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Maine HealthLeadership Retreat

3-6-09Applied Strategic Thinking

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OrganizationalDesign

OrganizationalBehavior

INTERMEDIATE RESULTSINTERMEDIATE RESULTS

ULTIMATE RESULTSULTIMATE RESULTS

How Organizations Succeed

StructuresSystems

ProcessesInformationResourcesLeadership

Professionalism/RespectCommunicationCommitmentTeamworkCustomer-centered Care

PDL Access ProductivityInternal AlignmentSatisfaction

Market ShareProfit MarginCustomer LoyaltyHorizontal Growth

The Interaction of DesignAnd Behavior Produces

Together They ProduceRESULTS

Culture, in turn,is Governed by

a Few KeyCULTURE

CUSTOMER REQUIREMENTS

ORGANIZATIONAL PURPOSE

CULTURE

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Strategic Evolution

Have aStrategy

Everyonein the

OrganizationUnderstandsthe Strategy

EveryoneKnows

His/Her Rolein Achievingthe Strategy

Everyone’sActions AreIn Alignment

withStrategy

CustomersPerceive

a Difference

OrganizationKnows

They areAchieving

the Strategy

Organizationis Capable

of AdjustingStrategy

to ChangingMarketForces

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Developing Strategic Focus

Clinical Improvement: Quality and safety

System and Clinical Integration Coordination of care Learning Patient satisfaction, experience

and service Technology Information management,

reporting and performance outcome and process metrics

People Access for care Efficiency, cost, utilization and

reliability PCP/SPC relationships Engaging community MD’s

Advocacy, policy and lobbying Developing partnerships Community health, prevention and

wellness New business opportunities and

growth Disease and care management;

Population health Practice management and process

improvement Innovation Credentialing Leadership Communication (up and down) Transparency Reimbursement, risk sharing,

contracts, P4P

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Applied Strategy

What do we mean by the term “Strategy”? What are some of the “Elements” of Strategic

Thinking? How do we translate Vision into Strategy? Given Maine Health’s overarching strategy…

Exercise: Can you say what your strategy is?

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Activity

Work in small groups to develop a “Strategy Statement” (35 words or less) that medical leaders at your level are intent on accomplishing on behalf of Maine Health

Share in the large group for discussion and feedback

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STRATEGIC PLANNING DEFINITIONSVISIONVISION IS THE ORGANIZATIONS COMPOSITE “LINE OF SIGHT” INTO ITS FUTURE

– Products and services– People/skill sets– Geographic markets and segments– Customers– Competitors– Suppliers– Research and development – Facilities

GOAL DEFINED AREAS OF EFFORT THAT SUPPORT THE VISION. A GOAL IS A

HIGHER LEVEL CONCEPT THAN AN OBJECTIVEOBJECTIVE FOCUSED, MEASURABLE OUTCOMES WITH TIMEFRAMES THAT

SUPPORT GOALSSTRATEGY A PLAN OF ACTION INTENDED TO ACCOMPLISH GOALS AND

OBJECTIVESTACTIC COORDINATED ACTIVITES THAT SUPPORT STRATEGY

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What is Strategic Planning? Environmental and competitive assessment

Emerging trends (Local, regional, national) Key customer’s “interests” Data analysis and synthesis (SWOT)

Identify strategic opportunities and prioritize Evaluate criteria for prioritization Best/worst case scenario’s (best choice)

Business Case Customer value assessment Cost to deliver (time and $$)

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The Strategic Mindset In Leadership: Has a clear sense of desired outcomes before acting.

Develops a plan capable of delivering outcomes that will add significant value to a state of affairs

Scopes outwards to capture the larger context, to see how the pieces fit together

Is adaptive to realities and flexible in choice of tactics. Recognizes that once action begins the "game board" is fluid offering both new threats and new opportunities

Where possible, tries to achieve multiple objectives through singular actions

Plans a couple of steps ahead. It is said that Napoleon could conceive of seven steps ahead, each one with its potential counteractions by opponents

Anticipates opponent's actions and mentally rehearses next responses should those contingencies arise

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Holds resources in reserve should their need arise Forms alliances with opponents of his opponents Learns opponent's strengths and weaknesses Is aggressive in pursuing goals and ready to move on to

the next Does not rest on old glories Taps diverse points of view in planning Assures that everyone knows their roles and are equipped

with the resources to contribute Maintains a state of readiness. Stays alert and ready Monitors activities in the operating environment Uses "what if" speculation to stretch thinking in the

direction of opportunities and possibilities

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Has a good sense of what may be possible to achieve in the prevailing state of "politics." The art of what's possible

Studies the logic of the opponent's tactics with an eye toward determining what their ultimate end purposes may be

Makes use of trial balloons. Feints actions to test reactions Usually prefers taking the offensive Patient, with a good sense of timing Acts decisively when the time to act has come Is able to scrap or alter plans when information indicates

actions are not attaining their intended results Doesn't signal punches. (Unless in the form of a ploy.) Knows what can be conceded or lost and what is essential

to retain, preserve, gain Doesn't bluff when the stakes are critical

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Seeks and exploits opponent's weaknesses, oversights and mistakes

Maintains forward momentum Uses surprise to advantage Uses speed to advantage Has the discipline to remain composed when the

unexpected occurs Tries to capitalize on crises or change, turn them to

advantage Stays future-focused Invents both sequential and parallel actions to accomplish

goals Picks battles that can be won and avoids those that cannot

be won. (At least not at an acceptable cost.) Supplements actions with those of others (allies, partners,

joint ventures.) 

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Elements of Our “Charter”

Your Improvement InitiativeStages of Change Prochaska and DiClemente

Pre-contemplation

Contemplation

Preparation

Action

Maintenance

Relapse

Awareness of Problem/Opportunity to Change Concern/Doubt in Current State“We SHOULD … “

Reason for ChangeWhat’s in it for ME?“We CAN …”

Course of Action for ChangeWhat’s Needed – skills, tools, resources“HOW do we … “

Implement Change – use skills tools, etc.Small Tests of ChangeProblem-Solve “Just DO it!”

Make the Change “Stick”Resolve associated problems (unintended consequences)Identify potential for relapse: mitigate

Whoops! “This didn’t work!!!”

Don’t Panic!Use as “lesson”

Return to contemplation…

Early Adopters

Early Majority

Late Majority

Laggards

Your Improvement InitiativeInnovation / Adoption Curve

Rogers

Your Improvement InitiativePerspectives that Support the Change

Business

Human

Process RedesignRole OptimizationAdvanced Access

Performance Dashboard: Metrics/Quality

Cultural Assessment/DevelopmentLeadership

Patient ExperienceTeamwork

Work-Life Balance

Your Improvement InitiativeTemplate for Change

Benefits Challenges / Barriers

How to Leverage How to Mitigate