The Purpose of a BHAG

In his book Built to Last, Jim Collins explores the characteristics of companies with sustained performance, and introduced the term “BHAG” for “Big, Hairy, Audacious Goal.” (or something close to that 😉  ).

Last week I had the honor and pleasure to spend a day at the Verbeeten Institute, a radiation oncology clinic in Tilburg, The Netherlands. It was clear they have been working very hard on improvement, built on coaching from Blom Consultancy, who were my hosts there.

Every Tuesday, the medical staff gathers for lunch and host a presentation on a topic of interest. Last week, that was me.

Though I had a fair idea where I wanted to go, I didn’t have a structured, prepared speech. I wanted to get started, and then see where the audience led things.

I started off with a somewhat tailored version of my “Project Apollo story” to emphasize the difference between Kennedy’s BHAG challenge and the higher level objective of “world leader in space exploration.”

Then I asked a question – what would be a BHAG for Verbeeten that they could use to drive themselves toward their goal of “World Class Care.” One of the audience members, from the very back, said “First treatment in one day.”

This was pretty radical. The current process of initial consultation, CT scan, preparing a detailed treatment plan, and getting the patient in for his first treatment can take 20+ days today, though the actual patient involvement in the process is only a few hours, actually less if you start sharpening your value-added pencil.

As we started to get general agreement that this might be a good thing, one of the doctors asked a really interesting question.

Why?

In most cases, there isn’t any compelling clinical reason to try to accelerate this process, and in some cases there are pretty good reasons not to. So Why? was a pretty damned good question to ask – why go to all of the trouble. Why does it matter?

Setting aside, for a minute, the logical arguments of an improved patient experience, let’s explore that a bit.

What it comes down to is, not so much the goal itself, but what you have to do to accomplish it.

It makes the organization push itself through thinking, innovation, and into territory that, as things are right now, is unachievable.

In other words, you have to get really good. You have to become intently focused on everything that is distracting from the core purpose of the organization. You have to excel at execution.

The only way to get there is to learn to define what results you want (a “defect free outcome”), what steps are required to achieve it, carry them out, respond immediately when something unprogrammed or unexpected happens, and seek to understand – at a detail level – what wasn’t understood before.

Napoleon Hill is quoted as saying “A goal is a dream with a deadline.” So long as the goal aligns with a sense of higher purpose, and people can emotionally get behind it, they are a great help in simplifying the message and keeping everyone focused. Deming famously walked about “consistency of purpose.” This is one way to show it.