• Raed Dweik, Peter Rea, and James K Stoller.
• Respiratory Institute, Cleveland Clinic, Baldwin Wallace University, Berea, OH.
• Chest. 2021 Sep 1; 160 (3): 1035-1041.

AbstractHaving a strategic plan is important to reach organizational goals. Equally important is knowing how to develop and execute that plan. Also, such plans evolve and are executed in the context of the organization's culture, which is another critical success element. Using a garden metaphor, the arrangement of the plants in the garden is like the strategy. With a good strategy, the arrangement of the plants will be appealing. But the soil in the garden is the organizational culture. If the soil is fouled, no plants will grow, regardless of how appealing the garden plan. This "How We Do It" paper addresses the issue of developing and executing a strategy and then, in a companion piece, the related process of envisioning and cultivating an organizational culture. The strategic planning discussion invokes a "real-win-worth" paradigm to address the real-world case of assuring uniform, best-in-class ICU outcomes across multiple ICUs in a large academic medical center system.Copyright © 2021 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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