The World Is Changing. Are YOU?
Every organization strives for success.
Few achieve it.
What differentiates successful
organizations from others?
It's not desire, talent, or even resources.
Instead, it is the choreographed interaction of 5 key domains that enables long-term success.
Integrated System Performance Model
DEFINING THE DOMAINS
Strategy | Focus: Many organizations have some level of strategy defined, yet less than 1 in 4 are able to successfully translate strategy to meaningful actions, implement those actions, and see results. Think about the following layers of strategy; does your organization struggle with one or more of these?
Ideation: Strategy Creation
Translation: Operationalizing from concept to meaningful, quantifiable frontline action
Implementation: Deployment and execution to results
Adjustment: Continuous refinement
Leadership serves as the critical underpinning for each of the other four domains in the system. It can promote or negate the development, impact, and viability of the other domains day-in and day-out through the direction of organizational attention, action, resources, and sustainability. The following elements should be considered when analyzing leadership:
Governance: Formal boards and structures
Management: Every level of leadership
Cultural Leaders: Informal influencers
How do your formal and informal leaders drive the culture you strive to personify?
Operational Mechanisms | Agility: Operations brings strategy to life. This manifests through the following key processes:
Delivery Services: Providing key services to patients and the community
Communication Loops: Creating open, multidirectional communication channels
Decision-Making: Empowering teams to quickly make data-driven decisions
Standard Work: Repeatable processes across departments, units, or facilities
Innovation of Ideas: Ease of developing, testing, and spreading new ideas
Structural Integration | Stability:
The counterbalance to agile operational mechanisms, structural elements are more difficult, timely, and expensive to change. Structural elements include the following
Technology & Data: EMRs, technology infrastructure, and data capture
Property & Equipment: Physical property, plant / buildings, and equipment
Market & Environment: Broad industry & competitive forces
Organizational Model: Reporting structure
Traditions & Legacies: Hardwired cultural elements can be difficult to change
METRICS & ACCOUNTABILITY
Metrics | Accountability: Accurate, timely, and transparent data drive organization-wide accountability. Similar to leadership, this domain crosses each of the others:
Strategy: Strategy without focused key performance indicators is wishful thinking.
Operations: Data locked behind a technology platform without transparency to the frontline prevents timely action & decision-making.
Structure: The most fundamental element of metrics is the ability to capture, measure, and report input, process, and results measures.
HOW DOMAINS INTERACT
Each of the five input domains are represented within an organization -- even if that manifestation is through a missing element. For example, the ABSENCE of metrics still represents the Metrics and Accountability domain within an organization.
Most contradictions are unintentional. Let's look at a common contradiction we see in hospitals. Internal policies and incentives represent an element of the Structure domain; they are intended to create stability by clarifying expected operational actions. Hospitals frequently create employee incentives and performance goals that contradict the strategic objectives of the organization.
Let's say a health system is targeting a system strategy of Population Health through integrated interactions in the community, but frontline nurses are held accountable for discharge times. Nurses may be discouraged in taking the extra time to ensure proper placement for the patient when it will harm their individual or team metrics. Misaligned incentives stimulate a slew of activities that are unrelated to system strategy.
This is one example, but similar contradictions abound in hospitals and systems of all sizes, regions, and service types.
Addressing the disconnect between the 5 input domains helps you move
from CONCEPTUAL STRATEGY to TANGIBLE RESULTS.