Stop the Stink’n Future-Phobia! 3 Ways Leaders Can Ditch the Fishbone Diagrams and Actually Think Strategically

Blip-Zip Executive Summary and Takeaways

Feeling overwhelmed by the “blip-zip” world? Struggling to squeeze strategic thinking into your overflowing in-basket? You’re not alone. But ditch the “no stink’n futures stuff” attitude and unlock your strategic superpower! This article reveals 3 actionable hacks to elevate your leadership, reignite your team, and propel your organization forward.

• Reframe: Ditch the reactive mindset. Shift to empowering “let go to grow” and “loyal dissent” for deeper insights.
• Refocus: Create “win-win” spaces for strategy & development. Track your time, adjust course, and prioritize reflection.
• Resound: Lead by example. Align strategy with action, communicate effectively, and celebrate progress.

Introduction To Strategic Thinking and the Future

Most leaders want more time for strategic thinking. However, for years, I have heard echoes from senior health leaders, “I am a prisoner of my in-basket… I spend all my time managing tactical problems…we do not have time for this futures stuff …I do not need no stink’n fishbone diagram session to solve my problem.” Similar echoes are derived from surveys. In one survey of 10,000 senior leaders, 97% said being strategic was the competency most important to their organization’s success.^1,2

In another study, 96% of the leaders surveyed said they lacked the time for strategic thinking and were too busy firefighting.³ It’s easy to rationalize it away when we are all oppressed with meetings and an average of 126 emails per day.⁴

If you ask them, “If you free up your day to be more ‘more strategic,’ what would you do?” Most have no idea.  The impact?  A small percentage of employees understand their organization’s strategy or feel the strategy is aligned with their responsibilities. Most leaders assume repeated explanations through dense PowerPoint presentations, newsletters, and emails are what increase understanding and ownership of strategy. Not.  Note: See the discussion questions.

Do You Have a Phobia Toward Strategic Thinking?

I can see your eyes rolling, the word strategy conjures up thoughts of large PowerPoint decks, and glossy brochures followed by a hundred-pound metrics lockbox. Oh, let’s not forget my tectonic plate article on 16 ways to engage in health futuring.  In study after study, newly assigned senior leaders struggle with “letting go to grow (and empower)” from their previous roles. Over half said they were expected to know details about projects beneath their level.⁵ Yet, 44% of managers spend most of their time firefighting in cultures rewarding reactivity.³ More than half say they were involved in decisions below their pay grade.³

In my experience in helping executives succeed, the best content for great strategic thinking comes from within their spheres of influence. Leaders assume being more strategically minded is a function of thinking up big thoughts, connecting the dots, pondering the world, or watching business trends. They are right, but they just can’t say “poof the magic futurist or strategy” and go do it. Sorry, it does not work that way. It must be a culmination of personal development and mentoring moments in between the annual strategic planning off-sites.  The solution?  Answer; reframe your approach and refocus your activities.

Reframe Your Approach

Leaders can take steps to prioritize the strategic thinking imperative. Ask: What accounts for the misalignment between my goals and actions? The problem has little to do with clearing calendars. It has more to do with reframing your approach:  let go to grow with a positive attitude and development of strategic thinkers through loyal dissent followed by aligning strategy into common culture and practice with the strength of will. Here are a few practical ways I have helped others shift their roles to assume an appropriate strategic focus:

1. Let Go to Grow with a Positive Attitude: I worked for a leader, one of the most negative in my career. He was responsible for the development of the Army and Police health sector in a foreign country. My job was to help the Police Surgeon General build a healthcare capability. He was adept at clinical care and tended to focus on tactical issues especially when they were complex, sensitive, and had high visibility. One day, I asked, “What are the 3-5 priorities we need to accomplish to help our counterparts take ownership of their healthcare system?” He had a puzzled angry look and begrudgingly relented to a series of strategic planning and leader development sessions.

As a result, the approach resulted in development of system-wide healthcare capabilities of care rather than solving complex individual clinical cases. The clarity resulted in improved coordination and collaboration within the development teams. Unfortunately, for many senior health leaders, letting go to grow is about having a positive attitude and shifting to a strategic thinking role.

• Development of Strategic Thinkers with “Loyal” Dissent: Strategic thinking must produce insight, sometimes heretical. Strategic leaders who challenge the status and create a safe environment for loyal dissent generate more creativity, insight, and innovation. I worked for a senior health leader (twice) who encouraged “loyal”  dissent–someone loyal to an organization but sees something wrong and works to fix it and remains loyal to the organization and idea despite the resistance.

This strategic leader habitually took his strategic insights to his team and challenged them to engage in constant intelligent inquiry, intentionally ask for dueling facts or positions to support, and refute his thinking. As debates unfolded, flawed assumptions surfaced and were replaced with shared understanding, initial ideas got refined, and ownership followed. Their commitment increased when they are talking and comfortable challenging the status quo.

• Align Strategy Into Common Culture And Practice With Strength Of Will: As a highlight of my career, I had the pleasure of working for a senior health leader who believed in the value of health futuring to not only strategically think about the future but as a way to develop future leaders. In this case, once a clear line of sight was drawn on a strategy–improve human performance and health, implement patient-centered medical home, and leverage talent and technology–resources were aligned or realigned to focus on the effort.

Aligning ideas, initiatives, budgets, personnel, and messaging around a unified direction is hard enough, more so when reactionary decisions are the norm. Great strategic leaders, as in this case, know how to use data, communicate the vision and progress, and tap into the collective wisdom of others, and capitalize on “aha moments.” about future opportunities.

The responsibilities placed upon strategic health leaders will not diminish anytime soon.⁶  Taking these steps will raise the bar to integrate strategic thinking into common practice and culture.

Refocus Your Activities

Strategic thinking and strategy making force leaders to confront an unfolding future. Then, they try to make the task less daunting by preparing comprehensive plans, action steps, and metrics for how to achieve an aspirational future. A good strategy is not the product of endless research, modeling, and war room meeting. It’s a continuous process of thinking on how to aim and hit a target. Discomfort is part of the process. It requires a positive growth mindset.  If you are comfortable, you’re probably stuck and may not know it – paralyzed by the issue of the moment.⁷  Here are a few tips on getting started:

1. Despite A “Blip-Zip” World, Create Safe Spaces for Strategizing: What you need are win-win spaces for strategizing and leader development moments. In another life, my Boss, three rungs higher, found time for personal, professional reading, led an organizational reading club, and used the time to reinforce his “Parthenon and four pillars” strategy.  He said it was his way of mentally washing away the tyranny of the in-basket.

He would often state, “30% of what showed up in his inbox should not have made it there, and would muse that maybe I have a leadership development and empowerment issue.”  Setting up strategic thinking and leader development opportunities no matter how big or small creates win-win moments is today’s “blip-zip” world.

• Document Where Your Time Is Going and Adjust: Track your busyness and your feelings of satisfaction on the issues you work Then document the issues you set aside.  When I was the CEO of a medical facility, I hired a bright young emergency room doctor as the Chief Medical Officer. During our first performance feedback session, he fully admitted he was comfortable with one-on-one care and got instant gratification from solving patient-level cases. 

I advised him to “Check His 6” on where his time was going, reminded him he was responsible for the enrolled population of a local health system, the feedback loop on satisfaction would be longer and to have faith the gratifying feelings would come later. Soon, he adjusted his approach. He found he could combine patient level issues and think through the effects of decisions affecting an enrolled population. To this day, he thanks me for the constructive feedback session and the advice.

• Know In Your Heart, A Strength Of Will Eventually Win Out:  Commit time for reflection and rest. A brain break and refocus develops you into a well rounded strategic health leaders.² I tend to do most of my professional reading in the AM.  Commit time with your team and peers as a leader development strategy.Don’t “short change” people around you by expecting them to know what’s happening Savor your time. Set aside time for critical long lead time priorities and treat them as if it was your last act. Practice mindfulness. Take 10–15 minutes to plan for tomorrow, next week, and next year!

Mentally rehearse a scenario or think through the implications of a significant initiative. Conduct a self-pep talk.  Summarize what went well, lessons learned, and alignment to the big picture. Make a commitment to  learning something new such as being more resilient or exploring media bias as a way to make you a better strategic thinker.

As leaders ascend the career ladder, leaders will be expected to produce more. Without a concerted effort, it would be easy for the strategy to slip down on the to-do list, despite best intentions.⁶  Don’t let it happen! Ask and answer the discussion questions below.

Discussion Questions For Your Next Mentoring Moment 

1. How much time per week or month do you invest in strategic planning? What do you do? (e.g. professional reading in the AM, subscribe to think tanks on big picture health reforms)
2. How do you inform your team and other departments within your organization about your strategic decisions? (e.g. strategic communication and executive message style)
3. Describe a time when you proactively identified and addressed a strategic or system-wide issue at your organization. (e.g. implement bundled payment model)
4. How do you set long-term goals for your team? How often do you check and review these goals? (e.g. align coordination of care with local social services)
5. Describe a time when you failed to achieve your goals and had to follow a different approach. What happened? (e.g. preventable patient harm)
6. What are the key factors you take into consideration when building an action plan? (e.g. improve patient referral process)
7. How do you measure a strategy’s effectiveness? (e.g. increased reliability)

Professional Development and Learning Activities

1. Conduct a time-tracking experiment for a week. Analyze your results and identify areas for strategic focus.
2. Host a “blip-zip brainstorm” session with your team. Challenge assumptions and generate out-of-the-box ideas.
3. Create a personal “strategic superpower action plan” with specific goals and milestones. Share it with a trusted mentor or colleague for accountability.
4. Start a book club or reading group to Focus on future-oriented health trends and leadership development
5. Develop a “Fishbone of Action” to visually map out the steps needed to implement your strategic vision.
6. Join a “Strategic Think Tank” to connect with peers and mentors to share best practices and learn from each other.
7. Read a “Strategic Leadership Book” to immerse yourself in the wisdom of experts to hone your skills.

Summary

Ok, I can hear my mentor now, “Anderson, I don’t need another stinking idea or fancy plan, I want solutions and follow through. Do you understand?’ Despite the “it’s a blip-zip” world complaint, strategic thinking and making strategy it is not the result of a lack of time. Leaders must recuse themselves from day-to-day minutia, align activities with the organization’s future. Making time is a function of letting go to grow, creating a safe environment for candid conversations, and diligently aligning strategies with common practice and culture.

Sound strategic thinking should not be an elusive skill only a few can realize or low priority.  Building teams of visionaries, healthy skeptics, and doers to operate in safe spaces contains the elements of strategic thinking. Leading by example helps too. Start by tracking your activities with a fishbone diagram. Being aware of decisions unrelated to strategy or not steps to embed strategic thinking into your schedule places you and your organization at risk. Implement your ideas gradually but have the strength of will to do so.  Do so, and others will follow.

Key Words

strategic thinking, leadership development, time management, healthcare future, organizational culture

Resources

1. The Power of Habit: Why We Do What We Do in Life and Businessby Charles Duhigg
2. The Future of Healthcare Leadership: 5 Essential Trends to Watch. American Hospital Association. https://www.youtube.com/watch?v=Mq4TVza1Om4
3. Thinking, Fast and Slow, 2013, Daniel Kahneman
4. Leading with Strategic Thinking: Four Ways Effective Leaders Gain Insight, Drive Change, and Get Results, 2015, Aaron K. Olson and B. Keith Simerson
5. The Decision Book: 50 Models for Strategic Thinking, 2013, Mikael Krogerus and Roman Tschäppeler
6. How Successful People Think: Change Your Thinking, Change Your Life, 2009, John C. Maxwell
7. Strategic Thinking Institute
8. 4 Strategic Thinking Exercises to Envision Future Strategy, 2017, Mike Brown in Brainzooming
9. The 7 Essential Skills of a Strategic Leader. Forbes. https://www.forbes.com/sites/rachelwells/2023/11/14/5-ways-to-build-strategy-skills-as-an-aspiring-leader/
10. The Biggest Challenges Healthcare Leaders Face Today. Becker’s Hospital Review. https://www.beckershospitalreview.com/hospital-management-administration/five-top-challenges-affecting-healthcare-leaders-in-the-future.html
11. 5 Leadership Skills Every Future Healthcare Leader Needs. HealthcareDive. https://www.phoenix.edu/blog/healthcare-leadership.html