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Intro: The following SHSMD podcast is a production of DoctorPodcasting.com.

Bill Klaproth (Host): On this edition of the SHSMD podcast, let me ask you this. Is your cup runneth over with plans, ideas, and initiatives, but eh, where you're falling short is the people power, the time and the execution. Hmm. For many of us that may sound familiar. So, let's talk about that with Greg Kain, Managing Director for Healthcare at Integrated Project Management Company, as he previews his upcoming in person session, at SHSMD Connections this September 19th through the 21st in San Antonio. The session is called, oh, it's a good one, You're Solving the Wrong Problem. It's Not Your Strategy Falling Short. It's Your Strategy Execution.

Oh, yeah, I like that. So let's get into that. Right now. This is the SHSMD podcast, Rapid Insights for healthcare strategy professionals in planning, business development, marketing, communications, and public relations. I'm your host Bill Klaproth. And in this episode, we talk with Greg Kain, Managing Director for Healthcare at Integrated Project Management Company. Greg is presenting a 50 minute concurrent session at this year's SHSMD Connections in-person annual conference, as a session on the strategic planning business development track. Of course, SHSMD Connections this year, held in San Antonio on September 19th through the 21st. The title of the session is You're Solving the Wrong Problem. It's Not Your Strategy Falling Short. It's Your Strategy Execution. What a great topic. So, let's talk with Greg about that, but first, Greg, welcome to the SHSMD podcast. As you know, we start every episode of the SHSMD podcast with Rapid Insights. One quick tip, someone can use to make their marketing communications better today. Greg, give us your Rapid Insight.

Greg Kain (Guest):  Well, Bill, I have two.

Host: Whoa. Two. This is a first. I love it. Yes.

Greg: It's ironic because part of my SHSMD Connections presentation is going to be about prioritization, but I couldn't narrow it down to one.

Host: Okay, give us those rapid insights, Greg.

Greg: First one is stop trying to do everything at once. And, in my presentation, I'll be talking about organizations, not trying to do everything at once, but I think that is good advice at the individual level, too. When you do that, you're just slowing everything down. So, it takes some time to prioritize.

Host: That is terrific. All right. And our second rapid insight, Greg, give it to us.

Greg: Second one is please, if you're doing a project, plan before you execute. And some context to that is we have a pretty steady project. What I consider a project rescue business. And I think we always will. Because I think there's something in human nature where people, when they're given a large project, there's this pressure to just start doing stuff. And invariably, when we're brought in, when a project's been going on for about a year, what we're doing is we're putting that planning foundation in place that should have been done to begin with.

Host: Absolutely. Well, there you go. It's a Rapid Insights first. Greg has delivered us two Rapid Insights. Stop trying to do everything at once and please plan before executing. We are so excited to talk to you about this stuff, Greg. So, thank you for your time. We appreciate it. We're very excited about your session at SHSMD Connections. Of course the title of your session is, You're Solving the Wrong Problem. It's Not your Strategy Falling Short. It's Your Strategy Execution. What a great topic. So, Greg, we just witnessed how quickly healthcare organizations, when pressed can implement one force to focus. So, overall then why is this type of focus so hard in healthcare?

Greg: I think there's a few things and some of this comes from observations of working in other industries before getting into healthcare over a decade ago now. And it starts with it's the nature of the strategies. Healthcare strategies, at the system level, sometimes at the hospital level, they generally, looked similar and there's some manifestation of needing to grow, improve, cut, change, all at the same time. And doing the day job too. And that is very difficult to do. It is hard to grow while you try to get more efficient. It is hard to improve, as you were trained to change the way that your organization provides healthcare.

Some of it comes back to just the nature of what is in the strategies. And it's difficult to prioritize them. Because it's driven by external forces. So, the hospitals and health systems are somewhat being forced to do all of this at the same time.

Host: Seems like we all fall to this. We try to do more than we can handle if you will. We have so many good ideas, but only so many of them are actionable, right? There's only so much we can do. And that's where that kind of that prioritization comes in.

Greg: Exactly, so we talk a lot about dilution. And I think whenever you mention dilution to a healthcare audience, you start seeing heads nod. Everybody has experienced it. But it's hard to shift yourself out of that. That's some of what I'll talk about in the presentation and can talk about here too. It's hard to do. It's hard to prioritize, whenever organizations are looking at what work needs to be done, a list is generated. It's a list of good ideas. It is hard for organizations to decide which of these are we going to do and which aren't we going to do.

But when you don't prioritize, what you get is dilution. Think of this visualization. Imagine if you have a board with a bunch of nails on it and you need to hammer that board into a wall. I think the way that most of us would logically go through that is hammer in the four nails at the corner, get the board to hold. And now you, pick one nail at a time of the rest and until they're all kind of hammered in.

So, imagine that board is your strategy, the nails, or the different strategic initiatives that you have to fulfill that strategy. The way that most organizations implement, is they tap each nail once. They go all the way around the board until they've tapped each nail once. And then they tap each nail twice and go all the way around the board. What you're doing is you're slowing down each initiative when you decide to not prioritize. So, it is a decision in and of itself.

Host: Dilution is such a great word. And that's such a great analogy. That board is not going anywhere fast. The way you just described it, just tapping each one, going around that board is not getting nailed in. So, now that we kind of understand this dilution problem, which is such a great word, I love that word, Greg. So what should healthcare organizations do about that? How do we fix this dilution if you will?

Greg: It starts with trying to create focus In your intro, you talked about how health organizations have done a really good job of reacting to the pandemic forces and what they had to do to that. It ultimately comes down to how do you make the strategy, your strategy, the focus of your organization.

So, there's few things that you can do kind of tactically. One is the strategy needs to be used to derive the work that your organization is doing. I know that can sound obvious, but I don't think that's the norm of what organizations do now. So, I think what is more typical, there is typically a budgeting process, that's going on, day to day operations going on and people are identifying work that needs to be done within the organization over the course of, let's say the next year or the next three years. In parallel with that, there is a group working on a strategy. And at some point, those merged together. Let's say there's a imperative around growth. We're going to grow by 10%. And, what happens is someone looks at this list of ideas that's been generated during budgeting or during day to day operations and says, this initiative will help us grow. Let's put it in the growth imperative kind of lane.

It sits there. That doesn't generate focus. What that does is a guarantee is that every idea that's come up, is deemed strategically important. So instead, you need to start that process with strategic goals in mind. If you go to the organization and say, we want to grow the organization by 10%. What should we do? You're going to identify more targeted work and I would say better ideas for achieving that goal. So, that's step one. Start with the goals in mind. So, it kind of engage the organization with the goals and then have the organization determine what the, what the right work is.

Host: Right. Now, I think that's really good. How do you make strategy the focus of your organization and the way you described that it's perfect. And I say, start with the goals in mind. Okay. So, what should we do next?

Greg: Next step is I guarantee you, you're still going to come up with more ideas than you have resources to do at the same time.

Host: There's no shortage of good ideas generally.

Greg: Without a doubt. And there's a lot that these healthcare organizations need to do because of these external forces. So, you are still going to have to prioritize within that list of initiatives. And that process is around identifying which of those initiatives is more important than the others. And treating those initiatives differently, where they get almost the same level of treatment as day job does.

Where the fire of the day that's happening kind of operationally, doesn't distract from the resources that are working on that initiative because that initiative has been deemed so strategically critical, it becomes some people's day job. Because you are treating these differently, I consider this meaningful prioritization. It's not just that you've said that this initiative is a priority. It's you've made some decisions to adjust to treat it differently and you kind of know you've done this because it's a little uncomfortable. You are taking people from day job and telling them this initiative is now your day job. So, you're moving things around, dollars and people. That's what this meaningful prioritization looks like.

Host: That's really cool. And then I love how you said this. You said make sure the fire of the day doesn't distract from the resources that are working on these important critical initiatives. Right?

Greg: Yeah, exactly. And this is part of, so one other factor that I think makes implementation so difficult within healthcare, is structural. So, if healthcare organizations logically and rightly so are built to deliver high quality clinical care 24/7, 365; over the years, they have become very good at doing this and very good at doing it efficiently. So, now healthcare transformation comes along with these strategies where you need to grow, improve, cut, change all at the same time.

They introduced this wave of initiatives that your organization needs to do while, continuing to do your day job of high quality clinical care, 24/7, 365. I think historically the way, or at least over the last let's say 10 years, the typical reaction to all right, how do we do all of these initiatives in our strategic plan, is they get shoved through the same organizational structure that wasn't designed to do these complicated cross-functional projects. It was designed to deliver clinical, high quality clinical care. If you were to design your organization to do these complicated cross-functional projects, you would design it differently. You would have some structure that can operate cross-functionally because these initiatives are invariably cross-functional.

And you would embed different skills. It's a different skillset to be able to identify the right projects, prioritize them and plan and implement them. So, I think that is something that healthcare is going through right now is trying to figure out that they've kinda I'd say the typical is organizations have identified their strategic plan. They've said, you know what? This initiative seems mostly operational. So, we'll put the COO's name next to this one. This one seems, is related to a clinical care. So, we'll put our chief medical officer in charge of this one. And have essentially said, go make sure that gets done.

I think more and more organizations are figuring out someone needs to manage implementation of the strategic plan that can operate cross-functionally and work with all these different executive sponsors. It's just been slow going.

Host: And ultimately you need that to be successful, if you're going to execute on the strategic plan. Right. So, instead of inserting this initiative into somebody's day job, you're saying you need other people or a team or someone executing the most critical initiatives and insulate them so they don't have distractions of the daily fires and the daily things that can take you off of the work of the mission and the plan, is that correct?

Greg: Yeah. You got it. It's getting better at figuring out the right work to do. Getting better at prioritizing that right work. And then growing the skills that are necessary to be able to execute that work. This is something that I think healthcare is slowly evolving to, primarily through experience of struggle. The goal is understanding the context of why is it a struggle and can we accelerate the evolution to produce a structure that makes more sense. Some group that is cross-functional and driving these strategic initiatives, strategy realization office, strategic initiatives group, enterprise project management office, something like that; that possesses, these different skills, the skill set around how do you build a portfolio? How do you prioritize it? How do you plan and run the initiatives that sit within it? So, strategy execution becomes a organizational capability, instead of a side job. It's no longer a side job. It's a critical part of what every health care organization needs to be able to do, and I don't think that's going to change.

Host: Yeah, that's another interesting way to phrase it using the word side job. That kind of puts it in perspective. So, Greg, it sounds like for this to really work, it needs buy-in from the C-suite too, because if you're going to need more resources, the C-suite or the executive team has to pave the way for that person or and or supply the additional resources. Right?

Greg: Absolutely. It has to start with the executive team. It has to start with the executive team being committed to prioritization because as we talked about earlier, a good prioritization process does not just exclude bad ideas, a good prioritization process results in hard decisions. But hopefully, if done right, with better information to make those decisions. So, if there isn't a commitment to prioritization; you're not going to be able to do it. It's very difficult. And there's little tips and tricks within there like, don't create your no list instead, create your on-hold list. That is more of a, it's a bit of a behavioral, easier for organizations to take type of step. But there still needs to be a commitment to prioritization. And I think that can come from just focusing on the notion of dilution, because I think everyone understands that and has felt it and is feeling it now. And know that there has to be a better way.

Host: Everyone knows that, understands that and feels it now, is so true. 100%. We all get that. When you use the word dilution, this is going to be a dynamite session. I think you're going to strike a nerve here with a lot of people that say, gosh, we've had so many great plans and we have so many ideas, but we just don't ever seem to really cross the finish line the way we thought we would with these ideas. So, I think this is going to be a dynamite session. You're Solving the Wrong Problem. It's Not Your Strategy Falling Short. It's Your Strategy Execution. Greg is going to be talking about this at the SHSMD Connections in-person annual conference in San Antonio, September 19th through the 21st. I'll be there. I'm looking forward to this, Greg. It's going to be awesome. Thank you so much for your time. We really appreciate it today.

Greg: Thanks for having me. And I look forward to meeting you in person.

Host: You got it. Thanks Greg. And once again, that's Greg Kain and registration for the SHSMD 2021 annual conference in San Antonio, September 19th through the 21st is open. You can learn more and please register at shsmd.org/education/annualconference. And if you found this podcast helpful and again, come on, how can you not? And you're going to find the SHSMD annual conference helpful too, believe me; please share it on all of your social channels. And please hit the subscribe or follow button to get every episode. This has been a production of Dr. Podcasting. I'm Bill Klaproth. See you.