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Strategy and Culture



Clearing the "Elephants' to Enable Space for Constructive Dialogue on Strategy

Situation: The Board of a joint venture (JV) organization engaged us to help them craft their first strategic plan. The JV had achieved the goals for which it was formed and enjoyed positive performance – clinically, financially, and operationally. Many changes were anticipated in the external environment, which the Board wanted to understand and consider as they looked to continued success in the future.


Approach:  Our two-phase process included: 1) context setting and 2) strategy development. One insight from the context setting was that there was an ‘elephant in the room’ that would diminish the ability to have open and constructive dialogue needed to effectively develop and execute the strategy. Due to our deep knowledge of strategy and culture, we were able to help the Board work through this issue successfully such that they could have the constructive dialogue needed. We helped them craft a strategy for the future and organize for effective strategy execution including understanding of the key action steps for implementation year one; clear accountabilities, target dates, and communication loops; and articulation of an effective progress monitoring approach.


Results:  Feedback from the participants was extremely positive in terms of the experience and the outcome on the strategy and the ability to work through the “elephants in the room”. The venture continues to enjoy success in a changing environment.


Culture Assessment to Achieve the Promise of a Merger 

Situation: An academic health system was merging with a small community hospital. They asked us to help them understand the culture of each organization and its potential impact on achieving the merger strategy.


Approach:  We conducted an extensive document review, interviews, focus groups, and walking tours to observe and experience the culture of each organization. We characterized each of the merging entities’ cultures and then analyzed them from the perspective of the merger strategy. The culmination was a series of conversations with senior leaders highlighting the similarities and differences in the cultures, what in the cultures could accelerate strategy execution and what could potentially inhibit it, and finally recommended steps to begin to use the cultural understanding as a source of strength for the merger strategy.


Results: Leadership of the merged entity gained significant insight from the intervention and adjusted some of their plans to more effectively use the cultures as a source of strength in fulfilling the promise of the merger.

Change Management

Design and Facilitation of Change Strategy to Realize New Strategic Plan  

Situation: A health system serving relatively distinct geographic markets invited us to help them craft strategy. The direction of the system had previously been dictated from the central office but the new CEO wanted to engage the regional entities in defining the future strategy.


Approach:  We designed and facilitated a strategy process within each region that included periodic connection with the central office leadership to assure alignment and address issues. As we worked in each region we continually observed and explored the organization culture. A consistent theme was distrust of the central office by the regional participants and fear that the regional strategy efforts would be a waste of time because the central office would do what they wanted. We addressed this during the process with periodic central office leadership joining regional leadership in meetings. We also gained the support of the central office top three executives to meet with each of the regions, once strategies were crafted, in a facilitated retreat to build understanding, alignment, and trust.


Result:  The retreats resulted in significantly increased understanding of the regional and central office perspectives and strategies, slight adjustment in the endorsement of the regional strategies, and greater engagement and accountability at the regional leadership level for their market and its relation to system success. We were invited to work with leadership in many other parts of the system in subsequent engagements and the system has enjoyed significant growth and success.




Team Development to Fuel and Manage Organizational Growth

Situation and Approach: 

The CEO of a large non-profit contacted us early in her tenure to help her leadership team align to their mission and strategy and strengthen their working relationships. As the organization grew, we were engaged several times to help work through the change related to growth and new strategies such as:  

  • Preserving the camaraderie and connection to the work, which had been possible in the smaller organization, while leveraging the growing staff for greater effectiveness and market impact;

  • Understanding each others’ styles and strengths and how to best leverage them;

  • Guiding through responsibility charting to enable clarity on key accountabilities, communication needs, and expectations; and

  • Helping Board and leadership draft a new organization design to execute successfully on a new market opportunity, gaining staff input to the redesign, and formulating the change strategy for the new organization design.


Result:  We were engaged several times over the life cycle of 2 CEOs due to success in helping them grow and change, staying true to their mission and maintaining their desired culture. The organization continues to be a vital and successful force in the region.

Aligning Departmental Team to New Enterprise Strategy


A department of a global company wanted to gain greater clarity on how they could contribute to the organization’s revised strategy. They engaged us to help clarify their shared goal and help strengthen the team effectiveness.


Approach:  We reviewed documents on the strategy, environment, and team’s work and interviewed each member to understand their perspectives. We designed and facilitated a meeting that enabled the team to gain a shared perspective, consider and chose opportunities for greater alignment with the enterprise’s new strategy while leveraging each team member’s talents more effectively, and create shared expectations for how they would work together more effectively.


Results:  Participants rated the meeting process and outcome very positively. The team leader shared, a month after our work with them,  that the team was making much greater progress and had greater satisfaction as a result.  

Leadership & Coaching


Building Leadership and Team Capability to Support Firm's Growth


A professional services firm faced significant staff turnover that was affecting their ability to deliver solid client service and stagnating growth of the firm’s client base and revenue.


Approach:  We helped the leader understand his role in the situation and increase his leader effectiveness. His strength as an independent self-starter that helped launch his career was one of his greatest challenges as he sought to grow a team to grow the firm.


We helped the leader and his team:

  • Gain a shared understanding of the growth strategy and clarify responsibility and accountability for executing key aspects of strategy,

  • Understand each other’s styles and talents and how to work most effectively together, and

  • Create effective communication channels including meetings, processes, and other information flow.


Results:  Staff turnover declined dramatically and firm client base and revenue increased significantly. The leader who had worked very long hours previously has, through growing his team leadership, increased his time for off-hours rejuvenation, which has increased his work hour productivity. 

Coaching a High Potential Physician Leader to New Heights

Situation: A physician researcher in an academic medical center was matched with us for executive coaching as part of a high potential leader development program. While highly successful in his medical sphere, he had not had much exposure or experience in the broader medical center environment.


Approach:  As part of our coaching relationship, he gained insights into how others saw and experienced him via a 360 assessment, expanded his views of other possible ways to ‘see’ what was happening through inquiry during sessions and reflection between sessions often guided by questions Carol would offer as ‘homework’. One of the most significant insights was the concept of relationships and support. As we ‘mapped’ the system and his relationships, the opportunity to broaden and deepen relationships was clear and we embarked on how to achieve that strategically and within his already challenging schedule.


Results:  As other leaders got to know him, his talents, and perspectives he was invited to participate in arenas outside of his specific medical area and ultimately was asked to take on a new challenge that was a promotion. He continues to this day to be highly successful. 


Design and Delivery of a Leader Development Strategy to Support Rapid Growth

Situation: We were invited to help design and deliver a leader development strategy to build capability in a role key to the organization's growth. 


Approach:  Conducted a needs assessment to understand the context and traits most needed for success in this role, developed a success profile, and identified core competencies.


Designed a multi-modal learning strategy that included:

  • periodic learning sessions;

  • 360 assessment and individual development plan;

  • self-development resources; and

  • monthly touch points with the participants’ leaders to assure timeliness and relevance of each sessions’ design.


Results:  Participants rated the initiative a 4 on a 5-point scale (5 was most positive) on each of the following:

  • Achieved the stated objectives

  • Value was worth the time invested

  • Confident in my ability to apply the learning

Some of the other benefits that were cited include:

  • The many “tools” provided;

  • The learning environment established with their peers;

  • Greater consciousness and awareness of oneself; and

  • Greater confidence.

Meetings And Retreats



Leveraging Expertise and Connections for Greater Impact:

A geographically dispersed organization was seeking to expand its client base and leverage the impact of people in community-facing roles (e.g. marketing, community and government relations, etc.). They asked us to design and facilitate a retreat to help people in these roles learn, align, and leverage their relationships and impact.


Approach:  We designed a day and a half meeting to bring all together with a focus on relationship building, creating a common knowledge base, articulating clear goals, and organizing for effective execution. The meeting began with a relatively casual dinner the night before to build relationships and included corporate leadership to signal the importance. The first day was focused on enabling people to understand the talent and perspectives of their colleagues and build an organization wide tapestry of the collective world in which they operated. The first full day ended with a list of possible strategies to more effectively leverage the talents in the room to achieve the common goal. The evening break was intentional to enable a fresh perspective the next morning. The participants had a vigorous discussion on the goals, finalized accountabilities, and closed with an open evaluation of how well they worked together.


Results:  Participants left with a sense of enthusiasm, clarity about the shared objective, and knowledge of the part they each played and the support and resources they could tap from their fellow participants. Silos were melted, minds and hearts were opened, perspectives were deepened and widened, and clarity was gained. Post-retreat leadership expressed satisfaction with the synergies gained and the increased impact of this group of individuals.

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