A new health system CEO brought energy and an expansive vision of the health system as a key contributor to a vibrant community of health and well-being. She and her leadership team were instilling performance improvement management principles system wide, including the Foundation. The Foundation had undergone some reorganization and process improvements in preparation for a more robust future. Recent efforts to reexamine the role of board leadership found this body in some flux, with some newer and younger members seeking a strategic role. Additionally, identification of meaningful and sustainable fundraising initiatives had been difficult in recent years, leaving some Foundation leaders to believe that the Foundation was drifting. After two years of operational and tactical improvements, Foundation leaders sought to frame a more dynamic future and to create a plan that could propel the Foundation to an entirely new level of impact and effectiveness.


The Foundation was the first adopter of the new system vision. The system CEO encouraged the Foundation to proceed with its own planning, recognizing the delicate dance of potentially "getting out ahead" of the whole system. Historically within the health system the Foundation's role had been viewed as an ATM for system capital needs, resulting in little authentic engagement in community well-being. Against the backdrop of sweeping health care reform initiatives, both the system and the Foundation realized a need to engage the community in unprecedented ways to achieve lasting impact and to achieve the vision: "optimal health and well-being for our patients, our community, and ourselves."


Design and guide a multi-dimensional, intentionally focused planning process that aligned missional, cultural, individual, and directional elements of the Foundation plan. We engaged system execs and board members, broad representation from the whole community, and Foundation board and staff leaders to:

  • Adopt a whole, connected ecosystem view

  • Examine the ecosystem's behavior over time, collectively identifying, mapping, and interpreting key patterns that shape the present moment so we could understand the interdependencies that influence the system's/the Foundation's future direction. This process produced a working draft picture of the evolving transactional environment of the last 30-40 years.

  • Employ a vision deployment matrix as a tool for creating a framework for large-scale change and investment.

  • Identify the forces of change and the key drivers. By examining the intersection of these drivers, we had the scaffolding for four plausible future scenarios of the whole community 20 years hence.

  • Use the scenario stories to imagine and rehearse adaptable strategies for the system and the Foundation.

  • Framed by this work, develop the Foundation's 36 month strategic plan.


  • The system and Foundation engaged community leaders in new ways, which elevated the organization's profile and credibility in community.

  • The system CEO leveraged her leadership team's involvement to accelerate system wide transformation efforts.

  • The Foundation leadership team came to comprehend and more clearly articulate the relationship of philanthropy to the collective vision of the community's well-being.

  • A strategic Foundation plan now aligns with the health system cultural and community initiatives, providing guidance to ongoing decision making and strengthening the credibility of the Foundation in attracting board and staff talent, health system allies, community partners, and visionary donors.

  • The Foundation Executive Director expanded his personal mastery with key concepts and tools for designing the path toward a resilient and relevant Foundation, coaching his team toward maturity and greater effectiveness.

  • The Foundation's organizational culture moved intentionally toward developing and reinforcing resilience.