By Michelle Mader / Special to Healthcare Facilities Today

After nearly a decade of upheaval in the healthcare industry resulting from legislative changes and market volatility, there are no signs that these trends are slowing.

Beginning this year, for example, federal legislation includes a rollback of the 340B Drug Discount Program. For one health system, this change alone cut the bottom line by $15 million and required significant scaling back of long-term strategic plans that had been tied to 340B revenue.

Compounding the effects of these kinds of scenarios, healthcare executives are fatigued by constant change as well as the demands of being “connected” 24/7. As a result, they do not have the optimal working environment in which to focus on the intensive intellectual work of creating and implementing vision and strategy.

Organizing complex, long-term strategies into smaller, more manageable pieces with short- and medium-range objectives, streamlining execution, and using accountability to maintain momentum are key to making real strategic progress in a rapidly changing industry.

Avoiding executive burnout through time for quiet, focused engagement in their work and professional coaching is also of critical importance in reducing turnover and supporting an environment for the formulation and successful execution of strategic objectives.

Here are some insights into these solutions.

Define scope and clarify objectives of strategic plans

Multiple factors regarding scope can cause challenges to successful execution of strategic plans. 

When confronting the challenges resulting from legislative changes such the rollback of the 340B Drug Discount Program, for example, targets move daily, altering leaders’ perceptions and outlook.  It becomes increasingly difficult to identify the appropriate scope, objectives, and implementation timeline for long-term strategic plans.

When strategies become too broad, there is a risk that decision-makers will suffer from “analysis paralysis.”  Likewise, if the timeline for achieving the objectives is too long, it is possible to lose sight of goals in the fast pace of today’s market. 

The most effective strategic plans comprise three major components:

• Define an appropriate strategic scope and measurable objectives. In addition to identifying the overarching long-term goal, focus on a handful of achievable, measurable short- and medium-range objectives and a timeline that will enable the executive team and individual task teams to achieve measurable results and maintain momentum from one strategy meeting to the next.

• Clarify objectives so all team members understand them and there are no information gaps.

The key is to ask all team members to repeat the objectives and then explain how they interpreted the goal based on their individual contribution. It is in this dialogue that leaders validate that team members understand the objective, associated expectations and have reconciled their personal responsibility with the project and team goals.

• Assign reasonable accountability.  For each clearly defined objective, set a deadline or timeframe for it, and delegate the responsibility to a particular team member. Too often tasks are discussed and then go nowhere as leaders are often distracted by the next conversation or a subsequent pressing issue. Participants tend to prioritize tasks when they know they will be held accountable. It is important that leaders also remember, especially within today’s healthcare environment, that things are changing rapidly and there will be unforeseen personal and market challenges that alter or derail strategic initiatives. Timely communication and managing expectations are vital to managing the overall project and understanding why individuals are unable to meet original tasks or objectives.

Developing an effective strategic plan often involves a series of “retreats and advances,” both figuratively and literally. In particular, quarterly retreats streamline strategy formulation and execution.

Quarterly retreats: Defining strategy; measuring progress  

A series of focused quarterly retreats can cut years off the time required to develop and execute strategic plans. Their success is rooted in the combination of education, due diligence, and focused discussion that they entail.

Effective retreats begin with a “state of the union” overview of the status quo and the most impactful priorities. These may include: key metrics, market information, recruitment plans, distribution — whatever items provide the biggest return. From there, a discussion ensues, with data and analytics available to answer any questions.

The goal of the retreat is to emerge with an agreed set of strategic initiatives, each of which includes “skeleton” deployment plans with a timeline, metrics to measure results, and assigned responsibilities/accountability measures.

Scheduling retreats every 12 weeks encourages accountability. At each retreat, team members review the goals of the previous retreat, present status reports of their results against targets, and decide whether to carry the earlier goals forward or to amend them. Regular status reports keep people focused and action items moving.

In between, busy professionals need “retreat” time every day to think about and execute these tasks. This avoids the burnout that comes from over-connectivity.

Daily/weekly retreats: Avoiding over-connectivity and burnout

High turnover rates suggest that healthcare executives are consistently struggling to handle ever-changing and competing priorities.

A major culprit in burnout is the consistently overwhelming work cycle of daily meetings, information-gathering, and decision-making.  This means they often spend their evenings and weekends catching up on emails and other tasks. Various strategies can counteract the inevitable fatigue that such a schedule creates; for example:

• Discontinue personal cell phones.  Some organizations stop paying for employees’ personal cell phones. This eliminates the pressure on leaders to be reachable at all times, allowing them the choice to step away during non-business hours.

• Put in place a “No-Meeting Days" policy.  To create breaks in the endless cycle of meetings — giving people a chance to focus and be intentional in their roles — some organizations have implemented “no-meeting days” once a week that allow people the time they need to catch up on their strategic initiatives. There is flexibility inherent in a day without the distraction of meetings; sometimes, executives need a day just to appropriately respond to emails and phone calls.  The most effective time managers will start a no-meeting day with a to-do list of items to execute that day. To keep the to-do list from getting out of hand, they focus on one or two top priorities rather than trying to check off 10 things in one day. Leaders will inevitably be pulled in other directions, even without the distraction of meetings, so they must plan wisely, isolating the top priorities that have the most impact on the organizational strategy and focusing on those.   

Executives and leaders are constantly busy but they aren’t always sharply focused. They need opportunities to take a break from the noise and focus on the task at hand, even for just half a day.

• Offer professional coaching.  In addition to reducing distractions and providing executives with task-focused time, professional coaching can be effective in helping them to prioritize their increasingly limited time and resources. This is not just for new promotions and young executives anymore — it also helps seasoned leaders keep their role front of mind when they are pulled in various directions. From a cost perspective, it makes more sense to spend the money on coaching than to spend 25 percent of that person’s base salary recruiting a replacement and the time it takes to onboard someone new. Executives are high-energy people who sometimes need to be reminded to delegate so they can put intentional focus on their main priority: creating vision and developing strategy.

In an ever-changing healthcare environment — in which the next legislative initiative or market shift always seems to be just around the corner — successful healthcare organizations will learn to avoid two common pitfalls to achieving their strategic goals. To survive and thrive, they will support both the development of clear, sustainable strategies that achieve objectives and their brightest stars.

Michelle Mader, is President of Catalyst, a healthcare strategy consulting firm.