MarieAnn Thornburg

The current economic environment in health care is so challenging that much of our time is spent managing from crisis to crisis.

Crisis management is not rewarding, nor does it lead healthcare organizations to a better future. Even when our very survival seems to be at stake, leaders should consider where they are taking their organizations. Effectively focusing on where to lead our organizations in the midst of uncertainty is like taking a road trip.

The organizational road trip to success parallels a family vacation. In this example, the vacation is a road trip using a GPS navigation system. Seven steps are involved for our family and for our corporate journey.

Step one is entering one's home address into the GPS. For organizations, defining "home" involves redefining mission. Why do we exist? Are our effort and resources being spent in a manner that aligns with our reason for being? Too many organizations stray into areas that are not their core strength, wasting resources and talent.

Step two in our family road trip is defining our final destination. Our GPS system does not help us without an end point, nor does it help us if we have only a vague end point or general direction. If we want to arrive at a specific destination, we need to enter an exact address. For organizations, this step means defining vision. We do not need the grandiose statements of the past that weren't particularly measurable ("We strive to be the high-quality, low-cost provider of choice"), but rather, a specific end point. What exactly are we driving our organizations toward? Does everyone share the same understanding of where we are going?

With the final destination entered into our GPS, our system now provides the road map for how we get from our home to our destination (step three). Although it is critical to have this road map to measure our progress, the road map is not what actually gets us there.

Healthcare organization leaders often mistakenly think strategy, metrics, and dashboards are what determine the organization's future. They are not. Vision determines the future. The road map (strategy, metrics, and dashboards) simply measure our progress toward our goal and help us stay on path. They are valuable tools and should be used as such. Strategy should adapt to vision, not vice versa. If our family wants to end up at the beach and the road is closed due to an accident, they reroute. They do not allow their original set of directions to throw them off course from their final destination. Although this seems obvious for the family journey, it often happens in organizations. Strategy that no longer makes sense is adhered to, and vision is lost.

Having gotten their road map, our family could still be sitting in their living room without any progress toward their destination. Knowing where they want to go and having the correct directions does not actually get them there. They need a car. Similarly, organizations need resources (step four). Starting down a path that cannot be traversed leads to defeat and distrust. Unrealistic vision isn't vision-it's hallucination. Although the organization's strategy (the road map to the vision) may need to be altered and adjusted to reach the final destination, the journey cannot begin without the vehicle (i.e., resources).

The fifth step for our family's journey is identifying a driver. The vehicle itself cannot get the family to its destination. For organizations, this step equates to the need for a leader. One person needs to be "in the driver's seat"-fully accountable for the journey. On a lengthy drive, our family may switch drivers. Similarly, an organizational leader may delegate to another individual for a phase of the corporate journey, but there should never be any confusion as to who is driving.

Our family needs to decide who gets to go on the trip and how the trip "works" (step six). Most families can identify with the strong desire to leave an unruly teenager at home-and some have! Organizations similarly need to decide who gets to go on the trip. Not everyone adds value, and perhaps some employees should be left behind lest they ruin the journey for others. The GPS also asks us if we want to take the fastest route, shortest route, or scenic route. Are we going to stop every couple of hours along the way or blast on through? Are we going to sightsee or push to the final destination? If expectations among the passengers are not understood, discord results.

In an organizational framework, this step requires that leaders communicate their values. Who gets to be part of this team? How do things get done? What are the unwritten rules? Values and ethics are critical to healthy organizations, and communicating them with clarity allows people to decide if they "belong on the bus or if it's time to get off." With the challenges we face in the current environment, leaders do not have time and energy to waste on internal obstacles. Strong corporate values ensure that little time is wasted on negative behavior. Employees are "on board" because they want to be part of the team, and because they share common values and ethics.

Finally, our family can look back and decide whether they had fun on the journey (step seven). Would they do it again or do something different? Were some family members ready to kill each other at the end, or were they ready to plan the next trip? What would they do differently next time to make the trip a greater success?

For healthcare organizations, stopping to consider lessons learned not only increases the likelihood that the same mistakes won't be repeated, it also establishes culture. Did the team have fun on the journey? Did the process build loyalty, provide a positive sense of accomplishment, and increase stability at the end? Is the organization at a better destination? Did it actually reach its vision, or did the team arrive at an entirely different destination (by design or by accident)?

Our vacationing family could have ended up at a different destination; bad weather could have resulted in a change of plans en route, canceling a beach trip and instead rerouting them to a mountain resort. But this would have been a conscientious decision by our family based on changing environmental reality, rather than on getting lost. The same should be true for organizations, but often isn't. Leaders get distracted by the crisis of the day and lose sight of the destination they are driving toward. They simply get lost, and drive around in circles until they run out of fuel.

Our family vacation trip is a practical example of how our organizations should optimally function, in good times as well as in challenging times. We need to emerge from our frustrations and discouragement with the current reality, and reformulate the big picture, putting ourselves as leaders back in the driver's seat. The process for this accomplishment is for our organizations to take a fresh look at mission, vision, strategy, resources, leadership, values, and culture. Only then can the journey be worthwhile.

MarieAnn Thornburg, FACMPE, is CEO, Posada Consulting, Charlotte, N.C. (MNorthTHG@aol.com). 

Publication Date: Friday, October 01, 2010

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