Goal Alignment, Part II: Developing Related Goals at All Practice Levels

“If you aim at nothing, you are sure to hit it.”

This adage certainly rings true in goal setting for dermatology and aesthetic practices. But to fully realize their potential, successful practices must create goals for all levels of the organization, not just for the top level. Having meaningful and well-written departmental, individual, and overall practice goals is essential to attaining optimal performance and productivity.

Establishing overall practice goals and then weaving them into other levels of the organization is a best-practice process that involves leaning into the practice’s vision, principles, and beliefs, and then making sure goals are related, well-written, and meaningful. Practices that take time to engage in a comprehensive goal-setting process will discover that practice success will be a valid expectation.

Getting Started: The Preliminary Steps

The process of developing a comprehensive top-to-bottom set of goals with a common thread requires some preliminary work. The purpose of this work is to obtain direction and identify priorities that will help influence and provide guidance in the creation of all subsequent goals. Getting started requires taking the following actions.

Define the practice vision. A practice vision provides the foundation upon which goals at all levels are developed. When clarity exists around an overall vision for the practice, direction and priorities for departments and individual staff members become apparent. When developing a practice vision, one may consider the answer to questions such as: What does the practice want to accomplish? What does the practice stand for? What is the practice mission? What are our core beliefs?

Develop a strategic plan. A strategic plan clearly defines the purpose of a practice and helps establish realistic objectives consistent with the mission in a defined timeframe within the practice’s capacity for implementation. The process is inextricably linked to the creation of enduring and meaningful practice goals; in fact, it is through strategizing that long- and short-term practice goals begin to emerge. Involving staff in the strategic planning process is helpful, since most strategies are carried out through actions or tactics of day-to-day operations. When staff help identify strategies at the practice level, buy-in is imminent and employees become more committed to attaining department and individual goals.

Setting Related Goals

Practice goal setting is a top-down process, starting with the development of overall practice goals, then department goals, and finally, individual goals. The key is to make sure all the goals are related not only to the vision and strategies, but to each other as well. All goals should support the next level up (i.e., individual goals should support department goals, and department goals should support practice goals). Using the following guidelines at each practice level will help in the development of meaningful goals that enhance a practice’s ability to survive in today’s challenging business climate.

Practice goals. Practice goals are born out of the strategic planning process and are intimately tied to the practice vision. These goals influence all other practice objectives. Areas requiring practice goals are commonly divided into several categories (e.g., financial, operational, employee management, etc.) and subcategories (e.g., income, processes, performance, etc.). The most effective goals are written using the SMART acronym as a guide. SMART goals are Specific, Measurable, Attainable, Realistic and Relevant, and Time-bound.

When creating practice goals, consider the answers to these questions for guidance: What will positively impact our success in the next year? Two years? Three? What are the key areas (e.g., profit centers, revenue streams, etc.) that will help us accomplish our vision? Where must we excel? What are the key aspects of our business that are most important in accomplishing our vision for the next year (i.e., planning, operations, marketing, finance/resources, etc.)? What are our three greatest strengths? What are our key areas of weakness? How will these strengths help us reach our vision? How will these weaknesses prevent us from accomplishing our vision?

Here are examples of overall practice goals that are likely to directly support a corresponding practice vision:

• Achieve a six percent annual growth rate in net collected revenue by the end of the year.
• Increase the number of procedures completed for the top five surgical and nonsurgical procedures by 20 percent within six months.
• Decrease operating expense by four percent by the end of the year.

Department goals. Once the practice goals are devised, it is time to set departmental goals. Because day-to-day operations impact whether or not a practice meets its goals, the aspirations of each department must reflect the overall practice goals. Practices should look at each department and identify specific contributions to the practice vision.

When creating department goals, consider the answers to these questions for guidance: What role does this department play in business operations? How do the functions or operations of this department impact practice goals? In what ways can this department best be leveraged to meet practice goals? Does this department have the appropriate resources to meet its goals?

Here are examples of department goals that directly support overall practice goals:

Marketing Department:

• Increase number of online new patient appointments scheduled on website by 25% by the end of the year.
• Increase new patient inquiry calls to the practice by 30% by the end of the year.
• Measure return on investment on all marketing campaigns and decrease cost per lead by 10%.

Front Office:

• Reduce no-show rate to less than 15% by the end of the year.
• Increase the percentage of appointments scheduled from initial phone inquiry (e.g., conversion from inquiry to consult) to 90% by the end of the year.
• Decrease appointment cancellation to below 10% within the first six months.

Back Office:

• Increase conversion from consult to procedure by 10% by the end of six months.
• Increase retention rate for aesthetic patients from one visit to three visits by the end of the year.
• Convert 50% of patients to an additional procedure or service at time of visit.

Individual goals. Each employee must have specific goals related to moving the practice and department forward in achieving its vision. The more aligned these individual goals are with department and practice goals, the more effective the employee will be in his or her role. If goals have been effectively aligned at all levels, an employee reaching his or her objectives will directly impact whether or not the department and practice achieve their goals. For this reason, it is important to have employee buy-in. An effective way to obtain buy-in is to allow staff to be involved in drafting these goals. Staff members involved in setting performance goals tend to have a better understanding of each goal and its corresponding expectation. This helps staff members better prioritize activities to produce meaningful results. Another way to obtain staff buy-in is to tie compensation and incentives to goals.

When creating individual goals, consider the answers to these questions for guidance: What role does the employee play? What actions or job duties impact whether or not departmental goals are met? Which positions must be leveraged to meet current departmental goals? Do staff members have the appropriate training and resources to meet their goals?

Here are examples of individual goals that directly support department goals:

• Receptionist: Answer all incoming calls to the practice within two rings.
• Individual provider: Receive an overall patient satisfaction rating of 4.5 (out of 5) at the end of six months.
• Individual provider and check-out receptionist: Schedule 75% of follow-up visits prior to the patient leaving the office.
• Marketing director: Obtain a 95% return on all patient satisfaction surveys.
• Marketing director: Schedule 80% of patients contacted through internal marketing recall program each month.

Cohesive Goals Writing and accomplishing appropriate goals—from top to bottom—is critical to achieving the mission and vision of the practice. If goals are only set at the practice level or are not aligned with goals set at department and individual levels, practices run the risk of employees not understanding the connection between their responsibilities and the overall goals of the practice. Creating cohesive goals at all levels helps ensure increased productivity and performance as well as a bull’s eye in the form of a realized practice vision.

Barbara Sifford is a management consultant with the Allergan Practice Consulting Group, of Allergan, Inc., in Irvine, CA.