Dear Andy,

I’m a physician working in the local health management system.

I’m really intrigued about the OKR approach and its potential to lead teams to success. I see it as a potentially strong, methodological approach to guide Objectives of our local departments (surgery department, laboratory department, radiology department) and I’m working to implement a pilot project with some of these next year.

I’d really appreciate feedback about one of the OKRs I’m formulating:

O: To define a network between our Neurology Units in three hospitals for an efficient time-dependent treatment of stroke.
KR1: Develop in three months a responsibility assignment matrix (RAM) for every hospital for the design of a hub-spoke network.
KR2: To write in six months a clinical pathway (= care map) to describe in precise manner the approach to the patient in every hospital and the patient journey into the clinical network.
KR3: To activate in 12 months a “job rotation project” to permit all Neurologists to spend time in the regional stroke unit (= hub of the clinical network).

Many thanks in advance for your input!

With best regards
Marco Angriman, MD


Hi Dr. Marco!

Thanks for writing in. Given the definitive and metric-based nature of health care, you are a wise man for looking to OKRs for help. I definitely have some thoughts to take your OKRs from good-to-great — let’s dive in!

Starting off with your Objective, I think we can simplify things quite a bit. Right now your Objective (and KRs, but more on that later) contains both the problem and the solution. Remember, you want to state your Objective as succinctly as possible — the fewer words the better. What is the core problem you want to solve? It sounds like, when you get down to it, you’re having issues with stroke treatment. Why not state your Objective as “Collaborating neurology teams treat strokes more efficiently.”? Simple, to the point, and impossible to misinterpret.

Now onto the KRs. It sounds like you’ve created terrific and specific steps to treat strokes more efficiently — however, those steps aren’t true Key Results. If you develop a responsibility assignment matrix, what would that improve about your team’s operations? What metric would tell you that operations were more efficient? Same with writing a care map for each patient. How would you measure that patients with personalized care maps had better outcomes? What would be the most important improvement in care, e.g. speed of treatment or accessibility of patient information to the full care team?

Finally, once everyone completes a full job rotation cycle, then what skill or process would improve? By how much? What are the most important metrics that will let you know when you’re treating strokes more efficiently?

Perhaps your OKR could look something like this:

Collaborating neurology teams treat strokes more efficiently.
X% decrease in morbidity rate.
X% decrease in time from door to treatment.
X% increase in patients being seen during viable “treatment window.”
X% decrease in 30-day stroke patient mortality.

(Disclaimer: Even though I consulted a doctor friend for these suggested metrics, this is by no means an official recommendation)

The above OKR will work as a guide to the broader issue, so the next step would be to have each unit (or type of clinician) write their own OKRs that will clarify their contributions to the greater goal — just make sure you’re all aligned with the same purpose.

Thanks for writing in, Marco, and best of luck to you on your OKR journey.

Billy from the What Matters Team


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