Simulation is an Instrument of Strategy

Simulation can be used to direct policy which sits at the top of the organizational pyramid.

In 2012 I completed my Joint Professional Military Education certification from the United States Naval War College. One of the most valuable concepts I learned about was the hierarchy of Strategic, Tactical, and Operational Levels of Warfare. 

When thinking about all the activity that goes on inside my hospital, I find it helpful to view an organization as three-tiered. This model may be an oversimplification, but I find it is possible to assign organizational activities to one of three categories. Why assign categories? Because doing so can help to ensure that the right individuals can align their talents with the right tasks.

At the bottom of the pyramid, the largest portion is the Operational level. These activities are largely autonomous. Much like the autonomic functions of the human body, such as breathing, the beating of the heart, and digestion, they occur without the direction of the higher levels of consciousness. Within an organization such as a medical center, day to day activities such as purchasing and supplies, patient flow, processing of labs, and the preparation and delivery of food fall under this category.

Above the Operational level lies the Tactical level. These activities translate the stated Strategic aims of the organization into the Operational domain. Tactics, therefore, involves problem-solving and how to overcome obstacles that lie in the way of implementing Strategic goals.

The highest level of organizational activity is Strategic. Leadership is responsible for charting the direction and culture of organizations, and they can do so by generating Policy. The purpose of Policy is to cultivate positive behaviors and extinguish negative ones.

Simulation is unique in that it is a tool that can be used to investigate and provide insights into behaviors. Hence, simulation's utility is as an Instrument of Policy.

Planning, Policy, and Execution

Organizations often function in "reaction" mode, hastily creating plans only as situations arise. This kind of approach to change can be emotionally exhausting and can lead to poor decision making, due to time pressures and an inherent lack of information.

Alternatively, hospitals and other organizations can follow a more proactive approach to change management. Organizations can use the three step process of Planning, Policy, and Execution to craft responses to stressful situations.

In the Planning Stage, leadership can identify perceived future challenges with the help of colleagues and employees. A task force can then develop prescribed responses to dealing with the problems. Studying the experiences and lessons learned from other institutions is a good place to start. However, it is unwise to implement someone else's Policy without testing it first. Simulation can be extremely useful in this step to determine the feasibility of the plan and to determine what gaps may exist.

After the problem has been well defined and solutions tested, then Policy can be crafted to direct the desired response. In the Execution Stage, leadership can implement Policy and then continue to monitor its effect on the organization.

The three step process is iterative. Data and information are collected during the Execution phase to determine the effectiveness of the Policy and to survey for gaps continually. A new cycle of Planning and Policy development may then be entered to fine tune the Execution. 

What business does Simulation have in Healthcare Leadership?

If Simulation is a tool of Strategic Management, then Leaders should be aware of how simulation can be used to implement policy using the three-step process outlined above. Furthermore, people who understand how Simulation can support Strategic aims are also in a unique position to help craft Policy. Hence, experts in Simulation are also experts in Leadership.

Organizational "Self-Awareness."

Part of a proactive approach to Change and Crisis Management is knowing exactly how an organization will react to a given situation. For instance, if a mass casualty incident stresses a medical center, it is tough to predict how the Center, its resources, and its staff will respond in such a rare event. This missing knowledge represents a lack of Institutional or Organizational Self-Awareness. Alternatively, an institution can use Simulation to "stress-test" itself, and gain valuable insight into how equipment and personnel can perform during a crisis.

© Edwin T. Ozawa 2017