Departments: Magnet® Perspectives
Having a strategy for the implementation of evidence-based practice and the creation of a research agenda for nursing is critical. Tapping into nurses’ clinical and intellectual curiosity generates an amazing array of potential researchable questions and enriches our patients’ lives with answers to questions that otherwise wouldn’t be addressed. That being said, it’s hard for chief nurse executives and nursing leaders to know exactly where and how to get started creating and implementing a nursing research agenda. I often think about a trip to the local mall. My first stop is to the mall map to first figure out where I am in the midst of the very big place and then to figure out how I am going to get where I need to be. So what is the mall map for the chief nurse? I would offer that the creation of a strategic plan for nursing services is the map for our work, and a logical place for our focus is to generate new knowledge.
What exactly is a strategic plan, and how do the best nurse leaders in the country go about creating and implementing one? What are some of the best ways to engage clinical nurses in the process? What are some of the critical factors in leveraging all that your organization has to offer? How can a nursing strategic plan integrate nursing research activities into the life of a healthcare organization?
Strategic planning is a process “by which the guiding members of an organization envision its future and develop the necessary procedures and operations to achieve that future.”1 (p3) The planning process includes creating a shared vision, understanding the current state of nursing services, and conducting a gap analysis based on that current state. The beauty of a strategic plan is that it helps to identify your strengths and opportunities and also address the gaps of any weaknesses that might exist in your services. Once gap analysis is complete, a realistic understanding of the distance between reality and a preferred vision can be determined.
The development of strategic objectives to get to that vision is the foundation for the next phase: developing tactics and action plans. The most effective and dynamic strategic planning processes include as many nurses as possible to provide input and share thoughts about a preferred future.2 Large group meetings and leveraging technology solutions as simple as online survey software allow many clinical nurses to help with prioritization and rank-ordering solutions. It can be tempting to address operational issues and urgent reactive concerns, but strategic planning goes beyond that.
What are some of the key critical factors in leveraging all that your organization has to offer when developing a strategic plan for nursing? Including key partners in the planning process is significant. Representatives from human resources, marketing, strategic planning, and finance all can offer rich perspectives and support during the process. Most organizations have a strategic plan and the incorporation of the organizational plan into the nursing strategy is important. Examining the strategic plan through the lens of what nursing can offer and spending time designing strategies that leverage the competitive advantage of nursing often lead to creative and innovative tactics. In addition, organizational strategies can include the nursing plans to maximize the integration of the work and lessen the infrastructure requirements for getting the work done.
Formal planning includes measurement of outcomes3,4 and an evaluation process. For each strategy and set of tactics, measurement is critical to determining whether the vision is being reached. Organizations often use balanced scorecard approaches to measuring and displaying quarterly and annual performance.
The creation of a strategic plan allows endless possibilities for stretching the vision for nursing. A nursing strategic plan can incorporate nursing research activities by defining nursing research as a strategic objective and developing tactics toward the creation of a nursing research agenda. Clinical nurses as bedside scientists elevate the profession and the practice of nursing. When given the latitude to develop the clinical agenda, nurses offer clinical issues and concerns that are the perfect starting place for the creation of researchable questions and generation of new knowledge. In addition to formal council and research meetings, Magnet® organizations have found creative ways to gather this information—including flipchart and post-it note offerings gathered in staff meetings, contests, lunch and learn sessions where clinical research questions are generated, and the creative use of technology to allow for interaction. Some of the more formal tactics to ensure that nurses participate in research activities include incorporating research accountability into shared governance councils, performance tools and reviews, and clinical ladder requirements.
A strategic plan for nursing is not a panacea for all of the tremendous pressures and challenges nurse leaders face today. But strategy can push us to dream bigger and reach higher as a profession. Strategic direction can integrate all parts of the care team, help to align scarce resources toward a common vision, can drive innovation, and can build excitement as milestones are met and positive change occurs. It moves us from reactive response to proactive high performance as nurses, and that is a preferred state that our patients expect.
1. Goodstein L, Nolan T, Pfeiffer JW. Applied Strategic Planning: How to Develop a Plan That Really Works. Washington, DC: McGraw Hill Inc; 1993.
2. Drenkard K. Creating a future worth experiencing: nursing strategic planning in an integrated healthcare delivery system. J Nurs Adm. 2001; 31 (7/8): 364–376.
3. Fox DH, Fox RT. Strategic planning for nursing. J Nurs Adm. 1983; 13( 5): 11–16.
4. Shoemaker LK, Fischer B. Creating a nursing strategic planning framework based on evidence. Nurs Clin North Am. 2011; 46 (1): 11–25.