The Top 10 Mistakes in Setting Goals

Likewise, the materials management leader is responsible for obtaining the best prices for supplies. So that person should have the organization's profitability goals under the Finance Pillar. Because a case management leader influences when a patient is discharged, the leader should own the hospital's length of stay goals. The human resources leader has the organization's overall turnover under the People Pillar versus the HR department's turnover, and so on.

Common Mistake No. 7: Lack of uniformity in measurement
Let's say the senior team voices the expectation that all leaders have a goal around achieving budget. What does that mean? When there is no guidance on how to meet budget—what they measure or how they count—ultimately leaders come up with their own definitions. A patient care leader interprets it as reducing agency expense or overtime. Another manager comes up with specific dollar amounts while a third manager considers managing flex expenses to be the way to meet budget. In other words, the lack of common definitions, targets or metrics means that leaders invent their own . . . which results in confusion and inconsistency across the organization.

Common Mistake No. 8: Leaders tend to "cherry pick" the easiest goals to meet instead of the most important
It's very tempting for managers to focus on goals they know can be met or those based on everyday tasks which will be accomplished regardless. Cherry-picking the easy goals gives staff the opportunity to achieve its targets, the leader looks good, and there is cause for celebration. However, in the long run, the organization suffers when a leader fails to concentrate on the important goals, the ones that will make the most difference.

For example, a pharmacy leader might assign a weight of 60% to the goal of having no expired drugs in the inventory. However, a goal such as this is not only easy to reach, but even worse, is benign in terms of moving the department to a higher level.

Or a nursing unit leader establishes a goal of reducing patient falls which is weighted at 50% under the Quality Pillar. Yet the organization already has an extremely effective process hard-wired which minimizes the fall rate. Thus it was a goal whose achievement was practically effortless to manage, while her real issue was a problem with central line infections.

Common Mistake No. 9: Setting numerical targets where all leaders move up at the same rate
For example, let's consider an organization's goal of moving patient satisfaction results upward. All leaders have the same target – a 10 point increase. One manager is at the bottom of the barrel; the department's patient satisfaction is at 5%. But another one has achieved results of 85% patient satisfaction. Each is expected to improve at the same rate – a ten-point increase. This puts the first manager at 15%, hardly much of an improvement. But the second one will have to hit 95%, a very difficult thing to do, plus it's hardly fair.

The organization needs to consider rate of improvement instead of targets founded on the baseline when setting goals such as these. It would have been more productive to ask the underachiever to increase to 30% patient satisfaction, while the high performer shoots for staying at the current level or perhaps only a 5% increase.

Common Mistake No. 10: Achieving a prestigious reward is the goal as opposed to the outcomes themselves.
A movie director knows if he makes an outstanding, critically acclaimed movie, it might earn an Academy Award. So he concentrates on the process of creating the film. Likewise, senior leadership must focus goals on getting results rather than winning top prizes—the healthcare entity dedicated to performance excellence in all areas will merit the recognition. It's the journey that warrants a Malcolm Baldrige National Quality award or Magnet status . . . which takes the organization to a whole new place.