Identifying Different Types of Plans

TYPES OF PLANS
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Types of Plan
               Policy plays an important role in healthcare, especially by improving health and promoting equity. According to Porche (2019, p.1), a policy can be described as the strategies utilised by healthcare professionals to bring change in communities and society in general. Goals must be set for policy to be effectively formulated and implemented. Also, Milstead and Short (2019, p.1) describe a policy as a course of action that has been intentionally selected to address an issue. A policy can be a law, regulation, procedure, rule or administrative action, among others. To successfully deliver health policy with the desired outcomes, it is important to ensure that all activities are planned. This paper examines different types of plans and how they can be applied in the emergency department (ED) by physicians to add value. Specifically, this paper will examine strategic, tactical, and operational plans as the main types of plans.
Strategic Plan
               A strategic plan looks at the bigger picture. It usually focuses on the long-term goals and decisions the span up to five or more years (Kahraman & Topcu 2018, p.469). Thus, one can say that a strategic plan provides healthcare organisations and systems with steps that can be followed to move from the current position to a better future position that is well-aligned with the vision, mission, and values of the organisation. According to Swain et al. (2020, p.418), a strategy focuses on actions. Therefore, a strategic plan must focus on choosing specific courses of actions that are aligned with the established long-term goals and objectives. A strategic plan must also identify the available resources and outline how they will be allocated to achieve the desired goals. In population and public health, a strategic plan can play a major role in addressing some of the major health issues affecting a population. Because such a plan is action-focused and future-oriented, it allows healthcare professionals and policymakers to take long-term actions to promote healthcare changes.
               To promote population health through policy, strategic planning allows stakeholders to identify the health needs of the population and understand the various interventions that can be used to address those needs (Phelps et al. 2016, p.112). This is the first step of a strategic plan. It allows for specific and targeted action to be taken. For instance, the Indian government was able to achieve significant improvement in the number of immunised children after it identified that most children in the country were not vaccinated. Thus, a strategic plan was laid out in 2014 to help achieve full immunisation by 2020 (Swain et al. 2020, p.419). The plan targeted children who had not been immunised and a lot of political support, as well as sustainable funding, were provided. Actions taken included mobilization as well as collaboration among different government ministriesthat targeted low immunisation coverage areas in the country. This strategic plan helped implement a specific type of health policy. As the Information Resources Management Association (2018, p.337) reveals, policy in healthcare can be classified as public, administrative, or clinical policy. Public policy is concerned with the decisions that establish the type of health services to be provided; administrative policy is concerned with operational decisions, and clinical policy is concerned with decisions on how healthcare services will be provided and managed. The Indian strategic plan allowed the government to take action to implement a public policy that supported full immunisation, thus promoting health equity in the area of immunisation. 
               It is worth noting that a strategic plan can be single-minded or dedicated to a number of goals. According to Phelps et al. (2016, p.113), a single-minded strategic plan focuses on just one single goal, such as profit maximisation. However, a strategic plan can also focus on achieving multiple goals. For instance, through their mission statements, healthcare organisations can have multiple goals such as providing equitable care, ensuring quality care through reduced hospital re-admissions, and enhancing care accessibility through telemedicine, among others. Sometimes, these goals can be conflicting and Phelps et al. (2016, p.114) reveal that a well-formulated strategic plan can help resolve the conflict. 
A strategic plan is especially useful in incremental policymaking which can be highly disjointed. According to Porche (2019, p.172), in the absence of political support for policy change, incremental policymaking is recommended, but it requires sticking to an extensive strategic plan to ensure that the policymaking process is not disjointed. As an ED physician, I would, therefore, apply a strategic plan to ensure that a policy change is approved by policymakers when I do not have enough political support for the policy change. 
Tactical Plan
               A strategic plan influences both tactical and operational decisions (Kahraman & Topcu 2018, p.469). Thus, it is important to effectively translate a strategic plan into a tactical plan. A tactical plan focuses on mid-term goals and activities that have to be undertaken to achieve the overall goals of a healthcare organisation or system (Kahraman & Topcu 2018, p.472). A tactical plan outlines the activities that will be done to achieve the specific strategic plan that has been laid out. As revealed by Hozack et al. (2021) integrating tactical planning is beneficial because it provides more opportunities for improvement. Rather than waiting for five years to improve a strategic plan, tactical planning allows strategic plans to be broken down into smaller activities that can be monitored and re-assessed more often than the strategic plan. Williams (2018, p.100) posit that tactical plans often specify the resources, both human and financial, that will be required to achieve the strategic objectives. In addition, a tactical plan directs the attention and efforts of the involved stakeholders on what needs to be achieved within six to twenty-four months. In healthcare, the role of tactical plans can be seen in how organizations are increasing healthcare accessibility using technological resources. For example, at my place of work, we wanted to increase the accessibility of healthcare to more rural areas. That was our strategic plan. To achieve this, we laid out a tactical plan which involved the adoption of telemedicine which allowed people in the rural area to access healthcare without having to visit the ED. 
               Tactical plans are effective in ensuring that there is operational efficiency and effectiveness (Larsson & Fredriksson, 2019, p.3). To achieve operational efficiency and effectiveness, tactical plans have to be translated into operational plans. According to Akhavizadegan et al. (2017, p.23), technical plans can be very effective when prioritizing the allocation of scarce resources in healthcare. The plans can ensure effective delivery of care through efficient allocation of beds as well as healthcare personnel. Thus, they help address some of the key tactical problems in healthcare, such as long waiting times and patient scheduling (Kiani, 2020). As an ED physician, I can use a tactical plan to further increase access to care by establishing mobile clinics in underserved communities. 
Operational Plan
               Unlike strategic and tactical plans, operational plans are smaller in scope but impactful. They are crucial in healthcare policy because they act as a link between the strategic plan and the activities that will be implemented to achieve the strategic objectives (Shuey et al. 2016, p.1). Usually, operational planning is concerned with the day-to-day implementation of the course of actions defined in the strategic plan. As Tosfa et al. (2021) posit, operational plans convert policies and strategic objectives into manageable and clear day-to-day activities. An operational plan is a roadmap outlining the resources and timelines that would facilitate the effective conversion of health policy into the desired outcomes (Eboreime et al. 2019, p.1). It is usually the responsibility of the people in managerial positions to create operational plans. For instance, as an ED physician, I work in the ED department and the operational plan is usually created by my boss, who also happens to be the head of the ED department. It is as a result of these operational plans that I understand my role and responsibility as a physician in the ED. In strategising health and healthcare policy, operational plans provide clarity on what needs to be done to achieve the set goals or translate policy into action (Shuey et al. 2016, p.1). For example, in the UK, there is a health and social care act that was passed in 2008 and it addresses infection control. However, for this policy to be translated into day-to-day activities, operational plans at the hospital level were necessary. 
               According to Shuey et al. (2016, p.1), a good operational plan should encompass the following:
* An extensive description of activities that need to be undertaken to achieve the strategic objectives outlined in the strategic plan. The said activities should be aligned with the strategic obje...