What is the BHAG?

BHAG is an abbreviation for Big Hairy Audacious Goal. A big picture ambitious definition of an objective such that those with a common desire can define it and work towards its achievement collaboratively.

Such as:

For a defined geographic area to be the pre-eminent provider of a chosen Specialist Service in the UK. This might mean the fewest bad outcomes, the best patient to cost ratio, whatever, those involved can pick the metrics better than I.

If that, or something similar, is adopted by all providers be they community or secondary care, the rest is easy. Easy and at the same time impossible. The conundrum being that while ambition is easy facilitating it is a complex task that can never end. You may be World Champion today but for how long?

Let us not allow ourselves to be diverted too much, let’s stick with being World Champion first. To start you need to want to do it. If you are part of a team then everybody, ideally, but certainly the majority, of the team needs to want it, (and be prepared to pay the price to achieve it).

The price is collaboration. Key to any significant achievement is the cooperation of those in pursuit of a clear and common goal. The lack of this collaboration or cooperation is widely accepted to a major factor for most failure.

As I said, that is the easy bit. Creating a team helping them to identify a vision and booking a room for them to get on with it. The Infinite Monkey Theorem might be applicable in so far as conceptually there is enough time, but the probability is still infinitely small. What would have helped a lot is collaboration, or a common language. 

So, it is important to have an ambitious goal generated through the collaboration of a team, but it is not likely to be successful without a common language. For a BHAG as suggested above that language is a Process Model. If you can get as far as a definitive what, a definite what by a definitive when, you can move on to process. Any solution is said to involve people, process and technology.

People might be the most complex of the three and “modern management’ might suggest the specialist skills required might be soft but none the less vital. To facilitate positive collaboration is a valuable and equally hard balance to maintain.

The process element might best be described as a wolf in sheep’s clothing. In a lot of ways, it must appear to all as a flexible framework but at the same time demands a pedantic attention to detail to achieve its aggressive attitude to short term targets. 

Start with the smallest thing you can, decide on an aggressive target to deliver it and back fill, as far as possible, everything else. One of the things you need to keep enthusiasm is a sense of urgency. Deliver what might be described as the minimum viable process and incrementally improve it.

Improvement can come in many ways; the team bolstered with early success and thus feel able to increase its support, for a collaborative effort, not least of all. The best ideas normally come from the people doing the job. The other big part of any potential for significant improvement is technology.

What do we know about technology? It is very clever, takes a long time and costs a lot. While I accept this might be overly simplistic and some assumptions need to be challenged it seems a lot harder than it should be. Often this is down to the tail wagging the dog syndrome, no matter how exciting the potential it is important to remember that it is a tool.

One example of relatively new technology, Robotic Process Automation, challenges the cost and time assumptions of the past. It might be best thought of as a one-to-one robot for any one worker in a white-collar profession. Not one solution fits all GP’s but more the 80:20 model, where 80% of the work can be re-used and it is accepted that 20% is per user.

We already have AI that can outperform a team of experts in a fraction of the time, as technologies such as this become more available it will be critical to adopt them quickly into to any process. This can and no doubt will be a significant challenge to the already difficult aspect of positive collaboration.

There is, in summary, no one thing. The more integrity the better, clarity and collaboration are critical, a shared vision of high ambition mandatory but above all these a process that can facilitate.

Martyn Richards

WTF