Hospital Impact: How to build execution into your new strategy

Table with chairs around it
Andrea Simon
Andrea Simon

One of the many challenges facing today’s healthcare strategists involves convincing the C-suite and leadership teams, as well as the entire organization, to implement a new strategy. Even when the new idea is supported by abundant data and there are excellent reasons to embrace the strategy, far too often change is a hard sell, and even harder to make happen.

In fact, change is painful, not only for organizations but also for the individuals working within them. Choosing a new direction, moving into new markets, altering processes in order to embrace MACRA or shifting to value-payment models may all be necessary--but very challenging to implement. Many times, people prefer to stay wedded to old ideas and prior strategic directions.

Here’s how to do it right

One of my recent clients, St. Vincent’s Medical Center in Bridgeport, Connecticut, discovered that its primary care referral network and long-time allies had signed on with its archrival. At a recent Society for Healthcare Strategy and Market Development conference, Dianne Auger, senior vice president for strategy at St. Vincent’s, and I spoke about this. Dianne explained how she successfully engaged the organization in a multi-pronged response to this new crisis, building an effective execution into a new strategic direction.

How did she do it? Resolutely, she redirected the efforts of virtually every department in the organization to shift its strategy, essentially building a new primary care and urgent care network with excellent results, and quickly. The St. Vincent’s story illustrates the right way to build execution into new strategic directions.

The strategic response involved three key components:

  1. Strategy and execution were team efforts. Dianne and her strategic co-workers assembled a Primary Care Institute with a multi-disciplinary team from across the institution. The team included representatives from IT, behavioral health services, nursing, marketing, design and construction, and the ACO. This had to be a strategy built and executed by a team, not by any single area.

    St. Vincent’s strategic “story”--namely, to build a new primary care network--was, ironically, one that had been suggested over the course of several years but never implemented. It took this crisis to shift focus and move in a new direction.

    For the change of strategy to work this time, everyone had to buy into it, from the top executives all the way down to the rank and file. Otherwise, employees would discount it and impede its execution. (I am sure you have all experienced a situation where those left out of the process become very good at undermining it.)
  2. Use the data wisely. Second, there was abundant data to collect, sort, analyze and interpret. A geographic information system helped identify market areas containing people who had no primary care physicians. These gaps in physician-patient relationships were important opportunities.

    It was from the data that this new strategy with real possibilities emerged. The data enabled St. Vincent’s to recognize that if it was to be aligned with population health management, it needed to engage differently with the people in the markets it was going to serve through this new network of care centers.
  3. Process is essential. Because of St. Vincent’s commitment to change, a strategic plan and an execution strategy came into being, encompassing a unified physician platform, anchor group partnerships and a retail and consumer focus. Through the Primary Care Institute, the organization structured itself into new groups focused around provider recruitment, a long-term provider pipeline, new access points, additional clinical services and dedicated healthcare consumer engagement.

For the new change strategy to work, several important steps had to be done very well:

  1. Secure the strategic intent: Staff from all levels and all divisions had to be onboard.
  2. Establish the new strategy across the organization, with everyone telling the same story.
  3. Align around priorities.
  4. Have the financial resources in place.
  5. Create new interdisciplinary teams without a hierarchical model of command and control but rather, a network of support for each other.
  6. Ensure there were clear milestones and check-ins.
  7. Make sure the strategy and operational leaders work in tandem.

As Honeywell’s Larry Bossidy, one of the world’s most acclaimed CEOs, wrote in his book, “Execution: The Discipline of Getting Things Done,“ “No worthwhile strategy can be planned without taking into account the organization’s ability to execute it.”

Hurdles to overcome as you build execution into strategy

Can you duplicate what St. Vincent’s did in your own healthcare organization to build execution into strategy? Absolutely.

First, you must have the right strategy told in the right way. People are smart. Tell them the wrong strategy, regardless of how detailed your data is to support it, or the charts are to affirm it, and they will disregard it and find other data that challenges it. Do not underestimate the power of the story.

Second, your strategy will inevitably face four hurdles that Dianne and her team overcame systematically. Do not be blindsided. Focus your efforts around these to succeed:

  1. Cognitive hurdle. You will have to alert employees to the need for a new or modified strategy. Most will be happy doing what they’ve always done and will not see (or like) the reasons for the changes.
  2. Resource hurdle. Will you have the resources to see it through? Everyone will object that the new strategy will deplete their department’s resources and will find ways to derail the new direction.
  3. Motivational hurdle. How will you motivate key players to move fast and engage collaboratively to ensure that the status quo must be left behind?
  4. Political hurdle. There is always the political environment. As one manager once told me, “In our organization, you get shot down before you stand up.”

The most important message, as the St. Vincent’s story illustrates so well, is that when all members of an organization are motivated to support a change strategy, you stand a good chance to actually change--and maintain that change.

Remember, your strategy needs a strategy.

Build execution into that strategy from the beginning and it will become a great execution--and the right strategy for your organization to embrace.

Andrea Simon, Ph.D., is the principal and founder of Simon Associates Management Consultants. She has more than 20 years of experience as a senior executive with financial services and healthcare institutions.