In conjunction with our newly released DVD on strategy deployment in healthcare, the ThedaCare Center for Healthcare Value has released a new white paper on the subject that you can download for free.
The white paper features quotes and insights from leaders at three leading healthcare organizations, all members of the Healthcare Value Leaders Network: ThedaCare, Group Health, and St. Boniface Hospital.
What is “strategy deployment” at a high level?
Strategy deployment is a management process that helps executives to focus and align their organizations around the most important goals. Goals and plans are cascaded down and up in an organization — senior leadership to middle management to frontline staff and back up — for repeated review, input, actions, and revisions. Senior leadership may initially point to priorities that support a vision or mission (True North), but the rest of the organization collaboratively translates those goals into specific plans, targets, and actions. And unlike traditional planning, it's not an annual exercise but an iterative approach for transformation and continuous improvement.
Why did ThedaCare, among others, need this new management system?
Prior to strategy deployment, planning at ThedaCare also was quite traditional. “Our planning  process before was usually a big batch where we'd have a board retreat for four or five hours,”  recalls Dr. Toussaint. “We'd set up questions and get the board into small groups. We'd take that  feedback and try to sort out a strategy, which then we'd use for the next year, and that went on  year after year after year. And, of course, the day after we had created this strategic plan, it was  sort of already out of date.” About three years into the lean journey at ThedaCare came the  realization that the real goal “was to engage frontline workers, in not only identifying defects but  solving problems. We were completely disconnected between the senior executive strategy and  the frontline workers, and I include doctors in that frontline group. We realized we needed to do  something different.”
In the paper, each organization describes how strategy deployment helps create alignment in performance measures and improvement activities – all aligned to the “true north” objectives of the organization.
As we were working on the DVD, I had a chance to observe and talk with leaders at different levels at ThedaCare and there really is a very high sense of alignment and ownership. First level managers can talk about how their local activities support the overall strategy, and vice versa.
The diagram, below, is explained in the white paper, a visual representation of the top-down bottom-up planning and communication cycles:
As with many things related to Lean, it can be easier to understand strategy deployment conceptually than it is to change habits and behaviors in an organization and at the senior leadership level.
“I don't think that [strategy deployment] is necessarily hard, I think it is just really different than  what most people are used to, both coming out of MBA schools and medical schools,” says Dr.  Toussaint. “We're not trained to think this way, and I think that is the challenge.”
A final quote from the paper:
Group Health's Hereford looks back at what's changed and how it positions his organization for  the future: “This is really about the dialogue. It is not about the answer so much as the surfacing  of all the tensions that will be there no matter how you approach this. This is about intentionally  going after and surfacing them at the front end.” He says, “Give yourself permission to have  those kinds of tensions surface.””Group Health is a fundamentally different place to work than it was five years ago,  fundamentally better,” stresses Hereford. “We have a different culture now. My prediction is that  in the next five years it will be fundamentally different than it is today and an even better place  to work.”
I hope you find the paper helpful. Feel free to post feedback or questions here.
- White paper link (via the Healthcare Value Leaders Network site)
- DVD: Thinking Lean at ThedaCare: Strategy Deployment
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Thanks for posting, Mark. I think Strategy Deployment may be one of the most underutilized Lean techniques but perhaps the most powerful in moving healthcare organizations from “optimizing the parts/local lean” to optimizing the whole. It would be interesting to examine the impact of the use of SD on unit level improvement and performance to provide more support for its effectiveness.