Posted June 24, 2014

What to do When Results Go South

By Jackie Gaines, MS, RN

We’ve all been there. We decide as an organization that we want to roll out several new tactics to improve results, increase efficiencies and decrease variability. We get excited as we see some initial gains and progress toward our strategic goals. The organization seems to be operating more efficiently, and has even made significant changes to anchor viability for the future. Then several months in, we realize that results have become stagnant and in some areas, even start to take a downward turn. We’re forced to reevaluate what is getting in our way from achieving the results we desire.

The missing ingredient is ensuring leaders can effectively diagnose their strategic barriers and put action plans in place to move them in the right direction. Just like a provider diagnosing a condition of health, we need to find the source of the barrier. If we try to treat without a clear understanding of cause, the results may be variable at best. Here are some factors to consider:

Informational Barriers. This includes facts, opinions and perspectives. Remember, communication glitches are one of biggest challenges organizations face. Are we clearly communicating goals and objectives, action plans and progress to date? Are we communicating in a variety of ways?
Try including a description of:

  • What “right looks like?” (Expected behaviors, outcomes)
  • Why is this strategy important at this time?
  • Who are the stakeholders? (Important to include early in the process- even to help develop action plans, if appropriate)
  • What you are expecting of leadership, providers and staff? (Clarity of “who” owns the plan and execution; defined expectations, timelines and results of inaction)
  • How you will execute the plan? (Required resources, action steps, follow-up, validation and communication plan)

Additional communication tip: Adult learners vary in the way they best receive messages. Preferences vary from e-mail, verbal, written, and so on. When possible, try to hit all types to ensure everyone receives the desired message.

Environmental Barriers. This includes physical barriers (plant capacity, safety issues), organizational culture, politics and mood. Leaders can address environmental barriers during department meetings, employee forums, leader training and so on, to ensure everyone receives a consistent message.

Relationship Barriers. This includes legacy events (mergers/acquisitions, expansions, service changes), reputation, internal relationships (administration/providers, site/departmental variation), and external relationships (community engagement). It’s important for leaders to openly communicate about organizational changes that will impact staff. Validating that the culture, mission and vision of the organization is intact and that the organization is equally committed to the surrounding community will help ease anxiety that comes with changes.

Individual Barriers. This includes values, knowledge/skills, experience, performance compliance (variance in execution), and attitudes/engagement. Leadership training and development is an important component. Organizations that invest in the development of their leaders (which then trickles down to front line staff) have more engaged employees and less variance.

Each of the barriers mentioned requires a unique action plan. Without a thoughtful diagnosis, we may be treating the wrong end of the problem. We also may be dealing with a combination of barriers. For instance, a failure to communicate clear expectations to staff could result in barriers in performance compliance. Both barriers need to be addressed in order to move results in a positive direction.

Once we carefully diagnose the challenges faced, we then need to match action plans with the diagnosis. Continue to monitor and course correct as appropriate. Beware of having excessive “number 1” priorities that can cause confusion for those who try to follow the road map to success. Try creating 90 day action plans that offer incremental progress and opportunities for small successes along the way. Tools like reviewing the Leader Evaluation Manager® “live” with your supervisor each month to keep you on track. This tactic can actually serve as a prevention strategy.

Jackie Gaines is author of the book, Wait a Hot Minute: How to Manage Your Life with the Minutes You Have, available from Fire Starter Publishing.

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