ACC Goals and Strategy
Introduction
In 1997, the College’s Board of Trustees (BOT) approved a five year strategic plan. While the Board recognized that this plan would expire at the end of 2002, it wisely chose not to update it through an extensive planning process. This decision was made recognizing that the College has continued to refine its planning process over the past few years. Over the next five years, the College’s planning activities became more dynamic and responsive to the organization’s needs with annual priority setting and the creation of an environmental scanning process. Furthermore, it also became much better linked to the College’s budget cycle with the change in the fiscal year, and better monitored with greater resource flexibility with the establishment of measures, targets, and quarterly reporting.
In addition to these improvements in the College’s planning process, strategic planning documents and/or recommendations have been presented by several major task forces including the following: (1) Environmental Scanning Work Group (2004-2006); (2) Cardiovascular Care Team (2003); (3) Task Force on Clinical Science and Quality of Care (2002); (4) International Strategy Task Force (2002); (5) Property Task Force (2002); (6) Task Force for the 21st Century (1999); (7) Task Force for Strategic Directions on CME (1998-2000); and (8) Task Force to Review the Annual Scientific Session (1997-1998).
Since the College’s original five-year plan expired at the end of 2002, it was appropriate that the Executive Committee, which serves as the College’s planning committee, should step back from its day-to-day activities and comprehensively review the College’s strategy. This review has been conducted each year under the leadership of the President-Elect who will continue to be responsible for overseeing the College’s planning activities. The resulting ACC Strategic Framework is the result of the integration of work that has been done to date and sets the course for the next three years in a format that can be communicated to members, staff and others. The strategic framework is also presented in a format that makes it easy for leadership to modify the plan, as needed, over the course of the year.
In 2004, the College chose to enhance its measurement and strategic management processes through the adoption of the balanced scorecard. The balanced scorecard is a management system (not only a measurement system) that enables organizations to clarify their vision and strategy and translate them into action. It provides feedback around both the internal business processes and external outcomes in order to continuously improve strategic performance and results. It was a new approach to strategic management that was developed in the early 1990's by Drs. Robert Kaplan (Harvard Business School) and David Norton.
Over the past two years, the College has worked with the balanced scorecard format to adapt and incorporate it into the College’s overall ACC Strategic Framework as illustrated in Exhibit 1. As part of the adaptation process, the College has updated its goals and objectives and created a new strategy map that depicts these goals and objectives according to the four perspectives of the balanced scorecard format.
The balanced scorecard suggests that organizations look at themselves from four perspectives, and to develop metrics, collect data and analyze this information relative to each of these perspectives so as to keep “in balance.” The four perspectives adopted by ACC include the following: (1) financial; (2) people and culture; (3) internal processes; and (4) members and stakeholders. Exhibit 2 presents the ACC Strategy Map with the revised goals and objectives organized according to these perspectives that was approved by the BOT in December 2005.
With the strategy map in place, significant work has occurred to develop measures and annual targets linked to the objectives. Furthermore, the College’s operational plan has been organized according to this format.
As the College plans and assesses its activities going forward, it will use several inputs to assist with strategy development: (1) assessment of performance according to annual targets; (2) analysis of initiatives by objective to see if they are in balance (e.g., do some objectives lack initiatives and why? Are the current initiatives making progress toward their primary objectives?); and (3) analysis of environmental scanning information to determine if there are new initiatives and/or new objectives to consider for the College’s planning.
Overview of ACC Strategic Framework 2006-2008
Exhibit 1, an overview of the ACC Strategic Framework, summarizes the relationship among the key components of the College’s strategy—mission, values, goals, objectives, initiatives and measures. Note that each year, the three-year ACC Strategic Framework can be updated on a rolling basis. Furthermore, each year, a set of annual initiatives by mission area is created to guide budget development and to serve as a tactical guide for implementation of the plan. Exhibit 2, the ACC Strategy Map, outlines the goals and objectives that are supported by annual initiatives. Leadership has the opportunity to review the annual plan’s status, and fine tune its direction as needed, by conducting quarterly reviews of annual initiatives and measures.
ACC Strategy Map
Dramatic changes in the health care environment, particularly changes in technology, health care legislation, the geopolitical environment, professional education, increased accountability to payers and patients, pressures in practice, as well as continuing advances in cardiovascular science, continue to alter the needs of College members and the resources at the College’s disposal to meet those needs. The ACC Strategic Framework and ACC Strategy Map should position the College to remain a vibrant professional organization and to continue its mission to advocate for quality cardiovascular care.
ACC Mission
The mission of the American College of Cardiology is to advocate for quality cardiovascular care—through education, research promotion, development and application of standards and guidelines—and to influence health care policy.
ACC Core Values
- Professionalism: The interests of patients are primary.
- Knowledge: The College must promote growth, dissemination and application of knowledge about cardiovascular medicine.
- Value of the cardiovascular specialist: The cardiovascular profession makes a distinct contribution to medical care that should be recognized and enhanced.
- Integrity: Honesty, compliance with legal requirements, and ethical behavior are essential in all activities.
- Member driven: The College and its major activities must be led by active members and must promote volunteerism.
- Inclusiveness: The College involves a broad range of volunteers that reflects the composition of its membership.
ACC Goals, Objectives, and Key Measures 2004-2007
Goal #1: Turn CV Knowledge into Practice
Objectives:
- Help improve cv care and practice through products, programs and services that 1) incorporate the standards, measures, and best practices, and 2) are easy to use (e.g. internal coordination of efforts across functional areas, incorporation of feedback from users into new iterations of offerings, timely production).
- Measures: Quality Improvement (QI) Collaboratives; QI Tools, Kits and Change Packages created
- Foster disease prevention and increase understanding of the importance of prevention by providing information and tools to cardiologists, general practitioners and internists to improve cardiovascular health in the general population and equip practitioners with the information and informational tools needed to effectively address prevention of cardiovascular disease.
- Measures: Number of Educational Programs/Products; Number of Annual Scientific Session Sessions and Abstracts
- Communicate the latest advances. ACC’s educational products, programs and other vehicles will be innovative and responsive to member needs.
- Measures: JACC Impact Factor (lags one year); PERQ HCI Score; Annual Scientific Session and i2 Summit Abstracts Presented (for forward year, i.e. 2007 column for ACC.07); Annual Scientific Session and i2 Summit Late Breaking Clinical Trials Presented (for forward year, i.e. 2007 column for ACC.07); Average monthly page views on Cardiosource website; Electronic Updates Opened
- Create and develop responsive, innovative, and relevant educational opportunities.
- Measures: Program Satisfaction Assessment (scale of 7); Product Satisfaction Assessment (scale of 7); Annual Scientific Session Satisfaction/i2 Assessment
- Disseminate tools and best practices (products, services, and programs) for ready use by practitioners, patients, and policymakers. Develop products, programs and services that disseminate the tools and best practices (e.g. educational programs and products, Cardiosource, GAP, quality KITS, NCDR, MDI, quality alliances such as IHI, Physicians’ Consortium, NQF, CMS, JCAHO, etc.). Synthesize and disseminate the latest science so that it can be optimally used in practice by practitioners to deliver patient care and to respond to the needs of policymakers around payment and appropriateness decisions.
- Measures: Total NCDR CathPCI Participants; Total NCDR ICD Participants; Total NCDR Carotid Participants
- Develop clinical standards (e.g., development of practice guidelines, competency statements, data standards, performance measures, and appropriateness criteria), expert consensus documents where controversy exists or evidence is weak/nonexistent, recommendations for training requirements (COCATs) and clinical competency standards for credentialing, and internal process improvements to make more efficient updates to standards.
Measures: JACC submissions; Annual Scientific Session and i2 Summit Abstract Submissions (for forward year, i.e. 2007 column for ACC.07); Twice Annual Review/Update of Guidelines; Annual Scientific Session and i2 Summit Late Breaking Clinical Trials Submitted (for forward year, i.e. 2007 column for ACC.07)
- Identify the latest advances in CV science that need to be translated into standards and measures (e.g., environmental scanning, work of joint ACC/AHA task forces in choosing topics). This is the cornerstone of the College’s mission.
- Measures: Clinical Policy Documents Published
- Promote and uphold the highest professional standards in patient care and physician conduct. ACC will develop a professional code of conduct and associated programs to make the code as concrete and effective as possible. The College seeks to be a hallmark (best practices) organization in terms of ethical standards, transparency and good governance.
- Measures: Code of Ethics / Awareness
- Promote adequate workforce, training, and support for CV patient care. Advocate for policies and program changes to respond to workforce needs. Develop training, competency statements, and standards so that professionals have optimal skills for patient care. Advocate for infrastructure improvements that will make time available for CV professionals to focus on patient care.
- Measures: Training slots available and filled
Goal #2: Increase the Value of Membership
Objectives:
- Strengthen members’ ability to effectively lead, manage, and improve their practices. Help our members to manage their respective practices in order to facilitate the delivery of high quality cardiovascular care. ACC will do this by developing tools and offering educational programs that focus on practice leadership, management and operations.
- Deliver cost-effective products and services for all member segments. Members expect value for their annual membership dues and their investment of time and financial resources in other activities. The College is expected to deliver value for dues in cost-effective and efficient ways. In addition, members expect products and services that are a good value in terms of their time, their financial resources, delivery method/ media/ location, and the effectiveness of the products and services. Members expect valuable and effective advocacy on their behalf.
- Measures: Total educational reach (ACC members); Number of Outcome Based Educational Programs
- Add value to the FACC designation. Make sure that the FACC credential maintains its value to members, patients, public and policymakers. Activities of the College should continue to add value to the credential so that it is recognized and highly respected worldwide.
- Measures: Media Impressions (millions)
- Obtain a high-level of member involvement and satisfaction. To ensure members are happy with their affiliation with the College, ACC must strive to deliver value to members and achieve increasing member involvement and participation. This should translate into greater satisfaction and loyalty. This can be done through the Committee structure and on-going activities of the College by creating initiatives that increase member participation, by monitoring member satisfaction with their affiliation with the College, and responding to deliver greater satisfaction as appropriate.
- Measures: Total Number of Paid Permanent Physician Members; Member satisfaction Score; Percent of Physician Members Utilization of CME-Based Activities; Eligible Trainees that become FACC members; CCA Membership; Market share of Certified CV Specialists who are FACC members; Percent of Members on Committees and Task Forces (for forward year); Percentage of Chapter-Eligible Chapter Members
- Run programs and services in an effective and efficient manner. Ensure that all operational activities of the College are performing at the highest level with the appropriate level of resources. This includes continuous improvement efforts for all activities and ensuring that new activities are initially planned for properly.
- Collaborate effectively with other health related organizations (U.S. and non-U.S.) to achieve mutual goals. Foster a collaborative and teaming environment across subspecialties and with other health-oriented organizations. ACC can do this by identifying synergistic partnerships and seeking strategic alliances that promote a win-win arrangement.
- Measures: Collaboration effectiveness survey (milestones completed)
- Strengthen policy, political, and payor advocacy to support and promote the role and importance of CV specialists. Ensure that our members’ interests and the College’s mission are supported within the legislative arenas. ACC can do this by developing and executing effective advocacy campaigns that involve members and ensure their awareness of the issues. Physicians, patients, the public and policymakers all understand the role and importance of the cv specialist. As the population ages and the risk factors for CV disease grow while the supply of professionals is inadequate to meet the demand, the importance of the CV professional will be increasingly important.
- Measures: Advocacy Legislator/Regulator visits; PAC Contributions; State Legislative/Regulatory Impact
- Communicate effectively to ensure members recognize and appreciate the impact of the College’s efforts. Continually uncover and understand our members’ needs in order to develop services, meetings, programs, products and services that will meet these needs. Ensure that members know about what the College offers and how this translates to value for the members through effective communications.
- Measures: Communications Awareness (survey score); Member Satisfaction Score Relative to Communications Efforts
- Use environmental and market information to drive member value. The College will be a member and market-driven organization in which leadership/expert input and sound market research drive development of products and services that meet the needs of members and other customers.
- Measures: Market/Needs Assessment-based Products and Services
Goal #3: Innovation, People and Culture, and Financial
Objectives:
- Promote innovation and cv science leadership in all we do. The College should proactively seek to innovate operations, products, services, processes and procedures to better meet the needs of members and other recipients of its products and services, bring new ideas forward, be contemporary, and achieve operational efficiency. This is not limited to areas in distress; it also applies to areas performing well. Staff is encouraged to seek new ways of doing business and is rewarded for advancing improvements and growth through innovation. We also seek to be innovative in our approach to the dissemination of knowledge in CV science in order that the College is recognized as the leader in this field of expertise.
- Measures: Time to “Market”/Cycle Time
- Promote good governance and maintain a member-driven organization. Ensure growth in leadership/governance effectiveness by exposing leadership to training/experiences/people which enable it to better perform its roles (e.g. strategy training, current trends in board governance, leading membership organizations, etc.). Further the growth of market research and needs assessment, and use the data gathered to make decisions to determine members' (and others') needs with respect to the College's mission.
- Measures: Governance (milestones completed); Leadership Orientation Effectiveness (survey score); Leadership Orientation Attendance
- Develop a high performing, satisfied staff. To be successful, the College needs to have engaged, high performing staff whose performance is linked with the College’s strategic goals and objectives. Management will address staff satisfaction issues to maintain high morale and performance.
- Measures: Percentage of Approved Staff Capacity; Staff Retention Percentage; Employee Satisfaction Survey; Employee Performance Feedback
- Cultivate leadership among engaged members. Develop and execute a strategy that creates a pipeline that identifies and cultivates the next generation of College leadership. Strengthen and grow the current relationships between leadership/volunteers and staff. Identify and support high performing and engaged leaders/volunteers to guide the College toward meeting its mission. This can be done through a number of leadership development initiatives which clarify roles, identify new potential leaders early in their career, provide leadership mentoring, and encourage healthy member/staff relations.
- Measures: New to ACC/ACCF Committee Appointments; Chapter, State or Providence Committee Members; Percent of Governors’ Nominations of Members to Committee Positions (for forward year)
- Maximize sales revenues from current activities to assure strong financial status in order to achieve the College’s mission.
- Manage net assets proactively to ensure adequate reserve levels (compliance with Fiscal Policies) and allow for an appropriate level of Available Reserves to support new initiatives, business lines and ventures. Reserve policies should be conservative to maintain appropriate “rainy day” contingency funds and appropriate business plan development and approval processes will be in place for funding of initiatives that require the use of Donor Restricted Funds and/or Available Reserves. While generally Net Assets should be increasing, funding of major initiatives that deliver mission impact may, at times, require consumption of overall Net Assets. Formalization of the Treasurer and CFO role of managing the consolidated operations bottom line of the College. The College’s DVPs retain management of the operations bottom line of their own areas. The Treasurer/ CFO stewardship role includes ensuring global compliance with financial requirements and performance expectations, soliciting resolutions for performance improvement while holding others accountable for the performance of their areas.
- Measures: Total change in Net Assets; Surplus from Operations; Available Reserve Balance; Compliance Standard (milestones completed)
- Manage expenses versus budget proactively, and be vigilant in maintaining expenses in line with budget, or allow spending in excess of budget only when additional revenues offset such expenses and/ or immediate and critical mission impact must be achieved in the short term.
- Measures: Total Direct Expenses (excluding variable costs)
- Ensure a healthy mix of funding sources. Maintaining a diverse and healthy mix of revenue resources is critical to support the ongoing activities of the College and to support a healthy growth rate. Diversify revenues to reduce the College’s dependence on one or two primary sources (Industry and Member dues support).
- Measures: Member Dues Percentage of Total Operating Revenue; Industry Support Percentage of Total Operating Revenue
Glossary of Terms
Annual Initiatives—Tactics that the College uses each year to achieve its goals and objectives.
Annual Target—Specific number linked to measures to assess annual progress for achieving goals and objectives. Annual targets are submitted to leadership with annual budget for review and approval.
Goal—Summary statement of what the College wants to accomplish over the next three years. Number of College goals not to exceed four or five in total.
Measure—Metric used to assess the College’s progress towards achieving its long term goals and objectives.
New Initiatives—New activities proposed to the Board as part of its planning process. Once an initiative is approved it is incorporated with the overall list of annual initiatives.
Objectives—How the College will achieve its long-term goals. Each long-term goal has a set of three to seven objectives.
Operational Plan—Document that integrates annual activities, annual budget, and metrics associated with annual activities (e.g., number of programs, unit sales, number of registrations, etc.).
Sources of External Commercial Support
The College* accepts support from pharmaceutical and medical device/equipment companies to enable the College to carry out its mission to advocate for improved quality cardiovascular (“cv”) care, and to promote science, as well as cv workforce development, diversity, medical education, and lifelong learning. The College solicits and uses such commercial support consistent with the College’s Code of Ethics, conflicts of interest and disclosure policies as reflected in the accompanying ACCF Position Statement for Industry Relations and the Consensus Conference Report on Professionalism and Ethics.
These policies require a strict segregation between the source of any commercial support and its use by the College and preclude any influence by the commercial supporter over such use. Specifically, in connection with all support received by the College, there are strict organizational firewalls between the development and fundraising related to commercial support and the College’s programmatic activities and personnel. The College adheres to internal policies, as well as external ones, that prohibit companies providing support from exercising any influence or control over programmatic content, speaker/faculty selection, program format, planning, partnering arrangements, program evaluation methods, and related matters.
Most of the College’s commercial support from pharmaceutical and medical device/equipment companies is solicited for specific new or ongoing programs and initiatives. For example, the College will solicit support for an educational program on congenital heart disease or support for an acute coronary syndrome disease registry. Commercial support is dedicated or directed exclusively to an objective; no supporter otherwise restricts, guides, or influences how the funds are used by the College in support of the particular program and/or initiative. Moreover, commercial supporters neither create programming or initiatives managed or operated by the College nor participate in the implementation or operation of any such College activities. Unlike an unrestricted educational or charitable grant, which can be used for any purpose by the College, dedicated or directed funds may not be used for unrelated programs or initiatives, e.g., support provided specifically for an acute coronary registry cannot be used to support an educational program related to cardiovascular genomics research. These use parameters are generally set forth in the funding document or letter of agreement with the supporter but do not dictate or direct content or editorial development in any way and could not be construed as an exercise of influence over the process or related program by the supporter.
Similarly, for non-programmatic support, such as advertising, exhibit fees, sponsorship/promotional funding, awards, and bulk sales, funding is designated or directed or restricted to a specific activity or event.
In addition, the College adheres to external rules and guidance related to commercial support including: Internal Revenue Service regulations governing organizations classified as federally tax exempt under sections 501(c)(3) and 501(c)(6) of the Internal Revenue Code; Accreditation Council for Continuing Medical Education (ACCME) Standards for Commercial Support; Advanced Medical Technology Association (AdvaMed) Code of Ethics for Interactions with Health Care Professionals;
American Medical Association Opinion 8.061—Gifts to Physicians from Industry;
Office of Inspector General (OIG)—Compliance Program Guidance for Pharmaceutical Manufacturers; and Pharmaceutical Research and Manufacturers of America (PhRMA)— Code on Interaction with Healthcare Professionals.
American College of Cardiology
* The term College refers to both the American College of Cardiology Foundation (“ACCF”), a nonprofit 501(c)(3) organization, and the American College of Cardiology (“ACC”), a nonprofit 501(c)(6) professional medical society. All educational grants, charitable contributions, and awards support ACCF. Both ACCF and ACC receive support from sponsorship, promotional grants, and advertising. ACC receives all of the support from exhibits and exposition space sales.
ACC Industry Forum Chronicle
Industry Support Revenue Sources
2007 Chart of Revenue Sources |
