Idea Two: Give a Pop Quiz
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Leaders exert much of their influence by how well they channel
attention—first for themselves, and then for the organization.
As a general rule, what the most senior leaders are paying
attention to gets the attention of everyone else. So if most
of the air time at senior leadership meetings is going to
reviews of budget performance, you can be pretty sure that
managers throughout the system will be watching their budgets
So, when the senior leadership team returns from a planning
retreat having adopted a new set of strategic goals, with
a major emphasis on quality and safety, everyone will be
watching to see whether the executives really start paying
attention to this new priority, or whether they are just
paying lip service to quality. One way to dramatize the
need for a new level of attention to quality is to give your
leadership team a “pop quiz” in which you find
out what in fact is top of mind for each of them. Without
warning, give each executive a single piece of paper with
each of the categories of strategic goals listed in the first
column. The next column should be headed “Most Recent
Month’s Result” and the third column “Goal
for this Year.” Ask them to fill in as many actual
numbers, by memory, as they can, without talking to each
other, or consulting their Blackberries.
The results of the pop quiz are usually revealing to everyone.
Typically, executive teams know the recent financial results
and targets (operating margin e.g.) and the service quality
results and targets. But they typically don’t know
clinical quality and safety results (and targets) on measures
such as hospital-acquired infections, surgical complications,
CMS Core Measure scores, etc. even when these things have
been adopted in the strategic plan as goals.
The pop quiz is best followed by a conversation among the
executives about how it is that they know the financial
and service quality data, but not the clinical quality data.
Usually, they quickly come up with some pretty obvious
e.g. “The financial data are reviewed at each weekly
meeting, but the clinical data only once a quarter.” Once
you see the differences between finance and clinical quality
in how senior executives are channeling attention, it becomes
pretty obvious how to change the meeting agendas, report
formats, and other leadership practices to make clinical
quality goals and results “top of mind.”
Because when they’re “top of mind” for
the senior team, everyone will be paying attention to them,
and results will start to happen.