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Checking your alignment

October 5, 2011
by Rick Wessling, AIA
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How do you make sure your business plan matches up with your master plan?
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It seems obvious. Your organization's business plan-the strategy that guides your business, defines the services you provide, and formulates your revenue and profit expectations-must be in sync with your master plan-the plan that guides your buildings, renovations, and expansions.  

As simple as that seems, many health providers fail to consider that the connection between the two is vital. Aligning your buildings with your business can spell success; having a disconnect between them can be disastrous.

Let's suppose your facility is completely primary care rooms, the standard for 28-day programs. You've projected that new business and growth will come from extended care programs. Will your facility be able to grow with your market?

Are new extended care rooms called for or can your existing rooms be altered to accommodate the change to your business model? That is one scenario that could be contemplated; many others exist. So how do you go about aligning your business with your buildings?

Mission sets the stage

Your organization, whether nonprofit or for profit, is built around a mission. That mission should be clear, concise, and focused. The mission statement should embody your core competencies, those services that are at the center of your activities, the “sweet spot” so to say.

If your primary service is to treat adults in a residential setting and the bulk of your business is treating older adults, this is likely your sweet spot. Starting an outpatient youth treatment program would be significantly outside of this sweet spot and likely would be much more difficult to execute successfully.

At the same time, your mission should be forward thinking, anticipating the developments and changes that are happening in behavioral health. Those changes may be due to new treatment strategies or mental health law for example. Without question, the recent legislation on health care insurance will impact how you serve clients and how your revenue is generated.

Your core competencies will naturally be suggestive of other services that may currently be marginal activities for you. Will you need to augment your services and design or development new expertise and incorporate new programs?

Business plan grows from mission

Your business plan (yes, nonprofits need a business plan too) defines services you will provide, revenue they will generate, and their associated costs. What professionals and staff will you require? Your business plan should spell that out in precise fashion. Capital expenses, operating expenses, costs of regulatory compliance? These all must be detailed in your business plan.

A business plan looks ahead, too. A three- to five-year projection of your plan isn't unreasonable and, in fact, will be expected if you are planning to obtain financing or are part of the budgeting process for a larger organization.

One way to think of a business plan is that it's a mission statement with dollars attached to it. That's a bit simplistic, but the connection between mission and business is critical; if they diverge too far from each other, you'll experience problems.

Refining your master plan

Your business plan ultimately must be translated into buildings and facilities. Whether you're in an existing facility or contemplating new construction, this is step in which you should begin talking to an architect. 

The architect you work with should be experienced in healthcare design or, ideally, behavioral health facilities. Most architects are reasonably competent and can design your building, but those who are experienced in the healthcare field can take you through a critical transition: making buildings that fulfill your business plan.

Buildings are not static; they must change and grow over time to continue to serve the activities that occur within them. A master plan lays out the way your buildings will grow, be renovated, and accommodate new uses over time. The architect you work with must be able to understand your long range plans and develop a master plan that successfully blends business plan, budget, and building design.

The planning and renovation of the Ignatia intake unit at Hazelden Foundation in Minnesota illustrates how an architect can translate a strategic plan into built reality. Hazelden's business plan, their position as a world class provider and the need to be responsive to changing and variable patient acuity established the framework for the nature and tone of the renovation.

A sophisticated entry court, day-lit spaces, and quality finishes in the lobby subtly portray Hazelden as a world-class facility. The number of patient rooms in the renovated unit was calculated to serve the business plan's goal for the overall number of beds on campus which in turn led to an increased total number of beds in the unit. The design of patient rooms takes into account the increased need for observation with some patients and even the ability to address the needs of bariatric patients.

Understanding the nature of Hazelden's mission and its specific business goals raised the planning effort from merely building the correct number of spaces to creating spaces that are in direct response to the business goals.


The alignment of your organization's business plan with your master plan is a key part of the long term success and growth of your business. While that connection seems intuitive, many healthcare providers fail to understand it. Engaging an architect who understands mental and behavioral health at the onset of master planning can insure that your buildings are aligned with your strategic business plan to fulfill your mission and ultimately serve your clients.

Rick Wessling is an architect and principal at TSP Architects, Sioux Falls, S.D.