"You have to measure on multiple levels," Thompson says. That may include measuring the organization's progress not just against past results, but against top performers.
"If you compare this mediocre year with your mediocre last year, and you are 1% better, you're still mediocre. So, you've got to compare with the best you can find. You've got to look at different measures, and with some real discipline, track them over time," he says.
Thompson says sometimes a CEO needs pushback on what a clinical or organizational team wants to measure.
"Sometimes they know what measure is best, but that's not what they're going to track because the really hard things don't always look so good," Thompson says.
One check for such measures is to install dyad teams of clinical and nonclinical leaders to coordinate a balanced set of measures that matter and provide the discipline to track over time, Thompson says.
Create a sense of purpose, not a collection of projects
Give up the idea that you can control every aspect of change. Change is organic. It may fight back. Things will happen.
Gundersen Health drew widespread attention and acclaim in the past decade with its commitment to save energy and reduce the amount of pollution it was generating as a health system.
Gundersen set an ambitious goal in 2008 that the system would reduce carbon emissions by 90%, and be 100% powered by renewable sources of energy, by 2014.
It all seemed to be going well, for a while. Then turbines that were supposed to generate power didn't work as planned.
A plan to use vented gas from a local brewery to power a generator failed when the brewery switched from beer to hard lemonade.
"There will be a project, and they'll hold it up and they'll celebrate too much and make too big a deal of it, and then it falls apart."
—Jeff Thompson, MD, executive adviser and chief executive officer emeritus, Gundersen Health System
So whether it is patient safety or mortality or the environment, leaders must keep the team focused on the end goal and not get too far down or too far up along the way.
"There will be a project, and they'll hold it up and they'll celebrate too much and make too big a deal of it, and then it falls apart," Thompson says.
Gundersen's team was able to "stay on the principles. The principles were that we were causing pollution and we believed we could lower the cost of care, improve the local economy, and address the pollution all at the same time."
Jim Molpus is an editor for HealthLeaders.