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:

• Translating the strategic plan narrative into a Balanced Scorecard that can executed
• Cascading the top-level Balanced Scorecard down and across the entire organization
• Gaining the buy-in and engagement of leadership at all levels to "USE" their cascaded and aligned balanced scorecards
• Coaching leadership at all levels how to conduct consistent, data-driven business reviews on their Balanced Scorecards
• Prioritizing and aligning projects (both large and small) to measures on the Balanced Scorecards

At our most successful clients, I see engaged top leadership that have appointed someone at the senior level to own strategy execution. They have the clout, skill set, and background to be successful in that position.  I usually see a 2 year effort to work through the cultural change and leadership coaching it takes before strategy execution is "institutionalized" or "hardwired."

Here are the consequences I see when organizations don't dedicate the leadership and time it takes to conduct this work:

• Lots of talk, but no changes in outcomes
• No predictability of outcomes (i.e., when they are good, nobody knows why; when they are not good, nobody knows why)
• Isolated pockets of teams gather their own data, but there is no effort to synthesize it, ensure consistency, or to act upon the various data sets
  
• Poor project prioritization, resulting most often in overworked nursing and quality reporting staffs
• Ad hoc requests for data and inconsistent reviews of performance

Do you have a person dedicated to Strategy Execution? Tell me about it.

Comments

[Amy Stevens]

As of this spring, functional duties were expanded/formalized within Sunrise Health (a regional system of hospitals & ASCs within HCA) to create the CSO role -- Chief Strategy Officer. The role basically functions as you've outlined, and is supported by a full-time analyst/project manager (MBA-trained) to help build and manage the tracking systems and ongoing activities. Our primary benefit to the enterprise is in aligning daily operations with our desired outcomes.

[Rohini Wadhawan]

Mercy Health Partners established its Office of Strategy Management (OSM) slightly more than a year and a half ago. It is led by a Sr. V.P, OSM, who reports to the system CEO. We have 1 FT staff, and have recently appointed a director. Strategy Planning and Communications also report upto him.