comprehensive health care solution to the community that is robust, yet limited in specialty, especially critical care, trauma, and pediatric services.



The primary catchment area for DKH includes the Connecticut towns of Brooklyn, Canterbury, Eastford, Killingly, Plainfield, Pomfret, Putnam, Sterling, Thompson, and Woodstock, and the Rhode Island towns of Foster and Glocester. According to the available U.S. Census data (2010), the population served is nearly 92,000 with average growth in the last ten years of nearly 9%. The median age of the catchment population (37.8) is merely 3 months older than the median age of the Connecticut population (37.4). The median household income is $66,422 (CT: $67,034).


DKH is the primary health care provider within the defined catchment area. Some of the population, however, rely on three other community-level hospitals, Backus Hospital (Norwich, CT), Southbridge Hospital (Southbridge, MA), and Windham Hospital (Windham, CT). Additionally, some of the population with advanced disease processes rely strictly on the primary and emergency care services of the nearest urban centers (Worcester, MA, Hartford, CT, and Providence, RI), with many of DKH’s emergency patients transferred to these tertiary care centers for trauma, critical care, and pediatric specialties.


DKH, as a health care organization, can be adversely affected by patterns of infectious diseases within the community. As each season mounts, the health care system becomes overwhelmed and requires coordination between other health care facilities in the area.

Additionally, a large disaster would strain the resources of DKH; however, this would be a temporary issue, resolving as the disaster winds down. There is ample opportunity within the catchment area for a disaster to unfold, including traffic on the major highway that divides the catchment area as well as the number of large manufacturing entities in the area.


Strengths. DKH provides comprehensive long-term health care to community members. DKH enjoys a strong and comprehensive relationship with a large network of physicians and other primary care providers.

Weaknesses. DKH has no intensivists, physicians with expertise in critical care, and provides very limited critical care service. As a result, DKH must transfer many cases to other facilities to rule in or rule out critical illnesses or injuries, which negatively affects earnings.

Another weakness lies in DKH’s reliance on electronic patient care reporting. DKH uses a number of patient care reporting platforms that do not integrate with each other. This creates a need for over-redundancy and opportunities for patient care errors. Further, a fully integrated system would allow for health care partners to access up-to-date patient care information without delay.

Opportunities. Opportunities exist for DKH to expand their services by further decentralizing the current services offered and concentrating on which scopes of service to expand or improve upon. By improving laboratory reporting standards and facilitating full integration of patient reporting, patients of DKH will be able to obtain a more standardized level of care throughout the health care continuum.

DKH should cultivate their relationship with the public by being more active and visible within the community performing screenings, vaccinations, blood drives, as well as other public relations endeavors.

Another opportunity exists with the patient population who suffer from critical illness or injury that is yet to be determined. These patients face risk in transport to tertiary care centers when, often times, the transfer is unwarranted by later findings. By cultivating relationships with specialties in the tertiary care centers, these patients could be more fully determined to need (or, not need) transfer to tertiary care centers, keeping the financial reward of caring for patients in-house while obtaining specialist coordination.

Threats. The largest threat to DKH, as with any organization, is its reputation within the community. Funding, which is largely based on governmental and private insurance providers, is also a considerable threat that must be managed continuously. However, other threats are significant and can be actively managed.

Pandemics are unlikely to occur but present catastrophic scenarios if they do, indeed, occur. Pandemic influenza, as well as other pandemic diseases, presents a situation of an increasing need for awareness and preparation.

Unpredictable weather in the northeastern Connecticut presents a likely and significant threat to the provision of health care. Recent and historical storms have proven to impede access and egress to and from patients both out in the community and at the hospital.


This SWOT analysis is limited by the a posteriori knowledge and perceptions of the author, a paramedic who is active within the health care system, and it is limited in the scope of an academic exercise to practice SWOT analyses.

However, DKH has overcome many adversities in the past and continues to grow, but seemingly without proper direction. The efforts thus far seem disjointed and without a clear structure or coherent path into the future. DKH would benefit from an internal SWOT analysis that could be performed without the limitations inherent herein.


Day Kimball Healthcare. (2011). Day Kimball Healthcare. Retrieved from

U.S. Census Bureau. (2010). 2010 census data. Retrieved from