STRATEGY

How Mayo Clinic Implemented a More Agile, Dynamic Approach to Strategic Planning
Business leader Sarah Poncelet explains a simple four-step process to reshape a health enterprise’s mindset

As Mayo Clinic started developing a new corporate strategy a few years ago, leaders labeled it as a “vision for 2030,” looking a decade ahead to where the industry might pivot. But when COVID-19 arrived, the number didn’t feel right anymore.

The health care field was changing so fast — with innovations sometimes dreamt up and implemented within weeks — that strategists experienced a sense of déjà vu.

“We stopped using a date because it feels like we’ve already lived 2030,” said Sarah Poncelet, MBA, director of business and strategy planning.  

The organization began pivoting toward a more agile planning process prior to the pandemic. Mayo’s approach is meant to help keep leaders on course, regardless of the business dynamics shaping their work. Rather than making modifications in a cyclical fashion every five to 10 years, they review strategy quarterly with Mayo’s board of directors.   

“We have to ensure we're keeping up on trends and that our “true north” stays the same as market forces change and we accelerate faster toward our future,” Poncelet said. “Each year we are updating those forecasts and each year we are validating with our board that the core framework of our strategy is still what we aspire to be."

Four Steps
To aid others in this way of thinking Mayo has developed guidance, in the form of a toolkit, for mapping the path from strategy to execution. The toolkit details four simple steps health care professionals can follow to reach this desired state. It’s broken down so that a team can tackle this task in a single day.

Here’s a quick look at the steps (with estimated time commitments):

1. Step into the Future (about 90 minutes): Imagine yourself in a vastly different environment. This should result in the health system defining a clear role in a future state and establishing its value proposition within the crystal ball.
   
   
2.  Chart Your Course (one hour): Align your department’s strategies and priorities within the institution’s overall roadmap. The goal is to develop a blueprint to approach the future state and determine your own division’s role in that framework.
   
   
3. Stress Test Your Future (one hour): Use different hypothetical endpoints to refine your hospital system’s ideal future state. This step should result in a refined desired destination that’s ready for planning how to get there.
   
   Poncelet said pressure testing “worked wonders” for Mayo amid the pandemic, having explored the possibility of an economic downturn, forthcoming technology advancements and consumer behavior changes, back in summer 2019.
    
   “Because we talked through and stress-tested our strategy to say what we would do in the event of a recession, we were much more focused when our external environment rapidly changed in March and April,” she said.
    
4. "Back-cast": There to Here (65 minutes): Develop the steps to take in the present to achieve your organization’s vision. This will result in an initial action plan on how to reach that ideal future state.
   
   Poncelet noted that this is much different from the traditional method of forecasting and perpetuating the status quo or path you’re already traversing in a linear fashion. 'Back-casting,' meanwhile, is starting from where you want to be in the future and then stepping backward into the key actions and decisions that must occur for your vision to come true. 
    
   “This ends up being the most difficult step for the people with whom I have facilitated because it’s really hard to back into your desired actions and operations in three- or five-years’ time and determine what we need to do today to get there,” she said.

Principles in Action
As one example of this strategy, Poncelet cited education at the Mayo Clinic. After the system devised its overall corporate plan using this process, she and colleagues then worked through all four exercises related to learning.

Mayo created multiple forecasts for education, expecting a surge in virtual care delivery during the public health crisis. Patients’ use of telehealth had swelled and providers wanted to talk through how they could ramp up preparing physicians and nurses to operate in this new reality.

Poncelet and colleagues ended up with five separate forecasts and they worked toward charting how to reach those possible realities.

“Then as we start imagining that new future, we're actually recreating what that end state looks like,” she said. “And as we move into the second step, we then had to align to the “true north” areas of Mayo Clinic. One of those areas is focusing on our own current talent, but also our future workforce pipeline.”

As Mayo started stress-testing the different possibilities, the economic downturn and how that might affect care-use patterns became critical.

“In a recession, when financials are constrained, it actually accelerates the rate in which we would want to push out that virtual mode because we'd be able to reach more people through a scalable solution,” she added. “That actually helped us to realize this was a higher priority for us in which to invest our time, our energy, our people and our resources.”

Finally, with a more firm idea of where they needed to go, Mayo Clinic began 'back-casting' to reach that destination. As part of this step, they worked through the key investments, initiatives and projects the system needed to tackle to move from an in-person model to a more virtual training and education environment. The pandemic only intensified this process, forcing leaders almost overnight to completely move the majority of content to the web.

“What we’ve found in corporate strategy is that especially in a time period where we just experienced COVID, there are external forces that will challenge you every single day, every month, every quarter and every year,” said Poncelet. “So, as we navigate those challenges, it forces us to think through the internal responses in preparation for the future. We believe that going through more of an agile or dynamic strategic approach is really important and that is exactly what this toolkit offers us the ability to do.”

Mayo Clinic’s leadership toolkit, presented at the SHSMD Connections Bytes conference, can be accessed here.

 

This article features an interview with: 

Sarah Poncelet
Director, Business Strategy and Planning
Mayo Clinic
Rochester, Minnesota