Strategeries and Tacticizing

If you've ever been to an emergency room, you know that waiting is part of the drill. Put two marketing types into one, add some interesting posters on the bulletin boards, and there's a new way to pass the time and for one of you to not think about the pain he's in. As we sat waiting for someone to come and draw blood from my partner, I said, "Hey, look... they've got a brand pyramid."

Not one that makes a lot of sense, though. How do strategies rest of initiatives? Why is the vision a tiny thing at the top? What does "best of the best" mean? (At least the brand promise makes sense, even if would probably apply to any hospital in the world.) To someone sitting there in pain - which would later turn out to be an appendix on its way to rupturing - is there really a brand promise besides "we will make you better" or "we will keep you from dying" which matters?

Here's the mark of a poorly organized strategy represented by any geometric shape of your choice: the documents that come from are even stranger. If the summary doesn't make sense, the things that arise from it will make less. And so next to the pyramid I spied this:

The first group isn't awful, although since the piece was tacked to a bulletin board in an area where patients sit and wait for care, I might have put "patient-centered" up at the top. And "competent." The second section, however, show signs of someone just giving up on sticking to the structure. "We are operational discipline?" And systemness? What the heck is systemness?

These characteristic lead to actual initiatives and something called "big dots." I'm not sure what "big dots" are and how they differ from initiatives...

Note that one of the items is to "maximize net revenue cycle." Now, we all know that hospitals are businesses, but as you're sitting in agony, or watching a loved one and getting scared because it's one in the morning and the pain is getting worse and something is wrong and you are not sure what, it's hard to take comfort from knowing that you're in a place that's truly committed to maximizing their net revenue cycle.

So perhaps lesson one is that these kinds of internal documents should not be stuck to bulletin boards where your customers (in this case, patients) should see them. But then lesson two is that they are often going to see them anyway, so perhaps you should be sure they leave people feeling better about you. And lesson three would be the ditch the strategy pyramid or obelisk or ziggurat and come up with a strategy that you could explain to someone in a few sentences while waiting for a bus and sound like a normal human being doing so, instead of like an MBA candidate with Tourette's Syndrome.

The good news is that when your strategy documents leads to this kind of stuff, if you've got good people, they generally just ignore it and do their jobs. That's precisely what seems to have happened at the hospital in question; while they should, perhaps, hire fewer people to think about strategy and more phlebotomists, the actual medical personnel were nice, caring, folks. My partner was admitted and had surgery is recovering, and fortunately everyone involved seems to be thinking about patient care and not the strategy doubletalk emanating from their management.

Clearly there's a disconnect between whoever is coming up with this stuff and the front line employees - and I am very glad about that.