Best Practices

Execution: The only way to avoid a slow death

You’ve got a plan — now what?

By Maureen Waddle

Recently, I chuckled as I recalled a quote from then-Tampa Bay Buccaneers Head Coach John McKay. After watching his lackluster NFL expansion team deal with yet another defeat in the late 1970s, Coach McKay had the following response ready for a reporter’s question:

Reporter: What did you think of your team’s execution?

Coach McKay: I’m all for it!

“Execution” was on my mind as I finished a two-day strategic planning session with a large, multi-specialty ophthalmic practice. I was confident this group had developed the discipline necessary to execute its plan. But I had since heard from others that they frequently fell short on implementation — to me, the most important step in the strategic planning process.

Practices rarely have trouble producing ideas and finding opportunities. But maintaining focus and momentum on the right opportunities, however, are other stories. When they can’t stay with the plan, many practices give up planning altogether. This reduces the chance of ever achieving the owners’ vision.

These tips can help create an implementable plan.

Outline specific steps to make your strategic plan happen.
COURTESY GOOGLE IMAGES

EXECUTION POINTERS

Keep it simple. Though a strategic planning session may incorporate broad looks at industry and external forces affecting a practice, the focus needs to be narrowed to goals and key points that the staff will understand. The result of a strategic session needn’t be a business plan in a two-inch-thick binder that collects dust on a shelf. To execute against a workable plan, the results of a planning session should include:

• Confirmation of the owners’ vision/direction for the practice.

• Consensus on three to five key imperatives necessary for success (achievement of your vision in a fiscally responsible fashion).

One large practice was looking for ways to increase its bottom line. The partners arrived at five imperatives, four of which were similar to the following:

• Re-assess the marketing plan to reduce the marketing expense ratio to less than 5% by year’s end;

• Enhance customer service levels by completing a review of all clinic processes and schedules so that patients do not wait more than 15 minutes at any point during their exam;

• Reduce patient complaints by at least 10% in patient satisfaction surveys;

• Identification of one to three opportunities to pursue over the next one to three years.

Another client identified the following as opportunities it would pursue this year:

• Finalize expansion location options for 2016 by completing demographic research and feasibility analysis of the top five possible satellite locations it had already identified.

• List action plan tactics to improve performance in key imperatives and pursue opportunities over the next 12 months.

• Conduct a time/flow study to improve clinical efficiency, its focus to be on reducing patient complaints. This is a common tactical item that appears on many action plans I see.

• Determine a financial and human resources budget to implement the plan.

Communicate the “why” early and often. Not all people need the “why” to perform, but experts believe that staff members are better decision-makers when they understand the “why.” Leaders should explain (and repeat, as necessary) the planning process and the reasons for selecting the key imperatives. This can be done in meetings, emails and personal communications about action-plan progress. Armed with a level of understanding and a sense of purpose, team members will figure out how to execute against a plan.

Measure and report. Enacting a plan requires cross-functional teamwork. Departments often function in silos without a consistent standard for communication and input from other departments. Establishing specific departmental goals directly related to practice goals will help change this, and speaking intradepartmentally about the plan and celebrating milestones will encourage cooperation.

For example, a common practice goal is to increase cataract surgery volume by a certain percentage. Practices most successful at achieving this first set specific departmental goals supporting that vision. Those who recognize the number of surgical consults must also rise simultaneously naturally identify that additional goal.

For practices that want to increase revenue by a certain percentage, I often point management-physicians toward identifying potential areas of opportunity and encouraging them to determine departmental goals accordingly. For example, several practices I’ve worked with reported struggles with reimbursement, so I suggested they adopt several key department-specific measures to ensure their practices are maximizing collections for all services provided. The practices that heeded the recommendation met their overall goal.

Be agile and keep planning. Strategic planning is a process, not a meeting. An initial action plan will be dynamic over the course of the year, as not all necessary barriers and tactics are foreseeable. For example, during the strategic planning session you decide you want to recruit a corneal fellowship-trained surgeon into the practice. However, as you start the recruiting process you cannot find a good practice fit with that subspecialty, but another candidate — a glaucoma specialist and a very good core value match — reaches out to you. Sometimes you have to be opportunistic and adjust your strategy. Allow the team to make adjustments as results start taking shape, keeping the key imperatives top of mind.

Learn the discipline of “no.” The complexity of practice operations makes it easy to spend time pursuing opportunities or working on projects that are not part of the strategic plan. Leaders must learn to consider changes and respectfully say “no” when appropriate. Remain focused on the identified priorities.

Celebrate successful execution. Make an effort to have certain bonuses that encourage plan implementation. For example, consider giving a bonus even if a department doesn’t achieve its usual bonus goals, yet does an outstanding job implementing plan tactics.

LONG-TERM VISION

While it takes time for staff members to learn how to execute effectively against a strategic plan, they will see results and improvement. Ultimately, working to fulfill the plan will become embedded in the practice culture. Committing effort to that fulfillment will improve your organization’s chances of achieving its long-term strategy. OM

Maureen Waddle is a senior consultant with BSM Consulting, an internationally recognized health care consulting firm headquartered in Incline Village, Nev. and Scottsdale, Ariz. For more information about the author, BSM Consulting, or content/resources discussed in this article, please visit the www.BSMconsulting.com.