Understanding the context for long-range planning in hospitals.

Using their own experience in an urban hospital of national reputation, the authors describe and illustrate some of the background issues for long-range planning decisions pointing out that managers must steer a clear course among a number of internal and external pressures. The expectations of trustees, philanthropists, reimbursing agencies, the university, medical staff, patients and the surrounding community may sometimes be at odds. Managers can use long-range planning as a tool to ease the hospital into changing modes of operation and to achieve, over a time, a smoother interaction among their several constituencies.