What role does your department play in your organization? Do you ever see it being any different? Are there opportunities to do more? If so, do you know how to bring those opportunities to fruition?

One of the biggest differences between managing and leading is putting into practice the concept of “visioning,” creating a mental picture of where you want your department to be with a very high level of detail, then selling that vision to the rest of your team and your organization. In Stephen Covey's The Seven Habits of Highly Effective People, Habit 2: Begin With the End in Mind, is specifically about this concept. In Covey's words, “Effective people realize that things are created mentally before they are created physically. They write mission (or purpose) statements and use them as a frame of reference for making future decisions. They clarify values and set priorities before selecting goals and going about their work.”

In your professional environment, it is so important to step back and think about where you want to be next year, the year after that, five years from now. Maintaining the status quo may keep you employed for now, but it's not necessarily what provides the greatest value to your organization. I guarantee it's nowhere near as exhilarating as thinking about what is possible—with no limitations, creating a blueprint or a road map to get you there, then watching your vision become reality. You always have an opportunity to leave your mark. So where do you start?

First, it is important to consider your department and organization's mission, values, and business objectives to ensure that whatever is in your plan aligns with them. Write them down and keep them in front of you. Then as you develop your plan, these become your compass. Also, think about what motivates you. Remember, you are going to be faced with selling this plan to others and that is going to be very difficult if you aren't excited about it yourself.

Next, assess where you are today. One of the best tools I've used for this is known as a “SWOT” analysis, which outlines your strengths, weaknesses, opportunities, and threats. Be brutally honest in doing this assessment because it enables you to identify and address areas that need attention. You don't want to build your house on a weak foundation. Your existing strengths are part of your solid foundation and will be what you want to take the greatest advantage of and expand on. Your weaknesses and threats will help identify the things you need to work on in the first year or two and potentially turn them into strengths. Threats can also become additional motivators, understanding that your business plan will help you minimize or altogether eliminate them. Examples of opportunities include service enhancement, service expansion, cost savings, or cost avoidance. The ones tied to cost savings and avoidances will really help you sell the plan to your leadership. Once you've completed this analysis, take some time to focus on your weaknesses. What is your plan to eliminate them? Be very specific and if possible, include timelines. It never hurts to add a degree of accountability to your plan.

Now, you are ready to create your vision. Like meditation, it is important to do this alone in a place that is quiet, with no interruptions. Think of it like planning to build a house. Picture it in your mind. Will it be a two-story, split-level, or a ranch? How many bedrooms and bathrooms will it have? What kind of siding and roofing will be on it? What kind of windows will you use? What kind of fixtures do you want? What about wall and window finishes? Carpet, laminate, or hardwood flooring? Be very specific, down to the smallest detail. Now that you have the vision, write it down. Describe on paper what you saw. Are you getting excited yet?

Now, a few key strategies must be developed. In the house-building analogy you would need to find a lender, get approval for a loan, select a builder, etc. In your business plan, you'll want to outline the things that will need to happen to make your vision a reality. What services do you plan to develop? Will you need additional staff? Is there specific software or interfaces you will need? Like you do in your annual goals, state what these are in detail and make them measurable.

Finally, prioritize your vision and strategies chronologically. List the things that are foundational and will have to happen before you are able to develop the rest of your plan. Those things should be in year one and year two. Then you can build on those to finish out your five-year plan. Once your plan is completed, you can begin selling it to your staff and leadership. Help them see what you see and you will start getting them engaged from the very beginning.

This article details the plan that I developed in 2001. All but one of the items on the plan had been completed by the end of the five years, culminating in a reorganization of our department into a zone-service model. We decided not to complete the last item (endoscope repair) because we identified a more economical way to provide that service.

The healthcare environment is constantly changing, so it is important to review your plan on an annual basis. New opportunities may have arisen or something may have occurred that made parts of your plan less feasible or desirable. Use your plan to help develop your goals every year so you stay on target. My leadership team and I have now made this a regular part of our strategic planning and goals process. They and their teams each own a piece of the plan that is written into their annual goals.

Renowned visionary and author Peter Nivio Zarlenga stated, “To come to be you must have a vision of Being, a Dream, a Purpose, a Principle. You will become what your vision is.” Take some time to create your vision, decide what your future will be, and make it a reality.

Strategic Plan for Aurora Clinical Engineering

This document sets out a strategic plan for Aurora Clinical Engineering. It reviews strengths, weaknesses, threats, and opportunities; presents a series of statements relating to Aurora Clinical Engineering's vision, mission, values, and objectives; and sets out its proposed strategies and goals.


The Aurora Clinical Engineering manager's vision of Aurora Clinical Engineering in five years is:

Aurora Clinical Engineering (ACE) will have expanded its staffing and expertise to provide 90% to 95% of support for all of Aurora's clinical applications and systems. It will have depot services for those specialized or low-end modalities that have been identified to be best serviced in that manner. ACE will have developed non-degreed clinical engineering aide or assistant positions to cost-effectively handle servicing the less technical, low-end devices. ACE will be able to easily benchmark, monitor, and report its cost effectiveness to senior administration. ACE will have developed Aurora's Asset Management System to the point where Clinical Management, Site Administration, Accounting, and Finance will have cost of ownership, depreciation, and service history data readily available to assist in budgeting and equipment replacement decisions.

Mission Statement

The central purpose of Aurora Clinical Engineering is defined as:

Aurora Clinical Engineering provides Engineering, Regulatory Compliance, Safety, Technical and Clinical Consulting, Asset Management, and Maintenance Management Services. We serve those who provide care to all Aurora Health Care patients by supplying them with the expertise to manage their technology safely, affordably, and effectively. We create and implement innovative, customer focused, high-quality solutions to ensure the accuracy, reliability, and safety of all patient care technology in a timely and cost-effective manner.


The values governing Aurora Clinical Engineering's development will include the following:

  • Accountability, teamwork, and respect

  • Setting the standard for service

  • Continually improving our quality

  • Controlling our costs

  • Power of diversity

Business Objectives

Long-term business objectives of Aurora Clinical Engineering are summarized as:

  • To expand and in-source services and build expertise to the point of virtual self-reliance

  • To become a highly visible, efficient, and cost effective entity of Aurora Health Care

Key Strategies

Aurora Clinical Engineering will pursue the following key strategies:

  1. Develop in-house support for high-end modalities (computed tomography (CT), magnetic resonance (MR), nuclear medicine) to eliminate costly outside services.

  2. Complete development of in-house support for anesthesia, laser, sterilizer, imaging, and diagnostic ultrasound equipment in all regions.

  3. Develop aide or assistant positions and work to push high-tech services to more experienced techs, while migrating low-end, low-tech services to non-degreed positions.

  4. Complete standardization of services, methods, policies, and procedures while maintaining flexibility to meet the needs of all customers.

  5. Complete development and implementation of Asset Management System. Work with Aurora Corporate Information Systems (IS) and St. Croix Systems to interface front end WOSYST Maintenance Management System to capital acquisition, accounting, accounts payable, finance, and purchasing systems.

  6. Develop IS applications expertise to provide support to any device or application that interfaces with clinical equipment.

  7. Expand clinical engineering website features to provide greater value to customers/staff.

  8. Complete development of lab services.

  9. Complete development of depot services.

  10. Develop parts specialist position.

  11. Complete development and staffing for support to the Visiting Nurses Association (VNA).

  12. Complete pilot program for in-house endoscopy service.

Year 1
  • Work with St. Croix Systems to consolidate clinical engineering databases onto one server.

  • Work with Corporate IS to interface WOSYST Maintenance Management System to AFE (Authorization for Expenditure), service contract and lease database, and other corporate systems to accommodate reporting of assets and costs.

  • Develop and standardize policies and procedures for all clinical engineering processes that feed data into WOSYST to ensure continued integrity of database.

  • Complete IS training in A+ Networking and Aurora standard operating systems to facilitate support of Clinical IS applications.

  • Begin inclusion of clinical engineering staff in training for specific clinical IS applications.

  • Complete training and pilot service programs for ACL (Aurora Consolidated Labs). Document successes and savings and present to ACL Administration and Finance.

  • Expand Sterilizer service in central and north regions. Document successes and savings and present to North and Central Region Administration and Finance.

Year 2
  • Evaluate effectiveness and abilities of Asset Management I. Identify and develop components of Asset Management System II.

  • Complete standardization of services, methods, policies, and procedures while maintaining flexibility to meet the needs of all customers.

  • Complete transition of support for Clinical IS applications.

  • Develop Clinical engineering aide or assistant positions and work to push high-tech services to more experienced technicians while migrating low-tech services to non-degreed positions.

Year 3
  • Develop in-house support for high-end modalities (CT, MR, Nuclear Medicine).

  • Identify areas best suited for depot repair services and develop those depot services.

  • Complete development of lab services.

Year 4
  • Expand support for high-end modalities.

  • Develop parts specialist position.

  • Expand anesthesia and laser services in all regions.

  • Complete development of depot services.

Year 5
  • Complete pilot program for in-house endoscopy service.

Author notes

Alan Gresch is director, corporate clinical engineering at Aurora Health Care. Email: alan.gresch@aurora.org