Intro: The following SHSMD Podcast is a production of DoctorPodcasting.com.

Bill Klaproth (host): On this edition of the SHSMD Podcast, all right, let me ask you this, how cool would it be if we could put together a strategic plan in 15 minutes? You're like, "Come on, Bill. That doesn't happen. What's wrong with you? Come on." Well, I might be over-exaggerating a little bit, but my guests today, Jerry Griffin and Vince Gallucci, are doing a session at SHSMD Connections 2023 called Building An Integrated System Strategy From the Middle Out.

Host: It's very interesting. Instead of doing the big, massive strategic plan, they boil it down to little mini playbooks. It's kind of a mini strategic plan, if you will. Doesn't that sound cool? It makes the process much easier and they can spread this around many departments, service lines or the whole system. It's going to be a cool session and I hope you attend it. So, let's talk to Jerry and Vince about it. I think you're going to love it. So, let's get to it right now.

This is the SHSMD Podcast, rapid insights for healthcare strategy professionals in planning, business development, marketing communications and public relations. I'm your host, Bill Klaproth.

In this episode, we're going to talk with Jerry Griffin, Director of Consumer Insights and Digital Engagement, and Vince Gallucci, Vice President of Strategy and Marketing, both from Penn State Health. As mentioned before, they are doing a session called Building An Integrated System Strategy From The Middle Out. It's on Monday, September 11th at SHSMD Connections 2023. You can register at shsmd.org. That's shsmd.org/education/annualconference.

Jerry and Vince, welcome. Let's get right to it, Vince. Let's start with you. When you mentioned building an integrated strategy from the middle out, what does that mean?

Vince Gallucci: You know, most organizations, healthcare and beyond healthcare, they start with a direction that usually comes from the board of directors, goes into the executive leadership team, and then it gets cascaded down. When Jerry and I were thinking about what would be a more innovative approach to build a plan, a strategic set of imperatives and priorities, we thought we have the direction from the board, maybe we can go directly to the sources, if you will, and start building some strategic planning work with the folks at a local level, we may call it. And we did that.

But what was interesting, Bill, what we received was when we went and said, "Would you like to start building your strategic plan?" There wasn't this great notion of excitement. It was more about a strategic plan. We said, "Well, how about a playbook?" And they said, "Well, what's inside of a playbook?" And so, we reframed a little bit of what a traditional strategic planning process would be with data analytics and so on, and hours and hours of work of studying data and metrics. We still did that, but that was probably the minority of the work that we did. And we really wanted to get closer to what's the priority across our regional and our academic hospital and then, ultimately, what's happening within departments that they could prioritize and what their breakthrough strategies are.

But the most important thing we were able to do from the middle out was to identify the deployment of people who are going to execute on the plans. And then, we would roll them back in to our executive leadership. So, we went from the very top of the board down to what we may refer to as the local level of hospitals and departments and department chairs. And then, we served up who is available for deployment of executing on these priorities and strategies.

Host: So instead of top-down, the alternate is middle out. So, you engage the frontline staff first, heard from them and then went back to leadership basically. So instead of starting at the top, you started at the middle. Is that correct?

Vince Gallucci: That was our intended definition. Absolutely.

Host: Got it. So, I know you said, you talked about, "Yeah, we're going to put a strategic plan together," and the reaction was, "Oh, great a strategic plan." So, Jerry, why is it so important that we have a strategic planning process and why do you think so many people have the reaction of, "Oh God, a strategic plan"? Why do many fail at this?

Jerry Griffin: Yeah. Well, first, as far as having a strong process, I think any organization, any industry, needs to have a strong strategic planning process in place. I came from a different industry, a for-profit industry. And I saw in the past that if you don't have that clear strategic plan, it could lead to confusion. It could lead to inefficiencies. It can lead to several missed opportunities as you try to grow your business overall. That's why I think it's imperative that everyone is aligned and on the same page, especially as hospitals and health systems grow. We're a five-hospital system. But as we grow, we want to make sure that all the hospitals are looking at the same way and going down that same true north.

As far as why they fail, I think it's a whole host of reasons. I think anywhere from, you know, they create the plan, but they don't really have a strong action plan, or they're not monitoring the action plan. I think they don't get input from the appropriate stakeholders. And I think Vince talked a little bit about it earlier, about engaging some of that frontline staff to keep them engaged. And if you don't get that appropriate input from those key stakeholders, you may not have some of that strong plan.

One area I think that is something to consider is, I think, because historically healthcare has not seen a lot of disruptors in this industry and I think that's in part probably because it's a government-regulated industry, I think they didn't see disruptors as a threat. And obviously, that's changed in the last several years now, but I think that's even more imperative that we start building a strong strategic plan because if not, it will fail because of some of these disruptors are starting to enter the market.

Host: Right. And as you said, without the plan, it leads to confusion and missed opportunities and other things. So Vince, the many strategic plans, the playbooks as you said, can you tell us more about those, what you did at Penn State Health and your process? And what are the benefits of doing it this way?

Vince Gallucci: You know, it's interesting. The process is something that we take a lot of pride in, because we use very efficient approaches to get the most inputs we can from the groups who are there. And here's something which could be pretty interesting as well, and we've heard this, Jerry and I have heard this, what do we need to bring? What do we need to prepare for? What things can you give us in advance? Maybe even call it an agenda. We tell people there isn't one. There's nothing to prepare for. There's nothing you need to do in advance. Just show up. And if you can imagine a group of leaders coming together, unknown to what's going to be asked of them, unknown to the way something is going to work, there's only been one or two cases where someone had said, "I didn't sleep well last night because I didn't know what we're going to do today." And I said, "Hang in there. We've got this. It's under control."

And coming from Penn State, we call it our big 10 of playbooks. So, we were trying to accomplish, and we did. We've actually accomplished our goal to have 10 playbooks in place that represent our hospitals' human resources, DEI, our medical group, the hospital leadership, operations and so on. So, we've built out the big 10 of playbooks, and not one of them knew what they were walking into. Now again, I would say some of that was disruptive to people. But then, the word got out. It's not painful, it's okay, it's just fine, and they're actually doing something fairly cool. So, we are not creating demand at all for this any longer, demand has been created. And we're starting to do some of the work with our department chairs within the academic setting as well. And we've done a playbook for our behavioral health and psychiatry department. We're walking into the children's and pediatrics this afternoon to get started. And we even have a request now coming from our dermatology department. So, demand is up, and we are busy doing the work that once was kind of like, "Ugh, strategic plan. How long will this take?" But we got the word out that this is efficient and it's actually very engaging. And all we're really doing is seeking the inputs with the process to get people to lean into it.

Jerry Griffin: And, Bill, if I may just add a comment to what Vince just said, you know, one of the things that Vince started early on when we first started running these, is soliciting input from everyone. So even when we invite the stakeholders, the expectation is that everyone is participating in this discussion. And one of the things that I love about it is we get a lot of "sticky ideas" that tend to gain traction And they start rallying around those sticky ideas and it makes it easier for people to remember too. So, I think there's been a lot of benefit that it's just been easier to remember because they've had these little sticky ideas that make it easy for them to remember and make it easy for them to embrace as well.

Host: So, it sounds like you make it easy for them to engage in the process. So, Jerry, if I could stay with you, so you put these playbooks together for individual departments, individual service lines, the whole system, is that right?

Jerry Griffin: Yeah. So as Vince said, I think we were up to 11 or so playbooks, and we probably started another five or six, they're in the works. So, our service lines have been things like cardiovascular, cancer. Departments have been HR; diversity, equity, inclusion. We're looking at finance and we did one for the whole system as well. So yes, it's been everything and everyone. And I think to Vince's point, we're getting a lot of requests to do more, which has been engaging because we're even looking at doing it somewhat on the academic side, the education and research side, where Vince referenced the behavioral health. And it wasn't just the clinical aspects of behavioral health, it was really the education and the research element, and we helped provide them some guidance in those areas as well.

Host: So Vince, give us a look inside. What is inside one of these playbooks and how do you implement these?

Vince Gallucci: Sure. I'll walk you and our listeners through it. We start with what's it all about, if you will. We let the team and the group and the department tell their story. So, they give us a sense of how their view of the world is from where they sit and the work that they do. And then, we try to emphasize a framework, Bill, around the framework in which they execute. And we give them guidance and perspective of the inputs that go into this. So, you've got an introduction, you have a framework. And then, we jump into building out a set of priorities. And we take these priorities from the many down to the vital few. We then turned the next round of our workshop or working sessions into breakthrough strategies, and Jerry started to hint a little bit about disruptors.

And when we work with the department or the group who's there with us building a playbook, it's somewhat of a challenge for them to think about breakthrough strategies. And this, in our terms, is how do you break out of the clutter? What would be unique and different? And for most, that's a challenging effort. And so, we take those priorities and we say, "Are these priorities aligned with the strategies? And are those breakthrough strategies driving our goals forward?" And we show folks then what we would like to refer to as a planning matrix and how this matrix feeds into each other and ultimately now feeds across the system. So an introduction, a framework within the framework of what we're doing, drive priorities, drive strategies, align those to the goals as the system goes. And then, we ultimately pay it off, if you will, with a set of data points. It's not the dashboard of the department or the dashboard of the hospital or the system. These are trending elements of data that the strategy department works closely with Jerry and I as well. So when you think about this playbook, you've got an intro, you've got a framework, you've got priority strategies aligning to and driving goals forward, you have a set of trending metrics that go into the plan. And then, ultimately, we'd like to show areas of recognition of what the group is most proud of, where they've been awarded something of excellence, of quality, of systemness, if you will. And that's pretty much it. We have a creative director who works closely with Jerry and I, and we actually build these out. They're a colorful ,full color view of the plan and people use them to speak into.

Host: Really, really interesting. And thank you for explaining that so in depth, Vince. I appreciate it. So Jerry then, what have the results been so far, and how has this all been received? It sounds like pretty good.

Jerry Griffin: Yeah. It's been well received and one of the things that we get a lot of is just a lot of interaction with the group and engagement with the groups that we do meet with. And one of the things I've seen a lot of the groups talk about is focus. And I think Vince talked about initially coming up with several priorities or several strategies and getting it down to a select few. I mean, there's been times where we'll meet with the group and they'll come up with 55 different priorities, which is tough because it really doesn't become a priority when you have 55. But it helps drive down to what is the most critical element that your department wants to focus in on. And it's a very open discussion. And we actually have a voting process and a really healthy discussion amongst the group, to say, "These are the top four or five priorities or strategies that we need to focus in on." So, what we've seen is a lot more tightening of what people want to do. And a lot of these have been launched in the last 10 months. And again, we've done 11. So, we've gotten several more in the works. But the biggest early success I think we've seen is just a lot more focus on what's critical for them to move forward within their area of the organization. And I expect to see more. We have heard some folks talk about how they're going to start using it for our next fiscal year's planning process or the ones we built recently.

And I think the only thing I wanted to mention is for our diversity, equity, and inclusion, our chief diversity officer actually brought in people from the community, which what I thought was a great way to engage not only internal folks around our strategy, but even our external patients and community members in this whole process.

Host: I love when you say we focus down to what is the most critical area we need to focus on. I think that really makes it crystal clearer in everybody's minds. That old saying, you know, "Hazy goals, hazy results," you know, "If you confuse, you lose." So, really defining it down to the most critical area we need to focus on really gets everybody pushing the wheel in the same direction. Is that right?

Vince Gallucci: Yeah. There's one more step of, I would say, deployment, if we wanted to talk about it, because we can clarify the vital few of priorities and strategies. It then comes down to what we started to build out, was the deployment of people, who's leading a priority, who's on that team. And we have full visual management, Bill, of who's participating. And if we see that, Bill, and Jerry and I are leading more than two projects inside the priority, we're going to suggest that someone there is overdeployed and the work's not going to get done. So, I would also add, we took it down a step level below, just prioritizing the priorities, if you will. And now, we're looking at the deployment of people. And because of the metrics that we're using, we're going to be able to see that across all of the 11 or 12 playbooks, which is really quite unique.

Jerry Griffin: Yeah. The planning process isn't just about building the strategy. It's about building an action plan to move forward with those strategies. So, it's exactly what Vince is talking about, and I think that's been very helpful for the group as well.

Host: I love this discussion, Jerry and Vince. I think this is so important. So, tell us about your session. I would imagine a lot of people are going to be interested in it. What are the key learning objectives? And will you go into in depth more of when you talk about the framework and driving priorities and driving strategies and the planning matrix? Will you go more in depth on those things in the session?

Vince Gallucci: We certainly will. And in fact, it's interesting that in one of the other affinity organizations where Jerry and I were speaking into this, we put a challenge out to them and said, "We bet we can build your strategic plan, the framework in 15 minutes."

Host: Oh, I love this.

Vince Gallucci: We did it in 10.

Host: I love it!

Vince Gallucci: And the people who were part of that organization said, "I cannot believe that you just had these 30 people give us a framework for our strategic planning or our level of organizing ourselves in that period of time." So, that was fun. We may not build that out. We could, but we probably won't. But in our session, I think it would be important for people to experience a little bit of more of an applied approach to the way we work through our playbooks. And we will show some of the techniques that we've used getting to the matrix and the deployment of people. And then, I think last it's just important to give people some of the stems, a way that we walk folks into the sessions where, you know, you go, "What's the first thing you ask?" And many times people have come to us and said, "Is that a little nerve-wracking in the way that you do this? Wouldn't you want a better plan?" And I'd say, and Jerry would say, and we have a team of about four others who are at our side doing this, we would do it no other way. We'd literally walk in with blank pieces of paper, a flip chart paper and Post-It notes. And there's nothing on them until we get started. And literally, that's the truth. So, we will show folks how we do it.

Host: And that's what people want to see. Well, I want to thank you both for your time today, Jerry and Vince. One last question for each of you as we wrap up talking about putting a strategic plan from the middle out, anything else you want to add? Jerry, I'll start with you.

Jerry Griffin: I think it's been a great experience for the organization. As we've gone through this process, we've really started to gain some engagement. I think there's been a driving culture change in our organization as we start focusing on this approach, because they see the value of engaging themselves. And so, we've gotten a lot of participation engagement with a lot of the different groups that we've met.

Host: Interesting. So, one of the benefits is culture change. So, another benefit of putting these mini strategic plans together in these playbooks, as you call them, and rolling them out. And Vince, same question to you, anything else you want to add, final word?

Vince Gallucci: I was going to feed off of Jerry's term of culture. And I was going to use that as well. That's how well he and I are aligned. I would say this, what part of culture is aligning itself? It's common language. So, we talk playbook, people know what that means now. We talk framework, people know what we mean. So, both Jerry and I also have a great passion towards standardization and LEAN process and efficiencies of work and removing waste. And so when we start to talk through this with the teams doing this, the cultural movement we have made is about common language. So, we talk playbook, people are getting a sense what that means. We talk about efficiency, people get it. We're talking about strategic A3s of action plans, they get it. And so, that is dead on. Jerry is spot on to the point. It's a cultural movement, it's a common set of languages and are starting to see the results and output from it and we're excited to keep it going.

Host: I would say common language and, from just talking with you two, clear goals, clear expectations, which I think everybody wants to be clear on what they're doing and what they're striving for. Is that right, Vince?

Vince Gallucci: Yeah, that's right. And we build these out with flexibility too. There is constant movement within healthcare and any business, but our industry and sector of healthcare is in a constant movement phase, and there's flexibility within this as well.

Host: Yeah. So, I guess one last question, Jerry, I'll just wrap up with you then. As Vince just said, constant flexibility and you're able to move, you're able to adjust these plans as forces develop down the road. Is that right?

Jerry Griffin: I think you almost have to, especially in healthcare, there's constant change in healthcare. Obviously, we've learned that three plus years ago. And I think we have to be a bit flexible as we go through this. And it has to be open because, even with the growing technology that occurs, I mean, we have to be flexible enough and nimble enough to move forward.

Host: Yeah. Well, Jerry and Vince, this has been great. So looking forward to your session. Thank you so much for your time today. We appreciate it.

Vince Gallucci: You're welcome. Thank you, Bill.

Jerry Griffin: Thank you so much, Bill.

Host: And once again, that's Jerry Griffin and Vince Gallucci. Make sure you check out their session at this year's 2023 SHSMD Connections Annual Conference in Chicago. The topic is Building An Integrated System From The Middle Out. It is on Monday, September 11th. You can register right now at shsmd.org, shsmd.org/education/annualconference. And if you found this podcast helpful, and of course, how could you not? Come on, chock-full of great information. Please share it on all of your social channels and please hit the subscribe or follow button to get every episode. This has been a production of Doctor Podcasting. I'm Bill Klaproth. See ya!