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Making Dreams Come True?. Implementing a Strategic Plan in an Healthcare Environment (Moving from Manager to Teacher) Dr Peter Hunter Director Integrated and Sub-Acute Care, St Vincent’s Health. Strategy Implementation – my starting point.

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making dreams come true

Making Dreams Come True?

Implementing a Strategic Plan in an Healthcare Environment

(Moving from Manager to Teacher)

Dr Peter Hunter

Director Integrated and Sub-Acute Care,

St Vincent’s Health

strategy implementation my starting point
Strategy Implementation – my starting point
  • There is a disconnection between strategy formation and strategy implementation
  • The capacity to implement strategy is dependent on the quality of it’s formation
  • Implementation and formation are brought together by considering strategy as a process of learning and ongoing conversation
  • Strategic skills can be learnt
strategic implementation key themes in the literature
Strategic Implementation – key themes in the literature
  • Little focus on implementation in literature
  • Barriers to implementation
    • Wrong strategies
    • No buy in
    • Poor communication
    • Inadequate resources
    • Poor leadership
  • SI is about managing change and all its complexity
strategic implementation key themes in the literature1
Strategic Implementation – key themes in the literature
  • Structural dimensions
  • Interpersonal dimensions
    • Meta-abilities; cognitive skills, self knowledge, emotional resilience, personal drive
    • Strategic consensus
    • Learning focus and skills
  • Strategic conversation
research methodology
Research Methodology
  • Strategic processes are social activities
  • Participatory Action Research
  • Insider manager researcher
    • Pros and Cons
  • Coghlan and Brannick model
    • Personal, team, inter-team and organisational levels
    • Content, process and assumptions
  • Grounded theory data analysis
organisational context
Organisational Context
  • Integrated and Sub-Acute Care (ISC)
    • Clinical directorate of SVH
    • 700 staff over more than 10 sites across 4 legal entities
    • 10 different funding streams
    • 2 program directors
    • 45 middle managers
    • Acute, subacute, community and residential care
research starting point
Research starting point
  • A cross section of 10 managers in ISC interviewed….
  • 2 dimensions
    • What are the issues for middle managers in ISC around strategy
    • Can “discussion” facilitate a more strategic focus and intent
  • The rest of the study dependent on the outcomes of the interviews
how the research actually unfolded
How the research actually unfolded
  • Interviews established key themes and drove subsequent cycles
    • Data collection
    • Interventions as
      • Getting to know the manager
      • Awareness raising
      • Knowledge giving
      • Teaching and role modeling
  • Presentations given as a response to feedback and discussion with the managers
    • E.g. Managing up
managing up
Managing Up
  • Gabarro-Kotter Perspective; understand the boss, understand yourself and work on the relationship
  • The boss as a customer
  • Political and social dynamics
  • Learn how to persuade well
  • Followership
  • Understand your own mental models and the ladder of inference
research findings
Research findings
  • Interviews analysed using grounded theory
  • Results of this analysis feedback to ISC management forum
feedback at isc management forum
Feedback at ISC Management Forum
  • Recurrent themes
  • What is strategic thinking?
  • What models help us conceptualise strategic thinking?
  • What do we do with this?
recurrent themes in interviews
Recurrent themes in interviews

Strategy is political

  • Issues are only strategic if the right people think they are
  • There is different levels of awareness of the political dimensions to strategy in ISC
  • ISC mangers have variable confidence and skills in
    • Influencing skills for getting issues moving up, down and across the organisation
    • Understanding and using their “power bases” optimally
      • position
      • resources
      • knowledge and expertise
      • personal influence
      • networks
      • energy and stamina.
recurrent themes in interviews1
Recurrent themes in interviews

We need to create an environment conducive for strategy being part of our daily management practice

  • Strategic conversation
    • Feeling involved and not disconnected
    • Formal and informal dimensions
    • MBWA
    • Strategic skills and the ability to act
  • Context setting
  • Allowing risk taking in progressing ideas
  • Fluid networks - making connections
  • Time resources; moving from the urgent and important to the non-urgent and important.
recurrent themes in interviews2
Recurrent themes in interviews

Strategy formation and implementation are a learning opportunities

  • Leaders are managers of learning
  • But what can be taught?
    • Strategic thinking skills
    • Managing up skills
    • Improving our understanding of perceptions
    • Reflective practice
    • Communication skills- persuading and listening skills
strategic thinking skills
Strategic Thinking Skills
  • Double loop learning
    • Scanning and thinking through data – asking why and seeing patterns
    • Problem solving at higher conceptual levels
  • Systems thinking
  • Creative thinking
  • Strategic intent –leveraging energy and attention
  • Thinking in time –connecting the past, the present and the future
  • Intelligent opportunism (making connections)
  • Hypothesis driven thinking
    • What if….. (divergent)
    • If….., then… (convergent)

Organizational Competencies

What can we do?

Threats and Opportunities

What might we do?


What can we learn to do?

How do we shape values?


What do we want to do?

Societal Responsibilities

What ought we do?

  • Strategic questions
where to from here
Where to from here?
  • From ISC executive?
    • A greater and more explicit attempt to get you all to think strategically
    • Working towards a conducive environment
    • Facilitating manager’s skills development
  • From you?
the action bit of action research
The Action bit of Action Research….
  • Establishing a more dynamic culture of learning and teaching and embedding it
    • Realized in retrospect
    • Realized and planned
      • Formal – professional development program
      • Informal
        • Role modeling
        • MBWA and local facilitating
  • ISC at a point of transition
issues arising from the research
Issues arising from the research
  • Fuzzy to Less Fuzzy;
    • Lets improve strategic implementation
    • The path to better strategic focus is developing a teaching organisation
  • The importance of leaders as the managers of learning the key finding
leaders as teachers the literature
Leaders as teachers - the literature
  • What do leaders need to do?
    • Accept and embrace their role as teachers
    • Have belief in their credibility and communication skills
    • Have a teachable point of view
    • Develop an understanding of adult learning principles
    • Create a conducive environment
      • Multiple modalities
      • Encourage questioning, experimenting and reviewing success and mistakes
      • Share experiences
leaders as teachers the literature1
Leaders as teachers - the literature
  • Learning organisations?
    • “organisations that create an environment where behaviours and practices in continuous are actively encouraged”
  • Teaching organisations?
    • Adds a proactive dimension to learning organisations
    • Learning starts with individuals
    • Role modelling and facilitating critical
    • Leadership’s most critical responsibility is to teach
    • Learning as a multiplier of power

Strategic Change


(Organizational Learning and Teaching)



  • Teaching organisations as a concept should sit alongside learning organisations
  • Leadership, learning, teaching and strategy are interlinked
  • Strategic capacity is linked to management competence development
  • What’s a conducive environment ? ..more research is needed
  • A conceptual model?
a model
A model



Adult Learning


The leadership of organisational learning = learning & teaching

Leadership Skills