DNP 840 Module 1 Mission, Vision and Strategic Planning Example

From Mission to Service Line: Strategic Planning for a Nurse-Led Dementia Care Program

Student Name

Doctor of Nursing Practice Program, Aspen University

DNP 840: Strategic Planning and Financial Management

Instructor Name

Month Day, Year

From Mission to Service Line: Strategic Planning for a Nurse-Led Dementia Care Program

Strategic planning answers three questions: where an organization is now, where it wants to be, and how it will get there. For a nursing leader proposing a new service line, planning also has to show how the service fits the organization's mission and vision, since leaders fund what advances the mission. This paper applies strategic planning to a proposed nurse-led dementia care program at a composite regional health system, describing the case for the service, the mission and vision that frame it, the planning process, and the goals it sets for its first three years.

Why Dementia Care

The number of people living with dementia is growing rapidly as the population ages. An analysis of population data estimated that about 6.07 million Americans aged 65 and older were living with clinical Alzheimer's disease in 2020, with prevalence higher among Black and Hispanic older adults than among White older adults, and projected that the number would reach 13.85 million by 2060 (Rajan et al., 2021). People with dementia use emergency and hospital care often, frequently move to long-term care when caregivers can no longer cope, and their family caregivers experience high rates of depression and burden.

Evidence shows that coordinated dementia care can help. In a randomized trial of a care program delivered by telephone and internet from a central hub by trained care team navigators supported by clinical specialists, people living with dementia reported better quality of life and made fewer trips to the emergency department, and caregivers had less depression and burden, compared with usual care (Possin et al., 2019). A comprehensive dementia care program led by nurse practitioner dementia care managers was associated with a lower likelihood of admission to long-term care and was cost neutral for Medicare once program costs were counted (Jennings et al., 2019).

Mission and Vision

The composite health system's mission is to improve the health of the communities it serves through compassionate, high-quality care close to home. Its strategic plan names aging well at home as one of four priorities. A service line's mission should express how it contributes to the organization's mission in specific terms. The proposed mission for the dementia care program is: to help people living with dementia and their families stay safely at home, with dignity and support, for as long as possible. Its vision is that every family in the region facing dementia has a trusted care partner from diagnosis onward.

Values guide choices within the mission: partnership with families as members of the care team, equity in access, particularly for communities with higher dementia prevalence, and continuity through a single named care navigator for each family. These statements matter because they decide close calls, for example choosing to serve families in rural counties even when home visits are costly.

The Planning Process

The planning process has six steps over four months. First, a steering group is formed, including the chief nursing officer as sponsor, the doctoral nurse leader, geriatric and neurology physicians, a social worker, finance and strategy staff, and two family caregivers. Second, the group conducts an environmental assessment of the internal and external situation, including population data, competitors, payer policies and the health system's own capabilities. Third, it sets strategic goals and measurable objectives. Fourth, it chooses strategies and a service model. Fifth, it develops a financial plan, including operating and capital budgets and a break-even analysis. Sixth, it defines how progress will be measured and reviewed.

Each step produces a document that the next step builds on, and the steering group presents the full plan to the health system's executive team for approval.

Three-Year Goals

The planning process produced four goals. First, access: enroll 400 families in the first year and 900 by the end of the third, with enrollment of Black and Hispanic families at least proportional to their share of the region's older population. Second, quality: improve caregiver burden scores by a meaningful amount at 12 months and reduce emergency department visits among enrolled patients compared with the year before enrollment, consistent with trial results. Third, community stability: lower the share of enrolled patients who move to long-term care, measured against a matched comparison group, in line with evidence from a comprehensive program. Fourth, financial sustainability: reach break-even on direct operating costs by the end of the second year through program revenue and savings under the health system's value-based contracts.

Each goal has an owner, a measure and a target date, and progress will be reported quarterly to the executive team.

Strategic Options Considered

The steering group weighed three ways of serving families before choosing a model. The first was to expand the existing memory clinic by adding physician visits, which would shorten waits for diagnosis but leave families without support between appointments. The second was to contract with a community agency for caregiver education, which would cost little but give the health system no role in coordinating medical care. The third, which the group chose, was a program in which registered nurses and nurse practitioners act as dementia care managers, backed by a geriatrician, a social worker and a pharmacist, and reach families by phone, video and home visits.

The chosen option fits the mission most closely because it follows families over time and at home, and it matches the model that trials have tested. It also builds on strengths the health system already has: a home health agency, a nurse advice line and an electronic record shared by its clinics. Its main weakness is that it requires new staff before any savings appear, which is why the financial plan receives close attention in later stages.

Conclusion

Strategic planning connects a nursing initiative to the organization's mission and to evidence of need and effectiveness. For a nurse-led dementia care program, rising prevalence and evidence that coordinated care improves quality of life, caregiver well-being and community living make a strong case. A service line mission and vision derived from the health system's own, a structured planning process with family caregivers at the table, and measurable three-year goals provide the foundation for the environmental analysis, budgets and financial plan that follow.

References

Jennings, L. A., Laffan, A. M., Schlissel, A. C., Colligan, E., Tan, Z., Wenger, N. S., & Reuben, D. B. (2019). Health care utilization and cost outcomes of a comprehensive dementia care program for Medicare beneficiaries. JAMA Internal Medicine, 179(2), 161-166. https://doi.org/10.1001/jamainternmed.2018.5579

Possin, K. L., Merrilees, J. J., Dulaney, S., Bonasera, S. J., Chiong, W., Lee, K., Hooper, S. M., Allen, I. E., Braley, T., Bernstein, A., Rosa, T. D., Harrison, K., Begert-Hellings, H., Kornak, J., Kahn, J. G., Naasan, G., Lanata, S., Clark, A. M., Chodos, A., . . . Miller, B. L. (2019). Effect of collaborative dementia care via telephone and internet on quality of life, caregiver well-being, and health care use: The Care Ecosystem randomized clinical trial. JAMA Internal Medicine, 179(12), 1658-1667. https://doi.org/10.1001/jamainternmed.2019.4101

Rajan, K. B., Weuve, J., Barnes, L. L., McAninch, E. A., Wilson, R. S., & Evans, D. A. (2021). Population estimate of people with clinical Alzheimer's disease and mild cognitive impairment in the United States (2020-2060). Alzheimer's & Dementia, 17(12), 1966-1975. https://doi.org/10.1002/alz.12362