The 4 Disciplines of Execution

Quality Forum 2015

BC Patient Safety Quality Forum Rapid Fire Session
February 19, 2015
Michael McMillan, Chief Operating Officer, NI HSDA
Suzanne Campbell, Director Community Services, Prince George
Sherri Tillotson, Manager Surgical Inpatients, UHNBC

Improving Patient Flow

- The 4DX Approach

The 4 Disciplines of Execution

The 4 Disciplines of Execution

1. Focus on the Wildly
Important
2. Act on Lead
Measures
3. Keep a Compelling
Scoreboard
4. Create a Cadence
of Accountability

WIG Wisdoms: The Whirlwind

All the work that is required just to keep
your operation going on a day to day
basis
The enemy of execution

1. The Wildly Important Goal

If everything else remained status quo, what
is the one area where change would make all
the difference?

VERB, X to Y, by
when?

2. Act on Lead Measures

Lead

Lag

Predictive

Retrospective

Influenceable

Unchangeable

3. Keep a Compelling Scoreboard

4. Create a Cadence of Accountability

McChesney, C., Covey, S., & Huling, J. (2012) The 4 Disciplines of

Execution. New York: Free Press

4DX Prince George

What Have We Learned - methodology

Strengths

Struggles

Brings
organizational
focus

Complexity of
healthcare

Builds discipline &

accountability
Measuring activity

Success requires
20% of our time
Measuring quality

How are we doing?

You have to decide what

your highest priorities are
and have the courage pleasantly, smilingly,
unapologetically - to say
no to other things. And
the way you do that is by
having a bigger YES
burning inside.

Learnings and Benefits

One Wildly Important Goal is difficult to define

Discipline and focus is necessary for implementation
A Cadence of Accountability is necessary
Other Projects

Increased residential bed capacity

SAMI Programs
Rapid Home Support
High Acuity Beds
Master Planning