The Top Ten Mistakes in Setting Goals

November 5, 2009

For years, healthcare leaders have been evaluated by means of a “Does Not Meet/Meets/Exceeds” scale. The problem with this is that it doesn’t really tell you what the leader accomplished. I believe a far more fair method is the use of a clear, objective, and weighted evaluation based on specific goal achievement.

The evaluation makes use of a one-to-five rating system for each goal, with the leader who exceeds expectations earning a five. And every goal is assigned a weight – a percentage – based on its importance so that leaders know where to put the most energy. However, my work with hospitals across the country has taught me that implementation of this leader evaluation system can be challenging for some. The good news is that missteps can be fixed with an understanding of what went wrong.

Here are the top ten, most common mistakes made during the first year of rollout and how they can be avoided:

  1. Inappropriately assigning organization-wide goals to middle managers. For instance, it’s not uncommon for a hospital to assign its overall patient satisfaction goal to middle managers who have nothing to do with direct patient care. Instead, these individuals should have goals relevant to their position in the organization.
  2. Goals are over- or under-valued in their assigned weight. Make sure you assign weights according to the goal’s importance and impact on the organization. The more significant the goal is to the organization’s success, the higher its weight should be.
  3. All leaders share the same weights for a goal, even when their responsibilities don’t impact the weights. Leader’s goals should be weighted according to what they’re directly accountable for. Why should a person with minimal financial oversight, for example, be given a budgetary goal weighted at 50%? Yet I’ve seen it happen.
  4. Instead of the outcomes, tactics such as projects or processes are used as goals. Don’t confuse the two – a tactic is the process/project used to reach a goal.
  5. Designating healthcare regulations as goals when they’re really expectations. Regulatory standards should be a presupposed life style in the healthcare world.
  6. Leaders fail to accept responsibility for far-reaching organizational goals they directly impact. Any leader who has influence over whether or not an organization-wide objective is achieved should own that goal.
  7. Lack of uniformity in measurement. Define the measurement criteria for achieving a goal and what success will look like. Otherwise, leaders will invent their own definitions, targets or metrics …which results in confusion and inconsistency across the organization.
  8. Leaders are allowed to “cherry pick” the easiest goals to meet instead of the most important. Cherry picking the undemanding targets gives staff the opportunity to achieve its goals, the leader looks good, and there is cause for celebration. However, in the long run, the organization suffers when a leader fails to concentrate on the important goals, the ones that will make the most difference.
  9. Setting numerical targets where all leaders move up at the same rate. For instance, an organization wanting to move patient satisfaction results upward asks every leader to be responsible for increasing the scores by ten points. One manager is at the bottom of the barrel with patient satisfaction at 5 percent, while another one has achieved an 85 percent approval rate. Yet both are expected to improve at the same rate. This puts the first manager shooting for 15 percent, hardly much of an upgrade. But the second one will have to hit 95 percent, a very difficult thing to do – plus it’s hardly fair. The organization needs to consider rate of improvement instead of targets founded on the baseline when setting goals.
  10. The goal is achieving a prestigious reward as opposed to the outcomes themselves. Don’t put the cart before the horse: Outcomes and results should be the priority – the awards will come. Remember, it’s the journey which warrants a Malcolm Baldrige National Quality award or Magnet status…that takes the organization to a whole new place.

If you have any questions or suggestions on how to implement goals in your organization please feel free to email me at bill.bielenda@studergroup.com.
Yours in service,

Bill Bielenda

Bill Bielenda, Studer Group Coach
Studer Group
http://www.studergroup.com

For more information on Studer Group’s Leader Evaluation Manager™ software tool that automates the goal setting and performance review process for all leaders, and to review sample leader goals visit http://www.studergroup.com/lem.

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3 Responses to “The Top Ten Mistakes in Setting Goals”

  1. Janet Silverman Says:

    The organization I work in has a goal of nothing less than 99th percentile performance in customer satisfaction, and this is creating a tremendous strain on the organization. Our leaders are feeling very overwhelmed and 75 percent of them are being penalized on their evaluations for not reaching these very ambitious goals. I am concerned that other aspects of the organization are slipping (quality, finance, morale, innovation, new business development, etc.) as we put such a disproportionate share of our resources into being the absolute best in customer service, as compared to our peer group. How do you determine the “right” customer goal for an organization? Should we all be shooting for nothing less than 99th percentile performance? Are we failing if we compromise on this and set a goal to be at or above the 90th percentile?

  2. Jonathan Kovall, MBA Says:

    Very good article, which emphasizes the importance of fairness and accountability in goal setting. It is very dangerous if one individual yields too much influence or power over any particular goal in a health care organization. Goals should be a stretch, but not to the point where they are based on unrealistic or unattainable expectations. An astute CEO and Board must use judgement when approving goals to attain a proper balance between the sometimes overzealous recommendations of key advisors and what they know from experience to be an appropriate stretch goal. Failure to do so can lead to serious morale issues, burnout of key leaders, and decline of overall performance in quality and financial performance.

  3. Eleanor Rogers Says:

    I am wondering if any readers have an opinion on how to determine an appropriate target for a customer service goal. Our organization is currently at the 90th percentile of our Press Ganey peer group, and are in the process of setting a customer goal for the next calendar year. We are debating whether there is really that much of a difference to customers between an organization that is performing at the 90th percentile of the peer group and one that is at the 99th percentile? Should our goal, and that of every health care organization be to attain the 99th percentile, and what affect will this journey have on the other important priorities of the organization?


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