Strategy is about both the what and the how

When we put together our strategic plan for the children’s hospital four years ago we used a modification of the triple aim as a frame, expanding it to the quadruple aim a year or so later. Super Health for all children was established as our primary purpose and passion, Super Care was affirmed as a presupposition of being in the business of providing health care to children, and a Super Supportive Care Experience being what makes a children’s hospital different, would be what we would need to make us different from any local or regional competitors.  A year later we added the essential element of engagement of our colleagues, as well as the patients, families and communities we serve.  For our colleagues we felt that feeling joy and pride in their work was important.  We identified the 2 most important things as reliability in providing care and engagement of all those supporting, delivering and experiencing that care.

In our efforts to fully realize a children’s hospital we focused equally on what we would do and how we would do it.  For example, we chose as a frame for how we would achieve engagement and a super care experience child- and family-centered care and decided we would need a child-friendly environment and family support systems.  When it came to achieving reliability and super care we chose high-reliability principles and robust continuous quality improvement methods for the how .  We borrowed from the theories and philosophies of Deming and Covey, and the methods of Lean management.  We focused on how we would achieve our desired results more so on a daily basis than what those results were.   The best example of this is measuring safety behaviors and practices daily, while paying attention to the outcomes of hospital acquired conditions (e.g. days since last event) weekly.

We developed a set of high-level guiding principles: transparency, collaboration, alignment, ownership for excellence and fiscal responsibility (aka efficiency).  After reliability and engagement, efficiency has become an essential management focus today, and yet to not pay attention to how that is achieved is to lose out on reliability and engagement.

Our strategic plan has been very successful, reaching most of our goals and milestones, and on time.  Our secret sauce comes down to disciplined improvement, relentless alignment and empowering accountability.  For a best practice conceptual frame for management we’ve used the Shingo model.

Our strategic measure of success, as well as our means to justify and secure what it would take to realize a children’s hospital, has been growth, including inpatient and outpatient, subspecialties and primary care.  We’ve realized growth through increasing our capacity through recruitment of more clinicians as well as improving the efficiency of our key processes, all along keeping front of mind that if we didn’t stick to our mantra of super care and a super supportive care experience, we wouldn’t gain the needed respect and awareness from the public.  Our growth has been consistent year to year and has exceeded our target of 10%.