Strategic Planning – Prioritizing Objectives and Strategies

Priorities - shutterstock_314490425Two of the toughest tasks in a planning retreat are:

  1. Making decisions as to which way to go when all do not agree.
  2. Agreeing on the priorities of objectives and strategies developed.


Deciding on Initiatives

At most retreats the participants identify a number of options, alternatives or solutions to deal with the challenges identified in the SWOT analysis. The challenge is that it is unlikely that things will be so neat that all participants immediately agree on a course of action.

So, what do you do?

This is where taking the time at the very beginning of the retreat to discuss to decision-making pays off.  As you may recall, there are three key questions:

  1. How will we make decisions?
  2. What is expected of each physician once a decision has been made?
  3. What are a physician’s options if he/she doesn’t like a decision?

If the group has gone through the process of agreeing to support group decisions, you can have a higher level of confidence that you can reach a decision that will be implemented.

With that as a base, here are a several options when all do not agree:

  • Pluses and minuses: Ask the attendees to identify the pluses and minuses of any course of action. Sometimes this discussion will identify a clear “winner.”
  • Use the “Broad Side of the Barn” approach: You may have heard the phrase that someone “can’t hit the broad side of a barn.” We have found that creating the “broad side of the barn” and letting people “throw rocks at it” to be an effective way to develop an agreed upon decision. If the issue discussed is mulit-factorial and a “packaged” solution (a solution with many elements) is required to deal with the issue, it can often help to present a recommended solution with all the parts delineated. The group then has something to debate and can “throw rocks” at it. You will often find that this process allows for tweaking of the various elements and ultimately an agreement on a packaged solution.
  • Motions: There are times that no amount of discussion will result in the group coming to agreement on an issue or direction. In that case you may be forced to resort to individuals making motions, discussion and debate on those motions, and voting on those motions. You may find that several motions may be offered and defeated before a final motion is passed. This can be a frustrating process, but the group should recognize that sometimes this is the only way to reach resolution on an issue.


Setting Priorities

Typically a planning process results in the development of many objectives and strategies. Unfortunately all groups have limited resources and not every objective, strategy or project can be given the same level of resources.

In addition, sometimes the attendees get so excited in the planning processes that they develop 30 initiatives that all are to be completed in the next 3 months. Oh, by the way, the manager’s name is on each project.

This won’t work. Groups have limited resources and must prioritize strategies and objectives so that management knows what is truly important.  Here are a few options:


The group can use the table shown below to categorize each initiative as to: 1. How much it will cost (money, effort) to implement or what risks are involved; versus 2. The benefits that the group will receive if successful. Naturally the group should pursue the items categorized in upper right hand quadrant first.

Cost Benefit Grid








We once worked with a 50 physician group who had 30 initiatives they wanted to pursue and were able to prioritize them in about 45 minutes.

Group Voting

Group voting allows the participants to “vote” on the initiatives they think are most important to the group. For example, if the group has identified 30 initiatives, you might give each physician 5 votes to cast for their favorite items. Those items with the most votes are pursued first.

Nominal Group Technique

An even better prioritization process is to use Nominal Group Technique (“NGT”). There are many resources on the internet that describe the process of NGT, but NGT’s benefit is that it not only identifies what the participants believe to be the most important priorities, but it also ranks how important each item is relative to the other items.


At the end of the retreat the group should have its Mission and Vision statements and a list of prioritized objectives, strategies and projects. But if you stop there, you only get part of the benefit of the planning process. There are important steps to be performed after the retreat that we will discuss in our next article.


Please contact me if you’d like to discuss this post.

Will Latham


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