Rethinking the purpose and power of goal-setting during the pandemic

by Burl Stamp

For health care organizations focused largely on operational survival, hour-to-hour may best describe their planning horizon right now. The stress and immediate challenges of the pandemic have thrown a wrench in most healthcare systems disciplined, predictable annual goal-setting processes.

But the pandemic shouldn’t cause organizations to toss aside goals and the process of goal-setting, especially at the workgroup level. This article is the fifth in our series Leadership in the Time of Coronavirus. Today, we look at how to use adapted goals to stay focused and to support a workforce that is physically exhausted, emotionally drained and, in some cases, disillusioned.

Following are three key ways to think differently about goal-setting during the pandemic, pulling back on some priorities and leaning into others.

Be as clear about what you’re not going to do as you are about your priorities

As a young strategic planner early in my career, I learned the hard lesson that deciding what we would not spend time and resources on was the toughest part of effective planning.

That same philosophy and discipline can help your team breathe a collective sigh of relief when your organization is overwhelmed by the pandemic. Telling employees that a major IT enhancement, a new program opening, or any other project that puts extra stress on staff has been put on hold can be both a relief and a signal that you really do understand what they’re up against.

Get staff more involved in workgroup goal-setting related to the current crisis

Too often, organizations focus all their attention on big, company-wide goals and expect those to automatically be translated to work at the frontline. An often-missed opportunities is frontline staff involvement in how goals get achieved.

In their book The Four Disciplines of Execution, authors Sean Covey, Chris McChesney and Jim Huling described the importance of setting both “lagging” and “leading” goals to change performance. Most leaders set and are most comfortable with lagging goals that look in the rear-view mirror and measure end results. (For example, our operating margin last quarter or quality scores last year.) Leading goals, on the other hand, target specific predictive behaviors that will lead to better performance. I always use this clinical example to illustrate: if your lagging goal is reduced infections, your leading goal should be hand hygiene compliance.

Getting staff involved in identifying leading goals is an ideal way to improve empowerment (which we covered in our last post). Examples of issues that could improve the care experience for staff, patients and family members might include:

  • How to share responsibility for communicating with family members who can’t visit;
  • How and when to proactively share visiting restrictions with family members to avoid conflict and disappointment; or
  • How the role of the charge nurse might be adapted on a COVID unit to better support staff
Dial up the focus on goals around leadership support

As we emphasized in an earlier post in this series, leadership visibility and listening have never been more important. During the pandemic, leadership rounding should be focused on just three key questions/topics:

  • How are you doing?
  • Here’s what we’re doing as an organization to better support you.
  • We appreciate beyond words what you are doing to help patients and our community.

The performance improvement saying that “if you don’t measure it, you can’t move (improve) it” applies to leadership rounding. Smart leadership teams set schedules and metrics to ensure rounding is consistent and appropriately distributed across all work groups and departments. What leaders hear and learn during rounding should be a standing item on management team agendas so that insights and hotspots can be shared.

Especially during the pandemic, organizations should adapt goals-setting processes in ways that communicate to staff that leaders understand the stress they’re under and appreciate the sacrifices they’re making. For organizations that want to empower staff, involving employees in setting “leading” work group goals is one of the best ways to achieve this priority.