The document summarizes a webinar on best practices for linking strategic planning and business intelligence to improve performance. It discusses organizing a strategic planning process, raising the bar on healthcare strategic planning, translating plans into action, and using business intelligence to monitor plan implementation and make decisions. Business intelligence tools like dashboards and ad hoc reports can help track key performance indicators, visualize strategy alignment, and drill down into details.
Plan, Measure & Act! Best Practices in Linking Strategic Planning and Business Intelligence to Improve Performance
1. NESHS Webinar Series
Sponsored by Gold Sponsors :
Berkshire Marketing Group
“Plan, Measure & Act!”
Best Practices in Linking Strategic Planning and
Business Intelligence to Improve Performance
December 17, 2009
MACNULTY CONSULTING, LLC
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2. Presentation Collaborators & Colleagues
Amy MacNulty
President
MACNULTY CONSULTING, LLC
781.405.2298
amy@macnultyconsulting.com
Pat Salem, M.B.A.
Vice President, Healthcare Planning & BI
BITadvisors
860.508.1865
psalem@BITadvisors.com
Mitch Ocampo, MCSD, MCDBA, MCT
Practice Director, Microsoft BI
BITadvisors
617.359.8194
mocampo@BITadvisors.com 3
Agenda
1. Results Oriented Enterprise Planning and Implementation
2. Closed‐Loop Planning – BI: “Plan, Measure & Act!”
3. Best Practices of BI and Dashboards: Tools, Techniques &
Mindset: “One Stop Reporting Platform”
4. Partners Case Study
Questions & Answers
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2
3. ?? ?? ?? ??
If you have questions during the presentation,
please submit them using the Q&A option at
the top of your screen.
We will address them at the conclusion of
today’s event.
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Organizing a Strategic Planning Process:
Typical Phases
Phase 1 Phase 2 Phase 3
Strategic Assessment Strategic Thinking Strategic Planning
Build the fact base to Evaluate strategic Define means to
support decision‐making alternatives & define achieve desired
a preferred future future position
Interviews, surveys Identification of key Definition of goals and
and focus groups issues and critical strategies
Assessment of success factors Framework for tactical
current position Review of mission/ planning
Portfolio model vision/values Strategic financial plan
Planning assumptions Development of future Communications plan
and key uncertainties vision and metrics
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3
4. Planning process will result in the
Planning process will result in the
Why Plan? development of a plan document.
development of a plan document.
Understanding of key uncontrollable issues
likely to impact the organization in the future
Environment, market, competition
Establish position in light of these key uncontrollables
Strengths and weaknesses
Determine optimal alternative strategic directions
Build consensus for an appropriate strategic direction among
stakeholders
Identify measures for success
Plan, Measure and Act!
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Raising the Bar: Best Practices for Healthcare
Strategic Planning
How would you rate your organizations strategic planning
performance against following best practices?
Linked to all parts of organization
Evolving, flexible and continuously improving
Communication throughout the process
Adherence to essential strategic planning components
Financial analysis and outcomes secondary to strategic thinking
Diverse competencies (vs. single core competency) drive the planning
process, i.e. key areas of competitive advantage
Action plans and strategic thinking at business unit level are emphasized
Innovation and creativity are emphasized
Performance management and knowledge management programs
are incorporated into strategic planning process
Strategic planning changes from static to dynamic process
Source: Raising the Bar: Best Practices for Healthcare Strategic Planning, Alan M.Zuckerman, HS&S, SHSMD
Benchmarking Study, 2007. 8
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5. Strategic Thinking and Strategic Planning
are Not the Same Thing
Strategic Thinking Strategic Planning
Conceptualizing the end Getting from here to there
game
Evaluating alternative
Future state definition paths to reach future state
Naming assumptions Resource allocation
Combination of dialogue, Laying the course
discussion, and debate
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Strategic Planning Continuum
Goal Scenario
Traditional Alignment Dynamic
Oriented Planning
Models of Strategic Planning
Linear‐ Top Match Environmental Align Mission Collaborative
Down Resources to Scan and and with focus on
Capabilities Optimize Performance Strategic
Response Thinking
Opportunities for Success:
Opportunities for Success:
Focus on dynamic process than solutions will increase commitment
Focus on dynamic process than solutions will increase commitment
Link to management cycle for effective implementation
Link to management cycle for effective implementation
Combine planning discipline with increased capacity for creative thinking
Combine planning discipline with increased capacity for creative thinking
Build on strengths and identify opportunities to differentiate: “we are the
Build on strengths and identify opportunities to differentiate: “we are the
best because…”
best because…”
Source: HBR, Putting Leadership Back into Strategy
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6. Understanding
Strategic Issues
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Where Do You Get Information?
What are your biggest data challenges?
Where have you been “creative?”
How do you decide what information to share
with others in a planning process?
When do you report back on progress?
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6
7. Quantitative Data Problems and Pitfalls
Problem Potential Solution
Data limited to inpatient services “Connect the dots”
Lacking primary market research Just do it
Out of date data Use what you have
Reluctance to believe what the Involve the right people
information tells us
Analysis paralysis Agree “what you need
to know”
Inability to turn data into Import expertise
information
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Qualitative Perspectives
Method Benefits Limitations
More "confidential" Interviewer bias is
than focus groups possible
One-on-One Allows for in-depth Time intensive
Interviews exploration of topics (expensive)
with each participant Limited number of
people can be involved
Allows more to Potential for “group
participate think”
Can begin process of Not possible to explore
Focus Groups
building consensus topics in depth with
Can explore reasons each participant
behind responses
Good way to get input Biased sample
from large numbers of Typically low response
internal or external rates
Written Surveys: constituents Generally not possible
On-line/ Telephone On-Line can be less to explore reasons
expensive than phone behind responses
surveys and easy to
tabulate
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8. Developing Elements of
the Strategic Plan
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Planning Horizon
Reach agreement about your planning timeframe
Time
Mission
Vision 3 years?
Goals 5 years?
10 years?
Strategies
Tactics Tactics Tactics
1 Year
Operating Plan
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9. Working Definitions
Mission A long-standing statement describing an organization’s core purpose
or reason for being.
Values Intrinsic beliefs an organization cherishes above all others.
Vision A statement describing an organization’s desired future position.
Goals Desired end results toward which effort is directed.
Strategic Metrics Measures and targets used to create clarity around desired outcome
of the strategic plan and to monitor progress.
Strategies Carefully designed plans for deploying resources to attain a favorable
position.
Tactics Specific steps to achieve strategies.
Management Metrics Indicators that management monitors to measure performance on
tactical steps.
Resource Requirements/Budget Financial and non-financial needs to support implementation.
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Strategic Metrics
Strategic Metrics Measures and targets used to
create clarity around desired
outcome of the strategic plan
and to monitor progress
Strategic Management
metrics can be metrics are developed
developed at the at the strategy and
vision or goal level tactic levels
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9
10. Competing on Analytics
Champion Analytics from the Top “Use
sophisticated
Create a Single Analytics Initiative data-collection
Focus Your Analytics Effort technology and
analysis to
Establish an Analytics Culture wring every last
Hire the Right People drop of value
from all your
Use the Right Technology business
processes.”
Source: Competing on Analytics, Thomas H.Davenport, HBR, 2005.
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Performance Management
Balanced Scorecard
◦ Measures to help monitor strategy implementation and
performance
Link Performance to Strategy
Healthcare Executive Dashboard
◦ Financial Perspective
◦ Patient Perspective
◦ Internal Processes
◦ Learning & Growth
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11. Strategic Metrics
Helpful Hints
Limit the number of measures
Emphasize outcome measures over process
measures
Use a balanced set of measures
Ensure that measures are clear and the data are
readily available
Recognize data limitations
Avoid measure “creep”
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Translating the Plan
Into Action
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11
12. Tactical Planning
Even good strategy isn’t enough
Must determine capability for implementing strategy
◦ Timeliness – Is there so much to do
that effective plan implementation
is unlikely?
◦ Affordability – Can we afford the plan,
in terms of operating expense and
capital expense?
◦ Availability of human resources – Do
we have the people with the right skills
to implement the plan?
Who will do What by When With What Resources to produce What Results
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After the Plan is Done
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12
13. Three Types of Links Needed
1. Functional links
◦ Strategic plan with long‐term financial plan
Critical for avoiding the dreaded “Shelf‐itis”
2. System plan to operating entity plan
3. Links of plans with varying time horizons
Strategic Annual Service Functional
Plan Business Plan Line Plans Plans
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Communicating the Plan
Provide feedback to all stakeholders involved in the
process
Provide sufficient information to support plan
implementation
Protect key strategic information from competitors
◦ How much of the plan is shared?
Support employee morale Everyone does NOT need
◦ Employees often the best to receive the same level of
plan detail!
ambassadors
◦ Use multiple communications vehicles
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13
14. Monitoring Plan Implementation
Frequency of reviews a function of plan time horizons
and the level at which the review is taking place
Remember, this is a strategic plan
◦ Reviews in the early stages of the planning horizon
focus on actions, not outcomes
◦ Later reviews assess both actions and outcomes
Management reviews typically occur on a semi‐annual
basis
Board reviews should occur at least annually
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Questions to Ask
Do we have the correct goals categories? Are they still
realistic? Do they need to be changed?
Is appropriate progress towards goal achievement being
made?
If not, is the issue one of strategy or execution? How do you know?
Do the strategies or timelines require adjustment?
Are action steps being implemented in a timely and
effective fashion?
If not, is the issue one of resources, execution, inappropriate steps
or unforeseen issues/complexity?
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15. Is your Plan on Target?
Using Business Intelligence to ACT
like a metrics‐driven organization
Pat Salem, VP Planning & BI, BITadvisors
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“Closing the Planning Loop”
From strategy to execution & measurement
Strategy
Performance Management
Dashboards, & Scorecards
Insight Decisions
Ad Hoc Reporting & Analytics
Real-time “actionable”
information; aligning actions
with strategy
Monitor key strategic metrics,
quality, financial & operational
Any Business Application performance.
Report across data sources
Execute across the continuum
Any Data Source care network
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15
16. What is Business Intelligence?
Business Intelligence (BI) technologies help an
organization collect, integrate, analyze and interpret
business information to support better decision‐making.
BI often uses metrics or key performance indicators (KPIs)
to assess the present state of business and to prescribe a
course of action, such as % Operating Margin, ALOS, FTE /
Adjusted Occupied Bed.
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How we “do” reporting today…..
“The Report Life Cycle”
Call IT 911!!
Get data
extracts
Into Power Point
Into Access…
Access… Out to Excel..& Pivot
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16
17. Schematic of BI Tool Set
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Information Discovery and Delivery
BI Creators
Executive Management
Business User Dashboards, Scorecards, KPIs
Business Analysts
Business User Ad-Hoc Queries, On-line
Analytical Processing (OLAP)
Front Line
Employees
IT Operational or
Standard Reports
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18. DASHBOARDS and AD HOC Reports – What can they do?
DASHBOARDS and AD HOC Reports –
Dashboards provide organizations the ability
to track performance of KPIs
Visualizations align actions with strategy
Alerts organizations to exception conditions
Users can drill down to detail to see root cause
Ad hoc reports provide users with a self-service
environment
Mangers can create reports from scratch or simply
update existing reports
Intuitive analysis via ad-hoc reports “on the fly”
Quick adoption rate …ease of use
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Data Lineage & Consistency
ce
ial rvi rt
nc Se po
a
Fin port Re
Re
TRUST... Business Intelligence provides
accurate & consistent information, for
users to make timely business decisions
Nursing
Log Sheets
36
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19. Healthcare Drivers for BI
ARRA & HITECH act provide incentives to stimulate EMR adoption.
Economic challenges / capital constraints – focus on financial performance & dashboards.
Healthcare consumerism is fueling the need for transparency of hospital quality & cost data.
Cost shifting spurs patients to become more involved in the healthcare purchasing decision.
Hospitals face growing demand for services and declining reimbursements.
CMS & private payers are moving toward “value‐driven healthcare.”
The number of P4P initiatives is increasing.
New emphasis on public reporting of quality data via “report cards”.
HCAHPS / patient satisfaction used as a proxy for quality performance.
Hospitals face increased competition from new “retail” providers, e.g. Minute Clinic, Wal‐
Mart, Target, Rite Aid….
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BI for the “Continuum of Care”
Retail
MD
Ambulatory Care Clinic Office
CHC SDC
s
Acute Care Acute LTC
Hospital Hospital
Post Acute Care Rehab Home
SNF Hospice
Care
38
19
20. BI Portal for Health Information Exchange
SUPPLIERS
REGULATORY
AGENCIES
MDS &
OTHER
PROVIDERS
PAYERS 39
BI for “Disparate” HC systems
Clinical Ancillary External
Finance IT Physician HR
Initiatives Depart Data
• GL / AR • Decision • Quality • ED • Credentialing
• Budgeting • Time and • Utilization
Support Measures • O.R. • Scheduling
• Planning Attendance • Mkt. analysis
• BI /Data • EMR • Pharmacy • MD Billing
• Medical Warehouse • CPOE • Radiology • MD A/R
Records
• BPOC • PACS • RVU
• Registration
• Disease • Cath Lab • PQRI
• Materials
Surveillance • Laboratory
(Supply Chain)
• Laboratory • Pathology
• Payroll
• Patient Billing • Pharmacy
Diverse Applications and Systems
• Meditech • SAP • TEIC • McKesson • IDX • Kronos • WebMD/
• Eclipsys • BOBJ • Midas + • Siemens • Siemens • ADP Healthshare
• Siemens • Eclipsys • Eclipsys • Cerner • McKesson • API • Press Ganey
• McKesson • McKesson • Siemens • Emergsoft • Meditech • HCAHP
• IDX • Trendstar • Cerner • Meditech • AHRQ
• Lawson • Peoplesoft • Allscripts • MISYS • Claritas
• Cognos • Eclinical • Mediware • Solucient
• GE Centricity • IDX
• GE
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21. Enterprise Healthcare Dashboards
Quality Management Strategic Initiatives
Volume Tracking Financial Performance
Patient Satisfaction Supply Chain Management
Staffing Productivity Operations/Business
Processes
Emerging trends in the healthcare industry
have accelerated the need to access more
timely, accurate and reliable data.
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Executive Balanced Scorecard
Provides:
Board level insight into key strategic
metrics
Actual vs. Goal for: financial, patient,
internal processes and growth
Automated data collection / analytical
processes for organizational performance
scorecard.
Historical trends and ability to drill down
into hierarchical detail to conduct root
cause analysis.
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21
22. Disease Management ‐ Diabetes Surveillance
Provides:
Conduct real‐time diabetic surveillance
Connect directly to your EMR, practice
management, and financial systems
Monitor alerts for patients with elevated
HgA1c levels (Hg A1c>9%)
Facilitates UDS reporting under HRSA
Identify patients that have not had an annual
eye / foot exam or flu shot.
Drill‐down by site, provider & payer to view
patient clinical detail “on the fly”
Track Hg A1c historical trends and quality
performance by payer
Improve diabetic patient quality outcomes by
identifying high‐risk patients
Track and reduce healthcare racial disparities
43
Patient Census Tracking
Provides:
Patient census, occupancy, and bed
tracking data.
The ability to connect to the hospital's
ADT system, and real‐time inpatient and
ED census monitoring
Automated inpatient census tracking, %
occupancy, and emergency department
volume by service.
Census alerts anticipate patient flow
bottlenecks, identify pending discharges,
and improve staffing efficiency.
44
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23. Case Study ‐ Radiology
Mitch Ocampo, MCSD, MCDBA, MCT
Practice Director, Microsoft BI
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MGH Imaging
Imaging in four main locations
10 Radiology Divisions (Neuro, Body, Chest)
10 Main imaging groups (CT, MR, US, Xray…)
2000 Employees in Imaging
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24. MGH’s Goals
Strategic Planning
Where are we gaining or losing business and why
How can we serve patient population and referring physicians
Tactical Operations
Utilization trends
Technologist & resource productivity
Physician productivity
Goals Cont………….
Monitor patient quality outcomes
Comply with patient safety & regulatory
requirements
Adhere to quality and safety programs
Track compliance
Conduct research on utilization & patient
outcomes
Innovation and best practices for Radiology “BI”
24
25. Challenges
Multiple data‐sources
Multiple versions of truth
Hard to gain access and use data
Resource bottleneck for report writers
Technology Decisions
Build
Radiology centric view of the world
Cost vs benefits of owning the technology
IMAP
Buy
Cost of Product/solution
Missing functionality
Cost of Consultants
25
33. Question & Answer Session
? ? ?
? ? ? ?
If you have questions, please submit them
using the Question’s Pane in your
GoToWebinar toolbar.
If we are unable to address your question during today’s live session,
a presenter will follow-up with you afterward. 65
Handouts
Case Studies & Dashboard Examples
66
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34. Boston Medical Center uses BI to Analyze Nursing
Operations, Outpatient metrics, and Quality of
Care
The Challenge
Major changes in the healthcare industry
◦ Pay‐for‐performance
◦ Transparency of quality and safety data
◦ Patient empowerment
Driving cost down
◦ Improve quality and safety of care
◦ Avoid healthcare associated infections
◦ Reduce length of stay
Using data and analysis for improving process and outcomes
Solution
CDW for integrated data analysis
Strategic and Operational Dashboards with Business Objects
67
Boston Medical Center uses BI to Analyze
Nursing Operations, Outpatient metrics, and
Quality of Care
Benefits / Impact
BMC Corporate Dashboard (VSSC)
◦ Individual Physician scorecard for credentialing
Nursing Dashboard
◦ Hospital, specialty group and unit levels
◦ Insight to staffing costs
◦ 10 key metrics
Outpatient Dashboard
◦ Department, clinic group, location, service, major billing code levels
◦ 3 key metrics
◦ Los, discharges, empty beds
Access to care
◦ Department, clinic location, provider group, provider levels
◦ 6 key metrics
Financial reports
◦ About 40 financial reports of Lawson data 68
34
35. Gaylord Hospital & MEDITECH
EDGE deployment for “Real-Time” Patient
Real- Time”
Census & Bed Tracking Dashboard
The Challenge
Executives needed a unified picture of Gaylord's patient population data
that would transcend the artificial segmentation created by the two EMR
systems and MEDITECH.
Goal to analyze, track and report on patient utilization, revenue, quality,
and costs across the entire continuum of care
Manually managing over 30 Crystal Reports within the hospital each
month
Solution
Census data that formerly updated only at midnight now updates
automatically every 5 minutes via a dashboard.
No more time wasted manually manipulating spreadsheets and slides just
to get a visual representation of data.
Deployed Crystal Reports against the MEDITECH sql data repository.
69
Community Health Center (CHC) Alliance & EMR
Data
EDGE deployment for Patient Quality Dashboard
The Challenge
Compiling, aggregating and analyzing GE Centricity EMR data
Need to benchmark patient quality data for network of 80 CHCs in
Florida.
Production reporting for Crystal Reports; scheduling and security.
Solution
Dashboard “Quick Start” for Edge deployment.
Quality dashboard for Diabetes and Hypertension tracking.
70
35
36. QuickVitalSigns – Executive Balanced Scorecard
Problem Addressed: Analysts manually compile
their scorecard in a static Excel format.
Target Market:
CEOs, CFOs and the Board of Trustees
Provides:
Board level insight into key strategic metrics
Actual vs. Goal for: financial, patient, internal
processes and growth
Automated data collection / analytical
processes for organizational performance
scorecard.
Historical trends and ability to drill down into
hierarchical detail to conduct root cause
analysis.
71
QuickVitalSigns – Physician Manpower Profiler
Problem Addressed: Strategic Planners and Physician Relation staff need
accurate & timely medical staff credentialing, utilization, and MD need
projection data for program planning & MD recruitment.
Provides:
Medical Staff credentialing data at your
fingertips: status, location, age and FTE etc…
Visual “Insight” into utilization trends by service,
sub‐specialty, and physician e.g. discharges, O.R.
cases
Dynamic MD Manpower planning tool keeps your
MD supply up‐to‐date, and provides “what‐if”
capabilities for Mkt. Share and Census scenarios.
Comparison of Actual vs. Budgeted data, with
flexible time period views (month, Qtr, Yr.).
Automated data collection / analytical processes
for dashboard information delivery.
72
36
37. QuickVitalSigns – CMS Core Measures
Provides:
Consolidated quality data.
A reporting repository for CORE
measures & HCHAP benchmarked
satisfaction scores
Historical trends for annual, quarterly
and monthly periods.
Visual color coded alerts to identify
variance in performance against
targets.
The ability to drill down from the
dashboard level to perform
"root cause analysis".
73
QuickVitalSigns‐ Disease Management
Diabetes Surveillance
Provides:
Conduct real‐time diabetic surveillance
Connect directly to your EMR, practice
management, and financial systems
Monitor alerts for patients with elevated
HgA1c levels (Hg A1c>9%)
Facilitates UDS reporting under HRSA
Identify patients that have not had an annual
eye / foot exam or flu shot.
Drill‐down by site, provider & payer to view
patient clinical detail “on the fly”
Track Hg A1c historical trends and quality
performance by payer
Improve diabetic patient quality outcomes by
identifying high‐risk patients
Track and reduce healthcare racial disparities
74
37
38. QuickVitalSigns – Patient Census Tracking
Provides:
Patient census, occupancy, and bed
tracking data.
The ability to connect to the hospital's
ADT system, and real‐time inpatient and
ED census monitoring
Automated inpatient census tracking, %
occupancy, and emergency department
volume by service.
Census alerts anticipate patient flow
bottlenecks, identify pending discharges,
and improve staffing efficiency.
75
Physician Manpower Profiler
Problem Addressed: Strategic Planners and Physician Relation staff need
accurate & timely medical staff credentialing, utilization, and MD need
projection data for program planning & MD recruitment.
Provides:
Medical Staff credentialing data at your
fingertips: status, location, age and FTE etc…
Visual “Insight” into utilization trends by service,
sub‐specialty, and physician e.g. discharges, O.R.
cases
Dynamic MD Manpower planning tool keeps your
MD supply up‐to‐date, and provides “what‐if”
capabilities for Mkt. Share and Census scenarios.
Comparison of Actual vs. Budgeted data, with
flexible time period views (month, Qtr, Yr.).
Automated data collection / analytical processes
for dashboard information delivery.
76
38
39. QuickVitalSigns – Practice Management Dashboard
Problem Addressed: Healthcare administrators need accurate, timely,
and “actionable” information to manage their ambulatory facilities.
Provides:
Practice management overview at your fingertips
Visual “Insight” into key metrics: Financial,
Utilization, Productivity, Coding, Quality
Comparison of Actual vs. Budgeted data, with
flexible time period views (month, Qtr, Yr.).
Automated data collection / analytical processes
for dashboard information delivery.
Interactive and intuitive features provide users
with the ability to navigate and drill down into
hierarchical detail: Physician, Payer, CPT
77
78
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40. QuickVitalSigns – EMR Meaningful Use Dashboard
Provides:
Incorporates the HITECH quality
measures required for “Meaningful
Use” to date…
Historical trends for annual, quarterly
and monthly periods.
Visual color coded alerts to identify
variance in performance against
targets.
The ability to drill down from the
dashboard level to perform
root cause analysis “on the fly”
Dashboard can either sit on top of
existing EMR & other data sources
OR
Jumpstart Quality reporting during
EMR implementation, or before EMR
selection via a quality data repository 79
BITadvisors
Healthcare Business Intelligence Specialists
Premier professional services organization
focused on Data Management, Business
Intelligence, and Project Management across the
United States and Canada
Proven best practices and methodology :
Data Warehousing and Reporting;
Corporate Performance Management;
Enterprise Application Integration;
Project Management
Dashboards & Scorecards
Over 500 successful implementations in New
England, leveraging solution accelerators for
industry verticals (Healthcare)
And beyond…… 80
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41. Technology Partners
81
Presentation Collaborators & Colleagues
Amy MacNulty
President
MACNULTY CONSULTING, LLC
781.405.2298
amy@macnultyconsulting.com
Pat Salem, M.B.A.
Vice President, Healthcare Planning & BI
BITadvisors
860.508.1865
psalem@BITadvisors.com
Mitch Ocampo, MCSD, MCDBA, MCT
Practice Director, Microsoft BI
BITadvisors
617.359.8194
mocampo@BITadvisors.com 82
41
42. MacNulty Consulting, LLC
Amy MacNulty
Services With over 24 years of healthcare experience in
Strategic Strategic Planning, Physician Strategies and
Regulatory Planning, Amy is a recognized
Planning
leader in facilitation and providing panning
Physician support for strengthening relationships
Alignment between hospitals and physicians. Her client
Community engagements range from strategic planning to strengthening
Needs physician-hospital relationships to clinical services business
Assessment planning.
Regulatory
Formerly as Senior Principal and Northeast Region Manager for
Planning
Noblis, a nationally recognized science, technology, and strategy
organization, she effectively combined her strategic planning,
organizational development, and program design skills to manage a
broad range of planning projects. Prior to her work at Noblis, Amy
was Managing Principal and Owner of The Bristol Group, Inc.
responsible for implementing firm-wide marketing activities,
expanding the client base and developing new service offerings. 83
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