Betsy Nabel discusses BWHC’s institutional strategy with Medicine residents.

As health care institutions navigate an increasingly complex environment, it is imperative that we, as an organization, continue to differentiate ourselves through discovery, innovation and excellence in patient care. Having a clear strategy with specific goals will ensure our organizational strength for generations to come.

BWH Bulletin sat down with BWHC President Betsy Nabel, MD, to talk about our strategy and what it means for the BWH community.

Could you briefly summarize why having a strategy is important?

Our strategy articulates what we believe in as an organization, who we want to be in the future and what we need to accomplish today in order to realize our goals over the next five years.

Walk us through the framework image.

The image resembles the exterior of the historic Peter Bent Brigham entrance at 15 Francis St., emphasizing that our values are the same today as they were more than a century ago when our predecessor hospitals were established. You’ll see our vision at the top of the framework—that is who we aspire to be—and our mission is underneath, describing what we do and why we’re here.

The seven boxes below represent our strategic objectives—in other words, what we need to do to achieve our mission and vision. Three pillars underneath those boxes outline the priorities that we will focus on to meet our strategic objectives. Our people and our financial strength are at the foundation, as we cannot accomplish any of our goals or carry out our precious mission without continued development of our talented, dedicated staff and a strong financial foundation.

Why is it important for all employees to know our institutional strategy?

Our people have a deep-seated connection to our mission of patient care, research, teaching and community engagement. It’s equally important that they connect with our strategy. If all 18,000 of us understand the big picture and the goals, we’re better positioned to achieve them. Having conversations with each other about what the goals are and how we contribute to achieving them reaffirms our sense of engagement, unity and commitment.

Is having a strategy new for us?

We have always set strategic goals, but this framework gives us a way to make difficult choices based on where the Brigham should be in five years, not just this year or next. This builds on the strategic commitments we laid out in 2011. Once everyone understands the strategy and feels connected to it, we can all work together to ensure that we succeed.

Can every staff member have an impact?

Absolutely. Our clinicians are among the best in the world and can ensure every patient receives the advanced, expert care that sets us apart by working and communicating as a team to deliver truly patient-focused care. In addition, we all can have an impact on affordability, for example. You can be more efficient in your work, regardless of your role, and look for cost-savings ideas to share with your manager or submit to Bold Ideas, Big Savings at BoldIdeasBigSavings.org.

Exceptional experience is another goal where we all can contribute. Each one of us can be on the lookout for patients who are lost and offer to help them. Offering words of encouragement, empathy and kindness, providing support to patients and families, and going above and beyond what is expected—these are the things that profoundly affect how our patients feel about their care and their experience at the Brigham.

Not every role or department has a direct impact on every area of the strategy, but we can all affect some of these areas. I encourage everyone to use the worksheet in this issue to think through how you connect to our strategy and talk with your colleagues about it.

Will this change how we do things?

Yes, our strategy will guide us as we consider new initiatives and programs. We realize that we can’t do everything and, going forward, this approach will help us determine what new things we will take on and also what we will discontinue or decide not to do. These decisions, guided by our strategy, will also help us set priorities during our budgeting process.

Can you elaborate on how changes in the budgeting process will affect us?

We know every year that our expenses are higher than our revenue, so each year we begin with a gap that we need to close. We want to be more strategic and thoughtful as we consider what we should be doing more or less of in order to differentiate ourselves in the market, rather than just focusing on the numbers for one year. We need to think about the big picture so that we can be successful for years to come.

Where does the education component of our mission fit into the strategy?

Education is a vital part of our mission. The newly formed Brigham Education Institute is mapping out our strategy for education and training programs. As that matures, we will be able to set specific objectives in this critical area as well.

At Town Meeting, you discussed the strategic priorities that differentiate us. Can you elaborate on that?

As you look at the strategy framework, you’ll see that two of the seven boxes below the mission are shaded: “Scalable Innovation” and “Advanced, Expert Care.” In the other five boxes are goals we know we must achieve to be competitive, but they don’t necessarily distinguish us. All hospitals must ensure safe care, for example. But scalable innovation and advanced, expert care are what make us different from many other hospitals in the nation.

People come to the Brigham from all over the world because of the outstanding, highly specialized care they receive here—we take care of many patients whose cases are too complex for other hospitals. And our research community continually innovates and makes discoveries that we can rapidly translate to the bedside and the clinic to improve care for many patients at the Brigham and beyond—that’s scalable innovation.

We have always excelled in these two areas, and we know that they need to be a focus of our strategy going forward.

Does focusing more on these initiatives mean we’re focusing less on others?

Yes. As ideas or proposals for new initiatives and programs come to us, we will look to our strategy to guide us. That means there are some things we will discontinue or downsize and new projects we will implement.

How will we measure our success relating to strategy?

Strategy constantly evolves and adapts to the environment. As we set our strategic objectives, we are also committing to consistently measuring our progress in these vital areas and the performance of the hospital as a whole. That way, we will know if we have selected the right programs and priorities, and whether we are moving in the right direction. If we don’t see the progress we anticipated, we will course-correct.

How will these efforts benefit our patients?

Patients are at the center of everything we do, and articulating our strategy is no exception. Our strategy is designed to help us be successful for generations to come, which will ensure that we can continue to provide patients with care they simply can’t receive anywhere else. In addition, our focus on discovery and innovation will help accelerate the prevention, treatment and, ultimately, cures for many of the health concerns that those who depend on us face. The strategy not only positions the Brigham for success; in doing so, we believe that it will also improve the health of patients around the world for generations to come.