Dream big
As you’re going through this process of defining what your company is about so you can deliver it, don’t be afraid to aim high. Proctor asked her company a big question, and she expected big answers.
“I’m of the mindset that you set aggressive goals and then you ask, ‘What will it take to get there?’” Proctor says. “And then you see if it’s realistic in terms of getting there.”
For example, the team debated over the term “perfect care.” Some worried that aiming for perfection stretched too far.
“Could we ever achieve perfect care? And was it arrogant of us to think that we could achieve perfect care?” Proctor says, recalling the dialogue. “The conversation around that really boiled down to, ‘How else would you state the goal: We want to give great care 90 percent of the time?’”
In the end, the group members agreed that it was best to state the outcome in terms of their aspiration, which was the best possible scenario: perfection.
“We’re not saying we’ll necessarily never fail at that, but it’s always our goal,” Proctor says.
The goal should also be broad enough to remain collective. In other words, make it applicable to all employees; later, you can fit more specific departmental initiatives under the umbrella it creates.
“If one of my strategies is to do something with information technology, that doesn’t excite the front-line employees — unless it’s going to make their job easier,” she says. “But if that technology helps us get to perfect care, that excites the employees. After you have those clear things in place that employees can relate to, then the strategies make sense.”
You make those broad, aggressive goals less daunting by breaking them down into achievable milestones. St. Joseph sets three tiers of each goal.
“We set a threshold level, which we want to achieve, the actual target and then an exceptional level,” Proctor says. “That gives you some range of performance to achieve. We say, minimally we have to achieve this much, we hope to achieve this much, but we’d be really excited if we achieved this much.”
For example, St. Joseph set out to lower its rate of ventilator-associated pneumonia. Initially, it fell into the seventh decile of industry-measured standards. It set a threshold target to be in the fourth decile, which was above average, an actual target in the third decile and an exceptional target in the first.
Now, St. Joseph is in the first.
“One thing that’s really important is to set aggressive targets — not unachievable targets but aggressive targets that cause people to really stretch,” Proctor says. “If you put that kind of goal out in front of people, I think people really do want to achieve.”
Of course, you also help make those goals attainable by slicing them into achievable steps.
“Obviously, in 2006, I couldn’t expect by 2007 that we would achieve those outcomes,” she says. “You have to say, ‘OK, what are the likely steps we have to take to be able to achieve that to get to perfect care?’ And then you have to break it into realistic strategies for getting to that.”
A good first step, for example, is often defining and communicating the goal — or the mission outcome, in this case. St. Joseph spent a whole year on that, again getting employees involved to refine the definitions.
“We knew before we could expect that everybody was having sacred encounters that people would have to understand what a sacred encounter meant,” Proctor says, explaining it means each encounter should leave people more healed and more whole. “So our first strategy was to define sacred encounters and to get some level of clarity where people could say, ‘This is what a sacred encounter looks like.’”
