Building clinic programs that drive a department of surgery's strategic plan.

Effectively navigating and executing change within a medical organization, particularly a large health care enterprise, such as a department of surgery within a major hospital system, can present a major challenge to both departmental and institutional leadership. In developing projects designed to bring about desired change, it is essential to be mindful of the strategic plan of the institution and department and to design change initiatives to create models that align with and serve to enhance both the institutional and departmental missions. Doing so requires careful definition of the mission and vision of the department and the key stakeholders within the institution; defining both short- and long-term goals; critical analysis of resources, needs, strengths, and weaknesses; and maintaining a clear understanding of the goals, expectations, and specific measures of success. A careful project design process should then follow before implementation. In the following paragraphs, some of the key considerations and challenges of this process are explored in the particular context of developing clinics and clinical services in such a manner that the departmental and institutional missions are well-supported and advanced.