New to healthcare, Pain Specialists of Cincinnati CEO Shawn Grubb is translating 18 years of Fortune 500 work to independent practice management. With experience developing international strategy and project management execution, he intends to create what he calls "a national powerhouse in pain."
Mr. Grubb shared insights on practice strategy and execution with Becker's ASC Review:
Question: Why is it important to distinguish between strategy and execution?
Shawn Grubb: Peter Drucker, the founder of modern management, said it best: "Plans are only good intentions unless they immediately degenerate into hard work." And I see no lack of plans in healthcare; what is missing is the executional hard work to deliver on those plans.
Q: When did you recognize that healthcare struggles with strategy and execution?
SG: I joined the healthcare industry in 2017. After 18 years in the consumer products [business], it was apparent that healthcare was infected just like the rest of the business world. The problem is twofold. First, leaders lean too heavily on developing a beautiful strategy but fail to recognize they don't have the organizational maturity to turn the pretty picture into reality. If the plan is effectively developed and rolled out, the second issue is that employees (as well as leaders) confuse "action" with "progress." An example of this last point is showing all the work being done on a new project, but failing to demonstrate progress against defined measures, or worse, not having any quantifiable measures to compare against.
Q: Why is it important to go beyond having good strategy?
SG: Many times, the people developing the strategy are the visionary, big-picture thinkers who imagine the future. But, to get the work done, those ideas need to be down to earth enough for the "get it done" executional person to be able to figure out, "OK, so now what do I go do" — and that is not always an easy jump. Good strategy is necessary, but not sufficient.
Q: How can you tell if your approach is doomed to fail?
SG: First is bad strategy, the second is bad execution. For the second point, history is your best indicator. If you have a litany of wonderful strategies that never really took hold, never really delivered or just kind of "fell out of vogue," that is a solid indicator your organization is not built to execute. This problem is evident at the year end, when you dig out that strategy document and find that the work was not started, not completed, or you can't tell if it delivered the promised results or not. Similarly, if you don't have a clear measure of success related to your strategy, your team may not be able to translate it into the "here's what I do now." At this point, you are at risk of action versus progress.
Q: Is execution an issue for both independent practices and hospitals?
SG: Although I don't have direct large system exposure, through informal networking with my colleagues in that world, it appears both systems get good at doing the day-in, day-out activities, but when it comes to executing on a new idea, we don't have the people who can take an idea and turn it into results.
While the independent clinic is hampered by both capacity and capability, I suspect that even if the larger system has people to do the work (capacity), without the right maturity (capability), the larger system can still fall short. Everywhere I have worked, this is where "actions" get confused with "execution." The team is reporting work being done, but they may not be doing the right work, or they don't know what work needs to be done to deliver the results. Thus, another pretty picture that does not deliver.
Q: What can practices do to overcome these issues?
SG: Starting now, go look at your strategy documents. Do they have clear measures of success? I mean real quantifiable numbers — not foofy mumbo jumbo. Examples of solid strategies might be "grow new patient referrals by 20 percent versus the prior period" or "reduce employee turnover by 14 percent." Poorly written strategies might be "develop meaningful referral relationships to increase partnerships" or "make clinic ABC a fun and fulfilling place to work."
Second, get a sense for your past ability to deliver on strategy. Do your projects deliver as expected? If not, why not? Were the strategies not clear enough, or did your team not have the capacity/capability to deliver? Once you have a handle on what your team can do and your strategies have clear measures, then make choices that will allow your organization to perform at its capability/capacity level. Said another way, focus on knocking a couple out of the park versus swinging at every pitch.
Want to participate in Becker's Q&As? Email Angie Stewart: astewart@beckershealthcare.com.
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