How to Craft Smart, Effective Goals at Your Medical Practice

February 5, 2014

Most practices engage in goal-setting, but many make big mistakes along the way. Here's how to create smart goals at your practice.

Many medical practices have just finished or are in the process of setting goals for 2014 practice performance. Common goals include targets for gross revenue, physician to staff ratios, and days in accounts receivable.

As useful as goals can be, however, they are not all created equal. I recommend practices follow the S.M.A.R.T. criteria (first set forth in the 1981 issue of Management Review) to ensure goals that are both worth pursuing and actionable.

Here's what S.M.A.R.T. stands for:

S. Good goals are specific in the answers they give to three questions:
• What do we want to accomplish?
• Why? What's the benefit to be gained?
• Who is going to be involved? Who will be affected by the change, doing the work of change, or be responsible for the outcome?

M. Good goals allow the office to measure both progress and success. "Shorter patient wait times" is a good example of a faulty goal. What does shorter mean?

A measurable goal is either binary or quantitative. That is, either the answer to a performance question is "Yes" or it is "No," or the results can be expressed in a number or percentage.

For instance, "We will attest to meaningful use - stage 1 and receive the incentive payment for year 2014." At the end of the year (or early in 2015), your practice will have the check in hand or not.

Quantitative goals require data gathering. First, determine the current value of a particular measure. Second, gather interim data to measure progress toward the goal. Third, gather data at the end of the period to confirm that the goal has been met or exceeded.

Maybe the goal is for patient wait times to average no longer than 15 minutes. You find that the current average wait time is 33 minutes. An interim measure in June shows the average wait time has dropped to 28 minutes. A December study reveals that the average wait time has dropped to 13.5 minutes. Success!

The common complaint is that data gathering is a lot of work. The challenge is to devise a way to gather the data that is not more trouble than it is worth. Without data gathering there is no way to gauge success or failure.

A. A meaningful goal must be achievable. Goals that are a stretch can be energizing; unattainable goals are demoralizing and, often, drive up costs.

How many offices can consistently maintain a schedule where patients are booked at five-minute intervals? A goal must take into account resource constraints, as well as the laws of nature.

R. This is where the "So what?" and the "What's in it for me?" questions are answered. Goals must be relevant. They must reinforce and not conflict with other goals. They should make the best use of limited resources, and it must be clear why everyone benefits from getting on board in pursuit of the goal.

T. A meaningful goal is time-bounded. It has a start date and an end date. By the end date, the goal will have been achieved or not. Time-boundedness establishes a sense of urgency. Nothing without a due date ever rises to the top of anyone's priority list. A beginning and end date also provide the bookends for the project schedule.

Well-crafted goals can drive commitment and achievement. They can strengthen teams and produce great results. They provide direction and are self-reinforcing.

Carelessly crafted goals do none of that, and they cause of a lot of confusion and frustration.

Spend a little time to make sure that your practice's goals for 2014 are S.M.A.R.T. I would be very interested to hear of experiences readers have had with goal setting and execution.