Friday, June 20, 2012
I spend a lot of my time working with providers on developing effective strategic plans, but no matter how brilliant the strategy, if it is not implemented, it will be a failure. One of the biggest barriers to the successful implementation of strategy is a “disconnect” between the strategy and organizational culture. Here are the two disconnects that I see challenging health and human service organizations.
Confusing the means with the ends – The means (how we are doing something) becomes much more important than the end (the mission of the organization). For example, the mission of many organizations treating children usually focuses on helping children and youth function well. Programs (residential, in-home, etc.) are the means to that end, and the means can change as the environment changes and advances in treatment technologies offer a whole range of new options. Unfortunately, in many organizations, program staff and leadership confuse the two and are unwilling to change what they do. The leader must have a plan to address this cultural issue, must model the desired culture, and must hold all other leaders and managers accountable for doing so also.
For example, I recently worked on a project where an organization was considering modifying one of its long standing community-based programs to reflect requests by its primary payer to utilize the payer’s preferred evidence-based model. For some staff (including the clinical director), even considering this was akin to “selling our soul” and giving up “what we have always been about.” Debating the advantages of one model versus the other in terms of efficacy is a legitimate and important process. Staff, or a whole organization, locked into a specific model at the expense of alternate approaches clearly illustrates how this “ends versus means” issue can negate the ability for organizations to adapt.
Moving to a culture of accountability and metrics – A critical part of any strategy is using metrics to track performance, and many leaders know this is what their organization needs to do. But in many cases this is a major shift from a culture of no or minimal accountability to a culture of open sharing of metrics and pay for performance. I recently saw this issue first hand at a provider organization where raising productivity requirements (always a popular topic) was being discussed. A clinician gave a very impassioned soliloquy on how this was just another example of that organization losing its family atmosphere in favor of more money. Unfortunately, in this case, the organization was facing a serious deficit, and needed to address what was by any measure, a very low productivity standard.
A critical aspect of effective leadership is understanding your organization’s culture, and knowing when cultural issues must be addressed. For a deeper look into the leadership attributes most important in today’s health and human services organizations, join me at The 2012 OPEN MINDS Executive Leadership Institute, September 14 in Gettysburg for my presentation, Enhance Your Leadership Style: Building Management Skills In A Chaotic Market.
John F. Talbot, Ph.D.
Executive Vice President, OPEN MINDS
For another free resource, see: Looking at Leadership Through a Big Picture Lens all members
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