How the Right Process, a Focus on Mission and Stakeholder Buy-In Can Help Leaders Make Better Decisions

By Todd Stevens & Art Favre

In many ways, decision making has never been easier. Technology provides better analytics and a clearer understanding of how to mitigate the perceptions and biases that can undermine the decision-making process.

But many leaders in senior management roles often face organizational dynamics that can impede the process and lead to frustration and poor outcomes. Mismatched agendas, a failure to send decision-makers to the table, and negotiators not successfully encoding speech, body language, and other soft signals can derail the best of intentions.

The stakes are even higher for so-called big-bet decisions. These high-risk decisions have the potential to shape the future of any organization (e.g. such as a possible new partnership, acquisition, or major resource allocation).

At Mary Bird Perkins, our commitment for the past 50 years has seen a single focus — advance cancer care. Mary Bird’s mission to improve survivorship and lessen the burden of cancer measures everything we do.

When faced with recent decisions about continuing partnerships with large healthcare organizations across the Mary Bird Perkins network, we found our mission and focus on cancer in the crosshairs of a major paradigm. Large healthcare systems consolidated services, aspiring to create a cradle-to-grave model of health services, where one “system” strives to meet all health needs, from prenatal care to end of life and everything in between.

This shift can be traced back to federal policy changes enacted in 2010. Today, within large healthcare systems, patient care programs (referred to as “services lines”) compete for access to limited resources. Across a large health system, there might be hundreds of services lines, some that generate positive financial returns, while many do not. External to these dynamics, each individual patients’ access to services can differ based on their location, their insurance coverage, and a host of other factors. This ecosystem is complicated, and the doctor-patient relationship is getting further and further away from decisions that can impact outcomes.

Continuing to operate in partnerships with large healthcare systems risked distancing Mary Bird Perkins Cancer Center’s ability to drive its mission forward.

Mary Bird Perkins Cancer Center’s founders had it right when they established it as an independent, community-led organization focused exclusively on cancer. By taking a process-oriented approach, keeping our mission at the forefront every step of the way, and ensuring that we had the buy-in of key stakeholders, we’re confident the organization’s focus on cancer will continue, as it has the past 50 years, to drive advances in care for individuals and families impacted by cancer.

Here’s how we did it.

Create the Right Decision-Making Process

Decisions affecting the future of any organization cannot be taken lightly. A careful and well-thought-out strategic process must be used to ensure that decisions are based on the best available data, input and evidence. Leaders must determine the best approach to make objective, informed decisions that align with the organization’s goals and mission.

Gathering data and conducting a thorough cost-benefit analysis, weighing the pros and cons, exploring potential future scenarios, and structuring the decision-making process so that stakeholders have clear charters to facilitate decision making are all essential. These types of decisions also frequently have interdependencies, so it’s important to step back and connect the dots to understand and avoid unintended consequences.

This structured approach to decision making looks remarkably the same whether you’re talking about negotiations in the healthcare industry or the bidding process in industrial construction.?Stakeholders should take emotion out of the process and trust that the right process will result in the best outcome for your organization.

But once you’ve undergone a thorough and structured decision making process, at the end of it, you must decide. Some leaders become paralyzed by the long process and the stakes of major decisions, but decision paralysis can be disastrous for an organization, causing it to miss out on opportunities or fail to address threats or risks to its mission. Once the process is complete, it’s time to move forward, one way or another.

Even when both sides of a negotiation have the best of intentions at the outset, those intentions can prove irreconcilable. Leaders need to recognize when the other side is willing or unwilling to come to the table or move the process forward when the decision makers determine major obstacles, such as fundamental differences in objectives. This often means that a successful resolution can’t be reached.

Stay Mission-Focused

Mary Bird Perkins’ long-established mission of improving survivorship and lessening the burden of cancer means that our objective is always clear. Fundamentally, every major decision overseen by Mary Bird Perkins’ board is measured by the same yardstick — will it make us better and serve the needs of individuals and communities impacted by cancer?

That clear mission provides a guiding compass for all our decisions, from day-to-day operations to big questions about the future of our organization.

Cancer is a unique area of medicine. Cancer treatment is evolving at an incredibly rapid pace. There is much we still do not know about the diseases that comprise cancer and many areas where we are working to improve survivability and quality of life outcomes for patients. This is not a field where it is easy to make decisions based on the most cost-effective course of treatment.

Individuals and supporters have embraced this focus by investing hundreds of thousands of volunteer hours and a similar measure in dollars. That support is why Mary Bird Perkins has been able to attract amazing professionals that continue to set the bar high in cancer education, prevention and early detection, diagnosis and treatment, and support programs.

The philanthropic support Mary Bird Perkins receives levels the playing field for our patients so that they have access to leading-edge cancer-focused programs.

When our decision making process exposed the fundamental mismatches that existed between Mary Bird Perkins’ focus on cancer and the compromises to the focus needed to work within a large integrated health system, it led us in a new direction. In our new partner, OneOncology, we found an organization that shares our singular focus on cancer care that embraces the same aspirations that have driven Mary Bird Perkins forward for these past 50 years — making a positive difference for individuals impacted by cancer.

For leaders, basing your decisions on who you serve and how you can best meet their needs provides a clear objective to guide your decision making and help ensure that you make the right choice for the people you serve.

Simply put, you can never go wrong by staying true to your mission.

Ensure Buy-In From Stakeholders

Decision making cannot happen in a vacuum. It’s critical that key stakeholders, e.g. board members and senior leadership, work together every step of the way. Transparency with those stakeholders and honesty about goals and objectives ensure that there are no surprises at the end of the decision-making process.

For nonprofit organizations, the diversity of experiences and perspectives represented by the board can be a real asset when making these kinds of decisions. Diverse backgrounds can bring a wealth of knowledge and experience from a wide variety of industries and backgrounds to the process, and including them ensures that senior leadership benefits from their expertise and guidance. They can also act as ambassadors in the community, helping to inform stakeholders about the decision and how it will benefit the organization and the community at large.

It’s also important to recognize the contributions team members play when an organizational decision has been made. They are instrumental in moving the new objectives forward and help those who depend on your business understand how it will benefit them.

In the end, major decisions that can propel an organization forward should not be avoided. That’s easy advice to write in words but very hard to see through.??