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By Monica E. Oss

I found the perspectives of our CEO panelists – Kim Bond, President & CEO, Mental Health Systems, Inc.; and Harriet Hall, Ph.D., Chief Executive Officer, Jefferson Center for Mental Health at the 2014 OPEN MINDS Performance Management Institute “townhall” session, What Keeps You Up At Night?  The CEO Role In Improving Organizational Performance , most interesting. In the past, when we’ve asked CEOs about their worries, the answers have been largely about the present – productivity, staffing, contract management, and more. What did I take away from this year’s session?  That those worries are also about the future – and how to “move” organizations to a sustainable and successful market position in that future scenario.

The ability to perceive events in the future is the very definition of clairvoyant.   The unique twist for a CEO – not only understanding what the future might hold, but doing something about it. As Dr. Hall noted, “As CEOs we tend to live in the future.  Out there in the future, I’m always looking for ways to make the things I’m thinking about relevant for the staff. How do we deal with the present?” For Dr. Hall, key to that relevancy is strategic planning, and specifically, scenario-based planning.  How many distinct futures can your executive team come up with, and then how do you prepare for the broadest range of possible futures? In this planning approach, your executive team outlines the likely scenarios in each market, develops a plan for each, and builds their action plan around the most likely scenario (for a look into the eight future developments organizations can count on, see Role Playing For Success and The Futurists View of Health & Human Services: A Briefing & Executive Exercise in Strategic Scenario Planning).

But preparing for future scenarios – making the hard choices that are required – is a huge challenge.  In the words of Ms. Bond, “It takes a while sometimes to turn the boat, and it’s a scary decision. How many scenarios are there?  That’s the job of the CEO.”  In her discussion of planning for the future, Ms. Bond touched on many of the scenarios that we have covered at OPEN MINDS – preparing for the PPACA (see We’ve Seen The Future Of Health Care & It’s Massachusetts), implementing EHRs (see Implementing An EHR System?), offering more retail services (see ‘Retail’ View Of Health Care Here To Stay), and providing more consumer choices (see If Consumers Have a Choice, Will They Choose You?).  The market variables that affect strategy are many.

My favorite new phrase from this year’s institute came from this session: Ms. Bond’s discussion of anticipating the “lethal competitor.”  The gist of the concept?  Imagine a new organization (or a “new to your particular market” organization) that starts competing with you for your core business. The question for CEOs – what assets could they have (staff, services, resources, contracts, technology, etc.) – and how does your organization compete?

While much has been written about mindfulness and the importance of a focus on the present, the present cannot be the sole focus of CEOs.  To quote the age old lesson of General Buford at Gettysburg (see Positioning For Strategic Advantage: General Buford & The High Ground), the leaders role is to make sure their organization is positioned and prepared for what lies ahead. That can keep you up at night.

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