The Importance of Aligning Vision, Mission, and Strategy in Fast-Changing Healthcare Environments

Virtually every health system and academic medical center everywhere is scrambling to succeed in an environment of rapid change. Regulation, payment, care models, competition, technology, and advancements in diagnosis and treatment continue to evolve at a rapid pace. While the challenges play out differently in different markets, leaders everywhere struggle to align short-term priorities with longer-term vision—all when they aren’t able to guess at what the future will hold. This article explores the powerful relationship between vision, mission, and strategy to help leaders stay true to who they are even as they are called to adapt to an uncertain environment.

Charting the Course Retired Harvard Business School professor Robert Hayes once commented that if one should find oneself in a rapidly changing swamp filled with quicksand, a map of particular paths would not be nearly as useful as a compass. The compass gives you a sense of orientation, like the North Star to a sailor on the ocean. It gives you a sense of direction and destination. As the local situation becomes too complex, people can reorient themselves and reestablish the link between immediate issues and the larger stakes.?

The sailing metaphor helps us to understand that just because we have a vision—a realistic, attractive, motivating image of a desired future—it does not mean the way to reach our destination will be as simple as the shortest path between here and there. That requires purpose and action. Like sailing, we must read water and wind. We need to know the capabilities of our craft and our crew. Sometimes we will be on a course that almost feels perpendicular to where we want to end up because it will position us to reach our destination at some future time. When a skipper resets a course, the crew does not perceive it as indecisiveness, as long as they understand the new course’s relationship to their desired destination. This metaphor demonstrates the power of an aligned vision, mission, and strategy to balance today’s realities while preparing for tomorrow’s unknowns.?

The Power of Aligning Vision, Mission, and Strategy A motivating vision is a powerful shaper of an organization’s behavior; in a sense, it can substitute for managerial control. Like a magnet, it has great power to align many separate elements. At the same time, many leaders can confuse or conflate vision and mission. They are integrally linked, but conceptually different. Campbell and Yeung define these terms as:?

• Vision is a mental image of a possible and desirable future state of an organization.?
• Mission is an organization’s character, identity, and reason for existence, including purpose, strategy, behavioral standards, and values.?

I recommend that vision be associated with aspirational goals—WHERE you want to go over the long haul—and mission with a way of behaving—the core of WHAT you do to achieve that vision. In times of change, there will be greater overlap of the two concepts because the organization is often seeking to change its culture—its ways of behaving—to help it to achieve its vision for the future. Strategy comes into play to link the short-term with the longer-term. Strategy is essentially HOW you will advance your mission in pursuit of your vision in the near term. Because of its more immediate time horizon, strategy can change to adapt to challenges and opportunities in the environment.?

I’ve seen the power of this concept come alive in a multi-state health system, where the markets served couldn’t have been more different. C-suite leaders could not see the value in being a collective system until they came together to create a vision and mission that aligned their identity and purpose. They could then return to their individual markets to craft strategies that advanced the vision and mission in ways that aligned with the on-the-ground realities of their local circumstances.?

Characteristics of a Successful Vision and Mission Leaders can often get tripped up crafting a vision statement. A vision can fail by being too achievable or too ambitious. Organizations are vitalized when both a dream and a hardheaded assessment of reality are simultaneously present. Some desirable qualities of a vision include:?

• Scale and scope. It should stretch the organization and feel significant.?
• Inspirational. It should excite people, help them give meaning to daily, often mundane tasks because of the link to the vision.?
• Sense of history. A vision about the future should tap deep historical roots of what people have found important and valuable. A historically grounded vision provides a clear sense of what will be transient and what is enduring in a world of rapid change.?
• Sense of context. A vision needs to connect people to the wider world so they can see the relationship between the organization’s work and their own passions.?

While some organizations use the vision and mission interchangeably, we think differentiating between the longer-term vision with the purpose-driven mission sets a strong foundation for the short-term strategy. Consider the following example from the Mayo Clinic:

• Vision — Mayo Clinic will provide an unparalleled experience as the most trusted partner for healthcare.
• Mission — To inspire hope and contribute to health and well-being by providing the best care to every patient through integrated clinical practice, education, and research.

Aligning Stakeholders to Vision, Mission, and Strategy Authentic organizational vision, mission and strategy arise out of relationships between a leader and colleagues and between an organization and the people both inside and outside of the organization who care about it, fund it, and consume its products and services. In a sense, these items are negotiated to ensure stakeholders understand where the organization is heading and why. When individuals have actively worked together on an organizational vision, mission, and strategy, they are better able to link them to their personal motivations and goals. The vision and mission can be realized through committed, empowered, and enrolled people who are able to translate strategy into action.?