In 1994, The American Association of Neurological Surgeons (AANS) embarked upon a critical process to update its long-range strategic direction. The Strategic Planning Committee of the Long-Range Planning Committee, then under the direction of Sidney Tolchin, MD, was charged with accomplishing this task. I am pleased to report that this process has been completed and a new Strategic Long-Range Plan has been approved by the AANS Board of Directors.
This project consisted of two major phases. Phase One involved a review of existing information databases and solicitation of members’ feedback concerning current and future assumptions about neurosurgical practice and the AANS. Phase Two of the planning process encompassed actual development of the strategic plan. It included three, two-day planning sessions with members of the Strategic Planning Committee and staff. In addition, a two-day, on site “situation scan” at the National Office was made to review the Association’s infrastructure and overall financial strength and to make a strategic assessment of the Association’s major programs, services, meetings, products, publications, etc.
Through this process the Strategic Planning Committee developed a long-range vision that recommends where the AANS should be in the year 2000. The vision touches upon the attributes, conditions and characteristics the Association needs to attain in order to be successful. From that vision were identified four long-range goal statements that form the core of the Strategic Plan.
It is important to note that at all times during the planning process a purposeful effort was made to concentrate on responding to the highest organizational priorities, keeping in mind that existing AANS resources must be used to maximum advantage. Strategies and check points were then established for accomplishing each goal. Finally, a series of recommendations were developed for infrastructure changes that must be made if the plan is to be successfully implemented.
The Strategic Long-Range Plan, the work product of a year-long effort, was presented to the Board of Directors on November 17, 1996 for action. The plan was approved unanimously. Now, the hard work of implementing the goals and objectives begins.
Following is a summary of the key elements of the plan, some highlights of the situation scan report, and my priority recommendations for actions to be taken during the first year of this five-year plan. I hope that you will familiarize yourself with this information; it represents the future of the AANS.
We will enclose a detailed copy of the Strategic Long-Range Plan in the Spring 1996 issue of the AANS Bulletin. In the meantime, if you have any questions about the Plan, please feel free to contact me through the National Office.
Situation Scan
An AANS Financial Analysis, Strategic Program Assessment and Operational Review were conducted on February 13 and 15, 1995 at the National Office in Park Ridge, Illinois. Department Heads, two volunteers from the Strategic Planning Committee and an outside consultant participated in the analysis. The objective of the Situation Scan was to identify any impediments in the Association’s internal infrastructure that could adversely impact the implementation of the proposed strategic direction as defined in the strategic plan — to better align the infrastructure with the new strategic plan. The Scan included a financial analysis (both income and expenses) of major programs and services, as well as an operational assessment. Some key factors identified that could impact the AANS in the future include:
Situation: Current projections indicate that future revenue will not keep up with projected expense increases without new, significant revenue stimulation and growth. Membership is projected to grow modestly over the next few years. Current revenue sources will be under pressure due to changes in neurosurgical practice, the impact of managed care, and increased competition from other associations, publications, and outside providers of educational programming.
Membership dues currently comprise 14% of the Association’s revenue stream (the median percentage of income from dues in similar medical organizations is 47.3%). The Journal of Neurosurgery provides approximately 22% of AANS revenues, while brings in 27% of all gross. Professional Development Programs represent 6.6% of AANS net income, and publication sales and Bulletin advertising account for 8.7% of annual revenues. While the AANS has experienced a positive operating net income in recent years, the long-term outlook will be more challenging.
Action Required: The AANS must develop strategies for increasing financial resources, including identifying sources of diversified, non-dues revenue to meet future needs. The AANS should identify additional opportunities in continuing medical education programs to increase the Association’s net revenue stream (i.e., exploring new formats through use of technology, develop new programs and topics that quickly address emerging issues in health care that impact members). The Association should explore alternative publication formats such as CD-ROM and on-line databases.
As the AANS grows in function and complexity, there will be a need to update the overall use of technology in managing the organization. In addition, professional, highly-skilled core staff with increased technology application, marketing skills and cross-functional teams will be required. Specific high-level skills and expertise will be acquired through outside contracted services.
AANS has 34 programs, services, tasks and volunteer work structures that should be reviewed after the development of the new strategic plan to ensure their relevancy and linkage to the new strategic direction.
There is a need to develop an overall, integrated business operational plan that both reaffirms the current markets that the AANS plans to continue operating in as well as identifies new, future markets that the AANS intends to develop. The Association should also develop individual business plans for each major new and existing programs, services, products, publications and meetings.
The Association must also develop a budgeting system with the goal of a 4-5% retained earnings at the end of each operational year in order to build adequate reserves. This will require a much harder look at current and future activities and programs to insure that they significantly support the Association’s strategic direction.
The Situation Scan was quite detailed and space constraints prevent me from providing further detail here. Rest assured that the full-range of AANS activities received a rather vigorous review.
Mission Statement
The mission statement defines the nature of the Association’s role and contribution in the achievement of its greater vision. The mission indicates why our Association exists, who it exists for and what it does. The mission is a statement of purpose. Following is the AANS mission statement:
“The American Association of Neurological Surgeons is dedicated to advancing the specialty of neurological surgery in order to provide the highest quality of neurosurgical care to the public.”
Long-Range Goals
Common themes from the planning group’s individual visions were developed into four-long range goal statements that form the core of the Strategic Plan. These goals are outcome oriented, meaning that they do not describe what the AANS will do, but rather are statements of how neurosurgery will be different because of the AANS. The following represents the AANS’ four long-range goals for the next five years. They encompass the Association’s vision and determine the direction the AANS will pursue. The achievement of each of these goals will move the Association toward the realization of that vision. They are not listed in any order of priority. All of the goals must be accomplished if the AANS is to fully achieve its vision.
- Goal A: Neurosurgeons will be recognized as the primary providers of quality care to patients with disorders that fall within the scope of neurosurgical practice.
- Goal B: AANS will be members’ principal resource for professional and practice information, education and interaction.
- Goal C: Clinical and basic neuroscience research will be expanded.
- Goal D: AANS will be acknowledged as the spokes-organization for the specialty of neurological surgery.
Each of these goals will be imple-mented through a variety of strategies that define how the AANS will organize, focus and expend its resources and actions to maximize its effectiveness and efficiency in achieving the goals.
Check points, which are measurable milestones for the Board of Directors to use in determining progress, were set for each goal. These check points indicate whether or not the Association is making any progress towards its goals as it works its strategies. Check points measure goal achievement, not strategy achievement.
As part of the process, a careful review of the AANS infrastructure was made to determine any changes that will be required to better align operations with the strategic plan. A key recommendation of our outside planning consultant was his suggestion that we tie our annual budgeting process directly to implementation of the strategic plan. That recommendation was taken closely to heart by both the Finance Committee and the Board of Directors in drafting the 1996 budget.
Plan Implementation-Back to Basics
In reviewing the situation scan report, I was impressed with the variety and number of activities the AANS is involved with — more than 34 different programs by my count. Supporting this ambitious agenda keeps our National Office very busy indeed. In fact, while analyzing the incoming telephone calls received in a single week this past Fall (September 14-22, 1995), we found that more than 2,100 inquiries were logged! The average number of calls handled per day was 437; on an hourly basis, 55 calls were received.
To some extent we have become victims of our own success; the more we do, the more we want. However, a wise friend who worked for many years in the corporate arena counseled me that his company was successful because he kept in mind at all times those activities they were the best at and refused to become involved in programs that were outside their area of expertise. They focused on the basics and prospered as a result.
As an organization, the AANS has taken on some very ambitious projects. Consequently, I have chosen three recommendations from the Strategic Long-Range Plan for focused emphasis during my Presidential year-April 1996 through April 1997. Overall, we will concentrate on stabilizing the relationship between AANS revenues and expenditures.
There is an assumption that other specific accomplishments will be achieved, of course, but we must ensure that our Association is solidly positioned to succeed in the years ahead. Therefore, the three objectives I have set for the year are:
Institute sunset mechanisms for AANS programs – Unless we can demonstrate a clearly derived benefit to our membership for each of our AANS committees, projects and products, a process should be in place to identify any lack of strategic benefit and allow them to die a dignified and natural death. That process should include what our Strategic Plan suggests: a so-called Business Plan developed for each of these functional entities. These plans will give us objective criteria which can aid us in judging the worthwhileness of these functions.
The next objective reflects the need to build a core group of leaders who will guide the AANS into the future:
Better integrate and mentor young neurosurgeons into meaningful volunteer positions – If significant and lasting changes are to be achieved, our younger members must play a stronger role in developing the goals and strategies to meet these challenges. We will look to the Young Neurosurgeons Committee to play a primary role in formulating a plan for progress in this regard.
The third objective I have selected has to do with our link up to the Internet:
Develop and utilize NEUROSURGERY://ON-CALL® – This project represents a tremendous investment in time and financial resources on behalf of our constituents. We must be able to demonstrate a functioning product of practical benefit to our members within a reasonable time frame.
Final Thoughts
In conclusion, I wish to thank the following individuals for their work on this important project:
Their collective wisdom and energy contributed greatly to the development of this Strategic Long-Range Plan.