That’s the question I encourage my healthcare clients to ask. Traditionally I helped clients develop one-, three-, five-, and ten-year strategies. I don’t do that anymore. Organizations change too quickly. Both technological advancements and their relevance to businesses change too fast, and external global forces tilt the world in unforeseen ways. Now, instead, I concentrate on the one- to three-year strategy to think about five-year results. Even the five-year crystal ball starts to fog and blur, so we formulate for the long-term but plan for the short-term.

In addition to setting more realistic timelines for their strategies, I encourage clients to talk about the strategy every day, in many ways, with various people. I have found most people in most hospitals cannot recite their mission statement, which seldom changes, much less the strategy that changes at least partially every year. If every leader recited the strategy every day, in every meeting, after five years, everyone would have heard the strategy approximately 10,000 times. (200 working days a year X five years X 10 times a day). This would give new meaning to Malcom Gladwell’s “10,000 Hour Rule,” his observation that virtuosos distinguish themselves after they have practiced at least that many hours—the approximate number he discovered most had practiced in to attain the level of excellence that caused others to consider them luminaries in their fields.

Knowing whether you’ll be relevant in five years starts with the question of just how relevant you are right now. A well-thought-out strategic principle pinpoints the intersection of the hospital’s passion, excellence, and profitability, or in the case of not-for-profit hospitals, its unique contribution. As you can see from the graphic, success lies at the intersection of the three.

If your hospital operates in Section One—The One-Hit-Wonder Section—you will probably experience some short-term success, and star performers will find themselves drawn to work for you—initially. People who do work they feel passionate about and engage in work that rewards efforts with large monetary compensation can often stay in the game for the short run. But if you aren’t the best—and the clever in your hospital will quickly figure out that you aren’t—the competition will soon surpass you, and your best will leave you.

Section Two—The Avocational Section—won’t even allow you a short run. This undisciplined orientation—to do what you like and are good at—without consideration of the market, will cause your strategic vision to become nothing more than unmet aspirations. Leaders in these kinds of hospitals often refer to their mission statement as the guiding light, which it should be. But I point out that if there’s no margin, there will be no mission.

Section Three—The Burn-Out Section—eventually offers a recipe for inertia. Driven to do something—an operational bias causes quick fixes, compromises, and knee-jerk attempts to get things done. But the seductive short-term activities quickly lose their allure when you don’t include passion. Star performers don’t dip their professional toes into the water; they show up to make waves. If they don’t feel passion for the work, they won’t do it either.

The sustained success of exceptional hospitals lies in Section Four—The Powerhouse Section—the intersection of passion, excellence, and profitability. These hospitals offer state-of-the-art services that consistently encourage them to develop newer and better offerings. Only here can your hospital thrive as you work diligently to produce excellence your competition can’t match.

When hospitals face change or turmoil—like a pandemic—the strategic principle acts as a lighthouse that keeps the ships from running aground. It helps maintain consistency but gives leaders the freedom to make decisions that best serve their part of the hospital. Even when the leadership changes, or the economic landscape shifts, the strategic principle remains the same.  It helps decision-makers know when to develop new practices, new services, and new markets.  When they face a choice, decision-makers can test their options against the strategic principle by simply applying this three-part litmus tests:

• Are we passionate about this work?
• Can we do it better than our competitors?
• Will it make us money?

When designed and executed well, a strategic principle gives people clear direction while inspiring them to be flexible and to take risks. It offers a disciplined way to think about decisions, strategy, and execution; and it challenges people to play an ever-evolving better game. Top performers embrace both change and risk, but they do their best work when they understand the parameters within which they must work. These allow star performers to act as agents for and champions of change—rather than as mavericks or benchwarmers, the people who love benchmarks.

The term “benchmark” started to show up in business circles in the late 1980s and early 1990s as leaders began using benchmarking to measure performance using a specific indicator (cost per unit of measure, productivity per unit of measure, defects per unit of measure, etc.) These results provided a metric of performance leaders could use to make comparisons. From these conclusions, decision-makers could then determine internal “best practices.” So far, so good.

Then, companies started looking outside their companies to the competition, and industry benchmarking and best practices started to surface. The problem? The more benchmarking they did, the more they started looking like their competitors. Leaders learned that the more homogeneous your organization becomes, the more you’re likely to imitate rather than outrun your competition. This can quickly turn into a creative approach to bankruptcy.

What’s the alternative? Understanding the competition can help, if it leads to improvement, not imitation. But too often it doesn’t. An alternative approach involves looking outside the hospital temporarily in order to look inside to the patient permanently.

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