OGSM example

OGSM example: an elderly care provider

Clients in control of their own care, in a sector where the constraint is people rather than money.

A care organization for older people, working in a region with several other providers and a shrinking workforce.

HealthcareCompany-wideFive yearsNon-profit

Objective

In five years the client and their family are in control of their own care, by equipping and supporting them to make their own choices and by working in partnership with other care providers.

Goals

  • Client satisfaction above 8.5 out of 10
  • Family satisfaction above 8.5 out of 10
  • Employees experiencing the freedom to do what a client needs: 4.5 out of 5
  • Partnerships across the regional care chain: 3
  • Profitability above 2 percent
1 Enable clients and their families to make their own choices by informing and equipping them properly

Dashboard: KPIs

  • Client satisfaction with their care: above 8.5 out of 10
  • Family satisfaction with the information they get: above 8.5 out of 10
  • Client files available online to authorised staff: 95 percent

Actions

  • Give every client a named contact who is easy to reach (Ilse, Q1)
  • Organise regular peer coaching so expertise is shared (Ilse, Q2)
  • Bring client information together in one digital file (Ruben, Q4)
2 Deliver care more flexibly by adopting care technology

Dashboard: KPIs

  • Clients using care technology: above 50 percent
  • Care technology pilots run: 6
  • Care innovations actually implemented: 2

Actions

  • Join industry association programmes and pilots (Ruben, Q1)
  • Appoint an innovation lead to structure the process (Ilse, Q2)
  • Build an adoption programme so pilots reach daily practice (Ruben, Q3)
3 Take the coordinating role in regional care by mapping the client journey and sharing what we learn

Dashboard: KPIs

  • Improvements delivered from a care coordination perspective: 15
  • Satisfaction with our coordinating role: above 7.5 out of 10

Actions

  • Map the client journey across the region (Marijke, Q2)
  • Prioritise and plan the improvements it surfaces (Marijke, Q3)
  • Formalise partner roles and responsibilities (Marijke, Q4)
4 Create room for improvement by reorganising processes and moving responsibility closer to the client

Dashboard: KPIs

  • Employee satisfaction with the autonomy they have: 4 out of 5
  • Improvement budget used: 95 percent
  • Teams working with their own OGSM: 35

Actions

  • Finish current IT projects before starting new ones (Ruben, Q1)
  • Give teams budget and time for their own improvements (Ilse, Q2)
  • Involve teams in change by giving each one its own plan (Marijke, Q3)
A five-year OGSM for an elderly care provider. Adapted from the book.

A care organization for older people. The sector’s constraint is not demand and it is not really money. It is people. There are not enough carers, there will be fewer, and the ones who stay are leaving partly because the work has become administration.

So the ambition is not growth. It is autonomy: for clients, and by extension for the people who look after them.

What to notice

The Objective is about a shift in control, not a target. “The client and their family are in control of their own care.” No revenue, no market position, no size. This is worth studying if you work somewhere that assumes an ambition has to be a number: the numbers come next, in the Goals, and the ambition is allowed to be about what kind of organization you want to be.

Profitability above 2 percent is there anyway. A non-profit still has to be solvent. Putting a modest margin in the Goals is more honest than leaving money out and discovering in year three that the ambition was never affordable.

One goal measures how employees feel about their own discretion. “Employees experiencing the freedom to do what a client needs: 4.5 out of 5.” That is an unusual and rather good measure. The ambition is client autonomy; you cannot give a client autonomy through a carer who has none. So the plan measures the thing that actually blocks it.

The fourth strategy is where the plan gets serious. Create room for improvement by reorganising processes and moving responsibility closer to the client. Everything else depends on it. The first three strategies all assume people have time and authority; this one is what creates them.

An action that says stop. Finish current IT projects before starting new ones. Not a new initiative: a decision to complete what is already in flight. In organizations where change fatigue is the real risk, this is often the highest-value line on the page, and it is almost never written down.

Where this plan could go wrong

Thirty-five team OGSMs is a programme, not a KPI. “Teams working with their own OGSM: 35” sits as a KPI under the fourth strategy with one supporting action. Getting 35 teams to write and then actually use their own plans is a substantial change effort. As written it is likely to be reported green because the plans exist, while the underlying behaviour has not changed. How connected plans stay coherent →

Marijke owns the whole regional strategy plus a piece of the fourth. Regional coordination depends on other organizations agreeing to things. One person carrying all of it is a single point of failure on the strategy with the least direct control.

The care technology strategy measures adoption, which is right, but late. Pilots and implementations are the leading measures; “clients using care technology: above 50 percent” will not move for two years. That is fine, provided the review does not treat a flat line in year one as failure.

The horizon

Five years. Long enough for a genuine shift in how care is delivered, and long enough that the plan will be wrong about something. Which is what the quarterly strategy review is for.

How the review rhythm works →

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