Step 1: EMS System Assessment & SWOT Analysis
An EMS system assessment provides a review of the emergency care environment in your state; environmental driving forces; changing demographics; political, social, and economic conditions, as well as available and missing resources. This step is often referred to as a SWOT analysis. It looks at the Strengths, Weaknesses, Opportunities and Threats that could potentially impact achieving the performance measures.
The baseline data collected for each performance measures can provide valuable information regarding the status of your system. The baseline data provides a foundation for the development of your program’s goals and objectives, and can be used for evaluating progress towards achieving these goals. Once baseline data has been collected and analyzed, a SWOT analysis can be a useful tool to identify strategies to make improvements in each of the performance measures. For example, you may have found through collection of baseline data that only 20% of your state’s hospitals have written agreements and guidelines regarding the transfer of children to higher levels of care. By conducting a SWOT analysis with key stakeholders, your program can help identify root causes and ways to overcome barriers. Conversely, a SWOT analysis could be conducted with EMS training coordinators, state EMS office administrators, and others to assess the adequacy of current pediatric training requirements for EMS providers and how these requirements might be strengthened.
Some of the important aspects of conducting an effective SWOT analyses include:
- process is facilitated by an outside or neutral party
- planning includes representation from all parties or organizations with a stake or interest in the outcome
- all parties and their input will be regarded equally
- discussion stays focused on the “system” rather than on individual people
- discussion does not drift into unrelated topics
- plans developed from the SWOT analysis are done by the group, and any revisions to the plans are done with input from the group
SWOT results can specifically be used to develop goals and objectives to address barriers identified and make system improvements in performance measure areas. There are a number of excellent resources for conducting SWOT analyses and facilitation techniques (see the SWOT Analysis Template)
Using the SMART approach is a helpful framework for developing your project goals and objectives. Goals and Objectives should be:
R Results oriented/Relevant
T Time bound
Step 2: Define Goals
Goals are broad value statements of desired outcomes. Define goals for your program which address the gaps identified in your assessment. Examples of goals related to the performance measures include:
- By 2016, assure access to quality pediatric emergency care for all children in every region of the STATE.
- By 2017, improve the operational capacity of STATE to provide pediatric emergency care.
Step 3: Develop Objectives
Objectives facilitate achievement of the goals. They should be specific and flow from specific goals developed for the state. They also should be measurable, quantifiable, and achievable in the time frame specified in your goals. Example objectives include:
- Provide pediatric training for 90% of BLS providers in STATE every two years.
- Ensure that 100% of the hospitals in STATE have pediatric emergency transfer guidelines that include all of the required components of transfer by 2016.
For more information on writing goals and objectives, see Establishing Goals and Objectives below and Tips for Writing Goals and Objectives.
Step 4: Identify Strategies
Clear strategies and activities are essential for setting out detailed work plans that will achieve the desired outcomes set out in project goals and objectives. Strategies are broad concepts or approaches to achieve the project objectives while activities are actions that are undertaken within these strategies. For each of the project objectives, create a list of major strategies, specific activities for each strategy, the individual or group responsible for implementing the activity, and a timeline for completion. Strategies should also be written to pass the SMART test. SMART strategies allow strategic managers to monitor the progress and outputs of the project and increase the likelihood of meeting objectives and effecting positive change.
When writing activities, use ‘active’ verbs and be very clear on what needs to be done. Be sure to include time to review your strategies and activities with your stakeholders. For more information, see Developing Strategies and Activities.
Step 5: Develop a Timeline
Program milestones should be plotted on a timeline. Timelines assist in outlining tasks to be worked on and specific accomplishments to be achieved within a proposed time frame.
A program timeline could also include essential grant activities that must be adhered to with your funding award (e.g. plotting the date by which updated data must be recorded into the EHB; plotting attendance at the annual grantee meeting). To have multiple successful outcomes occurring within the same time frame may be unrealistic. Often this multiplicity of activities may not be recognized until plotted on a timeline reflecting the numerous tasks and proposed outcomes. Timelines should be constructed with all activities listed and responsible individuals indicated for each activity. A Sample Program Timeline is available for download below.
Step 6: Evaluation
Evaluation is a critical part of any strategic plan. Evaluation provides a mechanism for celebrating success while identifying areas where action steps failed to fully actualize the desired changes. Reflection on well-crafted SMART objectives easily facilitates measures of success by focusing on process, degree of change, and outcome. Did the planned action steps facilitate achievement of the objective? Was the objective achieved in total or in increments necessitating further work? If the objective was achieved, what was the actual outcome resulting from achievement. For an example of how to put it all together, see the Project Plan Template.
For example, your objective is to assure that all hospitals have written inter-facility transfer agreements in place and that children are transferred to appropriate resources. In year one, only the eight designated trauma centers are noted to have such in place. Your objective is to devise a plan with your state hospital association and the regional hospital preparedness program to ensure that all hospitals in the state have written agreements in place. Collecting data on this measure in subsequent years will aid you in determining the success of this plan. Further success of the plan can be measured by looking at the number of children actually transferred to the appropriate facility and resources.