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StrategicPlanninginthePrivateSectorAugust19,2003StrategicPlanninginthePrAgendaWhatsuccessfulcompaniesdoExamplesfromtheprivatesectorApplicationstotheMHS2AgendaWhatsuccessfulcompanieSuccessisrareandfewentitiesaccomplishtheirgoals3Successisrareandfewentiti

KeystosuccessAwelldeveloped,differentiatedstrategyArigorous,factbasedplanningprocesstoconnectstrategywithtacticsAwellaligned,effectiveorganizationtoexecute4KeystosuccessAwelldevelop“Strategy”defined:BainperspectiveAdynamicplantodifferentiateabusinessfromitscompetitorsprofitablyandsustainablyAproprietarysetofactionsthatcreateandcapturevaluebyservingcustomersinasuperiorwayrelativetocompetitorsInformsvirtuallyalldecisionsPortfoliostrategy:Wheretoplay?Businessunitstrategy:Howtowin?5“Strategy”defined:BainpersStrategyisaboutmakingchoicesWherewewillandwon’tcompeteWherewewillandwon’tinvestBusinessesCustomersGeographiesActivitiesMarkets6StrategyisaboutmakingchoicCompanieswhosucceedarefocusedandarethebestatwhattheydo020406080100%MulticoreNoneRegionalfocusOnebusinessChannelfocusPercentofcompaniesCustomerfocus7Companieswhosucceedarefocu

KeystosuccessAwelldeveloped,differentiatedstrategyArigorous,factbasedplanningprocesstoconnectstrategywithtacticsAwellaligned,effectiveorganizationtoexecute8KeystosuccessAwelldevelop75%ofU.S.organizationsbelievetheyneedtoupgradetheirstrategicplanningprocess“Ourstrategicplanningprocessiseffective”“Ourstrategicplanningprocessisfullydeveloped”975%ofU.S.organizationsbeliBestdemonstratedstrategicplanningprocessMissionDefinethemissionRarelyPortfolioStrategyDecidewhatbusinessesandmarketstocompeteinDeterminesuccessmetricsbybusinessEvery5yearsBusinessUnitStrategyDevelopdifferentiatedofferingIdentifychangingdynamicsExternalInternalIdentifykeygapsEvery2-3yearsTacticalPlanningSettargetsandtimelinesDesignkeyinitiativesDevelopimplemen-tationplansRealignorganizationAnnuallyExecutionandTrackingTrackperformanceagainstplansModifyplansasnecessaryOn-going10BestdemonstratedstrategicplBusinessunitstrategymustbeinformedbythefactsaroundthe“3Cs”FactbaseddiagnosticandvaluepropositionCustomersCompetitorsCostsWhatdoesourtargetcustomervalue?Whatcancompetitorsofferandhowcanwebeatthisoffering?Howcanweprovideourvaluepropositionatminimumcosts?MarketsizeMarketgrowthCustomersegmentsChannelsegmentsPriceexperienceCostexperienceProductprofitabilityChannelprofitabilityValuechaineconomicsSystemscostCostpositionCompetitivepositionProfitabilityStrategyCommitment11BusinessunitstrategymustbeStrategicplanningisoftendonewithoutreferencetofactsActualaveragemarketgrowthForecastaveragecompanygrowthForecastaveragecompanyearningsgrowth12StrategicplanningisoftendoPlanningprocessesofbest-in-classfirmsSeniormanagementdevotessignificanttimeSystematic,withclearlydefinedstepsRigorous,fact-basedapproach,andaconsistentviewofthefutureCoordinatedacrossbusinessunitsEnablesquickdecisionmakingandcoursecorrectionNote:ExamplesincludeGE,Dell,Agilent,Abbott,EmersonElectric,Sun13Planningprocessesofbest-in-

KeystosuccessAwelldeveloped,differentiatedstrategyArigorous,factbasedplanningprocesstoconnectstrategywithtacticsAwellaligned,effectiveorganizationtoexecute14KeystosuccessAwelldevelopAhighperformanceorganizationalignsfiveelements2.Driveseffectivedecisions3.Alignsthefrontlinewithrightjobsandrightincentives4.RightpeopleLeadershipDecisionsProcessesPeople

Culture1.Providessustainedleadership5.Createsahighperformanceculture15AhighperformanceorganizatioAgendaWhatsuccessfulcompaniesdoExamplesfromtheprivatesectorApplicationstotheMHS16AgendaWhatsuccessfulcompanieSuccessfulstrategicplanningbeginswithaclear,focusedmissionForcetrade-offsbetweencompetingresourcedemandsTestsoundnessofaparticularactionSetclearboundariesonwhattodo…andwhatnottodoMakeclearwhat“thecore”isMemorabledistillationofstrategyclearlyunderstoodbyall17SuccessfulstrategicplanningExamplesofclear,focused,privatesectormissions:DellandSouthwestSouthwestAirlinesDellComputer“Meetcustomers’short-haultravelneedsatfarescompetitivewiththecostoftakingabus.”“Bedirect.”18Examplesofclear,focused,prIn1993,DellstrayedfromitsmissionanditscoreSituationOnlyinthedirectchannel(“core”)PCmarketwasexplodingWantedtocapturealargerpartofthegrowthComplicationExpansionintoretailchannel19In1993,DellstrayedfromitsDell:BacktothecoremissionDellwithdrewfromretail20Dell:BacktothecoremissioExamplesofclear,focused,privatesectormissions:DellandSouthwestSouthwestAirlinesDellComputer“Meetcustomers’short-haultravelneedsatfarescompetitivewiththecostoftakingabus.”“Bedirect.”21Examplesofclear,focused,prSouthwesttranslateditsmissionintoclear,measurablegoalsSuperiorcustomerserviceAchievelowcostposition30%lowerAffordabletravel40%lower22SouthwesttranslateditsmissiSouthwestresearchedtargetcustomersegmentneedsandpreferences23SouthwestresearchedtargetcuSpetitorsPriceSchedule24SouthwestfocusedonkeymetriSpetitorsOnetypeaircraftSecondaryairportsCustomerselfserviceNofrills,nomealsserviceCostInitiatives25SouthwestaligneditscoststrSouthwestignoredtraditionalairlinemeasuresthatcompetitorsfocusedonRepeatpurchase26SouthwestignoredtraditionalSouthwestaligneditsorganizationtoimplementsuccessfullyLeadershipDecisionsProcessesPeople

Culture“Belowcostanddeliverexcellentservice”Selectivehiring(2%acceptance)PeerrecruitingtoensurefitsFlexiblejobdescriptionsPilotsandattendants“doitall”RigorouscustomerservicetrainingDecisionmakingpushedtofrontlinesEmployeeloyaltyfocustoincreaseexperience(50%lessturnover)EmphasisonImportanceofpeopleEmployeerecognitionHavingfun27SouthwestaligneditsorganizaKeylearningsfromDellandSouthwestDefineaclearmissionandaclearcoreandsticktoyourcoreTranslateyourmissionintomeasurableoutcomesBuildavaluepropositionbasedonafactbaseddiagnosisCustomersCompetitorsCostsAligntheorganizationtoimplementyourstrategy28KeylearningsfromDellandSoAgendaWhatsuccessfulcompaniesdoExamplesfromtheprivatesectorApplicationstotheMHS29AgendaWhatsuccessfulcompanieTheNCAMHSisexperiencingsignificantpressuresfromanumberofdirectionsNCAMHSBudgetpressuresChangingdemographicsEvolvingmissionsRegulatorychanges30TheNCAMHSisexperiencingsiBestdemonstratedstrategicplanningprocessMissionDefinethemissionRarelyPortfolioStrategyDecidewhatbusinessesandmarketstocompeteinDeterminesuccessmetricsbybusinessEvery5yearsBusinessUnitStrategyDevelopdifferentiatedofferingIdentifychangingdynamicsExternalInternalIdentifykeygapsEvery2-3yearsTacticalPlanningSettargetsandtimelinesDesignkeyinitiativesDevelopimplemen-tationplansRealignorganizationAnnuallyExecutionandTrackingTrackperformanceagainstplansModifyplansasnecessaryOn-going31BestdemonstratedstrategicplItiscriticaltounderstandtheMHS’multiplemissionsandhowtheyrelatetooneanotherPeacetimemissionWartimemissionCallsforproviderstokeepactivedutyfitandtoprovidecasualtycareinthetheatersandatMTFsCallsforaparticularmixofproviders,focusedongeneralsurgeons,orthopedicsurgeons,etc.Requiresasignificantamountofchallengingcivilianpathology,whichmaybeoptimizedaround65+patientsCallsforpeacetimeproviderstoprovidehealthcaretoactiveduty,theirdependentsandserveretireesCallsforacertainmixofproviders,includingOB-GYN,pediatrics,etc.Typicallyoptimizedalongaccessforprimebeneficiaries32ItiscriticaltounderstandtKeyoutcomesareclearbuttheyneedtobetranslatedintomeasurablegoals

ReadinessTraining/GMEResourceoptimizationCustomerserviceandaccessQualityofcareKeyOutcomes

???????????????Targets33KeyoutcomesareclearbuttheSuccessfortheMHSwilllikelyrequirefocusingoncertainactivitiesandclinicalareasResearchGMEHospitalsandClinicsPhysiciansHealthPlanMgmtServicelinesActivitiesInfectiousdiseasePhysicaltherapyCardiologyNephrologyPainmanagementGIVascularsurgeryUrologyEndocrinologyNeurosurgeryRheumatologyFamilypracticeMentalhealthNeurologyHem-oncGeneralinternalmedicineDermatologyOrthopedicsOphthalmologyENTPlasticsurgeryEmergencymedicineCTsurgeryOb/gynGeneralsurgeryPediatrics(allspecialties)

PulmonaryOrgantransplantPediatricsurgery34SuccessfortheMHSwilllikelTheMHSmustpicktheservicelinesandactivitiesonwhichitshouldfocusInvestorpartnerFocusExitDivestorpartneroroutsourceHighLowLowHighCriticaltomissionAbilitytosucceed35TheMHSmustpicktheserviceTheMHSshouldcollectarigorousfactbasetosetstrategyandtargetsDemandSupplyOverall,servicelineandMTFlevelsAcademicandprivatepracticebenchmarksPatientpopulationOutpatientvisitsInpatientadmissionsServicelineuseratesVolumesperproviderPharmacyspendGMEprogramaccreditationNon-medicalcontractingcostsProvidermixandcapacityProviderproductivitySupportstaffproductivityClinicaloutcomesDirectandpurchasedcarecostsPatientaccessGeographicresourcedistributionPatientsatisfactionlevels36TheMHSshouldcollectarigorApreliminarydiagnosissuggeststhatvariousclinicalareashaveproductivitybelowacademicinstitutionbenchmarks37ApreliminarydiagnosissuggesAnumberofservicelinesarealsoexperiencingaccessissues38AnumberofservicelinesareRedesigninitiativesfortheMHSmaytakemanyforms…FacilitiesrationalizationClinicalprogramconsolidationContracting/collectionsfrom3rdpartypayorsResourceallocationsPatientandproviderretentionSharedsupportservicesSpecializationoffacilitiesRe-thinkingoutsourcingIncentivesacrosssystemPreventativecare/diseasemanagementGMEprogramdesignProcurementefforts…butmustbeinformedbydata39RedesigninitiativesfortheMKeyquestionsfortheMHSWhatis(are)themissionsandhowcantheybetranslatedintomeasurablegoals?WhatservicelinesandactivitiesshouldbeprovidedintheMTFsversuspurchasedfromtheciviliansector?Providersvs.hospital/clinicmanagementPrimaryvs.specialtycareHowistheMHSsystemperformingvs.targetsandthecompetitionandwhatinitiativesneedtobeputinplace?Whatorganizationalchangesarerequiredtoimplementtheseinitiatives?WhichdecisionsshouldbemadeatanintegratedversusattheService(Army,Navy,AirForce)level?40KeyquestionsfortheMHSWhatAsingle,integratedhealthcaresupplystrategyneedstobedevelopedtoserveasinglepatientpopulationArmyNavyAirForceSupplyofcare:MHS

BeneficiariesDemandforcare:Tri-Service,Coordinated,IntegratedSupplyofCare41Asingle,integratedhealthcarStrategicPlanninginthePrivateSectorAugust19,2003StrategicPlanninginthePrAgendaWhatsuccessfulcompaniesdoExamplesfromtheprivatesectorApplicationstotheMHS43AgendaWhatsuccessfulcompanieSuccessisrareandfewentitiesaccomplishtheirgoals44Successisrareandfewentiti

KeystosuccessAwelldeveloped,differentiatedstrategyArigorous,factbasedplanningprocesstoconnectstrategywithtacticsAwellaligned,effectiveorganizationtoexecute45KeystosuccessAwelldevelop“Strategy”defined:BainperspectiveAdynamicplantodifferentiateabusinessfromitscompetitorsprofitablyandsustainablyAproprietarysetofactionsthatcreateandcapturevaluebyservingcustomersinasuperiorwayrelativetocompetitorsInformsvirtuallyalldecisionsPortfoliostrategy:Wheretoplay?Businessunitstrategy:Howtowin?46“Strategy”defined:BainpersStrategyisaboutmakingchoicesWherewewillandwon’tcompeteWherewewillandwon’tinvestBusinessesCustomersGeographiesActivitiesMarkets47StrategyisaboutmakingchoicCompanieswhosucceedarefocusedandarethebestatwhattheydo020406080100%MulticoreNoneRegionalfocusOnebusinessChannelfocusPercentofcompaniesCustomerfocus48Companieswhosucceedarefocu

KeystosuccessAwelldeveloped,differentiatedstrategyArigorous,factbasedplanningprocesstoconnectstrategywithtacticsAwellaligned,effectiveorganizationtoexecute49KeystosuccessAwelldevelop75%ofU.S.organizationsbelievetheyneedtoupgradetheirstrategicplanningprocess“Ourstrategicplanningprocessiseffective”“Ourstrategicplanningprocessisfullydeveloped”5075%ofU.S.organizationsbeliBestdemonstratedstrategicplanningprocessMissionDefinethemissionRarelyPortfolioStrategyDecidewhatbusinessesandmarketstocompeteinDeterminesuccessmetricsbybusinessEvery5yearsBusinessUnitStrategyDevelopdifferentiatedofferingIdentifychangingdynamicsExternalInternalIdentifykeygapsEvery2-3yearsTacticalPlanningSettargetsandtimelinesDesignkeyinitiativesDevelopimplemen-tationplansRealignorganizationAnnuallyExecutionandTrackingTrackperformanceagainstplansModifyplansasnecessaryOn-going51BestdemonstratedstrategicplBusinessunitstrategymustbeinformedbythefactsaroundthe“3Cs”FactbaseddiagnosticandvaluepropositionCustomersCompetitorsCostsWhatdoesourtargetcustomervalue?Whatcancompetitorsofferandhowcanwebeatthisoffering?Howcanweprovideourvaluepropositionatminimumcosts?MarketsizeMarketgrowthCustomersegmentsChannelsegmentsPriceexperienceCostexperienceProductprofitabilityChannelprofitabilityValuechaineconomicsSystemscostCostpositionCompetitivepositionProfitabilityStrategyCommitment52BusinessunitstrategymustbeStrategicplanningisoftendonewithoutreferencetofactsActualaveragemarketgrowthForecastaveragecompanygrowthForecastaveragecompanyearningsgrowth53StrategicplanningisoftendoPlanningprocessesofbest-in-classfirmsSeniormanagementdevotessignificanttimeSystematic,withclearlydefinedstepsRigorous,fact-basedapproach,andaconsistentviewofthefutureCoordinatedacrossbusinessunitsEnablesquickdecisionmakingandcoursecorrectionNote:ExamplesincludeGE,Dell,Agilent,Abbott,EmersonElectric,Sun54Planningprocessesofbest-in-

KeystosuccessAwelldeveloped,differentiatedstrategyArigorous,factbasedplanningprocesstoconnectstrategywithtacticsAwellaligned,effectiveorganizationtoexecute55KeystosuccessAwelldevelopAhighperformanceorganizationalignsfiveelements2.Driveseffectivedecisions3.Alignsthefrontlinewithrightjobsandrightincentives4.RightpeopleLeadershipDecisionsProcessesPeople

Culture1.Providessustainedleadership5.Createsahighperformanceculture56AhighperformanceorganizatioAgendaWhatsuccessfulcompaniesdoExamplesfromtheprivatesectorApplicationstotheMHS57AgendaWhatsuccessfulcompanieSuccessfulstrategicplanningbeginswithaclear,focusedmissionForcetrade-offsbetweencompetingresourcedemandsTestsoundnessofaparticularactionSetclearboundariesonwhattodo…andwhatnottodoMakeclearwhat“thecore”isMemorabledistillationofstrategyclearlyunderstoodbyall58SuccessfulstrategicplanningExamplesofclear,focused,privatesectormissions:DellandSouthwestSouthwestAirlinesDellComputer“Meetcustomers’short-haultravelneedsatfarescompetitivewiththecostoftakingabus.”“Bedirect.”59Examplesofclear,focused,prIn1993,DellstrayedfromitsmissionanditscoreSituationOnlyinthedirectchannel(“core”)PCmarketwasexplodingWantedtocapturealargerpartofthegrowthComplicationExpansionintoretailchannel60In1993,DellstrayedfromitsDell:BacktothecoremissionDellwithdrewfromretail61Dell:BacktothecoremissioExamplesofclear,focused,privatesectormissions:DellandSouthwestSouthwestAirlinesDellComputer“Meetcustomers’short-haultravelneedsatfarescompetitivewiththecostoftakingabus.”“Bedirect.”62Examplesofclear,focused,prSouthwesttranslateditsmissionintoclear,measurablegoalsSuperiorcustomerserviceAchievelowcostposition30%lowerAffordabletravel40%lower63SouthwesttranslateditsmissiSouthwestresearchedtargetcustomersegmentneedsandpreferences64SouthwestresearchedtargetcuSpetitorsPriceSchedule65SouthwestfocusedonkeymetriSpetitorsOnetypeaircraftSecondaryairportsCustomerselfserviceNofrills,nomealsserviceCostInitiatives66SouthwestaligneditscoststrSouthwestignoredtraditionalairlinemeasuresthatcompetitorsfocusedonRepeatpurchase67SouthwestignoredtraditionalSouthwestaligneditsorganizationtoimplementsuccessfullyLeadershipDecisionsProcessesPeople

Culture“Belowcostanddeliverexcellentservice”Selectivehiring(2%acceptance)PeerrecruitingtoensurefitsFlexiblejobdescriptionsPilotsandattendants“doitall”RigorouscustomerservicetrainingDecisionmakingpushedtofrontlinesEmployeeloyaltyfocustoincreaseexperience(50%lessturnover)EmphasisonImportanceofpeopleEmployeerecognitionHavingfun68SouthwestaligneditsorganizaKeylearningsfromDellandSouthwestDefineaclearmissionandaclearcoreandsticktoyourcoreTranslateyourmissionintomeasurableoutcomesBuildavaluepropositionbasedonafactbaseddiagnosisCustomersCompetitorsCostsAligntheorganizationtoimplementyourstrategy69KeylearningsfromDellandSoAgendaWhatsuccessfulcompaniesdoExamplesfromtheprivatesectorApplicationstotheMHS70AgendaWhatsuccessfulcompanieTheNCAMHSisexperiencingsignificantpressuresfromanumberofdirectionsNCAMHSBudgetpressuresChangingdemographicsEvolvingmissionsRegulatorychanges71TheNCAMHSisexperiencingsiBestdemonstratedstrategicplanningprocessMissionDefinethemissionRarelyPortfolioStrategyDecidewhatbusinessesandmarketstocompeteinDeterminesuccessmetricsbybusinessEvery5yearsBusinessUnitStrategyDevelopdifferentiatedofferingIdentifychangingdynamicsExternalInternalIdentifykeygapsEvery2-3yearsTacticalPlanningSettargetsandtimelinesDesignkeyinitiativesDevelopimplemen-tationplansRealignorganizationAnnuallyExecutionandTrackingTrackperformanceagainstplansModifyplansasnecessaryOn-going72BestdemonstratedstrategicplItiscriticaltounderstandtheMHS’multiplemissionsandhowtheyrelatetooneanotherPeacetimemissionWartimemissionCallsforproviderstokeepactivedutyfitandtoprovidecasualtycareinthetheatersandatMTFsCallsforaparticularmixofproviders,focusedongeneralsurgeons,orthopedicsurgeons,etc.Requiresasignificantamountofchallengingcivilianpathology,whichmaybeoptimizedaround65+patientsCallsforpeacetimeproviderstoprovidehealthcaretoactiveduty,theirdependentsandserveretireesCallsforacertainmixofproviders,includingOB-GYN,pediatrics,etc.Typicallyoptimizedalongaccessforprimebeneficiaries73ItiscriticaltounderstandtKeyoutcomesareclearbuttheyneedtobetranslatedintomeasurablegoals

ReadinessTraining/GMEResourceoptimizationCustomerserviceandaccessQualityofcareKeyOutcomes

???????????????Targets74KeyoutcomesareclearbuttheSuccessfortheMHSwilllikelyrequirefocusingoncertainactivitiesandclinicalareasResearchGMEHospitalsandClinicsPhysiciansHealthPlanMgmtServicelinesActivitiesInfectiousdiseasePhysicaltherapyCardiologyNephrologyPainmanagementGIVascularsurgeryUrologyEndocrinologyNeurosurgeryRheumatologyFamilypracticeMentalhealthNeurologyHem-oncGeneralinternalmedicineDermatologyOrthopedicsOphthalmologyENTPlasticsurgeryEmergencymedicineCTsurgeryOb/gynGeneralsurgeryPediatrics(allspecialties)

PulmonaryOrgantransplantPediatricsurgery75SuccessfortheMHSwilllikelThe

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