Priority-setting and hospital strategic planning: a qualitative case study

Area of Science:

• Healthcare Management
• Health Policy
• Medical Ethics

Background:

• Effective strategic planning is crucial for hospital resource allocation and operational efficiency.
• Priority-setting within hospitals requires transparent and justifiable decision-making processes.
• The concept of 'accountability for reasonableness' provides a framework for evaluating such processes.

Purpose of the Study:

• To describe the priority-setting component of a hospital's strategic planning.
• To evaluate this process using the 'accountability for reasonableness' framework.

Main Methods:

• A qualitative case study design was employed.
• The strategic planning process of a large, urban, university-affiliated hospital was analyzed.
• Evaluation was conducted against the established conditions of 'accountability for reasonableness'.

Main Results:

• The hospital's strategic planning process largely adhered to 'accountability for reasonableness' conditions.
• Decisions were based on relevant reasons and criteria, with extensive participant involvement.
• Communication of decisions and reasons was robust; an ethical framework for evaluation and improvement was integrated.
• Areas for improvement included providing more time for information absorption, decision-making, and establishing appeal mechanisms.

Conclusions:

• A case study approach, combined with 'accountability for reasonableness' evaluation, can enhance hospital priority-setting.
• This methodology offers a practical tool for improving strategic planning in healthcare settings.