Are you ready to step out of the silo?

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How many of you feel your hospital operates in silos the way the Ford of 2006 operated? The silo mentality is one of the most common concerns expressed by our clients about their senior leadership teams, and it is often cited as the reason why the organization cannot get traction on its strategic initiatives and transformation efforts. Instead of working as one organization focused on common strategic imperatives, each operating unit is pulling in its own direction and following its own agenda.

The ironic thing is, although most clients cite the silos as a concern, few if any have truly tried to bring their leadership together for constructive, collaborative dialogue about the organization. While almost all clients have senior leadership meetings, few have the types of structured, focused, and honest conversations that Mulally pushed at Ford using his Business Plan Review meetings. Like Ford, we know the success of hospital transformations hinge on the ability of senior leadership to have honest, collaborative dialogue with one another. When we work with clients on activating strategy we create this dialogue through the Quarterly Operating Review (QOR) process.

Quarterly Operating Reviews are template-driven meetings where each initiative team updates their colleagues on where they are relative to their targets and what they plan to do over the next ninety days to meet their goals. As the primary operating mechanism for our strategy activation process, the QORs are designed to be mandatory checkpoints where leaders and teams are held accountable for their performance. The meetings, however, are not simply report-outs, they are action-focused discussions in which leaders discuss their plans for achieving their goals while other members of the leadership team ask questions and offer assistance. The QOR process creates a culture of shared responsibility for achieving the organization's goals -- leaders are expected to share where they are falling short of their targets and their peers are expected to have candid dialogue about where they can offer assistance or who can make up the shortfall through over-performance in their area. The QORs help educate every leader in the organization on where they stand relative to their goals and they help foster candid conversations about organization priorities, interdepartmental conflicts, and staff talent.

This type of dialogue has helped GE succeed for over 100 years and is a major reason why the company is considered a world-class operating organization. Despite the success of this approach, we often find this type of dialogue to be very unsettling for our clients because they operate in very siloed environments where successes and failures are treated as secrets to be shared only with immediate superiors; meaningful, strategic dialogue between peers on the senior leadership team is neither expected nor encouraged. Even many successful clients view their organizations as a collection of individual units and goals where dialogue among the leadership team is a nice to have but only necessary in instances where the work of one unit directly affects the work of another unit. Experience has shown, however, that in large, complex environments like Ford or GE or a hospital, candid dialogue across the entire leadership team is a key to unlocking the potential of the organization.


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