Cincinnati Children's Hospital Medical Center envisions the future Featured

8:00pm EDT October 26, 2008

When James M. Anderson started the

process of creating a new vision for

Cincinnati Children’s Hospital Medical

Center, there was great skepticism from

the hospital’s employees that it would

ever happen.

“I suppose you could say nobody

believed that we would do this, and this

would invest in doing things that would

improve care and probably reduce revenue but deliver better outcomes,” he


But as president and CEO of the children’s hospital, Anderson knew it was

important to brush off the doubts and

move forward on developing that vision

and executing it to help guide the hospital in future years.

As chairman of the hospital’s board,

Anderson was part of the group that developed the $1.16 billion hospital’s vision statement in 1996. The process took two years

before the statement was completed.

“It’s important to spend time defining your

vision because that points you in the direction you want to go,” he says. “Once you’re

comfortable with where you’re going, you

get to work doing it.”

When he became the hospital’s president

and CEO later that year, it became his

responsibility to execute on the vision he

helped create.

Anderson’s work hasn’t stopped there. He

has developed three strategic plans since

becoming CEO and has also declared a new

mission statement that better defines what

the hospital is looking to accomplish.

Here are the steps Anderson took to make

that vision development process a success.

Develop the vision

A good vision includes three key components that will help energize an organization

and set it on the path to achieving goals: a

vision statement, a strategic plan and a mission statement.

Anderson’s first vision statement was created with an informal process. He led a

group of trustees, senior physicians, senior

nurses and business leaders in a lot of brainstorming and discussion about the characteristics of the hospital, its strengths and

weaknesses, opportunities, and the best achievements of the past.

After two years of work, the end result

was a vision statement that focused on the

hospital committing its resources to be a

leader in improving child health.

“It was a rich process that caused all of us

to reflect on what the institution was and

what it could become and in the context of

wanting to be aggressive and bold about it

and expecting high potential to be

achieved,” Anderson says.

The key to getting the most out of these

types of discussion is keeping an open mind

and being an active listener. It allows you to

hear what everyone is saying while being

open to new ideas and possibilities.

Anderson says you just need to keep

reminding yourself to keep your mouth

closed more than it’s open and listen to


“I find myself in meetings from time to

time saying I could say something but that

doesn’t mean I should say it, and it’s probably better in many cases just to listen carefully and try to understand things in a new,

more helpful way,” he says. “If you’re doing

more talking, the probability is you’re not

going to be as revolutionary as you might

otherwise be by listening to the views that

are from a culture or an epicenter that you

don’t live in every day.”

The second piece of a vision is a strategic

plan. Anderson says it’s important to have a

plan in place to map out your goals for

achieving the vision and also gives you the

framework to make good decisions.

He’s been through the process three times

now — once in 1998, once in 2001 and again

in 2004. Each time the plan got a little better

and set the bar a little higher.

The most recent process involved a larger

and more diverse group of people working

together to create a 30-page document that

includes five focus areas and more than 100

specific action items.

When you are putting together a plan, it’s

best to get others involved to help achieve

buy-in and to make sure you don’t miss

anything. You can’t involve everyone, but

you can pick representatives who will be

able to be the voice of each group within

your organization.

Anderson involved about 300 of the hospital’s then 9,500 employees in the process.

“We tried, in a systematic way, to include

thought leaders and people whose position

in the organization or in the community

reflected broad views or the views of a broad

subset of people who would have a stake in

this,” he says. “You can’t go to everybody, but

you can have a thoughtful representation or

a process that leads to a thoughtful representation of a broad range of constituencies

into the process. While it’s not everyone, it’s

certainly a good group that gives rise to rich


The work was divided up among different

groups with each having a specific area of

responsibility. Each group broke up into

smaller groups and then an integrating

group, made up of 15 people from all representations within the hospital, brought all

the groups back together to listen to the

ideas and develop the plan.

As a result of the integration, the group

decided a new mission statement — which

is the third component of a vision — was

needed to reflect the changes.

“It was at the meeting of that integrating

group that we were all enormously excited

about the ideas that came out of the process

that we looked at our old mission statement

(developed in 1989) and said, ‘That’s not

good and certainly not helpful or energizing,” Anderson says. “In one session, we

came up with a new mission statement,

which is enormously helpful and is energizing and does provide direction and has been

proven to be a useful document.”

The new statement is more action oriented and reinforces the five themes in the

strategic plan — innovation, organization,

outcomes, experience and value.

When all three elements of a vision are in

place — vision statement, mission statement and strategic plan — they will help you

achieve your goals.

“The vision statement is the biggest,

broadest umbrella; that’s the kind of thing

we aspire to be and want to do,” Anderson

says. “The mission statement is fully consistent with that and, in the direction of

providing leadership, says a little about

how we’re going to do it and describes the

deliverables, mainly improved outcomes of

patient satisfaction and value. And then the

strategic plan itself says more specifically exactly what we’re going to do clustered under these five categories.”

Communicate the vision

A good vision that has been developed thoroughly won’t help a

company meet goals unless it is communicated properly to employees. Employees are the key to making a vision successful, so they

need to know what the vision is and the steps they need to take to

help reach it.

Anderson started with a brochure that each new employee receives

that explains the vision and its different components, and he also

meets with new employees during orientation to go over it. These

meetings take place for every employee in the organization, no matter their job or rank, and Anderson presents that same message to

them at the same time, trying to connect the importance of their job

to Cincinnati Children’s vision.

“I stress some of the important characteristics that reflect the

thinking behind it with a view toward getting them aligned and on

board in that earliest stage,” he says. “I do try to make sure that

everybody understands that we’re all in this together. Each of our

jobs needs to be done at a high level in order for others of us to do

our jobs at a high level and where one piece falls short, it’ll have an

adverse effect on other pieces.”

The employee discussions are also a way for Anderson to show

his commitment to the vision.

“When I talk about it, I try to act in a way that is fully consistent with

those goals so that there aren’t any sort of inconsistent behaviors

from me that undermine the credibility of what we’re saying,” he says.

“I try to use every tool that occurs to me to reinforce the importance

of the vision and the entirely realistic expectation that we can achieve

together extraordinary results.”

Having employees understand the vision is not enough. You

have to work through the organizational structure and have conversations with employees about their exact role and responsibility in the vision. Anderson says you can also connect an

employee incentive plan to the goals so there is reinforcement for

reaching those goals.

Once employees know their role, you have to hold them accountable for getting their work done toward achieving that goal.

“Then there’s continuing conversation and engagement through

the year on progress against either the goals specifically set forth in

the incentive plan or other activities that are being undertaken that

will arise during the year or are longer term and might not be in the

incentive goals.”

While most employees do become engaged and understand the

plan after communicating it to them through various means, sometimes it doesn’t work out that well. Anderson says that if employees

simply cannot become engaged with the plan, you need to work

with them to move on to do something else, either inside or outside

the organization.

“Then there’s basically no question but that these important goals

will get done — who actually does them we’re flexible about, but

everyone needs to know and do that,” he says.

Cincinnati Children’s has been pursuing its vision for more than 10

years and has seen numerous successes. The hospital has opened

several new buildings, added 720 net new employees each year for

the past 11 years to reach 10,948 today and had an impact on health

services in the Greater Cincinnati area.

“We’re a different organization than we were when we started,”

Anderson says. “It’s hard to put it into words but I would say there’s

a vitality that you can feel. We have embraced innovation and

improvement. We know that we have the will, expertise and

resources to take on big challenges. It’s exciting to be part of this.”

A vision can help you along the path for the future and help you

achieve the results that you want. Anderson says you just need to get

out and start planning and pursuing it.

“You have to start before you’re ready and the process is pretty

simple, pretty clear cut,” he says. “People should be bolder and

more energized to follow this relatively simple process and get to

common ground that you’re entitled to pursue in every aspect of the

organization and then reward and celebrate the successes and communicate that.”

HOW TO REACH: Cincinnati Children’s Hospital Medical Center, (513) 636-4200 or