Purposeful leadership, best practices in strategic planning and cultivating a strong organizational culture

The nuances of leadership growth, the role of strategic planning in healthcare today, and the importance of developing culture through shared values and purposes were explored in depth during a recent MGMA member-exclusive webinar, “Leading Healthcare with Purpose and Strategy: A Thought Leadership Exploration.” The panel for the presentation consisted of a trio of MGMA Consulting experts:

• Dawn Plested, JD, Esq., MBA, FACHE
• Chris Senkowski, MD, FACS;
• and Shawntea “Taya” Gordon, MBA, FACMPE, CMOM.

The leaders shed light on issues ranging from the significance of intentional leadership and the challenges and potential of technology in healthcare to the transformative power of an engaged organizational culture. Drawing from their vast experiences, the panelists also emphasized the cruciality of clear communication, consistent goal setting, and a patient-centered approach. As the healthcare landscape continues to evolve, these insights provide a beacon for organizations aiming to navigate the path ahead with clarity, purpose and optimism.

The need for medical group leaders to prioritize their personal development and that of their team members was a key focus, emphasizing reflection and planning as key practices. As the panelists related, organizations must clearly define what leadership means regarding their culture to effectively nurture leadership qualities. Further, they stressed the importance of building robust teams where leadership isn't confined to titles but extends to team members' capabilities to lead in the absence of formal leaders.

The panelists also noted that amidst busy schedules, finding time for learning, reflection and employee development is a challenge yet crucial for leadership growth. The discussion underscored that purposeful leadership — rooted in a shared mission and values — can guide meaningful impact and engagement for all stakeholders, fostering a culture aligned with the organization's overarching purpose.

Ultimately, living out these values and mission through authentic and intentional actions is fundamental to cultivating an engaged culture in line with the organization's mission.

 “If you are leading with purpose … you first need to know what your purpose is” Gordon noted. “So many people say, ‘be authentic,’ ‘be intentional.’ They've almost become buzzwords, but they are still very true." Without a daily focus on living with the importance of those pieces, “you're just you're not going to see those results that you want."

If you feel stuck on how to do this, Gordon suggests to get beyond your office and write out your goals, something she does regularly. “The thing about that is then nobody is standing around you, nobody is interrupting you constantly, the phone isn't ringing in the background,” she said. “If you can step away, and put on paper ... you're going to make progress to your goal."

Senkowski said that when developing physician leadership, direct feedback often is crucial. "The trick is how to be purposefully critical but not be personally human. … ‘I'm going to tell you the pluses and the minuses, and we're going to work together to try and make this better,’" he said. "Don't beat around the bush... people are willing in a closed room, where they're not being humiliated by other people. Straight up, right, and honesty works every time. And often for the leader, it's more difficult. It's harder to do, but you’ve got to try it. I promise you it'll work."

Additional resources

• “Leadership reimagined: Tomorrow’s success in healthcare starts today” (Insights podcast)

Panelists emphasized that organizations should formulate SMART (Specific, Measurable, Achievable, Relevant, and Time-Bound) goals. Engaging all stakeholders in the planning process is essential to ensure collective buy-in and valuable feedback. Additionally, they stressed that the strategic plan must resonate with the organization's mission, vision and value (MVV), as well as highlighted the usefulness of tools such as the impact/effort matrix to prioritize initiatives that, while demanding, have a high potential impact. There was a consensus on the importance of setting realistic timelines, routinely reviewing progress and staying adaptable to ever-evolving situations. Finally, aligning incentives and ensuring accountability relative to strategic objectives was deemed essential for effective implementation.

Senkowski on leveraging patient-reported outcomes

• “Let's pretend you have five cardiac surgeons that do heart surgery, and they're all very good quality. But some have better customer satisfaction scores, some are cheaper. You have to flatten the field and say, whatever this person is doing is cheaper but the same outcomes — figure it out, teach us. But the other person has better outcomes and better customer satisfaction — what are those patient-reported outcomes?”
• "We ran through a bunch of scenarios on the surgical side, looking at best practices. All your hernia [patients] — go and talk to the patients and ask, ‘When did you go back to work? Did that meet your expectation? What was your expectation?’ The patient says, ‘well, I thought I'd be back to work in two days. So, I'm actually dissatisfied that I was back to work in a week.’ All these individualized quality outcomes from a patient standpoint are patient reported outcomes. This is an interesting new topic — how do you think you’re doing as a doctor? It’s another piece of the puzzle that could help you see back to your whole process of what you want to work on as a practice.”

Gordon on getting stakeholder buy-in

• "If you are not engaging all of your stakeholders, you're never going to get their buy-in. If people don't feel like they were included in the solution, they're not going to participate in the solution. That is just a plan to fail."
• "For me, what I do is I highly reward engagement. I like to be super vocal with my praise, because that typically gets the bad actors out of there or back on the right path."
• "If you have a strategic plan for a project, you really want to push forward. It should be in alignment with the mission and vision and values of your organization. If it isn't, it doesn't matter how you present it to the board. You have to really look realistically at what your organization can do, and how many meetings you can have, and who can participate in research, and how much time you can dedicate to this."
• "The number one thing be clear with your expectations and goals, be inclusive of everybody that this is going to impact. Make sure everybody has a representative to make sure that their voice is heard."

Plested on open communication for buy-in

• "Clarity is key. So being very, very, very, very clear about what success looks like, what the goals are, what the strategic direction is — it should tie into your mission, your vision, your values, and it should be crystal clear what success means."
• "Empower people to determine where you want to get... It's empowering the whole organization to really engage in that purposeful, meaningful work and have a role to play in that final outcome. A strategic plan should be shared with the whole organization... and it's very important to tie your incentives to that. So, put your money where your mouth is."
• "The tool that I would just say everybody should be using is your impact effort matrix... it will have a big impact on your practice."

Gordon on being realistic

• "You have to be really practical about how we're estimating a project. You can't just say, 'Okay, we're going to have this implemented in quarter one of 2023.' You have to look realistically at what your organization can do, how many meetings you can have, who can participate in research and how much time you can dedicate to this.”
• "Be clear with your expectations and goals and be inclusive of everybody it is going to impact."

Senkowski on staying organized

• "You definitely need to have things written down and be going over lists and moving your lists around and trying to make little increments on each project. So, you have your priority items, you know, green light, yellow light, red light, or whatever you want to call them. And maybe you take something quick and easy, and then relish in the fact that it was quick and easy. If it's stalled, and you're ‘in the mechanic shop,’ figure out why. It sounds silly, these sort of things we're talking about, but it's true."
• "The best leaders are just organized. Just show up, be organized, listen to what people tell you, and give a darn about making it all better."

Additional resources

• MGMA Strategic Planning Toolkit (member resource)
• “Successful steps in medical group strategic planning for a value-based transformation” (Insights podcast)
• “Objectives and obstacles in strategic planning meetings” (Insight article)

The panelists also explored how an organization's culture has the power to either propel or impede its ability to realize its strategic goals and overarching mission, and that leaders should not overlook a toxic culture, working toward immediate rectification. They stressed that leadership should prioritize enhancing employee engagement, going beyond mere performance metrics — one tactic shared was establishing a distinct employee compact that clearly delineates cultural expectations. Moreover, the panelists encouraged recognizing and rewarding employees who embody and promote the organization's goals and values, which is instrumental in steering the culture in a positive way. They also stressed the necessity of confronting problematic employees, using data-driven insights and maintaining accountability, even if it leads to challenging conversations.

Plested on employee engagement

• "What's the old cliché? ‘Culture eats strategy for breakfast.’ Truly, you can have the best of intentions, have a fabulous, well-laid-out strategic plan, but if your culture won’t support or engage staff in carrying out that purpose-driven work, good luck."
• "What breeds toxicity faster than anything is having a disengaged group of employees who do not believe in the work and are not rowing for the same shore as you are in terms of building a purpose-driven organization. … It's very, very important to work on employee engagement and then work on accountability.”

Gordon on having difficult conversations

• "If you are uncomfortable with tough conversations, get ahead of that now. You have to be prepared to have those tough conversations. We pulled all the clinical support staff into a meeting, and I said, ‘Show of hands: who hates where they work?’ Obviously, nobody raised their hand because administration was there. So I said, ‘Show of hands, who wishes that they loved where they worked more than they do now?’ and everybody's hands were up.”
• "[Ask questions like], how do you need for us to support you and make that happen? I know this is what your goal is. This is my goal. How do we get this solved? That was one of those times where you need to sit down and have a tough but clear conversation, because clarity is just kind."
• "It takes time to fix cultural problems. It takes transparency. Not everybody's going to like you. There are going to be some people whose minds you will never change, and they will retire before they've decided to participate in whatever it is that you want to do."

Plested on defining expectations clearly and sticking to them

• "Have employee and provider compacts that outline cultural expectations. It goes back to clarity and laying out what is expected, what is allowed, what just doesn't fly at your organization and then stick to it."
• "The second you deviate or make an exception because somebody's a great surgeon, or a great nurse or a great whatever, your credibility is shot. If you stick to your guns and hold people accountable, that has an enormous impact on culture."
• "Sometimes it is really holding those people with the fabulous reputations accountable to [the organization’s] behavioral standards. Not everybody belongs on the bus. Sometimes people need to seek happiness elsewhere, and it's okay."

Additional resources

• “Why employee engagement tops business leaders' list of priorities” (2023 Leaders Conference session preview)
• “Shaping a culture: Implications for leaders” (Insight article, ACMPE credit available)