Action planning is an iterative process and it should involve appropriate stakeholders to ensure their buying-in and set realistic expectations and timeframes. Action planning may involve not only employees but also patients and their families, critical suppliers, and partners. There is no doubt that the actual implementation of the strategic plan is the hardest part of the strategic planning process requiring great discipline, persistence, constant communication, and unwavering leadership involvement. The organization still needs to serve the patients and conduct its daily activities. Therefore, all the action plans resulting from the strategic planning have to be integrated, both vertically and horizontally, coordinated and balanced with daily operational needs. Early development of a contingency plan is recommended to deal with unusual events that may have a negative effect on the organization. A process should be established to identify and resolve potential conflicts with respect to resource allocation and changing priorities. Action plans have to be regularly reviewed and if circumstances require a change, the organization must be able to rapidly execute new or changed plans. Repeated use of the Plan-Do-Study-Act (PDSA) cycle is useful to continually refine the objectives, adjust resources, rapidly test ideas for improvement, update action plans, and build knowledge that is necessary to institutionalize and standardize change.