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Episode Synopsis:

Welcome to Episode #60 of Habitual Excellence, presented by Value Capture.

Joining us today as our guest is Sandra Geiger. She is the Chief People Officer & Chief Strategy Deployment Officer at Atrius Health in MA. Sandra was previously VP of Performance Excellence at another Massachusetts health system. She’s a physical therapist by background.

Geiger, Sandra - Headshot

In today's episode, Sandra shares her experiences with "strategy development" and the Lean management practice of "strategy deployment" -- before, during and after a pandemic 

Host Mark Graban also asks Sandra questions and discusses topics including:

  • How did you get introduced to Lean?
  • How did you become CPO?
  • The aim of "never-ending success"
  • A quick pivot due to Covid - emergency strategy?
  • Connecting the strategy thread to the front line work and improvement and their role
  • People learning what the strategies are - doesn’t always happen?
  • Why Lean at Atrius Health?
  • How you can influence a company culture through Lean -- Continuous Improvement and Respect for People?
  • Beyond culture, where does “technical Lean” fit as well?

Click to visit the main Habitual Excellence podcast page.


"My definition of lean is creating value from the patient's perspective (or the customer's perspective) while using the creative talents of the people closest to the work.""The only way to really [have never-ending success] is to listen and understand - and go see the problems - versus making decisions based on what you think, or even best practices, because a best practice at one organization doesn't exactly work always at another organization." "When people see their leaders and they trust them, and you're getting a great result for the patient or the organization, it's a true win."


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Subscribe or Follow - Habitual Excellence Podcast, Presented by Value Capture


Mark Graban (2s):
Welcome to Habitual Excellence presented by Value Capture. This podcast, and our firm, is all about helping you and your organization achieve Habitual Excellence. Be a one unifying focus, one value based structure and one performance system. In other words, it's about helping you capture dramatically more value through achieving perfect care and perfect to safety for patients and staff. To learn more about Value Capture and our services, visit Hi everybody. Welcome to Habitual Excellence. I'm Mark Graban from Value Capture and our guest today is Sandra Geiger.

Mark Graban (43s):
She is the chief people officer and chief strategy deployment officer at Atrius Health in Massachusetts. Sandra was previously among other roles, VP of performance excellence at another Massachusetts health system, and she is a physical therapist by background. So we'll learn more about Sandra and what they're doing at Atrius Health, but first off, Sandra, welcome to the podcast. How are you?

Sandra Geiger (1m 7s):
Thank you. Thank you for having me in great, very happy to be here.

Mark Graban (1m 11s):
So in terms of your background, how did you become chief people officer? What were some of the steps in your career that led to that?

Sandra Geiger (1m 21s):
Wow, it's a, it was kind of a fun and different journey to become a CPO at a, at a health system. I started my time in healthcare as a physical therapist, as you mentioned, and, and that led me into leadership in general, as I, my first position was a director of rehabilitation services very early on in my career. Wasn't really sure how I got into that role so early, but taught me a lot right off the bat about people and, and connecting with people, both patients and providers. And that experience led me to fully go into an administrative pathway and get out of the physical therapy realm and into full-time administration.

Sandra Geiger (2m 7s):
And, and my first full-time job actually of administration was to be the manager of patient relations, which was a lot of listening to patient complaints and, and that type of thing, but it was a great way to get into what I really dug into for a good 10 years of my career, which is a culture and PR and improvement. As I think everyone understands in healthcare leadership that if the patient is not having a good experience behind that, it's usually an employee experience or employee engagement experience that's that needs some attention. And so that's what led me to really start to study the culture of hospitals first, which is where I spent a lot of my career in acute care.

Sandra Geiger (2m 54s):
And then, and then getting into really understanding the employee perspectives. And so lean came into my life really actually through oddly, an employee listening survey where, where five or six years into a cultural journey at acute at that acute care hospital in Massachusetts, we were working really hard on the, what I would call the food shelter and water of culture, like recognition and communication, transparency, leadership visibility, and every year we would survey our employees and, and get a good sense of where they were. And those were the things that they were asking for.

Sandra Geiger (3m 35s):
And we put things in place to fix them and, and move along. And one year, maybe year six or so the employees really the priorities that came out of their engagement surveys were, I want to be part of the solution. I want to be involved in decision-making when a change happens in my area, I want to be part of it. And I said, Hmm, well, that's really different than the last few iterations of these surveys, which we would eventually build leadership development priorities off of and, you know, studying how we could improve those perspectives of our employees was what led me to, to study lane.

Mark Graban (4m 17s):
So a couple of follow-up questions, Sandra, you mentioned people starting to speak up about wanting to be a part of the solution. Did that happen? It sounds like that happened maybe only after the food, water and shelter was in place, as you would put it is. Is there a connection there?

Sandra Geiger (4m 35s):
Yes. I completely agree that there is definitely a connection there and you have to have sort of the, the base of the pyramid, if you will, or the trust between a, an executive leadership team, especially, but any leadership team and the rest of an organization. So some of the things that we worked on early were, you know, open employee forums where, you know, any, anybody in the organization could have face time with the CEO. And we would talk about updates on people and service and finances. And we're super transparent about what was going on in the organization. And that just allowed really an open dialogue that was created over a long year period that brought out these more sophisticated perspectives that people, as they learned, what the strategies were for the organization, where our problems were, where we were doing well and where we weren't, it seemed as though they wanted to be part of that.

Sandra Geiger (5m 31s):
And, and also again, if there is going to be change, being part of that change and not having changed, be done to them, but being a part of that.

Mark Graban (5m 43s):
Yeah. And we'll, we'll come back and take a deeper dive into questions around strategy, but one other follow-up question I had for you based on, you know, you talked about that first director role, Sandra, you, I have one thing, you know, I'm sure the listeners realize happens a lot, not just in healthcare is that, you know, somebody is a really good individual contributor, you know, a really good physical therapist or whatever that role is. And then you get, you know, thrust into a management role at some level, you know, did, did that, did that early experience kind of, you know, provide some good perspectives. Now, when you talk about developing leaders, whether it's frontline managers or leaders at other levels, you know, giving them what, what, you know, what's the foundation of what they need to be an effective leader.

Sandra Geiger (6m 34s):
Yeah. That's a great question. If I put my mindset, I can picture myself sitting in that office there for the first time. I'm not really sure whether I was in the, just in the right place at the right time. I had the right degree to match a director who had been there for oh gosh, maybe 35 years and who really wanted to retire. It's was like, oh, Sandra's got a master's, but let's put her in there and see. So it, it really was, you know, reminding myself now looking back that every leader needs development and connection and purpose back to what you're trying to achieve in any department at that time, it was, you know, had departmental scope, not necessarily enterprise scope, but, and, you know, I, I, I remember having a great leader there, myself, my boss, who was the CEO at the time, I was a very small hospital.

Sandra Geiger (7m 23s):
And so I was reporting to the CEO and, and he, you know, trusted me and believed in me and allowed me to experiment with different ways of leading that, that team, which was a fairly, you know, significant, you know, collection of stuff that was physical therapy, occupational therapy, wound center, things like that. It was a lot to do in the beginning, but again, that baseline of, of trust and support and being there and allowing, allowing, you know, to experiment with ways to do things differently, especially coming in as a lot of us do into positions where the previous leader was in the position for a long period of time.

Sandra Geiger (8m 8s):
I think that those things are, are, are super important and in developing new leaders.

Mark Graban (8m 16s):
Well, thank you for the reflections on, on that. And like I said, developing leaders, developing employees, it's always a, you know, kind of an ongoing, never ending journey, the same way we might, same language we might use to talk about lean and improvement work. Are there, are there any other, you know, I guess one other questions just when it comes to developing leaders, any other sort of tips or lessons learned for, for people who are listening, who are trying to put more effort into developing leaders in different ways,

Sandra Geiger (8m 55s):
Learn over time was, and it's very much connected to, to lean. And one of the key principles of lean is to really go and see what's happening and not to assume so, and being humble and not having to have all the right answers as a leader. So it's okay. And sometimes even more admirable when to say, I don't know the answer to that versus staying. This is how this needs to be done and to, to appear as though you have to be in control of situations all the time, because it's the talents of the people closest to the work that really makes an organization thing.

Sandra Geiger (9m 39s):
In my opinion, that's really my, my, my definition of lean is creating value from the patient's perspective or the customer's perspective. If you will, if you're outside of healthcare while using the creative talents of the people closest to the work that is to me, if you can make that happen, you will have never ending success in your organization. And the only way to really do that is to listen and understand and go see the problems versus making decisions based on what you think, you know, or even best practices, because a best practice at one organization doesn't exactly work always at another organization.

Sandra Geiger (10m 19s):
So you have to really go and see and listen in here.

Mark Graban (10m 23s):
Yeah. So on that theme, I like that phrase that you use, you know, aiming for never ending success, you know, to, to, to reach, I guess, you know, that level of success and improvement, you know, every organization in, in healthcare would say they have a strategy or they, there there's a function, there's a strategy in place, but, you know, strategy deployment, you know, as, as we mean that in the context of lean management is, is, you know, I think not as common, you already alluded to the point of, you know, people, frontline staff, not always knowing what the strategy is or not knowing how their work connects to that strategy.

Mark Graban (11m 9s):
So as, as we dive a little bit deeper into this, I think, you know, first question is how would you compare the phrases or the practices of strategy development and strategy deployment if someone's unfamiliar, especially with the phrase strategy deployment,

Sandra Geiger (11m 25s):
Right? So strategy development is I think a little bit more understood widely of just breaking down where I used to describe it as breaking down, you know, vision into multi-year activities so that she can actually get closer to that vision. And if you have that vision and that vision actualizes, then you're, then you, then you get that mission of your organization. And so developing a strategy to break down a big, you know, idea into manageable pieces and identifying how you're going to do that and how you're going to show progress in that. And who's going to help you do it is the development strategy development portal.

Sandra Geiger (12m 8s):
Part of it, the strategy deployment is like pulling that string all the way from the, the highest level of the organization, the thinkers, the visionaries, and pulling that string all the way to the point of the customer or the patient and all along the way, how do you actually improve the work? So it's, it's a whole heck of a lot easier in my opinion, to create a strategy then to actually deploy it and to help different levels and people in the organization understand what their role is in. It kind of goes back to one of your first questions mark about, you know, how do you be transparent about communicating and what you're trying.

Sandra Geiger (12m 49s):
You have to communicate what you're trying to accomplish first. And so defining that that's, that's a lot more concrete than actually making your way through, say a company with 5,000 people in it, or 10,000 people in it. How do you get everyone aligned around that? And strategy deployment to me is that unique piece of, of helping to define that and having people feel a sense of purpose and a sense of involvement in, in making something happen for the place that they work.

Mark Graban (13m 24s):
So maybe we can first break down the strategy development process a little bit. Can, can you give us some example from Atrius Health of, of how you get more specific and breaking down a vision in a way that's understandable and digestible for people?

Sandra Geiger (13m 45s):
Yeah. And so, and I will say that I just, in my own studying of potion, I had, I had just to back up a tiny bit, I had the absolute pleasure and just sort of aha moment of traveling out to ThedaCare in Wisconsin a little bit, many years ago. Now I might say 10 years ago to visit John Toussaint and his team, and to actually see what strategy deployment looked like to me in my role at the time at the acute care hospital, that was, that was a missing piece for me. I started to, as my role grew into collecting patient experience priorities and employee priorities and medical staff, employees lining those things up with where we were underperforming at the highest level of KPIs, like patient experience and revenue and quality and safety lining.

Sandra Geiger (14m 45s):
All those things up was, was something that I think I did innately or intuitively when I started to learn and see what strategy and read about strategy deployment. I thought, oh, that is what I need to do. And that is what I need to share with this executive team. And at the time we were kind of moving from a hospital to a health system, if you will, and putting together some key components of, of the different parts of the health system. And I thought, well, we need strategy deployment more than we know. So let's go see it to my, to my principal. There let's go see it. And I did, and I was so impressed and I thought, this is a great way to tell the story and to get people engaged in the story.

Sandra Geiger (15m 32s):
So in that I heard a lot of great advice from John Toussaint to get back to your original question. And he said, you know, you have to think about this stuff until your brain hurts. And then once your brain hurts a lot, and you've done maybe five or six rounds of potion, then you finally might be doing Hoshin a little bit. Correct. And ocean, since we haven't used that term yet here day is a, is a Japanese word, obviously use saline to describe strategy development. And concrete is the second part of that, which is the deployment. So Hoshin Kanri is sort of another term that you might hear as strategy deployment for someone who might not have heard that before.

Sandra Geiger (16m 18s):
So, so making my way now to what I think is my eighth or ninth potion of five or six at, at my previous employer, and maybe now three or four, depending if you count our emergency COVID Hoshin, which we can get to a little bit later is, you know, hopefully I'm starting to get this a little bit. And, and I think, you know, what we always do is, is what I started to describe earlier is to look at where we want to be in, in three to five years, healthcare has changed so much. You know, we, back in the day, strategic planning was 10 years and it was seven years. Then it was five. Now it's like really like two to three years, where do we want to be?

Sandra Geiger (17m 1s):
And we started put a stake in the ground and say, you know, if I, if I give a concrete example where, you know, X percentage of, you know, w where we want to be for patient experience in three years, we want to be in the top desk style. So how far this year do we want it? Do we want to go, how far do you think we can get this year? And that how far question then gets broken down into, okay, then what is getting in the way of getting there and, and breaking that down and doing the gap analysis, reflecting on what we did the year before we actually use an, a three process at the strategic level for some of our big organizational KPIs, like quality and safety, patient experience and growth and, and value.

Sandra Geiger (17m 49s):
And so I'm using some of the technical lean tools interspersed into that macro, you know, PDSA, if you will, of the, of the whole strategy is, is where we start. And then it starts to deploy from there and get more and more granular and more and more specific as you get from the organizational level to a service line level, to a site level, to a department level. And, and that's that pulling the string closest as you can, to get to where the work happens and where change can occur and the patient can eventually experience it, and the employee can eventually feel that purpose of making that better.

Mark Graban (18m 34s):
Yeah. So how do you break down different categories of goals and KPIs within Atrius Health? So patient satisfaction is one of those, what are some of the other broad categories?

Sandra Geiger (18m 50s):
And I'll go back to some of my earlier studies. So in, in moving somewhere between being a physical therapist and the performance excellence VP, I was really focused for about seven or eight years on patient experience only. And in that obviously, you know, the connection to hospital culture is really strong. And so I, I studied a lot of the Studer models at Studer model. And so I still use that today because I think those true north sort of indicators of people, service, safety, quality, finance, and growth are just tried and true and stand the test of time.

Sandra Geiger (19m 31s):
And so we look at each one of those, you know, a time, you know, I'm, I'm an ambulatory for the first time. So, you know, I have to re reprogram my hospital, acute care brain sometimes where, especially at Atrius Health who have been leaders in value-based care for decades, we kind of sometimes combine that, you know, pitch experience, quality cost zone into patient value, which I think is another great way to, to express that. But, you know, having, having the big, you know, things that keep any health enterprise healthy, if you will, is having a great plan for your people, having a great service excellence plan, obviously quality and safety and finance and growth are keep our organization advancing as well.

Sandra Geiger (20m 18s):
So we break each one of those down and ideally, you know, COVID and pandemic is, has definitely interrupted all of our great habits at times of just because at a necessity. But ideally we'd like to have, you know, a three-year look at each one of those pillars and do that, how far this year discussion, and really look through the customer's perspective of what's getting in the way of delivering value for that particular key.

Mark Graban (20m 48s):
Yeah. So you mentioned the impact of COVID. So maybe let's, let's dive into that a little bit before we step back and think of the broader question of how to translate strategy to frontline staff and activities. So what was, you know, going into early 2020, I'm sure there was a strategy and a plan in place, and then COVID happened. We earlier, you mentioned an emergency potion. Can, can you kind of walk us through what happened and how strategy adapted in 2020?

Sandra Geiger (21m 25s):
Yeah, it's a, it's a really great question. I have a, you know, I have a partner in crime and Atrius who also worked with me at my previous organization who's also been studying lean and Hoshin for awhile. And so we thought that this was a really great foundation that we had this potion process in place of creating priorities and deploying them. Because as you know, in the, in the COVID year, we, we did all of our standard work of getting ready pre COVID to, to launch our Hoshin, as we normally did in January. And we had all these growth objectives and we had our total medical expense objectives and patient experience.

Sandra Geiger (22m 6s):
And as we started to get into January, February, and of course, early March, and we thought, oh my goodness, everything is turning to the pandemic response. And so we were able to quickly put our, our original potion priorities on a shelf, if you will, and said, okay, quickly, now we have new levels, zero objective objectives. It's, you know, caring for the patients, understanding it was protecting staff, moving to remote work, creating certain sites of care for different types of patients, whether it was COVID care or non COVID urgent, urgent care for, of what people needed.

Sandra Geiger (22m 50s):
And, and we were able to have a new Hoshin call if you will. I don't think I mentioned this before, but every year we'd ha we have a Hoshin call, which is our thematic goal for the Hoshin. And, you know, it might be growing the practice, or it might be employee listening, or I'm thinking in other organizations, not so much of interest there with different goals, but, you know, th the Hoshin called quickly turned to, you know, pandemic response and, and specific three or four specific elements that were related to keeping the business going, you know, keeping our patients safe and served and protecting our and our employees. And so we were able to identify different people.

Sandra Geiger (23m 34s):
We actually reorganized using our incident command team, and everyone went into different roles and everything, but we had that great infrastructure standard work of incident command, and we had that great infrastructure standard work of potion. So we were able to pivot very fast to have a defined set of goals, even metrics to make sure we were on target for each one of those things, and a set of people who assumed slightly different roles to, to make that happen. And it was, it was really excellent. And then further down the road is I, I would have to say it's a pandemic subsided. It did them side, obviously a little bit, but then we had to kind of run a little bit of a parallel of getting back to regular business again, but there was a, you know, the tail end or the tail of COVID activities that we, we kept alive and Hoshin a little bit.

Sandra Geiger (24m 26s):
And then we started to layer in, you know, getting patients back into the practice and getting employees unreal deployed if you will, from different roles and, and getting people back to work where we were. So using that tool of alignment and clear communication of, of goals and how we know that we are on track with them was, was super helpful to use Hoshin for open. Yeah.

Mark Graban (24m 53s):
And you talk about being more adaptable. There was the big adaptation is we realized that COVID was coming and things were going to change dramatically, but then as things continued to evolve through different phases of pandemic is as people's understanding of testing and treatment and vaccination improved, did can, can you talk a little bit more about that, that process of, I know it isn't a matter of continuous pivot or just refining the pivot that had been made and as, as the pandemic era continued,

Sandra Geiger (25m 31s):
I think it was, it was refining that pivot. I think that kind of goes into the plan, do study adjust category there, if, you know, how are we doing with this and what needs to be changed? And, you know, we had, we were learning new EV we were learning something new every day about the pandemic, and it was, it was a great way to titrate between, you know, getting back to regular business and still dealing with the new normal. And I think, you know, having a way to communicate and know that we were on target for certain things or behind target for other things, even, even more granular lately, having, having indicators to know, you know, when we needed our incident command in place and when we didn't and, or, you know, just using visual management or, you know, different types of tools within the larger Hoshin was, was, was really helpful in us navigating the, the ups and downs of, of the code waves, as well as starting to really have our sights on, you know, bringing people back into the practice for regular care.

Sandra Geiger (26m 45s):
As, you know, everybody just put everything on hold and we really wanted to get our patients who needed preventative care and back in. And so doing that while still trying to understand all the new COVID regulations was a, that's a good example of, you know, those, those two potions acting in a parallel process. Yeah.

Mark Graban (27m 8s):
And yeah, just thinking back to, to that time, all the, the uncertainty created a lot of anxiety and fear, you know, I think back to early days of the pandemic, a lot of us and a lot of people were afraid to touch anything. And then we sort of learned that, well, no, this is more, more airborne than it is a matter of surface risks. And I, I imagine, you know, that that environment of uncertainty and fear probably made it difficult to communicate with staff and to engage them. Did, were there any strategies that were helpful in terms of, you know, kind of laying a foundation of the kind of thinking back to a point you made earlier of Kevin having a foundation of whatever sense of safety we could feel at that point that was then a foundation for people to help adapt and develop new work and new ways of doing work and COVID times

Sandra Geiger (28m 12s):
Yeah. That's sort of the power of zoom actually kind of helped us out a bit. We just to give you a little background of our, of how we're set up, we have about 34 or so sites and 5,000 employees. And, you know, the idea that we, we actually created a virtual town hall in the midst of the pandemic, and we were planning it right before and then, and we really started to use that as that communication vehicle. You know, I, I kind of, I kind of put all of lean Hoshin strategy deployment and, and people all in one bucket. And part of that strategy deployment is our communication mechanisms are all hands on deck town hall meetings.

Sandra Geiger (28m 53s):
And then how that flows through to our CEO council, which flows through to a group, we call strategy deployment round table. That's the group that actually creates and shepherds the ocean, which flows to other communication meetings and the town, the sort of special edition town halls we ended up having, they were, could have been about anything vaccine hesitancy of our employees. They could have been about just thanking the, the heroes that were working on the frontline and highlighting when everyone was doing, we had our infection control leaders, advising our medical staff on the, the latest information medically of, of, of how to treat popping up.

Sandra Geiger (29m 39s):
Drive-through testing. All of stuff was communicated, you know, through zoom a lot of ways. But also, as I mentioned early on in our conversation, that face-to-face time with the senior team and our CEO, like saying to 900 people who were on that particular zoom to say, thank you, and we're going to be okay, here's our, here's our plan to how to get us through the pandemic, which was our ocean. And here's how we're doing. And here's all the miraculous, heroic things you're doing. And we want to thank you. So I think it did kind of come off full circle for me, and we hadn't done a CEO forum like that at Atrius yet.

Sandra Geiger (30m 22s):
And it was a perfect time to do it, and we're still doing it. We do it once a quarter. And it really, you know, we use it to, to communicate hoshun, but not in such an overly structured way. It's just getting people involved in, in problem solving and having them have that opportunity to chat in or raise their hand directly and just say right to the COO or the CMO or CEO, you know, I have a question about this, or I have an idea about this and it, and it's, it's a really great way to, to keep people connected. Yeah.

Mark Graban (30m 58s):
So I been the last thing we can touch on here a little bit for a wrap-up as more of that ongoing process of connecting people to the strategy, connecting their improvement, work to the strategy and KPIs. Can you walk through a little bit of the thought process of, let's say, you know, part of the organization comes to you for input and they say, Sandra, we've got these four projects that we think are all important, but we're trying to decide which one should really be a priority to work on first. How do you help connect that and help people prioritize

Sandra Geiger (31m 35s):
Just for these usually only more than I'd ever really answered your first question fully if I had to become chief people officer, I think that, I think your question now in that, in that question are connected to, you know, really, if you can have a strategy, but if you have no people, it won't be, it won't realize, or it won't actualize. And so, you know, after I actually came to, Atrius mostly to do a singular role in operational transformation, which, which quickly turned into help us put our Hoshin habits back together again, after a period of maybe laxing a little bit in the, in the practice of it.

Sandra Geiger (32m 20s):
So I, in my first seven or eight months of working for Atrius, I was just focused on helping everyone do exactly what you just asked, you know, taking pages and pages of priorities that were happening in all the different areas of the company and saying, what is it that we really want to align around at that point? You know, I was sort of resetting, so I, I met with each CEO council member of the major areas and I asked what they were working on. I looked for connections. I had sort of a, a mission control board of everything that was happening. And I, and I basically, you know, pulled all of those priorities into a recommended second, you know, nine or 10 things and said, here's what I think separately and together this team, the senior team is saying that you really need to work on.

Sandra Geiger (33m 12s):
And from there started to put the nuts and bolts of two Hoshin back together, somewhere in the middle of that, the, the CPO or the chief people officer at the time retired. And it was our CEO who said, Hey, you know, isn't art, forwardly companies connecting, you know, people and lean and strategy deployment. I said, yes, they are. And you know, long story short, we started talking about, you know, would, would we want to do that? And wouldn't it be a great opportunity to take sort of, you know, traditional HR, if you will, or transactional approach to HR and, and putting that the people into the strategy deployment process.

Sandra Geiger (33m 55s):
And so that's how that connection was made. And so putting those pieces back together, again, we, we started to communicate to a wider audience what those new priorities were. I think that was now 2018 pre pandemic. And, and we also use a very important approach that we call catch fall, which is showing those the priorities to, you know, a leadership group that's closer to the work and saying, how does this look? Is this, is this too far for that question? How far this year is this too far? Is this not far enough? Is this the wrong direction? And everybody would, would laugh because I had this practice of taking out my, my daughter's baseball glove and baseball and saying, it's time to catch the ball.

Sandra Geiger (34m 45s):
Cause he never asked me if this was a good goal. And so that visual of like, this is catch fall, we're doing it right now. How do you feel about these goals? And so we, we, you, we use this group, let me now call strategy deployment round table to do that catch ball to really define everything. And then also as the, the beginners of the deployment process

Mark Graban (35m 10s):
And yeah, it's, it's, it's an awkward translation. We would never say, Hey, let's go outside and play catch ball. We would just say, go play catch. But the idea is that go to an eye. I coincidentally have a baseball on my desk that I fidget with sometimes calls and meetings. But I mean, I appreciate how you, you talked about not just the communication flow and the catch ball of, Hey, we have ideas for improvement running, running that up the pole, if you will, for input, but you I'm glad you brought up the equally important question of getting input and, and not just dictating strategy in a top-down way catch ball.

Mark Graban (35m 55s):
It goes hand in hand, or it goes baseball and baseball and glove, but maybe it's just as a final question. Can, can you share any other reflection on kind of, you know, that, that, that up, up and down catch ball both around what is the strategy and what is the plan?

Sandra Geiger (36m 15s):
Yeah, it's actually just great question because, and I was going there anyway, as you were talking is if, if you're doing strategy deployment, right, then even someone on the very frontline would have a way to influence the strategy. One of my first instructors from the university of Michigan, when we were doing a lean in healthcare, you know, sort of baseline was she drew this picture of strategy deployment. And obviously we're, we're, I can't draw the picture for you right now, but she, she, she drew, you know, a cloud that said strategy, and then she drove an arrow down that said goals. And then she drew another arrow down that said where then it said the work.

Sandra Geiger (36m 56s):
And so what she meant by that was if you can get the strategy down to the closest point where the work is happening, and then she drew these arcs back to the goals and this another arc back to the, to the vision. And she said, these arcs are the employee's perspectives. These arcs are the find a way to get this influence arc back up to the top. And if you, and then I tried to take that to the next level in healthcare too, which is what's the patient's perspective. How is the patient involved in this? And so using, you know, patient advisory boards, or just even just discussions of making sure that the customer and the person closest to the work can help send it back up and say, yeah, that's great.

Sandra Geiger (37m 46s):
That was a great goal. It's really helping us, but this is what I actually see every day. And if we do this and if we do it really well, we'll probably get to that big goal that you want us to get to a little bit faster. So if you can really look for ways to be out and listening with patients or customers or our colleagues, that's when you're really, really doing it well And doing it well means you you've mentioned PDSA cycles getting started and learning and listening and adapting and continuing to improve because this, it does like it's, you're alluding to John Toussaint for different reasons.

Sandra Geiger (38m 29s):
You know, the, this will make your brain hurt. It requires many, many cycles both within the year developing the strategy deployment plan, but then over time improving the way that process works. So it kind of, you know, final, final thought or tip to somebody if this seems overwhelming or difficult at first thoughts on kind of improving this over time. Yeah. The final two final tips one is, you know, really try to go and see, I remember John Toussaint would come back and come and visit us at the hospital. We were working and he looked at my fancy strategy matrix that I was so proud of. And I knew what he was going to do.

Sandra Geiger (39m 9s):
He'd point to something and he'd say, I want to go see that. And I would have to take him there. And if we couldn't see it, we, it wasn't really deployed. And so being out there is probably the most important. If you're at the higher you get in these leadership positions, it sometimes takes you further and further away from the work and trusting that process and trusting the people who are doing the work, trusting their instincts, go so far both from getting the results that you want, but even more importantly, the cultural benefits that you want when, when leaders, when, when people see their leaders and they trust them, and you're getting a great result for the patient or the, the organization, it's a true win.

Mark Graban (39m 57s):
Well, Sandra, thank you for sharing your experiences and your reflections and your thoughts there as people are coming into 2022, and it's time to update or refresh or develop or deploy strategies, a lot of great thoughts that you shared with us today. So our, again, our guest today has been Sandra Geiger, chief people officer and chief strategy deployment officer at Atrius Health. Sandra, thank you so much for being a guest and sharing with us

Sandra Geiger (40m 25s):
Today. It was a pleasure to be here.

Mark Graban (40m 28s):
Thanks for listening to Habitual Excellence, presented by Value Capture. We hope you all subscribe to the podcast and please also rate and review it in your favorite podcast directory or app. To learn more about Value Capture and how we can help your organization on this journey to Habitual Excellence, visit our website

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