What have you experienced or what do you anticipate as the most challenging aspect of strategic planning in your field of interest?

This is discussion question, no minimum or maximum word count.  Just need ALL aspects of the question addressed.

American reference(s) cited throughout the body.

Please provide reference(s) at end of body.

Must be in the area of hospital management or something in the medical field.

Question:

What have you experienced or what do you anticipate as the most challenging aspect of strategic planning in your field of interest? What do you think can be done to improve strategic planning processes in your own organization or field?