Intro: The following SHSMD Podcast is a production of DoctorPodcasting.com.

Bill Klaproth (Host): On this edition of the  SHSMD Podcast, we have another  SHSMD Connections preview coming at you as we talk with Sergio Orozco and Jerry Vuchak and dive into strategic planning. This is really going to be a great session at  SHSMD Connections 2025. Sergio and Jerry are going to be talking about how they created a living strategic plan for Children's Nebraska. Hmm.

Living. Like it. They're going to tell you all about it in this  SHSMD Connections preview. So let's get to Sergio and Jerry, right now.

This is the  SHSMD Podcast, rapid insights for healthcare strategy professionals in planning, business development, marketing, communications, and public relations. I'm Bill Klaproth, and today it's another  SHSMD Connection preview as we talk with Sergio Orozco, Manager of Strategic Planning at Children's Nebraska.

And Jerry Vuchak, Executive Vice President, Chief Information Innovation, and Strategic Planning Officer, also at Children's Nebraska as we talk about their advanced session, Getting Strategy Off the Shelf and Into the Healthcare Workplace, Creating a Living, Breathing Strategic Plan. They're going to do this topic during the 2025  SHSMD Connections Conference on Monday, October 13th at 3:20.

Sergio and Jerry welcome.

Sergio Orozco: Thank you for having us Bill.

Jerry Vuchak: Yeah, thanks for the opportunity Bill. Really appreciate it.

Host: Absolutely, and thank you both for your time in presenting at  SHSMD Connections. Jerry, let me start with you. Children's Nebraska took a hard look at its five year strategic plan in 2024. What were the biggest pain points you uncovered in the old plan that made you realize it was time for a reset?

Jerry Vuchak: Yeah, that's a really, really great question. You know, here at Children's Nebraska, we had a traditional five year plan, so 2016 to 2020, and then we recast that plan from 2021 to 2025, and we took a hard look at that as we were in the early part of 2024, and we realized what we really wanted to morph to was a more iterative plan.

So we took the years off the plan and we now call it a five year rolling plan. Just because we saw the market conditions with COVID and the way things were changing in healthcare so rapidly; we wanted to have that ability to be able to reiterate the plan as we went along.

Host: Well, Jerry, that's very interesting. You called it a rolling plan. Obviously changes because of COVID and other factors as well had to play into all of this. So how did that reality shape the way you approached this updated strategic framework?

Jerry Vuchak: Yeah, that's a really, really great question as well. As you know, there's a lot of financial pressures in the industry right now. Especially this year coming into potential supply chain issues with tariffs as well as what's happening in Medicaid. And so we really needed to take a look at the five major areas of our plan, which are care, advocacy, research, and education. And say, how do we reframe that work to be innovative in our approach to that? So it's not all about the financial impact, but how do we make impacts within patient care by using the tools we already have in-house for example, and optimizing those tools rather than implementing new things? And so, you know, part of our iterative plan, which I think Sergio will get into, is we meet on a more frequent basis to talk about how we're doing against the plan.

So we can reiterate at any time. We can change our strategies and objectives as we go along and we can adapt to those market influences much more quickly and much more agilely.

Host: So you talk about an iterative plan that makes it easier for you to change on the go. So Sergio, I know in the session, one of the objectives is creating a living plan, and this is what it sounds like Jerry is talking about how you can kinda change as you go. Can you explain what this living plan looks like in practice and how it's different from static plans that many hospitals are used to?

Sergio Orozco: So, as Jerry mentioned, historically the strategic plan had a lot of tactical, very detailed minutia level of work. And then once COVID started and happened, we had to pivot and put it on the back shelf and don't touch it and just focus on how do we survive. One of the items that we got from feedback from the team as we were getting at the end of the cycle from the last plan is the plan was very static.

It had very weird timelines that were not tangible. And it had an overwhelming number of KPIs. Every person, had their own different ideas of what made them successful. And we also didn't do a really good job of using data to make decision making. So one of the items that we did is, we changed the approach and we mostly focused on the approach on how do we define success and having a unifying definition of what does success look like for us as an org. And then from there, challenging those leaders and using change management theory. And how do we identify key champions on who's the real people that are helping us move the needle.

So that will be directors and vice presidents and team members that ease and breathe on their day-to-day work. So we asked those leaders on coming up with focus groups and identifying what does success mean to them. But then we also challenged the team to choose key measures of success that are truly telling us if we're winning.

If we're moving the needle, if we're better than we were before. So we really challenged the team to be more thinking of what is truly telling us if we're making a difference, not some retroactive measure of success that is a volume based, more like how are we making the biggest impact as a team.

And then every quarter, we get together, I call it our strategic planning village. Every champion, and every sponsor of our strategic plan, we get together every quarter, and we have a town hall where we kind of discuss the successes of our plan, what is working well, and we kind of create the accountability piece. But we don't make it just a informing meeting. We take the time to also make it dynamic. So with the help of Jerry and some of our other team members, we choose a topic every quarter. And then based on the topic of consumerism and AI, for example, or consumerism and social determinants of health; we kind of look at how is our strategic plan challenging and tying into topics that are happening in the industry right now, or what's happening in the landscape. And we have conversations as a group. Do we need to modify our strategic plan? Do we need to consider making modifications? Do we need to be more mindful from a budget perspective next year as we go into budget cycle?

So that's how has made it more of a livable document where the chance to meet quarterly and pivot and adapt on the spot.

Jerry Vuchak: Yeah, no I'll add, Sergio did a great job of recapping that. It's also a really, really great opportunity for our sponsors and champions to ask for assistance. So if they see barriers in their environment that they're struggling with, that another cross-functional team can help with, it's really an opportunity for them to come to the table and say, Hey, I'm struggling with this. I need some help. And, you know, collaboration is one of our core values here at Children's Nebraska. So it's really, really a collaborative process where we're all helping each other to achieve the best outcomes.

Host: And I just want to say the strategic planning village sounds lovely. It sounds like a good place to live.

Jerry Vuchak: That's right.

Host: And I hear the rent there is very, very affordable. So sorry. Enough of the fooling around here people, back to the serious stuff. So Jerry, Sergio mentioned champions and sponsors. Can you expound on that for us? Champions and sponsors. Who are these champions? How did you select these champions, and what impact have they had on keeping the plan actionable and accountable?

Jerry Vuchak: Absolutely. So we have five Gold Star strategic plan and we have executive sponsors for each of those. So my peers and I each take accountability across the strategic plan for the goals. And then, for example, goal one, which is all about providing the safest, highest, quality care and an exceptional patient experience.

Kathy English, our COO, is the sponsor of the goal, and then under that goal there are strategies. Four strategies and each of the strategies will have champions that are a dyad of an executive and a provider. So we really felt it important that we have our provider leaders helping us with the strategies and the plan to make it cohesive, to make sure that the providers gave us great input in the plan. And then as we iterated the plan and we've gone to this quarterly mechanism where we review, we've actually added some of our directors in as champions as well. So it can be an executive, a provider, and then key directors in the process. So, one of our strategies around patient experience, so our director over patient experience is also in that cohort to help with championing that strategy to success.

So it's again, a really collaborative process. It also allows us to do great cascading of the goals and the strategies through the organization from our executives down to their leadership, to their team members, as well as from the provider champions into our provider, partner environment.

Host: So I'm wondering in the session, will you go over examples of how the living plan helped you adjust and pivot on the fly? Will you talk about that?

Jerry Vuchak: So as we meet and we talk about, for example, I can give you an example of we had a strategy around safety, which means a lot in the environment. There's patient safety, and as you know, in healthcare, there's been a lot of lateral violence from patients and families to our caregivers.

And so we wanted to have a real focus on our team member safety as well. So we split that out into a separate strategy where we're talking about respecting the environment, we're talking about how we're securing the environment to make sure our team members feel safe at all times while they're here working at the hospital.

So that's just a easy example of splitting out safety into patient safety and team member safety. It came outta one of those sessions.

Sergio Orozco: I wanted to echo a little bit more on what Jerry mentioned. One of the things that I feel like we've been really successful is taking the alignment of our work, and thinking about change management. We have done a really good job as a team challenging the team to utilize and truly live out our core value of collaboration and instead of having individual goals out of the department level or the executive level, and now we are transitioning to having a team impact or high impact team goals. So throughout the last few years, through the guidance of Jerry's leadership, we have done a really good job of going from having 50 plus goals that we had to do as an org wide on top of departmental goals.

Now we have very helpfully narrowed down our approach into tangible goals that are easy to manage and they are goals that are being worked on by multiple team members in the org and they're aligned directly either to a specific strategy or strategic plan, or we're able to adapt to things that are happening in the industry.

Like Jerry mentioned, we got direct feedback on how we can improve our safety, based on feedback that we got from our patients and our employees. So we wanted to make sure that we quickly were able to pivot and identify a way that we can make a difference right away.

Host: That's really good, Sergio, let's stay on that for a minute. Because many hospitals struggle with too many measures of success, and you said you had a lot of goals that you had to trim back on. How did you simplify and focus only on the most impactful metrics or goals, and how has that changed reporting and decision making?

Sergio Orozco: So one of the things that we challenged the team at large is whatever goals they're working on, do they align to the strategic plan at large? Which I know it seems kind of simple, but if they don't align to the strategic plan at large, that was an easy way that we can potentially look and redefine it with something we needed to do. From there if they do align, the next set of questions that we challenge the team, well, do you have the proper definition of what is success? So how do we know we're going to be successful in achieving that goal?

And then we challenged the team to make sure that they identify what is truly going to be the definition of success. But making sure that whatever they decide success is, it's a measure of success that is easy to create, repeatable, but then also being able to make sure that it's a metric that we can easily pull from our data warehouse.

So that way we have a one true source of truth on what does success look like. But I think the most important thing is getting buy-in from the team. Like Jerry mentioned, getting those champions and those sponsors who truly believe in the work that we are doing, not just on the administrative side, but also on the clinical physician leadership side.

I think that has been the biggest change. Getting the buy-in from the physician, getting their engagement and their excitement to say, this is the area that I want the organization to focus on. Having them in the room as we do those progress tracking quarterly has been really great. Because now we're also able to see and hear the stories of patients that have been influenced based on the alignment of the work that we are doing as an organization.

Host: Sergio, I like the alignment of goals with the strategic plan. That just makes sense. And how you made sure that the staff all knew what success meant. I think a lot of time people don't know what that is, so making sure you defined what success means, I think that's really, really a good idea. So Jerry, the updated plan coincided with a rebrand in reportedly increasing employee engagement.

So we've talked about change management a little bit. Can you expound on that and how change management tools played a part in making sure employees bought into the new plan and felt connected to the hospital's mission, vision, and values?

Jerry Vuchak: It's really important to us as we recast the plan, that it's relatable down to our team members. So, the health and wellbeing of our team members is one thing that we really concentrate on. We have a people-first culture here, and we want to tie their work very intentionally to the mission, vision, and values of the organization.

And so, a prime example of that is as we recast the plan, we originally had eight values when I came to Children's Nebraska. You know, no one can remember eight values, right? And so we recast those values. We took a stab at establishing the values, and then we did focus groups around the organization of our team members and of our provider partners, and we came up with innovation, collaboration, accountability, and respect and excellence.

This was not intentional, but when you put those words together, the first letter of those words together, it spells ICARE. So very relatable to our team members to understand that innovation, collaboration, accountability, respect, and excellence. In a very similar fashion as we came up with the goals of the strategic plan, they're around care, advocacy, research, and education.

If you take the first letter of each of those words, it spells CARE. So very relatable to our team members. They can understand. We're focused on care, we're focused on advocating for children, we're focused on research, and we are an educational institution. We have an academic affiliation with two organizations.

We have residency programs, and that's significant to us. And then the fifth goal in our strategic plan is around our enablers of our plan. Our most important asset are people. Our financial sustainability, we have to be financially sustainable to be an asset to the community far into the future.

And then our use of technology and innovation, those are really the three foundational things. And I mentioned that our people are the most important part. They fuel our plan. So team engagement is very, very significant to us. We do a team engagement survey every 18 months. And we're at the 89th percentile in engagement in the organization.

We do that survey through Perceptyx and when we're one of the tops in their benchmarking, certainly in healthcare and then in other organizations across the country. And that, part of our part process really is that team member engagement and focus groups to make sure that we're doing the right things by our patients, our families, and our team members.

So, you know, our focus is really to be people-first, whether that's our patients' families, our team members, and to get input along the way.

Host: IC acronym. Very easy to remember. I can see why that works so well. I'm surprised more people don't do something like that. Well, Jerry and Sergio, I want to thank you both for your time. Before we wrap up, I'd love to get final thoughts from each of you. Sergio, let me start with you. Anything else you want to add?

Sergio Orozco: The only other thing that I want to mention is that as we also refresh our enterprise strategic plan, we will also looked at how do we help each division grow, and being thoughtful on the financial sustainability. So where do we identify key growth divisions in coming up with a process that kind of aligns over our process.

So I'm excited to kind of share some of the knowledge that we have done, and hopefully have some great takeaways for some of the people that attend our session so that way we can kind of share our best practices and what we learned at Children's Nebraska.

Jerry Vuchak: I will expand on that. I was going to say the same thing. And so, you know, this is really a compliment to Sergio and his team. I am not a strategic planning, that's not my background. My background's IT, and our CEO gave me strategic planning and it's really been a great journey with Sergio and his team. When I took strategic planning, we did not have a great reputation in the organization specifically with our specialty divisions. They had been through strategic planning, growth planning many, many times. The feedback that we got from them is, why are we doing this? No one cares about it. The organization doesn't support us, and we don't get the resources to actually execute these plans.

And so, if you asked our specialty divisions now, they would say the process is engaging, it's collaborative, and administration is actually listening to us and giving us a forum to talk about what is important to us strategically, whether it's our heart center, whether it's our neurosciences program. And so it's a lot of back and forth collaboration and prioritization. And, it feels good to our provider partners now, where four years ago, wasn't so much.

Host: Absolutely. Sergio and Jerry, thank you so much for your time.

Jerry Vuchak: Thank you.

Sergio Orozco: Thank you, Bill.

Host: Absolutely, and once again, that is Sergio Orozco and Jerry Vuchak. They will be speaking Monday, October 13th at 3:20 at the 2025  SHSMD Connections Conference. It's going to be great. Make sure you get registered at  SHSMD.org/education/annualconference so you can experience and walk away with great stuff like Sergio and Jerry are going to go over in their session.

And if you found this podcast helpful, please share it on your social channels and please hit the subscribe or follow button to get every episode. And to access our full podcast library, for other topics of interest to you, visit  SHSMD.org/podcasts. This has been a production of DoctorPodcasting. I'm Bill Klaproth. See ya.