Stumbled upon this article from 1995, BUILDING A VISIONARY ORGANIZATION IS A DO-IT-YOURSELF PROJECT: A CONVERSATION WITH JAMES C. COLLINS by Joe Flower. Although it's ten years old, many principles and ideas still apply.
And here's an excerpt from it on "why we exist":
What are the timeless core values of what you do? Why do you exist? Suppose you could somehow shut down your institution without anyone losing their jobs? What would be lost? How would the world be worse off? When you have thought about that, then you can put everything that you are doing up against that purpose, and you can say, "Is what we are doing here serving that purpose?"
Healthcare is going through re-engineering and re-organization like everyone else. It's in even greater chaos than most industries. Acute healthcare is shrinking. But if you know your deep purpose, then you can do all that in a context. We have to ask: Why? We have to ask: So what? We have to ask: Why not just shut this place down?
People consider it axiomatic that a company exists to return profit to its shareholders, that even a not-for-profit exists to return benefit to its stakeholders, and must have a healthy margin in order to survive. But all of the visionary companies we studied -- all of them major profit-makers -- are about something else, something beyond profit.
Is your life about eating? We all have to eat to survive, but our lives are about more than eating. Organizations must make a profit, or meet their margin, to survive. But to be great they must be about more than survival. David Packard at Hewlett-Packard understood that HP exists to make technical contributions. But in order to make technical contributions it must make a profit. Profit is a necessary condition for pursuing the organization's true goals.