This article is a follow-up to the Strategic Planning Process Part 1 article, Escalate Growth through Effective Strategic Planning. This article picks up where we left off and discusses the strategic planning execution process. These steps include launch preparations, a system-wide participation strategy, creation of a culture of strategic management and action, as well as implementation and feedback.
LAUNCH PREPARATIONS
In a robust healthcare system, strategy is executed from the ranks. Despite this reality, according to the March 2006 Financial Times article, “The Man Who Has to Shake Up Merck,” Christopher Bowe states, “95% of workers typically do not understand their organization’s strategy.” Employees must be told the strategy, understand it and have a clearly defined role in executing it. Not merely because the culture and “brand” of an organization lives within its employees, but because your employees are the people who activate the corporate strategy on the front lines. Bowe goes on to quote Dick Clark, CEO of Merck, stating “Culture eats strategy for lunch.” If your hospital culture is not one of unified strategic vision—your hospital’s brilliant strategy may never get out of the boardroom. To execute a strategic plan, a hospital or health system must create a culture of communication, support and empowerment.
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. A healthcare strategy is a complex web of business, finance, information technology, market share data, competitive issues, clinical issues and more. Leadership teams understand the need for strategic planning communications. In a recent study conducted by Forbes Insights and FD, they analyzed the interdependence of strategy and communications in getting a strategy right and bringing it to a successful result.
Among their key findings were:
- While senior management does not have a common definition of what strategy is at the conceptual level, it does have a very clear definition of what strategy is not, as well as a very clear, pragmatic definition of what types of corporate initiatives are and are not strategic.
- Management tends to be overly optimistic about the success of strategies, while recognizing that as many as one-third of initiatives fail.
- Communications is unilaterally deemed critical to the success of strategic initiatives.
- It goes without saying that a disciplined strategic planning process is essential to success.
- In the current economy, it’s not unexpected that the majority of respondents will alter their strategic agendas; however, it’s notable that a solid one-third will move forward with their existing plans.
- In the current downturn, communications reports it will maintain focus on two key audiences: employees and customers.
- According to the survey, on average about one-third of strategies fail for any of the five reasons noted below—and 82 percent of failures are preventable.
- They fail because of unforeseen external circumstances (24 percent).
- They fail because of a lack of understanding among those involved in developing the strategy and what they need to do to make it successful (19 percent).
- They fail because the strategy itself is flawed (18 percent) or because there is a poor match between the strategy and the core competencies of the organization (16 percent).
- They also sometimes fail because there is a lack of accountability or of holding the team responsible (13 percent).
A corporate communications team, perhaps headed up by the system’s marketing and public relations department, should be put in place as part of the strategic planning initiative. They will need to define a strategic planning communications program that is as clearly defined as a hospital’s external advertising plan. Developing an effective strategic planning communications program requires an understanding of behavioral dynamics of various target audiences, developing the right message for each target, deciding the most efficient and effective ways to deliver the message, and verifying that the message was received and understood. Target audiences, communication goals, key messages, timing and channels of communications must all be defined and coordinated.
SYSTEM-WIDE PARTICIPATION STRATEGY
The strategic planning communications program must penetrate all levels of the health system and create a feedback loop to track communications effectiveness and feed vital information for ongoing planning. The information used to formulate the strategy can come from the ground up, but the formulation and finalization of a strategy is usually formed at the Board of Directors, Executive Leadership and Senior Management level. Therefore, all levels of an organization are important in the development and implementation process. Target audience segments can be broken down into four groupings:
Just like a master-brand advertising campaign produces a consistent look, message and image for a health system overall, providing an umbrella for service-line advertising to fit into, the strategic planning communications program will produce an overall consistent look, message and image for the organization and specific targeted messaging will fall under that umbrella. Overall messages need to be defined around answering the following questions:
- What is the system’s brand identity, based on the organization’s mission and vision?
- What are the strategic initiatives, and how are they in line with the brand identity, mission and vision?
- What are the organizational critical success factors (CSF) to achieving the strategic initiatives, and what is the timing of those CSFs?
- What is the community impact of the organization’s success in achieving strategic initiatives?
CREATING A CULTURE OF STRATEGIC MANAGEMENT AND ACTION
On a tactical level, senior management must work with their service-line or department employees to define a “roadmap to success” for their employees. Employees should have their own defined CSFs to achieve on a quarterly basis. Each department’s employee CSFs should roll-up into the department’s CSFs. Cross-functional teams within the departments of marketing, finance, IT, environmental services, and so on will also have defined CSFs based on the needs of the service lines or departments.
The corporate communications team will play a critical role in mapping out how the entire system should function to achieve these CSFs. They will design the strategic planning communications program, as well as receiving and reporting CSF status every quarter to determine whether the organization is on schedule for success. Every service line and department will have to report the overall feedback of their employees’ CSF achievements by threshold, goal, or exceeds goal. Senior management should work with human resources to tie in CSFs to employee evaluations with review and recognition incentives.
Using the CSF information noted above, the corporate communications team should determine the strategic planning communications program targeting the right audiences with the right information at the right time. Messages must be relevant to the individuals targeted. Messages should be organized by target audience segments. Key messages need to answer:
- Why is a strategic plan important?
- What is the strategic plan, specifically?
- Why is a successful strategic plan execution important to me (the employee) personally?
- What are my CSFs, and why are they important?
- What do I need to do to achieve success?
- How is the health system supporting me in my success?
- How does my CSF success build toward the overall organizational success?
- What are my personal rewards for success?
- What are the “greater community rewards” for success?
Just like in an advertising plan, reach and frequency of message delivery through a variety of communications channels will be vital for success. Because different people react to information in different ways, using both “rich” and “lean” channels of communications is important. Rich channels are “sticky” media and involve personal interaction such as meetings, workshops and webinars. Lean channels are more impersonal, passive forms of communications such as brochures and newsletters. Communications channels may include:
IMPLEMENTATION AND FEEDBACK STAGES
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 CSFs, 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,” states 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.”
To empower employees to take action and succeed above and beyond their CSFs, as well as recognize and reward 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 honestly 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.
CONCLUSION
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 their 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.
To ask questions or inquire about consultant services for effective and efficient strategic planning execution, please contact Gabrielle DeTora at gabrielle@detoraconsulting.com.
As seen in:
Spectrum! The Society of Health Strategy and Market Development (SHSMD), part of the American Hospital Association.