Performance Improvement

The Five Questions Every Leader Needs Answers To

I know senior executives literally cannot sleep some nights worrying about the strength of their company or how they are going to get through a particular situation, having been one of them myself in the past. As a framework for discussion I’ve created “The Five Questions Every Leader Needs Answers To” because I’ve found that few organizations have solid answers to these questions, and the process of answering them gives leaders a better handle on their organization’s direction, performance, and improvements than they’ve ever had before.
Here are the Five Questions along with some of the reasons I think trying to answer them can be so helpful:

The First Question: What business are you in today?

The answer to the question, “what business are you in today?” or “why does my organization exist” is inspired by the book “Built to Last” by Collins and Porris. It’s important because how you define what business you’re in will have an impact on how you run and grow your organization, and on where your people choose to focus their time, attention, and resources.

The answer is not always intuitive, either. For example, the leadership team from my client, MEDIC, the EMS Agency for Mecklenburg County, in Charlotte, North Carolina, worked through several concepts before clarifying that the reason they exist is “to help people.” Unlike other EMS organizations who view their purpose as saving lives, the folks at MEDIC provide extraordinary care and customer service to everyone they encounter, even people who are not their patients.

Developing a clear sense of purpose for your organization is the first step in developing a process that is fully geared toward achieving the results of your dreams.

The Second Question: Where am I going?

This question relates to setting your vision for the future of your organization. I am not a fortuneteller and probably you aren’t either. However, I’m a big fan of Peter Drucker who said that, “The best way to predict the future is to create it.” That’s why a strong, crystal clear, unambiguous vision is vital. A vision should be someplace that you’re hoping to head or some state that your organization is working to create that doesn’t yet exist.

For example, one of the organizations I’ve worked with over the years, Medtronic Physio-Control has a vision that says, “We envision a society in which no person dies suddenly as a result of a cardiorespiratory event.” As a result, that company doesn’t limit itself to selling one type of device or even to selling products, and the people who work there understand that the end goal of what they do every day is to prevent cardiorespiratory-related sudden death, not just meet a quota.

The Third Question: What guides my day-to-day actions?

Every day leaders and their employees are confronted with dozens of decision points that will affect their organization’s direction, its employees, or its customers. While there always will be “tough” decisions to make, decision-making becomes easier when there are clear values to measure your choices against.

Having a clear set of values is also critical to achieving a coherent progression toward your goals for the organization, its employees and customers. The STAR CARE values Thom Dick created for our organization when we were integrating thousands of employees from over a hundred different organizations have been used to guide the decisions of management and frontline staff of paramedic organizations worldwide since their creation in 1990:

S – Safe

Were my actions safe — for me, for my colleagues, for other professionals and for the public?

T – Team-based

Were my actions taken with due regard for the opinions and feelings of my co-workers, including those from other agencies?

A – Attentive to human needs

Did I treat my patient as a person? Did I keep him/her warm? Was I gentle? Did I use his/her name throughout the call? Did I tell him/her what to expect in advance? Did I treat his/her family and/or relatives with similar respect?

R – Respectful

Did I act toward my patient, my colleagues, my first-responders, the hospital staff and the public with the kind of respect that I would have wanted to receive myself?

C – Customer Accountable

If I were face-to-face right now with the customers I dealt with on this response, could I look them in the eye and say, “I did my very best for you.”

A – Appropriate

Was my care appropriate—medically, professionally, legally and practically considering the circumstances I faced?

R – Reasonable

Did my actions make sense? Would a reasonable colleague of my experience have acted similarly, under the same circumstances?

E – Ethical

Were my actions fair and honest in every way? Are my answers to these questions?

You are welcome to use the STAR CARE values for your own organization. Feel free to print up cards and posters with your own name and logo on them. I only ask that you give credit by including the phrase, “Used with permission of Thom Dick” somewhere on your literature.

The Fourth Question: How are you doing?

When I visit organizations I’ll often ask, “How’s your performance? How are you doing?” Usually they will tell me something like, “great” or “we are one of the top EMS organizations in the region” or, state, or country. Next, I’ll ask them, “How do you know?” Too often, that question results in blank stares or some utterance of something like, “We haven’t gotten sued lately.”

When healthcare providers take care of patients they constantly monitor vital signs. When pilots fly aircraft they constantly monitor the gauges in the cockpit. Vital signs and aircraft gauges don’t measure everything that’s possible to measure. Instead they measure a vital few indicators that show the performance of the things that really matter for sick people and for aircraft.

In the quality management world these are known as Key Performance Indicators (KPI’s). A solid set of KPI’s that tracks the performance of the essential processes in an organization answers the question, “how are you doing?” better than anything else. KPI’s should also be developed for new programs so that the employees and leadership team know how they are doing on their progress toward that goal.

Just measuring KPI’s is not enough to know what’s going on. In addition to defining KPI’s for the organization it’s essential to know how to analyze the data from the KPI’s so that the answer to the question, “how are you doing?” is valid.

The most powerful tool for understanding the performance of a process is a Statistical Process Control Chart (SPC). This method of tracking performance gives leaders and employees a statistically valid way to know if something unusual has affected their performance and if any of the improvements they implement have produced the results they hoped for.

One KPI organizations I work with track is the results of quarterly employee satisfaction surveys because issues like employee retention and job satisfaction affect all aspects of their businesses. They’ve used the results of these surveys to drive leadership changes that improved satisfaction scores. For a sample employee satisfaction survey click here.

The Fifth Question: What are you doing to make things better?

From my perspective, in addition to helping clarify, purpose, vision, values, and performance indicators, effective leaders design interventions to make things better. These interventions can be to improve performance, help sustain strong performance, or to take advantage of new opportunities. The answer to the question, “What are you doing to make things better?” Is the organization’s list of interventions or projects.

For example, many EMS organizations I work with are experiencing higher than desirable employee turnover combined with what many people believe is a shortage of EMTs and paramedics. One of my client organizations is addressing this by creating a new employee hiring process that includes training citizens to become EMTs rather than hiring only people who already have an EMT certification. They have increased the base pay for all their employees and are working on implementing a robust wellness program. These projects are part of what they are doing to make things better. Their progress is being tracked by their KPIs that look at employee retention rates. For more information about making improvements, click the “Resources” page.