The Glue

Is Strategy Execution Anyone's Full Time Job in a Hospital?

Virtually all hospitals and health systems have full-time staff responsible for developing strategy. These VPs and Directors of Strategic Planning work in concert with their CEOs, Executive Teams, and Board Members to create what is often a 100+ page document we're all used to seeing.  Unfortunately, what we're not used to seeing is a single person who has the full-time job of executing that strategy. 

After years of working with our nation's largest and smallest hospitals, my advice for all of these organizations is to appoint a "Strategy Execution Officer" (an SEO). This person's job would be to address two themes that I see across all hospitals: a lack of understanding of the effort it takes to execute strategy and a lack of accountability for doing it.

In a nutshell, here are the major responsibilities for the SEO:

How to Measure the Hard to Measure: Part 3 - Strategies for Too Many Measures

In my last post on How to Measure the Hard to Measure, I focused on strategies for narrowing large quantities of measures down to the critical few for a Balanced Scorecard. Here are some approaches to consider with this issue:

One approach is to use a measure that focuses on HOW MANY of the child measures actually hit their targets.  Now, rather than having a green indicator that hides the red performance of one of 10 child measures we talked about earlier, we would actually see that 9 out of 10 of the children met their goal. That might give me a better feel for what is going on and at the very least makes me feel more comfortable that I'm not missing anything if the measure stoplight is green (this approach is called "percent of measures which achieved target" in ActiveStrategy Enterprise).

Hospital Scorecards Should Reflect CMS P4P Plan

I have spoken with many hospitals who are working hard to prepare their balanced scorecard systems for POA requirements and IPPS payment reforms. There’s another subtle change affecting reimbursement that hospital executives should have their scorecards reflect.

At the March 6, 2008 Senate Finance Committee roundtable, AHA said the goal of the CMS P4P plan should be to improve performance, not to cut the program’s budget. Their recommendation is to award points on any required safety or quality measure for both performance AND improvement over a baseline.

This concept is very much in line with the spirit and structure of the balanced scorecard, where measures are evaluated based on trend analysis, looking for sustained improvement over time.

This will require two efforts:

• show the baseline performance on your scorecard
  
• provide training to department leaders to discuss the trend during performance discussions