PNP 6003 Module 2 Logic Model and Strategic Plan Example

From Visits to Health: A Logic Model and Three-Year Strategic Plan for a Free Clinic Facing Thin Capacity and Rising Funder Expectations

Student Name

American College of Education

PNP6003: Leading and Managing Public and Nonprofit Organizations

Module 2 Assignment

Instructor Name

October 19, 2026

Introduction

Module 1 found that the free clinic in Spokane delivers compassionate care on a fragile budget, measures activity rather than results and depends on a few funders and on volunteer availability. A strategic plan has to respond to those findings without losing what makes the clinic valuable. This paper first builds a logic model of how the clinic expects its work to improve health, because the plan should strengthen the links in that chain that are weakest. It then identifies three strategic issues, sets goals and measurable objectives for the next three years, proposes a revised mission statement and explains how the plan will be tied to regular performance review.

The Logic Model

The model follows the standard sequence from resources to results (W. K. Kellogg Foundation, 2004). Inputs: paid staff, about 140 volunteers, donated medications and specialist visits, the leased clinic space and an operating budget of roughly $1.2 million. Activities: primary care visits, chronic disease management for diabetes and hypertension, medication dispensing, eligibility screening and referral. Outputs: about 6,400 visits a year, 2,100 patients, prescriptions filled and referrals completed. Short-term outcomes: patients with chronic disease have regular follow-up and continuous access to medication. Intermediate outcomes: more enrolled patients reach blood pressure and A1C targets, and eligible patients gain coverage and a medical home. Long-term outcomes: fewer complications and avoidable hospital use among the uninsured and underinsured adults the clinic serves.

Drawing the model makes the problem visible: the clinic measures everything up to outputs and nothing after them. The outcomes that justify its existence are assumed rather than shown.

Assumptions and External Factors

The model rests on assumptions that could fail. It assumes patients return for follow-up, yet the clinic does not know its no-show rate for chronic disease visits. It assumes donated medications remain available, but two pharmaceutical assistance programs narrowed their eligibility last year. It assumes volunteer clinicians are available in every season, which summer staffing contradicts. External factors include Medicaid enrollment rules, the capacity of local health centers and the hospital funder's changing priorities. Naming these assumptions shows where the plan must build resilience rather than take continuity for granted.

Three Strategic Issues

Strategic issues are the fundamental choices an organization must face to fulfill its mission (Bryson et al., 2018). Three emerge from the profile and the logic model. First, the clinic cannot show that its care improves health, which weakens its case to funders and limits its ability to improve. Second, its capacity depends on volunteers whose availability varies and on a reserve of about three months. Third, three funders provide 69% of revenue, so if even one of them pulled back, cuts would follow. Each issue threatens the mission if left alone, and none can be solved by working harder at current activities.

Goals, Objectives and Initiatives

Goal 1: Show and improve health results. Objective 1.1: by the end of year one, record blood pressure and A1C at every chronic disease visit in a searchable registry. Objective 1.2: by the end of year three, increase the share of enrolled hypertension patients at target from a baseline to be set in year one by ten percentage points. Initiative: adopt a low-cost registry tool and train medical assistants to enter readings.

Goal 2: Stabilize clinical capacity. Objective 2.1: by the end of year two, fund a second part-time nurse practitioner so that core hours do not depend on volunteers. Objective 2.2: increase summer volunteer clinician hours by 25% through partnerships with two residency and nurse practitioner programs. Initiative: formal agreements with training programs for supervised clinical rotations.

Goal 3: Spread financial risk. Objective 3.1: reduce the share of revenue from the three largest funders from 69% to 55% within three years. Objective 3.2: build reserves to six months of operations. Initiative: a monthly giving program and two new foundation relationships cultivated each year.

Why These Goals and Not Others

Several attractive options were set aside. Adding dental services was the most requested by patients, but it would require new space, equipment and licensed staff the clinic cannot fund without first stabilizing its existing capacity. Expanding to a second site in the north of the county would reach more people but would spread an already thin volunteer base across two locations. Becoming a federally qualified health center look-alike would bring new revenue streams but would change the clinic's identity and governance and is better considered once the current plan succeeds. Each option remains on a list the board will revisit in year three. Choosing three goals rather than six was deliberate: an organization of eleven staff can pursue a few priorities well, and studies of strategic planning suggest that the way a plan is put into practice matters more than the size of its ambitions (Bryson et al., 2018).

A Revised Mission

The mission should describe the patients the clinic now serves and commit it to the results it will now measure. A proposed revision for the board reads: "To provide free, compassionate primary care to adults in Spokane County who cannot get it elsewhere, and to help them reach and keep better health." The phrase cannot get it elsewhere includes Medicaid patients who lack an accessible provider, while keeping the clinic's focus on people left out. The second clause turns quality from a claim into a commitment the registry can track. The board will discuss the revision before any change is made, since mission statements carry history and donor loyalty as well as direction.

Linking the Plan to Performance Management

Strategic plans fail most often when they become documents rather than practices. Poister (2010) argued that public organizations should move from periodic strategic planning to ongoing strategic management, linking goals to performance measures that leaders review regularly. The clinic will therefore replace its monthly activity report with a one-page dashboard showing each objective, its measure, its target and its current value, reviewed at every board meeting. The strategic triangle Moore (2000) described will serve as a yearly check that value, support and capacity stay aligned as the plan unfolds.

Risks to the Plan

Three risks deserve watching. Measurement could burden volunteers and slow visits; the registry will be piloted with one clinician team first. Hiring a paid nurse practitioner raises fixed costs before diversified revenue is secured; the hire will be timed to new commitments. And a revised mission could unsettle long-time donors; the change will be explained to them as a sharpening of purpose, not a departure from it.

Conclusion

The logic model shows a clinic that measures through outputs and stops. Three strategic issues follow: unproven outcomes, unstable capacity and concentrated funding. The plan sets one goal for each with measurable objectives and initiatives, proposes a mission that describes current patients and commits to results and ties everything to a dashboard reviewed by the board. Module 3 sets the performance measures in detail and uses data to make a decision the plan requires.

References

Bryson, J. M., Edwards, L. H., & Van Slyke, D. M. (2018). Getting strategic about strategic planning research. Public Management Review, 20(3), 317-339. https://doi.org/10.1080/14719037.2017.1285111

Moore, M. H. (2000). Managing for value: Organizational strategy in for-profit, nonprofit, and governmental organizations. Nonprofit and Voluntary Sector Quarterly, 29(1 Suppl.), 183-204. https://doi.org/10.1177/0899764000291S009

Poister, T. H. (2010). The future of strategic planning in the public sector: Linking strategic management and performance. Public Administration Review, 70(s1), s246-s254. https://doi.org/10.1111/j.1540-6210.2010.02284.x

W. K. Kellogg Foundation. (2004). Logic model development guide. W. K. Kellogg Foundation.