Give everyone a compass and teach them to use it

August 31, 2020
Nick C
Nicholas M. Comeau
Senior Director for Process Improvement

Developing mission, vision, and values statements are how an organization declares "who we are, what we're about, and how we're going to accomplish our goals together." They are intended to be living documents that guide not only long-term planning but daily actions and decision making. Creating these statements is an essential step of strategic planning—but only the first step in how an organization sets its destination and achieves its goals.

Organizations must also develop specific goals and metrics aligned with the organization's mission/vision/values. With clearly articulated goals (what we're aiming for) and metrics (how we will measure progress towards our goals), organizations can develop actionable plans to move forward.

But goal-setting can't be based merely on the organization's objectives. Instead, they must be patient-centered and developed within the context of industry regulations, the current economic environment and forecast, and the latest (and anticipated) tools and technology.

Moreover, goals shouldn't only be outward-focused on patient care and outcomes. They should also be inward-focused, incorporating ways to engage employees in creating the best patient experience possible, and maintaining the best working environment.

Perhaps most important of all is achieving "organizational alignment," where every individual employee and every process focuses on executing the agreed-upon strategies to achieve the organization's shared goals. Vertical alignment assures that individual activities and metrics are understood by all and support the broader organizational objectives. Horizontal alignment focuses on process improvement, the sharing of key information, and ensuring adjustments are made, as needed, to maintain momentum.

Let's examine how this would apply to an emergency department. Vertical alignment in the emergency department will keep senior leaders informed on ED boarding data and engage frontline nurses and doctors in coming up with ideas to improve flow in the ED, based on their daily experience. Horizontal alignment refers to how various outpatient clinics will stay connected to the ED, sharing ideas and best practices related to upstream and downstream flow, and removing barriers to progress.

Horizontal and vertical alignment is not an either-or proposition. These approaches are not mutually exclusive, nor do they compete for success. Instead, they are two related approaches that, when properly implemented, will ensure all employees work together to achieve shared goals.

The heart of organizational alignment is making sure that everyone understands how they contribute to the organization's goals. Achieving this constancy of purpose means that peoples' decisions about priorities and daily activities will help move the organization forward, building its strength, and delivering better results.

The responsibility for achieving organizational alignment rests with senior leadership, who must engage all levels of the organization in defining its mission, vision, and values and establishing processes to communicate the progress toward shared goals regularly, sometimes referred to as "True North metrics." And they should make sure that every employee's individual goals and performance metrics align with those of the whole organization.

For example, in an inpatient unit where goals are focused on patient flow, leadership should be involved in helping remove barriers for frontline workers to develop, test, and implement their ideas for achieving unit-specific goals. This might include regular rounding by leaders in frontline work areas, and standard management practices that reinforce the emphasis and desire to achieve organizational goals through collaboration and shared accountability.

It is important to note that this approach is more than a regular internal advertising or promotional campaign. For employees to understand the full meaning and change their behaviors or habits to help reach the True North goals, there must be constant messaging and modeling by senior leaders. The purpose is to create an environment where every employee understands and, importantly, takes pride of ownership in their role in helping the organization deliver on its mission and achieve its goals.

To help your organization create constancy of purpose, follow these helpful tips:

  • Decide what matters most – Organizations that set too many goals (even with the best of intentions) are less likely to make progress on any of them. Instead, limit key initiatives to just a few (three to five) that are most closely aligned with strategic goals.
  • Measure only that which keeps you oriented and moving toward True North – Make sure that how you measure progress in every department throughout the organization focuses on True North goals and metrics.
  • Never stop communicating your mission and strategy – Communication is not a "one and done" affair. Done well, it is a continuous process that improves employee engagement by helping employees connect their efforts to the organization's mission and goals.
  • Give everyone a compass – Even constant communication isn't enough. It's also necessary to build robust systems and simple processes to help keep every department and employee oriented to True North. Many health care professionals chose their career paths based on their desire to help others. It's leadership's responsibility to enable employees to do so by removing technical, process, and policy barriers. Consider utilizing an employee-generated idea sharing system at all levels of the organization.
  • Be flexible and adjust course as needed – To make steady progress, your organization must stay focused on the most productive activities. Don't be afraid to adapt or, if necessary, to abandon an initiative or process that isn't working or delivering adequate progress.
  • Share goal setting and progress throughout the organization – In strategic planning, it's crucial to establish a process for how employees will collaborate on goals, strategy, and progress. Think of your staff like a muscle: the more it is actively engaged in the strategic planning process, the stronger and more dependable it will become.
  • Celebrate successes, even small ones – This is hard work, and some may even view it as above and beyond their job responsibilities. It's vitally important that this work is integrated with everyday activities so that it becomes part of the job, not just an add-on. Take the time to recognize teams, individuals, and processes for their contributions to the strategic plan, no matter how minor they may be. These efforts will help maintain momentum, keep employees engaged, and set up success for the future.

To learn more about Commonwealth Medicine's strategic planning solutions, contact Nicholas Comeau, Sr. Director for Process Improvement.