What every Healthcare Executive must learn from… Measure What Matters.

Whether you work for a Hospital, ASC or anything in between, the Healthcare Industry can learn a lot from the goal-setting habits of companies like Amazon, Apple & Google.?

Plus, as healthcare organizations are more and more strained because of staffing issues, having strong organizational alignment is essential if the organization is expected to succeed & grow amidst the challenges of today.?

So here is a summary of the excellent book, Measure What Matters, with a healthcare lens applied…

The author of Measure What Matters is John Doerr. He is a famous venture capitalist, helping some of the most successful technology companies on the planet get off the ground, including Amazon, Intuit, and Google.

While Doerr was at Intel in the 70’s, a colleague of his (Andy Grove) told him that at Intel, it almost doesn’t matter what you know. It’s what you can actually accomplish that tends to be valued. Hence the company’s slogan: “Intel delivers."

That relentless focus on delivering results led to the creation of Objectives and Key Results (OKRs), which is the focus of this book.

It's a methodology that has gone on to be used in some of the world's most successful companies, including, most famously, Google.

Over the next 7 minutes, we’ll explore what OKRs are and how you can use them at your healthcare facility to transform the results you and your teams are getting.

What are OKRS?

In the fall of 1999, Doerr had placed the largest bet in his career as venture capitalist. He had pledged $11.8 million of his firm's money for a 12 percent stake in Google - which at that time as a startup founded by a pair of Stanford dropouts.

Throughout his career, Doerr had seen over and over again that ideas were the easy part - execution was everything. And while Google had an amazing idea and business plan, he wanted to make sure his huge bet paid off.

So, standing in front of a ping-pong table surrounded by Sergey Brin, Larry Page, Marissa Meyer, and about 30 or so other early employees at Google, he launched into his pitch for Google to adopt the OKR framework.

His first slide defined what OKRs actually were:

“A management methodology that helps to ensure that the company focuses efforts on the same important issues throughout the organization.”

An objective is what is to be achieved - nothing more, and nothing less. They are concrete, action oriented, and hopefully, inspirational.?

A key result is the how, which is tied to a number that is time bound, aggressive, and realistic. This ensures that the results are measurable and verifiable.

Eric Schmidt, who would later be brought in as professional help for the young company, credits this system with changing the course of the company, forever.

Before we move on, here are a few takeaways about what makes a great OKR system:

• Less is more. You should have between 3 and 5 OKRs per cycle (which is usually a quarter).
• Set goals from the bottom up. To encourage engagement in the process, half of the OKRs should be set by the teams and individuals themselves (like SPD, Scrub Techs, OR Nurses, etc..), in consultation with their managers;
• Stay flexible. If an objective or key result no longer seems to be relevant, get rid of them.
• Dare to fail. People achieve more when goals are set that require them to grow beyond their current capability.
• Be patient. This is a process, and trial and error is your friend.

Some great categories of OKRs that could be established inside your surgical department, for instance, are:

• Surgery Cancellation Rate
• Preference Card Standardization
• Waste Reduction
• Cut to Close Times

So that's what OKRs are, now let's move on to what they can do for your organization.

Benefit #1: Focus & Commitment to Priorities

The first thing OKRs will do for you is help you focus on the most important priorities.

The process begins with deciding what is most important for the next three months. The lesson here is no matter how large or small your company is, you can't "do it all."

By deciding what can get done in a fixed period of time, you'll naturally focus on initiatives and projects that will make a real difference, right now.

But a note of caution: this is a process that requires participation from the entire organization. Leaders, you must practice what you preach. Publicly committing to your ORKs, and making them visible to the organization, is critical.

The ultimate end result is that it will lead to real performance gains.

Benefit #2 - Teamwork

Transparency seeds collaboration. Colleagues can see when someone needs help and offer support. 92 percent of the US working adults said they’d be more motivated to reach their goals if colleagues could see their progress.

Public goals are more likely to be attained than goals held in private. When people see how their goals are connected with their colleagues’ goals, they can contribute more meaningfully to the company’s success and see the overall consequences of their actions.

Healthy organizations encourage some goals to emerge from the bottom up (bottom-up OKRs foster engagement and innovation), while other goals get defined by the company’s leaders (top-down alignment brings meaning to work, authority, and long-term vision).

In other words, a healthy OKR environment strikes a balance between alignment and autonomy, common purpose and creative latitude.

“Connected goal-setting is critical to enabling employees to do the best work of their lives.” – Brad Smith, Intuit CEO

Benefit #3 – Accountability

"In God we trust; all others must bring data." - W. Edwards Deming

Unlike traditional, “set and forget” business goals, OKRs are living, breathing organisms driven by data: they can be tracked and revised or adapted as circumstances dictate.

But if all OKRs are public in a general-purpose software (say, Google Docs), who would have the patience to search out connections or alignment? It’s not scalable.

Likewise, without frequent status updates, goals become irrelevant. At quarter’s end (or worse, year’s end), we’re left with on-paper, zombie OKRs devoid of meaning.

Fortunately, more and more organizations are adopting robust, dedicated, cloud-based OKR management software, where users can navigate a digital dashboard to create, track, edit, and score their OKRs, as well as see their connections with others’ OKRs.

One software solution we’ve personally used at PREFcards? to track our OKRs is Blaast.

Such platforms make everyone’s goals more visible, drive engagement, promote internal networking, and save time, money, and frustration.

Most importantly, frequently tracked OKRs speak to something powerful: the intrinsic value of the work itself.

People crave to know how they’re progressing and see it visually represented, down to the percentage point.

Periodic check-ins – preferably weekly – are essential, too. Without them, the executive has no way of knowing what matters and what’s noise.

Tracking OKRs can stop you from persisting in the wrong direction. Feel free to end an obsolete Key Result or Objective midstream. Just make sure you notify everyone depending on it and reflect on what you’ve learned.

Finally, objective grading, continuous reassessment, and reflection will help you reveal information hidden inside the numbers that you couldn’t reveal otherwise.

We can learn a lot from Google: they divide their OKRs into two categories.

Committed Objectives: they are tied to Google’s metrics, such as product releases, bookings, hiring, customers. Management sets them at the company level, employees at the departmental level. These committed objectives (sales & revenue goals) are to be achieved in full (100 percent) within a set time frame.?

Aspirational Objectives: they reflect bigger-picture, higher-risk, more future-tilting ideas. They originate from any tier and aim to mobilise the entire organisation. By definition, they are challenging to achieve. Failures – at an average rate of 40 percent – are part of this territory.

Leaders are forced to ask the following question: What type of company do we need to be in the coming year? Agile and daring, to crack a new market – or more conservative and operational, to firm up our existing position?

In pursuing high-effort, high-risk goals, employee commitment is essential. Stretch your team too fast and too far, and it may snap. Leaders must convey two things: the importance of the outcome, and the belief that it’s attainable.

Starting with a modest stretch, over time teams and individuals gain experience with OKRs, and their Key Results become more precise and more aggressive.

Continuous Performance Management and Culture

Continuous performance management is implemented with an instrument called CFR, which give OKRs their human voice:

Conversations: an authentic, richly textured exchange between manager and contributor, aimed at driving performance.

Feedback: bidirectional or networked communication among peers to evaluate progress and guide future improvements.

Recognition: expressions of appreciation to deserving individuals for contributions of all sizes.

Conversations

Five critical areas emerge from conversation between managers and contributors:

1. Goal setting and reflection. The discussion focuses on how best to align individual Objectives and Key Results with organizational priorities.
2. Ongoing progress updates. The brief and data-driven check-ins on the employee’s real-time progress, with problem solving as needed.
3. Two-way coaching. It helps contributors reach their potential and managers do a better job.
4. Career growth. It develops skills, identifies growth opportunities, and expands employees’ vision of their future at the company.
5. Lightweight performance reviews. A feedback mechanism to gather inputs and summarise what the employee has accomplished since the last meeting.

Feedback

Today’s workers want to be ‘empowered’ and ‘inspired,’ not told what to do. They want to provide feedback to their managers, not wait for a year to receive feedback from their managers. They want to discuss their goals on a regular basis, share them with others, and track progress from peers.

Recognition

Modern recognition is performance-based and horizontal. Here are some ways to implement it:

• Institute peer-to-peer recognition. When employee achievements are consistently recognized by peers, a culture of gratitude is born.
• Establish clear criteria. Recognize people for actions and results: completion of special projects, achievement of company goals, demonstrations of company values.
• Share recognition stories. Newsletters or company blogs can supply the narrative behind the accomplishment, giving recognition more meaning.
• Make recognition frequent and attainable. Hail smaller accomplishments, too: that extra effort to meet a deadline, that special polish on a proposal, the little things a manager might take for granted.
• Tie recognition to company goals and strategies. Customer service, innovation, teamwork, cost cutting – any organizational priority can be supported by a timely shout-out.
• To sum up, OKRs are clear vessels for leaders’ priorities and insights. CFRs help ensure that those priorities and insights get transmitted. But goals cannot be attained without a medium: an organization’s culture.

Culture is “a set of values and beliefs, as well as familiarity with the way things are done and should be done in a company.”

An OKR culture is an accountable culture. You don’t push toward a goal just because the boss gave you an order. You do it because every OKR is transparently important to the company and to the colleagues who count on you. It’s a social contract, but a self-governed one.