Business 101: Goal Execution for Radiology

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This article is the third installment in a four-part series on applying basic business concepts to radiology. To read the first installment, click here; to read the second, click here. greg_thomsondan_simileExecuting strategic goals represents a challenge for any organization, in terms of both maintaining momentum and creating a sense of accountability among staff. For radiology groups, add another obstacle to that list: balancing the achievement of overarching goals against increasingly hectic day-to-day routines in which maximizing efficiency is critical to survival. Greg Thomson, executive vice president, Medical Management Professionals Inc (MMP), Atlanta, Georgia, advises, “The execution of goals has to be part of daily operations. It has to be a scheduled part of your calendar—at least monthly, if not biweekly.” Thomson and Dan Simile Jr, MMP’s executive vice president of practice management, recommend that radiology organizations establish a set of annual wildly important goals (WIGs) that are consistently reinforced through meetings, scoreboarding, and feedback. Executing WIGs requires self-discipline, they stress, as well as commitment and enthusiasm from leaders. “So many companies and practices get involved in activities that are not moving them toward their goals,” Thomson says. “All members of the organization need to be accountable to one another.” Simile notes that goals should be disseminated throughout the organization, planting the seeds for a cultural shift in how all employees—from radiologists to technologists to administrative staff—view their contributions to the larger group. “Goal setting takes place at a high level; as you move down the levels of your organization, each level sets its own goals related to the overall goal,” he says. “You are resetting the expectations and the culture. In the execution phase, you follow through on what you have begun.” Cadence of Accountability Thomson summarizes the atmosphere that radiology groups should attempt to create with a phrase taken from FranklinCovey® (West Valley City, Utah), a global business-consulting and training firm: cadence of accountability. “Organizations should meet to discuss their WIGs however often is necessary to create the cadence of accountability, so people do not forget what their goals are,” he says. “If you are meeting monthly, but are finding yourself going several weeks without doing activities that move you toward your goal, you are not meeting often enough.” The cadence of accountability helps maintain momentum and reinforces the importance of the group’s strategic objectives. “If you want to keep people engaged, the biggest thing you can do is make everyone buy into the goals,” Simile says. “When you have frequent meetings to talk about them, people remember the enthusiasm they felt for the goals they had set.” In some cases, groups might even have goals that need to be reinforced daily, Simile notes. In these instances, the cadence of accountability also acts as a change-management tool, retraining employees to act in a way that benefits the organization’s larger objectives. He offers the example of a practice trying to improve its customer service through being friendlier to patients. Progress on this goal might be assessed through periodic patient surveys, but daily checks could be necessary to prevent inertia. “You could say, ‘To help change our tone, we are going to start every day with a quick meeting about having a positive attitude and have every staff member share one positive thought,’” he says. “It sounds simple, but it keeps people involved. Once everyone gets the hang of it, you could take the frequency down to every week and then every other week.” WIG Meetings and Scoreboarding WIG meetings should differ from conventional staff meetings, Thomson says, in that they should be highly focused and limited to a small group of individuals. “Everybody is invited to a staff meeting, and the purpose of that meeting is communication and dialogue—it’s an informational thing,” he says. “A WIG session is shorter and more focused. Its purpose is to determine what everyone needs to do to move the scoreboard closer to the goal.” The scoreboard is a visual representation of the WIG, quantifying it in terms of something easily measured and assessing its progress. Simile notes that the WIG itself might not appear on the scoreboard at all—instead, the scoreboard should display “an activity that will allow you to accomplish the WIG,” he says. He offers the example of a practice where the WIG is improving its hospital relationship: In this case, the activity for the scoreboard might be holding meetings with hospital leaders at regular intervals, and the scoreboard would display when each meeting was scheduled and whether it actually took place. Scoreboards should be kept somewhere readily accessible to employees, and can be designed to drum up enthusiasm and motivation. Thomson has seen scoreboards designed like baseball diamonds, where progress is indicated by a player rounding the bases, or like old-fashioned board games. “Whatever is interesting, visual, and shows your progress toward the goal is key,” he says. “Keep it simple. You should be able to glance at it and immediately know where you are.” Each segment of an organization should establish its own goals that support the larger group’s WIGs, and these segments should meet individually for scoreboarding. “Organizations should have a pyramid of goals. Leaders determine the overall WIGs and then go to the different parts of the company to determine what they will do to help accomplish them,” Simile says. Thomson adds, “WIG meetings should be held by each subset focused on a particular goal or activity. They are very focused because they can be; they consist of small, homogeneous groups working toward the same objective.” Thomson stresses that shortchanging this aspect of the process in favor of attending to daily responsibilities, tempting though it might be, often spells failure at goal execution—even when the goals in question are highly attainable. “The goal of your practice may be to improve your hospital relationships, but merely stating that goal leaves everyone in the room wondering, ‘Okay, but how do I do that?’” he says. “The purpose of this process is to document the goal and the activities that will lead to success, and to keep that goal a front-of-mind thought for all members of the organization.” Cat Vasko is editor of and associate editor of Radiology Business Journal.