Idea Two: Give a Pop Quiz

Download PDF Version

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 closely.

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 senior 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 reasons 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.