Bring Your Strategy to Life: Implementation and Feedback Stages

In a robust healthcare system, strategy is executed from the ranks. Employees must understand what the corporate strategy is, why it is important, what their role is within it and how to make decisions in everyday activities that breathe life into the strategy. In other words: they need to know how to execute the strategy. But explaining a strategy is not easy. Here's how to translate effective strategic imperatives to the rank-and-file.

Support
Promoting a culture of communication, support and empowerment has to come from the top down. Employees need to see that everyone who works for the organization is part of its strategic success. All managers, from the CEO down, need to be accountable for achieving their critical success factors, as well as working closely with their direct reports to develop their CSFs, determine timing for achievement and establish responsibilities for each item. Every employee should be given the tools necessary for their success, from IT support to managerial coaching. Scheduled evaluations on CSF standing and support should occur on a weekly to monthly basis and become part of the culture of the organization.

Along with the strategic planning communications program, incorporating integrated lean communications—such as a strategic planning quarterly newsletter, monthly e-mail blasts on achievements, posters and brochures on the five top strategic planning initiatives, and a CEO video on where the health system has been and where it is going—can be supported by personal training and development. Rich communication channels, such as seminars or webinars, on the organizational strategic plan, steps to success, or being a strategic manager may be helpful. Employee role-playing may demonstrate how they can achieve their CSFs in everyday interactions with patients and other employees.

Executive leadership should be able to walk through the halls of the hospital or out to the ambulatory sites and ask a physician, janitor or office clerk, "What are the strategic planning initiatives for our health system?" and "What are your critical success factors for achieving organizational success?" Every employee and volunteer should be able to answer these questions. They should also be able to name the tools for success provided to them by their management as well as the personal reward allocated to them if they achieve their CSFs on time.

At AtlantiCare, each employee carries a strategic planning "roadmap" that outlines the overall strategic planning initiatives and exactly how their individual CSFs work toward achieving organizational success.

"There is a deep employee pride in AtlantiCare's strategic initiatives, because each employee knows specifically how their day-to-day actions matter," says Rene Bunting, Vice President of Marketing at AtlantiCare. It is said that David Tilton, CEO of AtlantiCare, can walk up to any employee at any time and ask the questions noted above, and all employees are able to show him their roadmap and discuss how their contributions are making a difference to their organization and the community in which it serves.

Empowerment
The single greatest cause of corporate underperformance is the failure to execute. In the Harvard Business Review article "Conquering a Culture of Indecision," author Ram Charan writes, "The inability to take decisive action is rooted in a company's culture. Leaders create this culture of indecisiveness—and they can break it by doing three things:

First, they must engender intellectual honesty in the connections between people. Second, they must see to it that the organization's social operating mechanisms—the meetings, reviews, and other situations through which people in the corporation transact business—have honest dialogue at their cores. And third, leaders must ensure that feedback and follow-through are used to reward high achievers, coach those who are struggling, and discourage those whose behaviors are blocking the organization's progress."

Empowering employees to take action and succeed above and beyond their CSFs, as well as recognizing and rewarding employees for doing so, is a necessity for achievement. Proving a culture of honesty and support for underachievers is equally important. You do not want your employees covering up failures and not sharing information that could lead to process improvements. Health system managers must also hold employees accountable for not achieving their CSFs, all the while creating a culture of honesty for employees to admit the reality of where they stand. Then management needs to discuss if there is an opportunity for more support through training, IT, marketing or other support services.

Sharing the organization's CSFs in a data dashboard is also helpful. Information may include goals for numbers of procedures preformed, average length of stay, market share, operating margin and so on. Clear information readily available to health system leadership is vital to ensuring honest communications and smart decisions to build organizational success. You can't have a culture of decisive action when management is working in a vacuum, without accurate, up-to-date information.

Lastly, throughout the execution process, it is beneficial to conduct periodic checks of CSFs against the overall vision and goals. If the CSFs which you thought were correct are tracking well, but the plan is not actually being realized, you may not be really measuring what you thought you were.

Out-executing competitors
As Lou Gerstner, former CEO of IBM, stated in his book Who Says Elephants Can't Dance? Inside IBM's Historic Turnaround, "If you want to out-execute your competitors, you must communicate clear strategies and values, reinforce those values in everything the company does, and allow people to act, trusting they will execute consistent with the values."

It is sometimes difficult to see the forest for the trees. Just as a hospital hires outside consultants to write their master-brand and service-line marketing plans, having external support in creating a plan to execute a health system's strategic plan may be necessary for success. They can support healthcare leadership by clearly communicating organizational strategy to all employees, setting up feedback loops to listen to employee feedback, and include all stakeholders in the execution process. A hospital's physicians and employees are the lifeblood of the organization. Having pride in them and challenging them to make a difference with their day-to-day actions may mean the difference between strategic success and failure.