Though some physicians I've talked to seem to loathe the term "evidence-based medicine," it's a long-overdue attempt to ground decisions on the care of individual patients in "...the conscientious, explicit and judicious use of current best evidence..." (Centre for Evidence-Based Medicine, courtesy of Wikipedia.)
As this new culture takes hold throughout the medical community, it seems fair to ask whether evidence-based discussions might benefit other processes outside of the clinical realm, say, the process of crafting organizational strategy. And what might "evidence-based strategy" look like compared to current practices?
Some planners may argue with me on this point (actually I hope they do; sparking arguments is one of my goals for this blog) but large briefing books and PowerPoint decks, though ubiquitous, are not by themselves evidence for anything except planners' inability to separate the "vital few" facts from the trivial many. Planning processes I've observed - and, alas, a few I've facilitated - suffered from an acute lack of clear evidence on the road map to higher performance levels. Data-rich but knowledge-poor, I call it.
Consider for a moment the SWOT analysis, fashionable among planners and leaders. Strengths, Weaknesses, Opportunities and Threats. Four simple words, so simple they're often entrusted to a nominal group technique where a room full of smart people discuss, synthesize, vote and adjourn, congratulating each other on another great meeting. Maybe they got it right. It happens sometimes.
But let's speculate what an evidence-based SWOT analysis might look like, and how it improves on the rather superficial and self-serving process described above. Moving the typical SWOT analysis from a nice, comfortable exercise to actionable insights requires your team to ask and answer three simple questions and a few follow-ups.
Questions like these for example, directed at the organization's strengths - the 'S' in SWOT:
- HOW DO WE KNOW we're strong at XYZ? Where's the evidence and how good is it? Contrary to her esteemed opinion, your Chief of Staff saying you rock at cardiac surgery isn't really evidence and may, in fact, be little more than wishful thinking. Make her prove it. Not everybody can be above average.
- How strong are we RELATIVE TO EVERYBODY ELSE? In our market? Relative to our industry's best practices? To best practices in ANY industry anywhere? So your satisfaction scores are consistently at the 99th percentile of health care providers. Maybe you should set your sights a little higher and stop defining "excellence" based on the benchmarks of a frequently mediocre industry!
- Finally, since strategy is about the future, HOW STRONG MUST WE BE to thrive in 5 years? 10 years? 20? What's the industry's trend line and what's ours? What rate of improvement does that imply? Are we improving faster than our competition or falling behind?
You'll notice that some of the questions are data-related. "How do we know...?"
Others are values-related, dealing with implications of data-driven conclusions. "Are we content to be...?"
Sounds like a lot of work, doesn't it? It can be but even so it's work worth doing, as I'll point out in future articles. Stay tuned.
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