Most organizations have a strategic plan. Most organizations also have the experience of watching that plan fragment as it moves downstream. Priorities stall. Initiatives compete for the same resources. Different parts of the organization work on the same problem in parallel without knowing it. Accountability fades as the distance from the executive review grows. The plan that everyone agreed to in November becomes unrecognizable by March.
Bill Griffith opened his session by describing exactly that situation at Broward Health two years before the webinar. The four-hospital system was doing strategic planning the way most organizations do — PowerPoint decks, Excel trackers, Word documents, individual hospital presentations to the executive team. Each hospital owned its piece. Each hospital tracked its piece in whatever format made sense locally. The executive team saw the pieces in series, one presentation at a time, with no view across the system.
The result was predictable. Key timelines slipped because nobody saw them slipping in time to intervene. Two hospitals worked on the same trauma program improvements in parallel, with no coordination, because neither knew the other was doing it. The strategic plan wasn't wrong. The infrastructure for executing it wasn't there.
Bill's session walked through what changed when his team rebuilt strategy deployment as an ongoing management system inside KaiNexus — the template work, the consolidation that took growth strategies from over 400 down to 95, the monthly operating reviews that replaced what used to be a finance-only review, the balanced scorecard structured around the five pillars (quality, service, people, growth, finance), and the lessons learned across two strategic planning cycles. The session also acknowledged what didn't work the first time, including the mistake of trying to replicate the PowerPoint template inside the software rather than redesigning for the medium.
The framing was practical throughout. Bill's team didn't claim to have solved strategy deployment. They claimed to have moved it forward, learned from what worked and didn't, and built the discipline that lets them keep improving.
Bill Griffith is VP of Integration and Standardization at Broward Health. He has worked as a senior executive coach to transform healthcare by eliminating waste, with over $1 billion in cost enhancements, reduced length of stay, and increased volume in key service lines.
Bill has a strong operational background in Lean Six Sigma with implementations in multiple industries around the world. He has identified process improvements that have eliminated millions of dollars of waste while adding time back for customers and associates. He holds a BA in Finance and Economics and an MBA in Management.
Broward Health serves Broward County, Florida — Fort Lauderdale and the surrounding area. The county has a large permanent population skewed heavily toward the 35-to-64 age range, with a projected growth rate of roughly five percent, plus seasonal influx from snowbirds. The health system includes four hospitals, multiple clinics, urgent care centers, and other facilities. More than 8,000 employees. Roughly 3,000 credentialed physicians.
The system is also a safety net provider for Broward County. The status brings unique service obligations, plus access to state and federal funding where applicable, plus operational complexity that's different from a private health system of comparable size.
The system operates under five pillars: quality, service, people, growth, finance. Bill's team uses these pillars to organize the strategic plan, the balanced scorecard, and the monthly operating reviews. The pillars themselves are common across health systems and were common in the manufacturing organizations Bill came from before healthcare. What Broward Health spent time on was the specificity underneath each pillar name — what does "quality" actually mean for Broward Health, what does "service" actually include — because the value of the pillars sits in the operational specificity, not in the labels.
Broward Health's fiscal year starts July 1. The strategic planning cycle for the upcoming fiscal year starts the previous November — roughly eight months ahead. The lead time is deliberate. By the time the fiscal year begins, the strategic plan is fully built, cascaded, owned, and measured. The plan isn't being finalized in June while operations are already running against it.
The November cycle starts with executives and board members reviewing the ten-year vision. The conversation is anchored on Broward Health's mission — care for patients and associates — and the question of what the system needs to be ten years out to achieve that mission. From the ten-year vision, the executive group identifies the strategies that need to advance in the upcoming three-year window, with the upcoming year as the first slice.
By December, the work cascades. The system-level strategies get connected to specific hospital opportunities. Orthopedics, cardiovascular, and population health management were three of the cross-system service lines Bill named. Each hospital looks at what they need to do to advance the system-wide strategy in their facility. The plans build out locally — department to hospital to system — with department-level plans rolling up to hospital-level plans rolling up to corporate strategy.
The 2021 cycle had a particular benefit Bill flagged. The bulk of the strategic planning was complete by late February or early March, before the COVID-19 disruption took over operations. The 2020 plan slipped substantially because of the pandemic. The 2021 plan was largely intact going into the new fiscal year because the work had been done early enough to be locked in.
Bill spent significant time walking through the template his team built inside KaiNexus for tracking each strategic initiative. The template wasn't a cosmetic choice. It was a working artifact that drives the discipline of how strategies get defined, cascaded, reviewed, and updated.
The top section of the template captures the basics. The strategy name, the pillar it belongs to, and a status indicator — green for on track, yellow for caution or needing assistance, red for behind schedule or in trouble. A brief description sits underneath. The description got dramatically shorter in the 2021 cycle than it had been in 2020, which is the kind of small change that reflects a larger lesson the team learned.
The middle section is where the discipline lives. Three columns, one for each year of the three-year cycle. Each column captures the specific improvements planned for that year — what the team will actually do to move the strategy forward. The right side captures the KPI for the strategy — the metric that says whether progress is being made and whether the strategy is achieving what it set out to achieve. The top right captures the facilitators — the executive sponsor (typically the hospital CEO) and the key team members responsible for executing.
The bottom section captures the key activities across all three years in a single Gantt chart. The Gantt view was an addition the team made after the first cycle. The first cycle had the activities listed by year, but the year-over-year view obscured how the whole three-year plan flowed. The Gantt view shows the progression in one picture, which makes it possible to see whether the activities actually add up to the strategic outcome and whether the sequencing makes sense.
Two design choices Bill called out as the most important lessons from the first cycle.
The first: the 2020 template was text-driven. The team described what they were going to do in prose. The 2021 template is timeline- and due-date-driven. The same content lives in the template, but the structure forces specificity about when each piece happens and how the pieces relate to each other. The shift from text to dated activities changed the conversations in the monthly reviews. Instead of discussing intent, the team discusses progress against specific commitments.
The second: every strategy needs a KPI. The 2020 plan had strategies without metrics, which meant the team couldn't tell whether the strategy was achieving its purpose even when the activities were being completed. The 2021 plan requires a metric tied to each strategy. If the strategy is growing orthopedics, the KPI is case volume or percentage growth. If the strategy is adding a new service line, the KPI tracks the establishment and ramp of that service. Where historical data exists, the team pulls twelve months of baseline to compare against. The discipline of the metric is what makes the strategy operationally real.
Bill named one design lesson explicitly because it generalizes beyond his organization. The first time the team built the template inside KaiNexus, they replicated the PowerPoint structure they had been using. The boxes in the PowerPoint became the boxes in the software. The flow that had worked on a slide became the flow inside the platform.
The result didn't work. The constraints of PowerPoint had shaped the PowerPoint version in ways that didn't translate. The medium was different. The interactions were different. The constraints were different. Replicating the old artifact inside the new tool produced an awkward hybrid that worked less well than either the original or a native redesign would have.
The lesson Bill drew, particularly for healthcare organizations moving from paper to electronic forms: don't copy what you did on paper. Start with what the electronic medium can do and design for it. The exercise of redesigning is itself useful — it forces the team to articulate what the template is actually for, separate from the legacy format that happened to hold it before.
The 2021 template was a fresh design. The team sketched it on a piece of paper during a senior executive meeting, iterated with the KaiNexus team, came back to the executives for review, and had the final version running roughly 60 to 75 days from start to finish. The speed was possible because the design constraints were native rather than inherited.
The most concrete payoff Bill described from moving strategy deployment into a shared platform was the consolidation that became possible once everyone could see everyone else's plans.
The first time the four hospitals put their strategic plans into the system, the aggregate count was striking. Over 400 growth strategies. 288 finance strategies. Other pillars at comparable scale. The numbers reflected what happens when multiple hospitals plan in isolation — each hospital lists what they want to do, plus what they think the system wants them to do, plus what they assume other hospitals won't be doing. The result is duplication at a scale that nobody intended and nobody could have seen before the plans existed in one place.
Bill's team ran a consolidation session with all hospital executives and the system leadership group. The conversation focused on three questions. Where are two hospitals working on the same thing without coordinating? Where can strategies be combined into a single system-level effort? What's on the list that simply isn't going to happen in the next three years given resource constraints?
The trauma program was the clearest example. Two of the four hospitals are trauma centers. Both had independent trauma improvement strategies. Both were working on substantially similar problems. The consolidation paired them, replaced two parallel efforts with one coordinated effort, and freed capacity in both hospitals to work on something else.
The team also built a naming convention so that any strategy could be identified at a glance by hospital, pillar, and topic. The naming work matters because it makes the master list usable for the consolidation conversation in the first place. Without consistent naming, the duplicate work hides inside slightly different phrasings of similar strategies.
After consolidation, the growth pillar dropped from over 400 strategies to 95. Finance dropped from 288 to 69. Other pillars saw similar reductions. Bill was clear that the remaining numbers still include some duplicate work that the team will address in the next cycle. The cleanup is ongoing rather than complete. But the trajectory is the trajectory. The system went from being unable to see its duplicate work to being able to see and address it.
The piece that holds the strategic plan together over time is the monthly operating review. Bill described the meeting as having evolved into something different from what it used to be.
The historical version of the meeting was finance-driven. The conversation focused on monthly financial performance — variance to budget, key revenue and expense items, the state of the financial statements. Strategic priorities came up occasionally but weren't the focus.
The current version inverts the emphasis. The monthly operating review is primarily a strategic plan review. Roughly ten minutes still goes to financial performance, but the bulk of the meeting works through the strategy deployment status across the pillars. The KaiNexus pillar boards show each strategic plan, who owns it, when it was last updated, whether it's on track, and the status of the improvement activities underneath it. The team comes to the meeting with the updates already in the system rather than reporting them verbally during the meeting itself.
The discipline that makes the meeting work is the asymmetric attention to red items. Green items get verified briefly — confirmed as on track, any lessons learned noted, and the meeting moves on. Red items — the ones overdue or behind plan — get the meeting's actual time. The team builds action plans during the meeting to get those items back on track. The accountability isn't punitive. It's structural. Once a strategy is red, the meeting won't let it sit there without a recovery plan.
Bill noted that KaiNexus turns items orange when they're within five days of going overdue. The visual cue starts the conversation before the item is actually red, which gives the team time to act. By the time something is overdue, the conversation has been happening for at least a week.
The shift in the meeting's character also changed who treats it as a priority. When the monthly operating review is primarily about finance, executives outside the CFO's reporting line treat it as a finance meeting they have to attend. When the meeting is primarily about strategy, the same executives treat it as the place where their work gets reviewed. The attendance and engagement change accordingly.
The strategy deployment work at Broward Health doesn't stop at the hospital level. The cascade continues down to individual departments, including support departments most strategic plans never reach.
Bill used patient transport as his example. Transport is a support function. It doesn't show up in most healthcare strategic plans because most healthcare strategic plans focus on clinical service lines. But transport has measurable performance against each of the five pillars. Response time as a quality indicator. Three and a half jobs per hour per transporter as a finance/productivity metric. A custom Press Ganey question about the patient experience with their transporter as a service metric. Productivity numbers and other metrics across people and growth.
The department has its own strategic plan tied to those metrics. The four hospital transport departments roll up into a system-level transport project, which lets the four units be compared and coordinated. The department understands how its work connects to the system's strategic priorities because the cascade goes down that far. The transporter who's improving response time understands they're contributing to the quality and service pillars, not just doing their job better in isolation.
The principle generalizes. Strategy deployment that stops at the hospital level leaves everyone below the hospital level wondering how their work connects to anything strategic. Strategy deployment that cascades to the department level — with metrics specific to that department in each pillar — closes the gap. Frontline staff can see the line from their daily work to the system's three-year vision.
One of the technical points Bill spent time on was the distinction between leading and lagging indicators, particularly in healthcare where so much of the standard performance data lags by long enough to be operationally useless for daily management.
Press Ganey customer satisfaction scores are the canonical example. The scores arrive roughly 60 days after the patient is discharged. A team trying to improve their patient satisfaction performance can't manage to a 60-day-delayed signal. By the time the signal arrives, two months of operations have already happened, and the team can't tell whether what they did during those two months made a difference until another 60 days passes.
The team's approach was to identify leading indicators that correlate with the lagging outcome. For nursing communication scores, hourly rounding was the leading indicator. Completing hourly rounding consistently — and sharing the progress and next steps with the patient during each round — is one of the practices that drives the patient experience that eventually shows up in the satisfaction score. The team can measure hourly rounding compliance daily. The 60-day-delayed Press Ganey score becomes the validation, not the operational signal.
The principle: build leading indicators you can manage in real time, then connect them to the lagging outcomes you're ultimately accountable for. The leading indicators drive daily behavior. The lagging indicators confirm that the daily behavior is producing the outcome it was supposed to produce.
The question Bill got asked multiple times in different forms was how the strategic plan survives external disruption — and specifically how the team adapted when COVID-19 hit while the 2021 plan was being finalized.
Bill's answer wasn't that the plan didn't change. It changed substantially. The 2020 plan had work that didn't happen. The 2021 plan had additions that weren't part of the original strategic vision. Supply chain capability, imaging requirements, processes for managing visitors and patients through the new safety constraints — these surfaced as needs the team hadn't fully appreciated before and got built into updated strategic priorities.
What allowed the adaptation was treating the strategic plan as a living document rather than a fixed commitment. The monthly operating review provides the natural rhythm for adjustment. A new strategy can be added by an executive at any monthly review. An existing strategy can be paused or removed if conditions change. The team built a simple risk priority scoring system tied to specific criteria, which lets them prioritize quickly when something needs to bump existing work. Below a threshold score, the work comes off the list. Above the threshold, the work gets prioritized into the active plan.
The phrase Bill used: "this is not set in stone, this is a living breathing document that we update in real time and review monthly." The phrase describes both the discipline and the flexibility. Strategy deployment that's too rigid breaks when conditions change. Strategy deployment that's too loose dissolves into a list of intentions that never get executed. The middle ground requires both the structure (templates, KPIs, monthly reviews, cascade) and the practice of treating the structure as something that gets updated rather than frozen.
The morning huddle structure at each Broward Health hospital is where strategy deployment touches the daily work. Each hospital runs a morning huddle starting at 8:30, staggered so that the system-wide functions (like the patient logistics center) can participate.
The huddle reviews KPIs and metrics for the day. The huddle board in KaiNexus pulls patient flow data (from TeleTracking via API), quality and patient safety data, customer experience signals, and other operational metrics. Ideas and issues that surface during the huddle get created as improvements in the huddle board and tracked from there.
The flow from frontline to executive runs through a tiered structure. The 7 AM nursing shift change huddle on each unit is where the initial frontline feedback enters the system. If the nurse manager can address it locally, they do. If not, it goes to the director-level meeting at 7:30 or 7:45. If it can't be resolved there, it goes to the 8:30 huddle, where it becomes a tracked improvement with system-wide visibility. Supply chain executives, operations, and others get notified. The goal is resolution by end of day so that the 7 AM huddle the next morning can report back on what was fixed.
Not every huddle board item links to a strategic priority. Many items are local — supplies, equipment issues, safety concerns, problems in a parking garage. Those get resolved locally and don't need to be connected to a strategic plan. The improvement form has a drop-down to link to a strategy if there's a real connection, but linking isn't required. The huddle board captures everything; the strategic plan only takes the items that genuinely advance a strategic priority.
The Press Ganey data flow Bill described is also worth noting. The integration is partly automated and partly manual. TeleTracking flows in through an API. Press Ganey doesn't flow in automatically because the API integration hasn't worked reliably, so the team does an Excel download and import process weekly. The team has 150 questions across four hospitals; the upload takes about 15 minutes once a week. Bill noted that the format of Press Ganey's output seems to change monthly, which makes the API integration harder to lock down. The honest assessment was that the manual workaround is acceptable given the scale and the team will keep trying to automate.
The framing Bill used throughout the session was that the work could be done without a platform — Broward Health did strategy deployment for years using PowerPoint, Excel, and Word — but the visibility and consolidation that made the work materially better required infrastructure that the legacy tools couldn't provide.
His direct comparison: "we are ten years ahead of where we could be now than just using PowerPoint."
The specific capabilities the platform supports map to the specific problems strategy deployment runs into.
Visibility across the system is what made the consolidation from 400 to 95 strategies possible. The CEO of one hospital can see what the CEO of another hospital is planning. The system leadership can see all four hospitals' plans simultaneously. Duplicate work surfaces by being visible at the same time, in the same view, instead of hiding inside separate documents that nobody reads side by side.
The template structure encodes the discipline. Every strategy has a pillar, a status, a description, three years of activities, a KPI, an executive sponsor, and a team. The template doesn't allow strategies that skip those elements. The discipline of completing the template is what makes the strategies operationally real.
The monthly operating review needs the data to be in one place so the meeting can focus on the items that need attention rather than on consolidating the information. The pillar boards in KaiNexus serve as the meeting's working surface — the place where green, yellow, and red status is visible, where overdue items are flagged before they're overdue, and where action plans are captured during the meeting itself.
The cascade from system to hospital to department needs the platform to hold all three levels and the relationships between them. The transporter who has a department-level project rolled up into a system-level transport project needs that hierarchy to be navigable for the cascade to mean anything. The platform holds the hierarchy; the hierarchy holds the cascade.
The huddle board integration with strategy deployment lets local work and strategic work share a common system. A local issue surfaced at a 7 AM huddle on three North can be addressed locally without strategic linkage. A pattern of local issues — say, repeated parking garage problems — can be escalated into a system-level improvement effort. The platform lets the data accumulate enough to see the pattern.
The board-level visibility Bill mentioned also depends on infrastructure. Broward Health is a public hospital district subject to Sunshine Law, so strategic planning happens in private sunset meetings, but the board members have access to KaiNexus and use it to review the plans, comment on strategies, ask questions, and acknowledge progress. The board's engagement is operationally real — not just receiving presentations but interacting with the plan directly — which changes the quality of governance over the work.
None of this changes what strategy deployment fundamentally is. It's still the work of defining the right strategies, cascading them through the organization, measuring progress, holding people accountable, and adapting when conditions change. The platform doesn't do that work. The leaders and the teams do. What the platform does is preserve the structure and visibility that make the work scalable across four hospitals, 8,000 employees, and a three-year horizon. Without that infrastructure, the same effort produces less because too much of it goes into consolidating information that should already be consolidated.
What is strategy deployment? A management system that translates a multi-year strategic vision into specific, cascaded, measured, and reviewed work across an organization. The term is often used interchangeably with Hoshin Kanri, the Japanese practice of policy deployment that originated at Toyota and other Japanese manufacturers. Strategy deployment is what happens after strategic planning produces a plan — the discipline of making sure the plan actually gets executed across the organization rather than fragmenting as it moves downstream.
How is strategy different from a plan or from operational improvement? Bill drew the distinction explicitly. Strategic work is what advances the organization toward its ten-year vision — adding new capabilities, expanding services, building new capacity, achieving outcomes that aren't possible at the current state. Operational work is what maintains or modestly improves current operations — equipment upgrades, routine projects, ordinary business. The two need different treatment. A plan to replace an MRI is operational. A plan to build a new freestanding medical building with primary care, specialty care, radiology, and lab services is strategic. Mixing them inflates the strategic plan with operational items and obscures what's actually strategic.
Why did Broward Health move from PowerPoint and Excel to a platform? Because the legacy tools didn't provide visibility across the system. Each hospital planned in isolation. The executive team saw each hospital's plan as a separate presentation, with no view across the four hospitals together. The team didn't discover duplicate work until they could see all the plans at the same time in the same view. The platform made consolidation possible by making the duplicate work visible.
What were the most important template changes between 2020 and 2021? Three changes. First, the template went from text-driven (descriptive prose) to timeline- and due-date-driven (specific activities with specific dates). Second, every strategy now requires a KPI — a metric that says whether the strategy is achieving its purpose. Third, the activities are now visible across all three years in a single Gantt chart, which makes the sequencing and flow of the three-year plan visible in one picture. The 2020 template tried to replicate the PowerPoint structure inside the software, which didn't work; the 2021 template was redesigned for the medium from scratch.
How did Broward Health get from 400+ strategies to 95? Through consolidation. Once all four hospitals' plans were in the platform, the system leadership ran a consolidation session that addressed three questions: where are hospitals working on the same thing in parallel, where can strategies be combined into a single system-level effort, and what on the list isn't realistically going to happen in three years. The growth pillar dropped from over 400 to 95. Finance dropped from 288 to 69. Bill noted that some duplicate work remains and the cleanup is ongoing.
What are the five pillars Broward Health uses? Quality, service, people, growth, and finance. The pillars themselves are common across health systems and many manufacturing organizations. What Broward Health invested in was the specificity underneath each pillar — what does each pillar actually mean operationally for the system. The agreement on labels was the easy part. The agreement on what sits underneath the labels was where the work was.
How does Broward Health think about leading versus lagging indicators? Most healthcare performance data lags by long enough to be operationally useless for daily management. Press Ganey customer satisfaction scores arrive roughly 60 days after discharge. The team identifies leading indicators that correlate with the lagging outcome — for nursing communication, the leading indicator is hourly rounding compliance, which can be measured daily. The leading indicator drives daily behavior. The lagging indicator confirms that the daily behavior is producing the outcome it was supposed to produce.
What is the monthly operating review? The recurring forum that holds strategy deployment together over time. Historically a finance-focused review, the meeting has evolved into a primarily strategic plan review with roughly 10 minutes still allocated to financial performance. The team comes with status already in the system. Green items get verified briefly. The meeting's actual time goes to red items — strategies overdue or behind plan — where action plans are built during the meeting to recover them. The discipline of asymmetric attention to red items is what makes the meeting operationally useful rather than a status update.
How far does the strategy cascade in the organization? Down to the department level, including support functions like patient transport that most healthcare strategic plans never reach. Each department has its own strategic plan tied to metrics across the five pillars. Department plans roll up to hospital plans, which roll up to system plans. Frontline staff can see the line from their daily work to the system's three-year vision because the cascade is built into the structure.
How does strategy deployment connect to daily management and huddles? The morning huddle structure at each hospital is where strategy deployment touches daily work. Huddles run at 7 AM (frontline), 7:30 or 7:45 (director-level), and 8:30 (executive-level), with escalation paths between tiers. Huddle boards in KaiNexus pull operational data and surface issues. Not every huddle item links to a strategic priority — many are local fixes — but the form has a drop-down to link to a strategy when there's a real connection. The data also accumulates enough to surface patterns that warrant strategic attention.
How does the team adapt the plan when conditions change? By treating the strategic plan as a living document. The monthly operating review provides the natural rhythm for adjustment. New strategies can be added when conditions warrant. Existing strategies can be paused or removed. A simple risk priority scoring system tied to specific criteria lets the team prioritize quickly when something new needs to bump existing work. COVID-19 produced substantial changes to the 2020 plan and additions to the 2021 plan, all handled through the monthly review process rather than through a special replanning exercise.
How long did it take to stand up the new strategy deployment process? The redesigned template and process took roughly 60 to 75 days from start to finish. The team sketched the new template on paper during a senior executive meeting in October, iterated with the KaiNexus team, came back to the executives for review, and had the version running by December when the planning cycle started.
How engaged are the board members with strategy deployment? Highly engaged. Broward Health is a public hospital district subject to Sunshine Law, which means most meetings are public — but strategic planning happens in private sunset meetings. Several board members have direct access to KaiNexus, review plans there, comment on strategies, ask questions about items that appear behind schedule, and acknowledge progress on items that are on track. The board's engagement is operationally real rather than limited to receiving presentations.
What about the relationship between strategy deployment and executive compensation? The strategic plan feeds into the balanced scorecard, and the balanced scorecard ties into executive incentive plans and partnership compensation structures. The connection is part of why executives engaged with strategy deployment from the beginning — their incentive comp is structurally tied to the outcomes the strategic plan is supposed to produce. The percentage of compensation at risk varies by level, with senior executives carrying a higher percentage tied to performance than managers and directors.
Is risk assessment part of the strategy deployment process? Yes. Broward Health does an annual risk assessment using an online survey tool. Each hospital completes a detailed assessment covering patient safety, quality, contracts, financial and legal obligations, and other risk areas. The output identifies key areas for focus, which can become projects integrated into the strategic plan. The Q&A surfaced the related concept of Key Risk Indicators (KRIs) — leading indicators that signal a risk tolerance may be reached before the risk materializes — as a complement to KPIs. Bill noted he wanted to dig into KRIs further as a refinement to the current framework.
.svg)
Copyright © 2026
Privacy Policy