A Tool for More Effective Strategy Development and Execution

Posted by: Larry Sobal on Thursday, December 15, 2016
A Tool for More Effective Strategy Development and Execution


Last week in my blog post, A Proven Health Care Strategy for Uncertain Times, I suggested that rather than trying to guess at a strategy, organizations should fix the problems they already know they have. Coincidentally, last week I was facilitating an organization’s annual strategic planning retreat and we faced that exact challenge. Today I want to share some approaches to help you focus on your strategic priorities with the organizational alignment that ensures plans get executed and measureable progress is made.

I have been a strong advocate for using Hoshin Kanri (aka Strategy Deployment) for many years; it is an ideal way to avoid some strategic plan problems I commonly see including:

  • Failing to prioritize your strategies so that you end up with multiple “#1” priorities, causing confusion on what is most important and resulting in insufficient efforts being spread across too many initiatives
  • Poor linkages between your short- and long-term goals, resulting in actions that don’t create the type of breakthrough initiatives that are critical to success
  • Lack of a clear way to cascade your organizational goals to different operating units, resulting in misaligned organizational focus and priorities, and silo’d thinking and behavior
  • Inability to understand the resource implications that will be required to execute your strategies, resulting in the possible overload of certain people or departments that is not apparent until it occurs

So, what tool can address and avoid these issues?  Let me introduce you to the X-Matrix. If you search X-Matrix, you can find 5.5 million sites to visit. I happen to favor the format shown below, particularly when I am facilitating a strategic plan for a service line or physician practice.

There are many benefits to this format, including that on a single sheet of paper (usually 11x17) you can see many different aspects of your strategy at once, and how they relate to each other. For example:

  • Do your long-term goals align with your Mission and Vision?
  • Have we identified the types of “Breakthroughs” that will get us to our long-term goals and Vision?
  • Will our coming year priorities (Must Do/Can’t Fails or MDCFs) help lead to breakthrough results in 2-3 years?
  • What are the priorities next year in terms of what is really #1 versus #2, etc.?
  • What roles do people or key functions play in executing this year’s strategic priorities?
  • Who is the owner of each Must Do/Can’t Fail priority? Who is the decider?  Who has input?
  • Is there any person or department that may become a constraint because they have critical roles in too many of the MDCFs?

Imagine if your 2017 strategic planning retreat, like the one I facilitated last week, had all the key stakeholders in a room to develop an X-Matrix like this one. Now also imagine if each MDCF creator and owner (with the identified people providing input) flushed out the details of the current and future state, including the leading and lagging metrics, using the appropriate A3

Format? Would there be better consensus, clarity, alignment, and reflection on how 2017’s priorities related to long-term goals and vision? Would you stand a better chance for execution and attainment of your MDCFs? I suspect so.

By starting with an overall “master” organizational X-Matrix, each individual service line and department can then build their X-Matrix to clearly align with the global version.

Even more powerful is when an organization uses the X-Matrix and A3s as part of an overall Strategy Deployment, as this organization intends to do. By starting with an overall “master” organizational X-Matrix, each individual service line and department can then build their X-Matrix to clearly align with the global version. People at all levels of the organization can understand the priorities, visually see the alignments, look for resource constraints, and know what role they (or other people) will play in the work. In addition, by using A3s to guide the execution, a standard language and methodology evolves for solving problems and implementing programs.

From what I see around the country, this would be a huge improvement on how strategic plans are often created, and it would offer the opportunity for more effective plan execution. Leave a comment if you are using the X-Matrix, and whether you have found it to be effective.


llustration: Lee Sauer


Larry SobalLarry Sobal is Executive Vice President of Business Development at MedAxiom. He has a 35-year background as a senior executive in medical group leadership, hospital leadership and insurance. Larry consults, writes and presents on topics relevant to transforming physician practices and health systems.

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