Non-Profit Health Care Organization.

Project Focus: Creating a More Strategic and Disciplined Organization

This organization engaged its management team, workforce, Board of Directors, and representative stakeholders and formulated a clear future vision, refined the organization's sense of mission, and developed a long-term strategic plan along with a near-term action plan for the next year. The project also supported the client's objective to actively mature its management culture with a more sophisticated planning process, increased expectations and supporting protocols for discipline in adhering to a Strategic Plan, and a more transparent cross-management dialogue about overall direction and resource allocation.

An organization in transition without a plan is a reactive organization.
When this small (less than 200 employees) health care services organization hired its new Executive Director, it was in a state of rapid growth and transition. In fact, the organization had undergone a series of transitions, but without the benefit of either a future vision or strategic plan to guide or inform its approach to managing change and responding to opportunities for growth. The organization was constantly focused on maintaining the integrity of operations and identifying funding resources, and was essentially holding things together by being creative and doing the best they could. While this approach kept the organization above water, it was becoming increasingly apparent to all parties that the organization could not thrive and might not even survive without some changes. The organization was beginning to show serious fraying as a result of growing pains and a corresponding demand to increase its operational and managerial sophistication. The Executive Director decided that one of his initial challenges was to help the organization establish a clear sense of strategic direction and develop a realistic plan for proceeding.


GMS had previously worked with the organization's Management Team, and separately with its Board of Directors, to strengthen each group's sense of direction and the effectiveness of their respective teamwork and overall working dynamics.


In addition to developing a long-term strategic plan, the new Executive Director also wanted to institute a more rigorous and disciplined management methodology that would emphasize execution and accountability. The organization had a very informal culture that had served it well up until the very recent past. The management culture had reached a crossroads where it would either evolve and guide the organization into a more stable future, or it would be a significant anchor weighing down the organization's efforts to survive in an increasingly complex environment.


GMS worked in partnership with Executive Director to outline a planning methodology that would emphasize analysis, engage the entire workforce, and involve the entire management structure at key junctures, but not become so collaborative and democratic that it would lack a leadership presence. Additionally, a substantial effort was built into the project to focus on instituting and supporting a new management discipline throughout the organization.

The project commenced with an all-employee one-day meeting examining the tradition and strengths of the organization, along with the workforce's future hopes and expectations for their organization both in terms of their workplace and their contribution to the their patients and stakeholders.

A committee structure comprised of Board Members, senior managers, middle managers, and staff was created to conduct a comprehensive environmental scan, evaluate the potential impacts of demographic and other social and political changes on the organization's future, and poll a number of outside experts for perspectives that would help inform a leadership dialogue about the future the organization wanted to create. The committees analyzed their data and formulated recommendations. During a two-day planning retreat for the Board and Managers, the committees presented their findings along with the implications for change and their preliminary recommendations. During that same Retreat, participants created a future Vision and a new business success model that the organization expected to grow into over the next few years.

The initial Planning Retreat was followed with another planning session to establish the strategic directions that would form the foundation of a long-term strategy to achieve the Vision.

Managers who did not participate in the two previous planning sessions were then all briefed and trained in a process to engage their staffs. Each manager presented the draft Vision and Strategic Directions structure to their staff, and then facilitated a process to examine their department's objectives and operations for alignment with the strategy. Additionally, each department generated a set of recommendations for how to improve the overall functioning of the organization.

The entire management team then met for a full day to evaluate this process and to review staff recommendations. They then prioritized the long-term Strategic Directions and developed a set of near-term objectives to be accomplished during the proceeding twelve months.

A subset of the senior management team conducted a further review of staff recommendations and developed a framework for acting on or postponing action on each staff recommendation. They then met with the staff from each department to provide feedback on their recommendations and proposed actions.

The Strategic Plan was further refined and ultimately presented to the Board of Directors for its approval. Following its approval, an outcome facilitated by the Board's early engagement in the development of the Plan, senior management met to establish near- and long-term measures and to begin discussing the management and accountability protocols that the entire management team will employ in order to ensure an organization-wide discipline with respect to executing the Plan.

Each of the above mentioned management and planing sessions was designed and facilitated by GMS. The client's workforce invested significant effort in the work of conducting the planning process, but at no point had to invest effort in designing or worrying about the structure, or facilitating the actual mechanics of the process.

The organization is implementing its Strategic Plan, and GMS will continue to work with its management team on a quarterly basis to support and institutionalize the new management disciplines.

Federal Government Regulatory Organization

Project Focus: Creating a More Strategic and Disciplined Organization

The senior management team of this large office within a Federal Government Agency was by its own admission highly dysfunctional. Meetings would break down into sniping and arguments that created an atmosphere in which participants and their subordinates could not tell they were on the same team. Trust was low. Tension was high. Despite these challenges, the organization was meeting many of its performance objectives. The key questions were how much more might be possible within a healthier environment, and how much longer could the organization continue to perform at existing levels without addressing some of its fundamental challenges? While short-term performance is always possible within and sometimes augmented by a stressful environment, there is always limit on the sustainability of that performance before inevitable break-downs occur.

GMS began by conducting an assessment, meeting individually with each senior manager and a few other managers from partner-organizations with constructive perspectives about the functioning and effectiveness of the senior team. In an uncomfortable but very constructive conversation, a detailed debriefing was provided for the Director outlining the team's issues as well as his own contribution to the unhealthy team dynamic. A number of recommendations were also offered for enhancing the Director's individual leadership within the team, along with an additional series of recommendations for the entire team's consideration. A session for the entire team eas then held to provide whole group with the feedback and recommendations.

The next step was an off-site retreat to review the assessment findings more carefully, begin a team building process, and start establishing specific expectations concerning leadership and teamwork values and behavioral norms.

This initial retreat was followed by another off-site retreat two months later. One of the major contributors to conflict within the team was the lack of a shared direction for the future. The organization had multiple priorities and initiatives but no future vision nor strategic plan that it could use as a basis for making difficult decisions and compromises concerning direction and resource allocations. Absent a shared vision and plan, resource discussions became arguments.

The team decided to use the lack of a shared vision and strategic plan as the focal point for improving its effectiveness. They participated in another two-day off-site retreat to analyze their organization's future challenges and opportunities, and begin developing themes for an organizational Vision and accompanying Strategic Directions. Over a series of subsequent one and two-day meetings, some with the next level of managers participating, the team created a shared Vision of the future; a refined sense of the organization's Mission; a long-term Strategic Plan with primary Strategic Directions, goals, objectives, and actions; a set of annual priorities to align existing activities with the new Vision and Plan; and has begun establishing the management mechanisms necessary to ensure that future annual planning will be driven by the long-term Strategy.

Equally important, all of the members of the Senior Team acknowledge that they are working and relating together in a much healthier and more productive way, with much less energy being syphoned off by unproductive or damaging interactions.