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Maintaining alignment between strategic and tactical goals in an innovative healthcare organization
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Maintaining alignment between strategic and tactical goals in an innovative healthcare organization
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Running head: ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 1
MAINTAINING ALIGNMENT BETWEEN STRATEGIC AND TACTICAL GOALS IN AN
INNOVATIVE HEALTHCARE ORGANIZATION
by
Jeffrey B. Benyacar
A Dissertation Presented to the
FACULTY OF THE USC ROSSIER SCHOOL OF EDUCATION
UNIVERSITY OF SOUTHERN CALIFORNIA
In Partial Fulfillment of the
Requirements for the Degree
DOCTOR OF EDUCATION
August 2018
Copyright 2018 Jeffrey B. Benyacar
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 2
Acknowledgements
I have had the privilege of working with some amazing leaders in my career and would
like to acknowledge a couple of them. John Driscoll not only encouraged me to pursue this
program but always inquired as to whether I was taking proper care of myself. Your passion for
healthcare and people inspires me every day. Mary Daschner taught me perseverance by holding
me, the team, and the company to very high standards while at the same time being a role model
with her graciousness and humility. Her humbleness and humanity imparted a wisdom that is not
taught in textbooks but has helped me grow as a leader and person. I would also like to recognize
Michael Ducharme for his input and support, especially as the problem of practice was being
crystallized.
To my dissertation committee who provided guidance and support through this arduous
journey. A special thank you to my chair, Dr. Kimberly Hirabayashi, who provided valuable
insights and feedback on my dissertation topic and writing. She was unfailingly kind and
supportive during this process. Dr. Doug Lynch was one of my first professors in the program.
He was an intellectual provocateur from the outset challenging us to test our assumptions while
inviting guest speakers who sparked lively discussion. I appreciated Dr. Lynch’s encouragement
to connect with him at the outset and his desire to stay connected. Dr. Eric Canny was an
invaluable resource not just for his unbelievable editing prowess, but for his constant
encouragement and support throughout the program. If I had a question or just needed a pulse
check on my progress, he always made himself available. I am grateful for his generosity of spirt
and urging to pay it forward—which I try to do every day.
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 3
To all of the OCL faculty and staff, a huge thank you for your professionalism and
support. Whether it be coordinating the complicated logistics of the immersions or injecting
energy into a long class discussion, you made this journey both rewarding and fun.
To my Cohort 4 Ed.D. colleagues and friends, I reckon we all remember those first weeks
of APA indoctrination and the dissertation being viewed as some abstraction far off in the future.
Well, the advice to trust the process was spot on! Now we can catch up on all the things we put
on hold.
To my nephew and niece, Harris and Dara, let me say that you both rock! Uncle Jeff will
now have more time to visit! I would also like to thank their father, my brother David, for his
support and valuable advice. No longer will he have to endure my grousing about the latest
obstacle. To my parents, who unfailingly supported me even when they would have preferred
more in-person visits—thank you!
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 4
Table of Contents
Acknowledgements 2
List of Tables 5
Introduction to Problem of Practice 6
Organizational Context and Mission 6
Importance of the Evaluation 7
Purpose of the Project and Questions 8
Organizational Performance Goal 8
Stakeholder Group of Focus and Stakeholder Goal 9
Review of the Literature 10
Knowledge, Motivation and Organizational Influences 15
Interactive Conceptual Framework 23
Figure 1. Conceptual framework. 25
Data Collection and Instrumentation 25
Interviews 26
Data Analysis 26
Findings 27
Knowledge 27
Motivation 30
Organization 35
Solutions and Recommendations 40
Knowledge Recommendations 41
Motivation Recommendations 44
Organization Recommendations 48
Limitations and Delimitations 52
Recommendations for Future Research 53
Conclusion 54
References 56
Appendix A Participating Stakeholders with Sampling Criteria for Interview 71
Appendix B Interview Protocols 74
Appendix C Credibility and Trustworthiness 78
Appendix D Ethics 80
Appendix E Integrated Implementation and Evaluation Framework and Plan 82
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 5
List of Tables
Table 1: Knowledge Influences 15
Table 2: Motivation Influences 15
Table 3: Organizational Influences 16
Table 4: Summary of Knowledge Influences and Recommendations 41
Table 5: Summary of Motivation Influences and Recommendations 44
Table 6: Summary of Organization Influences and Recommendations 49
Table 7: Outcomes, Metrics, and Methods for External and Internal Outcomes 84
Table 8: Critical Behaviors, Metrics, Methods 85
Table 9: Required Drivers to Support Critical Behaviors 86
Table 10: Components of Learning for the Program. 91
Table 11: Components to Measure Reactions to the Program 92
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 6
Introduction to Problem of Practice
Several studies have shown that strategic planning and goal setting are essential to
organizational success (Bowell, 2006 Phillips, 2011; Wang, Walker, & Redmond, 2007;
Wunder, 2005). Robust plans are required to communicate effectively with both internal and
external stakeholders about a company’s focus and objectives (Spee & Jarzabkowski, 2011).
Without clear and transparent goals, employees will flounder as there is no compass to guide
them and their actions will align more to personal aggrandizement than to helping the company
thrive (Clark & Estes, 2008). Small businesses are especially lax at creating and communicating
strategy (Sandberg, Robinson, & Pearce, 2001; Wang et al, 2007). That only 7% of employees
have a profound understanding of their organization’s business goals and strategy leaves the
majority of the workforce unmoored to any centralized vision and planning to appropriately
guide them (Kaplan & Norton, 2001). At Forward Health (a pseudonym), a growing company
committed to improving health outcomes and rationalizing costs, the focus remains on creating
strategic alignment and encouraging communication with area vice presidents (AVPs, the middle
management) as they are the conduit to the rest of the company and help communicate the
corporate strategy. Alignment is defined as AVPs understanding the company’s strategy and
knowing how their own objectives fit into it (Biggs, Brough, & Barbour, 2014; Boswell, 2006).
Organizational Context and Mission
Forward Health improves patients’ health outcomes while managing costs by partnering
with payers and providers to transition to a value-based care model which includes identifying
the most appropriate care setting. It is a community of professionals consisting of doctors,
nurses, pharmacists, customer service agents, statisticians, and healthcare policy experts
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 7
committed to transforming healthcare services by developing innovative products that reduce or
eliminate hospital admissions.
Forward Health is a private equity owned company managed by a group of investors with
expertise in the healthcare market. Its headquarters are in the Eastern United States, and the
organization has a national footprint. The company is on a growth trajectory with the addition of
new clients, services, and products. Demographic information is not made public.
Importance of the Evaluation
If Forward Health does not promote organizational alignment with its strategic objectives
amongst the AVPs, it risks poorer performance and jeopardizes the company’s ability to support
sustained growth and compete. The experience of Motorola is a textbook example of the
criticality of achieving this alignment. Finkelstein (2006) observed a culture of warring tribes
with incentives tied to division goals without overarching strategic objectives. This dysfunction
and misalignment delayed the company’s investment in digital technology, as a new imperative
to migrate away from analog could not be articulated above the din. An insular culture, hubris,
and unclear strategy at Motorola contributed to this myopia (Finkelstein, 2006). Jamieson (2003)
asserted that middle management is pivotal in ensuring that change initiatives are sustainable. In
fact, research found that middle managers’ knowledge of the strategy is instrumental in
catalyzing change; they help unite and align the organization and function as cultural advocates
(Embertson, 2006; Pappas, Flaherty, & Wooldridge, 2004; Valentino, 2004). An exploration of
the culture at Forward Health will help illuminate the extent to which objectives can be crafted
and updated in a cogent fashion consistent with the strategic plan. Evaluating whether the
company is tribalistic and, therefore, susceptible to the kind of shortsightedness seen at Motorola
will inform decision-makers on potential prophylactic measures to consider.
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 8
Purpose of the Project and Questions
The purpose of this project is to evaluate the degree to which Forward Health is clearly
communicating its strategic plan and associated organizational objectives to AVPs in the
organization. The analysis will focus on knowledge, motivation, and organizational influences
related to alignment with the company’s strategy. While a complete performance evaluation
would focus on all stakeholders, for practical purposes, the stakeholders to be focused on in this
research are AVPs.
Two questions will guide the evaluation of this organization:
1. What are the knowledge, motivation and organizational influences related to achieving
the alignment between area vice presidents and the organization’s strategic goals?
2. What are the recommendations for organizational practice in the areas of knowledge,
motivation, and organizational resources?
Organizational Performance Goal
Forward Health’s goal is to transition the current healthcare paradigm to a value-based
model where patients can heal and receive services in the most appropriate care setting. The
company is committed to rationalizing costs while providing better patient outcomes and
reimbursing providers based on quality of care. To accomplish this, Forward Health must forge a
culture of collaboration, transparency, and trust. Strategic alignment with its AVPs is critical, as
these leaders are responsible for executing on objectives that will help the company achieve its
goals. Being the market leader in transformational healthcare requires that AVPs clearly
understand how their individual and departmental roles contribute to the strategic plan and have
objectives that clearly support the overarching strategy. A steadfastness to sticking to the strategy
means AVPs believe they are obtainable and can identify and reduce non-value-added work. The
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 9
company’s role is to create a culture that removes barriers and inspires AVPs to align their work
with the company’s strategy. The performance goal should be achieved no later than the end of
2018 with incremental changes occurring throughout the year.
Stakeholder Group of Focus and Stakeholder Goal
AVPs need to fully comprehend the company’s strategy so they can appropriately align
their, and their team’s, own work. Their goal is to craft and adhere to detailed performance
objectives that further the company’s strategy. AVPs should eschew or de-prioritize requests not
directly aligned with the company’s strategy. In addition, they should reflect on why such
requests are made and the potential distraction in both time and effort to separate critical from
non-critical work. This study focused on a self-selected group of AVPs, as participation was
optional based on a solicitation email. AVPs are also one of the conduits by which information is
communicated and parsed to the organization, as they have the most interaction with the more
junior roles in the company. Some expressed concerns at senior leadership meetings that prior
failures to effectively execute on the company’s strategic plan rests with an inability to align
strategy to actionable behaviors and create a climate that promotes critical thinking skills. One of
the executive leaders commented that there is an inability to stay focused on the key initiatives
critical to the company’s success. Good strategic leadership involves prioritizing and saying no.
This leader opined that the company may be overtaxing some of the same AVPs because of an
organizational knowledge deficit. If Forward Health fails to effectively communicate the
strategic plan in tangible ways with its AVP and clearly prioritize their work while ensuring
there are enough skilled resources to handle the demand, it risks burning them out potentially
causing some of them to seek other opportunities or simply disengage.
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 10
Review of the Literature
This section begins by providing an overview of the research related to the importance of
creating clear objectives in an organization. This includes the pivotal role of communication,
which can act as either an emollient or barrier to success. Second, the review underscores and
explicates cultural constructs and how they influence employee behavior and perceptions, which
are important drivers of organizational alignment. Third, the section examines obstacles to
maintaining clarity on the goals and inherent risks to achieving them. It ends with an
examination of the organizational influencers—knowledge, motivation, and organization—and
how they affect employees’ understanding and implementation of a company’s objectives (Clark
& Estes, 2008).
Aligning Strategic and Organizational Objectives
Aligning the workforce with a company’s strategy is a key driver to an organization’s
success (Bowell, 2006; Phillips, 2011; Wunder, 2005). This cascading of strategy is a
differentiator as many companies fail to appreciate the importance of information sharing in
driving commitment (Wunder, 2005). Strategic mishaps are caused by the following: an
inflexible strategic process causing misalignment, a failure to define a strategy that is pertinent to
all business units, an inability to rationalize the plan across disparate business units, and too
much focus on structure rather than creativity (Wunder, 2005). The final point underscores the
importance of allowing employees the freedom to be innovative lest they become prisoners to
strategy rather than its master. Strategic alignment is a key ingredient to increasing velocity and
serving all customers (Zhou, Collier, & Wilson, 2008).
While it is generally accepted that strategic alignment contributes to a company’s
success, employee perceptions of their grasp of the organization’s strategy can be partially
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 11
erroneous and even patently wrong (Boswell, 2006). In fact, one researcher noted that employees
can often be blinded or unmoved by new strategies and ideas because their original lens and
expectations are what initially attracted them to these roles (Schneider, 1987). Employees must
have a clear line of sight into the organization’s strategy to be effective. Line of sight is defined
as having a deep understanding of the overall strategy and synthesizing how individual
contributions affect progress (Boswell & Boudreau, 2001). Mintzberg (1983) argued that those
on the lower rungs of the organizational hierarchy hear only “vague echoes of these goals” (p.
126). Indeed, information can be purposefully exploited and withheld as a control mechanism. In
addition, those with lengthy tenure in a position may also be closed to embracing new strategies
and ideas as they are ensconced in the legacy ways of behaving (Boswell, 2006). Lack of clarity
and role ambiguity leads to job burnout, exhaustion, and diminution of loyalty causing
employees emotional and physical angst (Boswell, 2006; Lee & Ashforth, 1996). Executives
must, therefore, aim for a “shared mindset” with sufficient resources devoted to evangelizing the
organization’s strategy and ensuring it penetrates, in ways that are appropriate to those with
different backgrounds, to all workers (Boswell, 2006).
Middle managers, in particular, can view strategic planning as airy fairy stuff that
executives toil over annually and then file until the next iteration the following year (Phillips,
2011). This is especially noteworthy as research has shown the important role of middle
managers in sense making during organizational change, with the executive leadership being
rather inconsequential due to either geographic or relational gaps (Balogun & Johnson, 2004).
Schein (2010) defined corporate culture as shared assumptions that undergird how
individuals in an organization learn and solve problems. It impacts every facet of a company’s
performance and can be either a force multiplier for success or a corrosive force eroding the
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 12
bottom line (Want, 2003). Culture is dynamic and fluid as individuals negotiate the challenges
and opportunities they face every day (Rueda, 2011). The extent to which an organization’s
mores and values are imbued in employees’ beliefs has a direct impact on behavior (Schein,
2010). Morgan (1986) and Watkins (2013) elaborated that culture involves sense making and
shared awareness, thus discouraging misaligned thinking from entering the fray. Traphagan
(2017) emphasized that culture is not just about uniting people; it can be a spark to challenge
norms and rituals. Knowledge management is contingent on building a strong culture, which
encompasses reward systems, people, and the leadership team (Rai, 2011). Workers are, in fact,
more prone to work for a lower salary if there is a supportive organizational culture (Catanzaro,
Moore & Marshall, 2010).
Understanding the different cultural taxonomies and their correlation to how managers
view their roles is an important ingredient if executive leaders desire to foster an environment
conducive to strategic and goal alignment. Schein (2010) referenced earlier work conducted by
Enzioni (1975) to codify three types of organizations: coercive, utilitarian, and normative.
Coercive organizations manage by fear with workers displaying little individuality. Utilitarian
ones find workers following the essential rules of the group, but they do allow for dissent.
Normative organizations, by contrast, conspire to align the goals of the individual with the
organization, thus creating a powerful parity. Cultural models, the “shared mental schema or
normative understanding of how things work,” can manifest in different ways (Rueda, 2011, p.
55). Cameron and Quinn (2006) shared four distinct ones: clan, adhocracy, hierarchy, and
market. Clan is illustrated by collaboration and team building, while adhocracy is punctuated by
agility, creativity, and entrepreneurship. Hierarchy, as the name suggests, is controlling and
monitoring while market is aggressively competitive and driven by competition. Cameron and
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 13
colleagues underscored that the highest performing leaders can adapt and thrive in any of these
models.
Dysfunctional cultures can minimize employee engagement and even precipitate tragic
consequences such as the Challenger Shuttle disaster (Balthazard, Cooke, & Potter, 2006). The
attributes include an unwillingness to change, a failure to hold people accountable for
performance, few role-model leaders, and a reactive mindset (Harper, 2009). In addition,
dysfunctional cultures are characterized by analysis paralysis dotted with sacred cow initiatives
and a silo mentality (Tobak, 2012). If organizations promote zero-sum competitions and devalue
interpersonal, human relationships with superiors, the culture can be destructive and counter-
productive (Schneider, Brief, & Guzzo, 1996).
Poor or ill-defined objectives lead to organizational chaos and have profound
consequences for both internal and external stakeholders (Moore, Ellsworth, & Kaufman, 2008).
Business objectives must be tied to a strategy with clarity around the expected outcomes and
timeframes for completion (Temple, 2002). In rapidly changing business environments, workers
can create their own narratives and interpretations around strategy that is not necessarily
consistent with the leaderships’ (Sonenshein, 2010). Cook (1991) stated that the major reason
misalignment occurs in organizations is because employees do not know what the company’s
goals are. He advocated that the role of CEO should primarily be chief alignment officer.
Middle management’s role in organizations has become more even important with senior
leaders separated geographically from the workforce requiring middle management to act as the
tether to drive organizational alignment (Balogun & Johnson, 2004). They are critical to supply
information to senior executives and can use their status to influence the decisions of their bosses
(Pappas et al., 2004). Middle managers, however, are often viewed as guardians of the status quo
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 14
with little agency to effectuate change (Embertson, 2006). They often fear retribution and are
compelled to stay within the confines of the organizational hierarchy (Detert, 2015). They face a
series of challenges balancing relationships with their subordinates and superiors (Rajagopal,
2014; Zenger & Folkman, 2014). They feel underappreciated, overworked, and often feel as if
issues they raise will be ignored (Zenger & Folkman, 2014). They are often unable to articulate
the organizational strategy and feel victimized by the decisions foisted upon them, many of
which appear to be made haphazardly (Valentino, 2004). Middle managers in healthcare are
especially susceptible to being forced to work beyond capacity with few remedies (Buchanan et
al., 2013). These healthcare middle managers often have jobs requiring long hours and
conflicting priorities causing stress and poor work-life balance (Buchanan et al., 2013). Collins
(2001) noted how companies often fail to create stop-doing lists thus causing even more stress
and anxiety.
Executives exert many resources defining the strategic imperatives of their organizations.
Crafting them requires a careful distillation of the company’s strengths and market positioning
(Moore et al., 2008). Cascading strategic imperatives in a meaningful way to middle
management is a key determinant as to whether they are understood and translated into tangible
action consistent with the organizational strategy (Pappas et al., 2004). Poorly crafted objectives
or lack of sustained focus leads to organizational chaos. A lack of effective and honest
communication can contribute to failure, malfeasance, and illegality (Milliken, Morrison, &
Hewlin, 2003; Silveira, 2013). Cultural constructs are important ingredients to achieving
consonance between strategy and tactics. In this global marketplace where information is a
commodity, tying strategic direction to middle management tactics and maintaining alignment is
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 15
a competitive advantage. Understanding the influencers of performance, the Clark and Estes’
(2008) gap model, is needed to grasp the behavioral catalysts of middle managers.
Knowledge, Motivation and Organizational Influences
The tables below utilize Clark and Estes’ (2008) gap analysis framework to identify the
knowledge, motivation, and organizational factors influencing AVPs’ ability to excel at their
jobs by primarily working on only those tasks aligned with the strategic plan.
Table 1
Knowledge Influences
Knowledge Influence
What knowledge or skills do
employees need to achieve the
organizational goal
Knowledge Type
(i.e., declarative (factual
or conceptual), procedural, or
Metacognitive
Knowledge Influence
Assessment
AVPs need to know how to
translate the organization’s
strategic objectives into
specific tasks.
Procedural AVPs were interviewed on
the extent to which their
prioritization list (this is
something they are now
required to complete)
reflects their sequencing of
work.
AVPs need to reflect on ways
their own behaviors and
intellectual curiosity help
them align with the company’s
strategy.
Metacognition AVPs were asked what
methods they employed to
learn about the company’s
strategy (if any).
Table 2
Motivation Influences
Assumed Motivation Influences Motivational Influence Assessment
Attributions: AVPs need to feel recognized to
excel.
AVPs should be willing to think creatively to
achieve their own goals and help others.
Interview questions discerned whether
recognition was adequate and the extent AVPs
viewed themselves as acting creatively.
Self-Efficacy: Managers need to feel confident
in their ability to achieve their performance
goals.
Interview questions determined the degree to
which AVPs felt empowered.
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 16
Table 3
Organizational Influences
Assumed Organizational Influences Organization Influence Assessment
Cultural Model Influence 1: The organization
needs to promote teamwork to gauge if there is
a culture that encourages collaboration.
Interview questions to discern the collaboration
between teams or lack thereof.
Cultural Model Influence 2: The organization
needs to emphasize the importance of adhering
to objectives and help AVPs avoid non-
essential work.
Interview questions to gauge distraction level.
Knowledge Influences
There are four different dimensions of knowledge: factual, conceptual, procedural, and
metacognitive (Rueda, 2011). Factual knowledge is the most fundamental. It is understanding the
terminology and nomenclature of a business (Anderson & Krathwohl, 2001). Conceptual
knowledge is being able to synthesize information and draw relevant connections, or
understanding, which leads to applying what was learned (Blumberg, 2009). The company’s
AVPs need to draw connections between their own work and the strategic plan. Understanding
the concepts and translating them into actionable objectives requires the ability to handle a level
of abstraction. In addition, AVPs need the insight to prioritize their objectives consistent with the
strategic plan and to minimize or eliminate distractions. Metacognitive knowledge involves
higher-order thinking skills (Rueda, 2011). AVPs need to reflect on their own work habits and
behaviors to stay focused on their objectives and evaluate new requests for their time using the
strategic plan as their crucible. The meaning-making process of reflection and the importance of
translating the results into action are well documented in the literature (Barley, 2012; Ferry &
Gordon, 1998; Rogers, 2002; Schon, 1983; Wilson, 2008).
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 17
The ability to harness and focus the talent of the AVPs to both understand and devise
coping mechanisms to stay aligned with the strategic plan will be instrumental in ensuring clear
and relevant objectives serve to meet or exceed the company’s goals. Gibson and Nurius (1992)
shared that those who use procedural knowledge “make observations, draw inferences, exercise
judgments, and make decisions with an increasing number and ever more complex and multi-
faceted problem” (p. 24). Using a survey instrument called the Professional Thinking Form, they
measured the critical thinking skills of students enrolled in a social work master’s program. Each
question measured students’ ability to recognize tautologies and bias; the results were
underwhelming with a mean score of 39.5 out of 100. Procedural knowledge, the scholars
concluded, must be better ingrained in the curriculum if these future practitioners are going to be
effective. Those on the forefront of bringing humanity to healthcare must also hone their critical
thinking skills to identify how to appropriately sequence their work based on exogenous factors
to stay aligned with the company’s strategy and push to understand the purpose of a change in
direction rather than just follow edicts.
The useful heuristic that metacognitive knowledge is thinking about thinking is
instructive. Rueda (2011) found it an important component of strategizing and solving problems.
In other words, it requires higher-order thinking skills with a focus on synthesizing available
information and making inferences from available facts. Pintrich (2002) related the three general
categories of metacognitive knowledge: strategic knowledge, knowledge about cognitive tasks,
and self-knowledge. Strategic knowledge requires one to consider abstract concepts and consider
alternatives that transcend tactics. Knowledge about cognitive tasks is associated with
discriminating between often inchoate chunks of information to create a new evaluation frame
(Pintrich, 2002).
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 18
Metacognitive knowledge demands introspection, as it requires an examination of how
individuals learn and make sense of information and the environment. Self-knowledge is perhaps
the most sophisticated construct, as it is predicated on one’s ability to realistically evaluate both
weaknesses and strengths. Velzen (2012) explained that superior problem-solving acumen
includes “well organized knowledge, thorough problem analysis and problem representation, and
explaining to oneself why some solutions are suitable” (p. 368). In fact, developing
metacognitive knowledge has been associated with perpetual learning in that, once it is
developed, people are in control of their own learning henceforth (Velzen, 2012). The AVPs at
Forward Health are important constituents in promoting the company’s strategic plan. The
executives create the strategy and are, therefore, responsible for explaining it, as AVPs want to
understand the rationale. The executives should provide regular updates highlighting successes
and specific points of concerns. Allotting time at meetings to field questions from AVPs allows
the executive team to clarify any misunderstandings. The AVPs, in response, need to reflect on
the information and adjust their actions accordingly. As such, part of the metacognitive process
for the AVPs is soliciting feedback and synthesizing it in useful ways (Miller & Geraci, 2011).
Motivation Influences
Measuring motivational influences determines the extent to which AVPs feel empowered
to succeed. Clark and Estes (2008) described motivation as those things that energize people to
achieve goals. Vroom introduced expectancy theory that showed a triumvirate of multiplicative
influences: expectancy, instrumentality, and valence (Ambrose & Kulik, 1999). Expectancy is
the equating of effort with performance (i.e., investing significantly in a task will correlate to
success). Instrumentality is the tying of performance with specific outcomes (e.g., recognition or
special awards). Valence is whether the outcomes are satisfactory. These may include extrinsic
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 19
rewards such as bonuses or time off or intrinsic outcomes like a sense of accomplishment or skill
enhancement.
Empirical research has shown that a motivated workforce improves corporate
performance (Nohria, Groysberg, & Eling Lee, 2008). Nohria et al. (2008) noted four drivers that
contribute to employee motivation: acquire, bond, comprehend, and defend. People have an
impulse to acquire not only physical goods but things like status and organizational positioning.
Bonding includes the strong affinity some employees feel towards the company and their
coworkers. Comprehension is the need to make sense out of situations and understand the
rationale for decisions. Employees can become frustrated when direction appears rudderless. The
defense driver is especially prevalent when a company is experiencing rapid change such as an
acquisition making them feel vulnerable. They further delineated that the levers include a reward
system that differentiates top performers, a culture of teamwork, jobs that are designed in a
meaningful way, and the fair administration of a performance and resource allocation process.
In the workplace, understanding what motivates employees and identifying deleterious
behavior will likely lead to a more engaged workforce. Gallup (2017) found that only 45% of
executives felt engaged with a paltry 29% engagement score for managers. Engaged individuals
are likely to build relationships and are assiduously focused on results (Jensen, 2012). Nicu
(2012) underscored that motivation drives organizational success and is one of the most
important elements of employee engagement. Forward Health is committed to improving
healthcare outcomes for patients in the United States recognizing their unique needs as
individuals by ensuring its AVPs are both motivated and aligned with the strategic plan. They
have implemented new recognition programs and hosted off-site retreats to rally and educate the
AVPs on the organization’s strategy. The executives have discussed that the ability for AVPs to
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 20
have down time to recharge and to attend to their personal needs are required if AVPs are to
really embrace the strategy. The retreats actually include sessions on mindfulness hosted by
experts in meditation. The AVPs remain critical change catalysts so understanding their
motivation, or lack thereof, will help the company better serve their needs.
Based on the works of Fritz Heider and Bernard Weiner, attribution theory describes how
people ascribe accountability for outcomes (Anderman & Anderman, 2009). It is an exploration
of situational root causes and the judgments people make based on the prism of their own
experiences. There are two frames: internal and external loci of control. Those who have an
internal locus of control view themselves as the masters of their fate (Fishman & Husman, 2016).
By contrast, those who assume a victim mentality see themselves as powerless and hostage to
events. Understanding how AVPs view their ability to influence and foster change consistent
with the strategic plan even when confronted with obstacles will provide valuable insight on how
they perceive themselves. In addition, AVPs should feel compelled and inspired to collaborate
with their peers to achieve the objectives in the strategic plan. When cooperation is required to
achieve the joint interests of an organization, weak incentives are often more appropriate
(Holmstrom, 1999; Roberts, 2010). They suggest one possible alternative is tie individual
compensation to organizational results. The extent to which AVPs feel encouraged to cooperate
and collaborate is included in the interview protocols.
Research shows that healthcare is now more complex and requires more technical
acumen than even 20 years ago (Griffith, 2007). Motivated employees will be better equipped to
handle the changes that require updates to the company’s strategy. Forward Health needs to
ensure the AVPs are inspired to handle these new challenges and feel empowered to effect
change. It is not enough that they have the knowledge and skills to cope but must also be
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 21
confident in their own ability to make a difference. This concept is called self-efficacy, a
construct developed by Albert Bandura; social cognitive theory presumes that people are capable
of self-control and behavior is purposive (Bandura & Locke, 2003; Lent & Maddux, 1997).
Self-efficacy can be viewed as the extent to which individuals perceive their ability to
complete tasks and how they modulate their motivation and perseverance levels (Bandura &
Locke, 2003). Low self-efficacy can contribute to stress, depression, and influence decision
making. Self-efficacy can be a contributor to acquiring new capabilities and enhancing
interpersonal skills, which are both necessary if AVPs are to balance the conflicting demands on
their time (Bumann & Younkin, 2012). Bandura (2000) noted that only individuals who believe
they can achieve a desired result will be motivated to act. AVPs who lack self-efficacy may not
be able to achieve their objectives and will likely exhibit self-defeating behaviors. Those with
higher self-efficacy may have more stamina and are likely to rebound from setbacks and
disappointments (Bolanos-Medina, 2014). There is a renewed focus at Forward Health to create
a culture that supports self-efficacious leaders. Better understanding the extent to which AVPs
believe in themselves and their abilities will likely yield actionable information (Lunenburg,
2011).
Organizational Influences
Viewing organizational practices through the prisms of cultural models and settings
provides a utilitarian framework to analyze factors that influence performance (Gallimore &
Goldenberg, 2001; Rueda, 2011). Cultural models represent ways of perceiving and synthesizing
responses to adaptation challenges (Gallimore & Goldenberg, 2001). They are usually unnoticed
by the community, as its members are all bounded by the same influences and environment.
When culture is misaligned, hypocrisy, malfeasance, and dishonesty can flourish. The emissions
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 22
deception perpetrated by Volkswagen’s engineers, for example, can be traced to a cultural model
where achieving corporate targets were apparently not bounded by ethical mores or constricts
(Geier, 2015; Tuttle, 2015). Forward Health, operating in a heavily-regulated industry, also risks
opacity and misalignment if the AVPs do not view themselves in a symbiotic relationship with
their peers wherein all are committed to achieving the company’s strategic objectives.
Forward Health is committed to a transparent culture where collaboration, teamwork, and
a spirit of shared consciousness animates the workplace. The executive team consistently
verbalizes the necessity for AVPs to work together towards a common goal. They invested much
time over the last 18 months attempting to create a cultural model that supports the strategic
plan. These included striving for a climate of trust, agility, accountability, and even fun. Healthy
organizational cultures characterized by the aforementioned attributes encourage better
performance while authoritarian ones breed contempt (Dizik, 2016). Evaluating the extent to
which AVPs feel committed to the organization’s strategy along with their views on whether
others embrace it will help evaluate the state of the culture. Shared purpose includes behaviors
that promote the common good irrespective of department or function. Self-aggrandizement and
sabotage are not practiced nor tolerated. Teamwork is a natural successor to shared purpose as
AVPs collaborate as a team of committed professionals to effect positive change.
Cultural settings, by contrast, are visible manifestations of an organization’s practices and
procedures (Rueda, 2011). They are the visible embodiment of the community of workers
(Gallimore & Goldenberg, 2002; Tharp & Gallimore, 1988). Rueda (2011) defined them as the
who, what, where, and why. They are visible and virtually tactile, as they imprint themselves on
the employee’s workday. In organizations, cultural settings include the documented policies,
procedures, and standard operating procedures outlining acceptable work protocols. At Forward
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 23
Health, the cultural settings include desk level procedures, call monitoring, chartering
documentation, and regular check point meetings with superiors.
Cultural settings include understanding the distractions that keep AVPs from achieving
their stated objectives. Keeping the main thing the main thing takes work and focus (Covey,
1994). AVPs can oft-times unwittingly, and sometimes purposefully, spend most of their time
occupied with the latest problem or fad and lose sight of the strategic imperatives. Impromptu
interruptions, non-stop instant messages, and system anomalies can make AVPs less efficient
and prone to fatigue, thus causing misalignment.
Interactive Conceptual Framework
Ravitch and Riggan (2016) explained that a conceptual framework is an argument
advocating for the importance of the topic under consideration and how the methodological
approach is both rigorous and appropriate. Figure 1 below illustrates the conceptual framework
at Forward Health. The organizational influences, identified by the larger blue concentric circle
representing Forward Health, inform every decision and set the tone for the company. The
organizational influences at Forward Health need to include providing AVPs the appropriate
feedback to behave in ways consistent with a company dedicated to teamwork. The organization
must endeavor to continually communicate as the strategic plan and prioritization of objectives
are updated and refined.
The stakeholders studied here are AVPs identified in the orange circle. Both knowledge
and motivational factors influence their performance. Meta-cognitive knowledge is especially
important, as reflection is a key component to personal and professional growth. There are
different temporal reflection frames: reflection on action, reflection in action, and reflection
before action (Barley, 2012). Reflection on action is equivalent to a mental post-mortem; it is the
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 24
ability to perform a forensic analysis and glean learnings from the past. Reflection in action is
responding in real time; in healthcare, waiting for an after-action report may mean the patient
experienced a poor outcome. Reflection before action requires harnessing one’s own experiences
and knowledge and carefully considering different outcomes based on a host of variables. AVPs
at Forward Health need to harness all these frames to be successful because events can
monopolize time and resources.
AVPs also need to be motivated to achieve their goals. They need to be inspired by their
leaders and feel empowered to effect change. Collins (2001) advocated for employees viewing
themselves as players, meaning that they have an inner locus of control. Expectancy,
instrumentality, and valence are noted as influencers to gauge their engagement to stay aligned
with the strategy.
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 25
Figure 1. Conceptual framework.
Data Collection and Instrumentation
Qualitative research is focused on understanding the ways people interpret their
experiences and the meanings they ascribe to them (McEwan & McEwan, 2003; Merriam &
Tisdell, 2016). Qualitative research is “exploratory—the researcher generates or constructs
knowledge, hypotheses, and grounded theory from data collected during fieldwork” (Johnson &
Christensen, 2014, p. 34). Qualitative methodological approaches were optimal for this research,
as understanding the perceptions and motivations of the AVPs at Forward Health uncovered
• Understand corporate strategic plan
• Ability to translate strategic plan into
actionable objectives
• Use the different reflection frames to
modify behavior to achieve goals
• Inspired by leader’s behaviors and values
• High self-efficacy and internal
locus of control
Stakeholder: Knowledge, Skills, Motivation
Organization:
• Sense of shared purpose and goals
• Focus on strategic alignment with goals
• Culture of teamwork and cooperation
• Communication is clear and frequent
Complete alignment with Forward
Health’s strategy as evidenced by
stakeholders’ actions and behaviors
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 26
opportunities to remove obstacles thus helping the company achieve its objective. Qualitative
research also explores how people make meaning of their experiences from an emic viewpoint
(Merriam & Tisdell, 2016). This is especially important in this context, as AVPs are the primary
funnel through which the strategic plan is decoded, explained, and executed. Without
ascertaining how they wrestle with their understanding of the plan and impediments to
implementation, it is impossible to suggest solutions for the company’s goal of driving
alignment. Having leveraged Clark and Estes’ (2008) gap analysis model, the constraints
hindering the AVPs from understanding and executing on the strategic plan became clear.
Interviews
DiCicco-Bloom and Crabtree (2006) noted that interviewees in a qualitative interview
should be a relatively homogenous group so they all have similar experiences. They noted that
semi-structured interviews center around a core set of questions and allow the investigator to
probe and ask clarifying questions. To comprehensively explore the research questions in this
study, 11 self-selected AVPs were interviewed to understand how the strategic plan is
communicated to them and explore what obstacles prevent them from executing on it. The
interview protocols found in Appendix B allowed for a deep probe into the three dimensions
from the Clark and Estes’ (2008) model which gave the AVPs a safe and constructive forum to
share their anxieties and concerns.
Data Analysis
The data analysis started with highlighting the research questions and leveraging them to
establish a priori codes derived from the conceptual framework. Key themes were teamwork,
shared purpose, communication, strategic plan alignment, and self-efficacy. The recorded
interviews were all transcribed and cleaned for accuracy. The next step was In Vivo coding,
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 27
using the interviewees own words and sentiments to describe their responses to the interview
questions. What emerged from this exercise were colorful descriptions of the participants’
challenges with the three frames of Clark and Estes’ (2008) gap analysis. In parallel, I used
“jottings”, marginalia in the transcripts that captured my own observations of emergent themes
or a particularly striking turn of phrase. This was followed by analytic memoing, during which I
attempted to synthesize and rationalize the data. I noted potential recommendations for future
study and my own reactions to what the AVPs were sharing.
Findings
The following section synthesizes the results from semi-structured AVP interviews
facilitated between October 16, 2017 and November 3, 2017. There were 11 participants
representing most areas in the organization. The names are pseudonyms which bear no
resemblance to the actual interviewees’ names. To avoid any inference as to the gender of the
pseudonyms, I have consistently used the third person pronouns to further protect those who
elected to speak with me. The quotes in this section have been lightly edited to protect the
identity of both the contributors and the company. There were situations where interviewees
elected to provide a brief answer or answer a question other than the one asked. The following is
representative of the AVPs’ responses, sometimes prompted with follow-up questions.
Knowledge
The company’s AVPs need to possess the procedural knowledge to translate the
organization’s strategy into specific tactical objectives. The research revealed that only one
participant could comfortably elaborate on the strategic plan and the relation to his own work.
One meeting that all participants found particularly helpful in communicating general
information, however, was the monthly directors meeting, a session hosted by the CEO where
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 28
[they] and the other company leaders discuss key initiatives and provide sales updates. That
forum was uniformly praised for being a conduit to learning about the health of the organization
and a venue to ask questions, but there was no feeling that the strategic plan of the company was
overtly reviewed. Andy summed it up as follows:
Honestly, I’m not 100% sure. You have to make money, I guess. You can go to our
online sites to get information. I can always call someone in the business. I am not sure
there is a formal process to communicate the strategic plan.
Dale also referenced using the Internet to do research, but framed it differently: “I can’t say I do
[understand the strategic plan]. We’re not public, so, in other companies, it’s easier to research
things online, but we only get exposed to the directors-and-above meeting.” [They] expressed
irritation at not having learned about the strategy: “You get lost in the weeds—you’re so far
down into boots on the ground that you’re not really focusing on the overall strategy of the
battle, of war.” Casey, by contrast, recognized that [they] did not have a comprehensive
understanding of the strategic plan:
I have a good understanding of what it is at 30,000 feet. Where I struggle is that, day to
day, there’s lots of, I think, a lot of distractions. Sometimes, it feels like we are chasing
our tails a bit. So, I don’t know whether that connects directly to the strategic plan. I think
it’s a matter of interpretation, so I know how our department is interpreting the strategic
plan and then, sometimes, feel like other departments might not interpret it the same way.
Jordan shared that [they] were “not sure what the strategic goals of the company are. It’s been a
rough year understanding whether or not we want to be a better version of who we are today.”
Karen noted a tendency to conflate the company’s vision with its strategic plan: “We emphasize
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 29
those [values] in most of our communications, but I think we could identify ways in which we
could communicate frequently what our strategic vision is.” Lindsay echoed a similar sentiment:
Well, that’s a great question. I’m not sure how I would describe the strategic plan. I guess
I’m not as close it as I should be. As far as the strategic plan, I think you’ve just
uncovered a little bit of a gray area for me.
Max and Pat expressed confusion when asked to describe the strategic plan. Max thought
it might be something confidential the company was reticent to distribute: “I feel like there are
things that I’m not privy to, but I’m okay with that because I think that’s common in our type of
organization.” Max mentioned that [they] likely learned more about the company’s strategic plan
at external client meetings than anything the leadership shared. Max framed his understanding as
bits of information that eventually “trickle down in meetings and we can ask questions.” Taylor,
the interviewee with the most tenure, simply responded “I don’t know.” Blair noted that [their]
role was dependent on others understanding the plan and providing clear tactical direction to
[their] quotidian work.
Randy, in contrast to the other interviewees, did understand the strategic plan, but noted
that [they] had a unique vantage point as [they] worked in a department responsible for crafting
the plan and had much interaction with [their] senior leader. [They] recognized that [they] were
in an enviable position: “So. it’s a unique situation, but we’re at the front line there.”
The AVPs interviewed, with one exception, were not overly concerned with the dearth of
knowledge on the strategic plan. There were no specific mechanisms or tools they used to
reinforce either their own understanding of the plan or to help their subordinates better tie their
goals to the strategy. Dale and Andy mentioned going onto the Internet to learn about the plan,
but this would have only resulted in them learning about the company’s values. Max assumed the
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 30
company would be clearer in communicating the strategy if it were important and thought that
joint client meetings were potential educational forums. Casey, by contrast, asked questions on
the strategic plan and was curious to learn the details. [They] shared that the interview gave
[them] pause, for [they] might be missing something. Casey asked for reassurance that the plan
had not been updated at the time of the interview.
Motivation
Although 10 of the interviewees admitted that they did not understand the strategic plan
and had only an inchoate understanding, many of them expressed some degree of confidence in
aligning their own objectives to the strategy. Max stated that [they] were very confident in
aligning [their] objectives with the strategy. Andy, Randy, and Taylor all shared that they were
somewhat confident in their ability to translate the company’s strategy into clear objectives.
Sarah elaborated on this theme: “I think I am because I think mine’s quite defined because, at the
end of the day, mine is fairly straightforward to a certain degree.” Max was ambivalent:
I guess in general, again, if I had more visibility to the specifics of the strategic plan, I
still know, in general, where we’re headed but I don’t know that’s the definition of the
strategic plan. Because I don’t honestly know what—what’s exactly in our strategic plan.
So, I am making assumptions on what the company wants me to do.
Dale directly tied [their] lack of understanding of the strategic plan to an inability to align
objectives to tactics: “So, I don’t really. I’m not sure I get it right all the time.” Taylor used a
Likert scale to rate confidence level: a 7 on a scale of 1 to 10.
When asked about the benefits the AVPs realize when the company hits its strategic plan,
every participant noted the monetary reward. Nine participants listed either salary or bonus as the
primary benefit. However, everyone had other perceived benefits aside from the financial
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 31
impetus. Andy shared that “it makes me really feel good that I was part of something that
succeeded. I think it’s good for the morale of the company and good for everyone.” Lindsay said
[they] derived personal satisfaction from hitting the strategic plan because, as [they] put it, “I’m
competitive, and I like to ensure that, every day, I’m adding to—or contributing to—driving
better results for the organization.” [They] reiterated that “I stay employed” if the company hits
its strategic plan. Max had a similar response: “We all share in this success, either through, first
of all, additional clients, additional, membership and rewards for everybody on the team.” Jordan
expressed a similar sentiment: “Yeah, when the company meets those strategic plans we’re able
to achieve growth of both the top and the bottom line which has kind of more immediate impact
to our annual incentive pay.”
Five of the AVPs felt under-recognized for their contributions to the company. Every
participant, however, mentioned that they appreciated i-care points, an enterprise program that
allows leaders to award points to individuals demonstrating the company’s values. The recipient
can then order goods tiered to the number of points they have earned. Nine of the AVPs also
mentioned receiving decorative objects in recognition of their contribution to a particular
initiative. Andy lamented receiving half-hearted, back-handed types of compliments. [They]
continued that, “at my level, we don’t get too much recognition.”
To feeling recognized, Blair said, “Not really. I don’t know. I think I used to feel much
more part of that bigger picture. I used to feel excited about my responsibility, but, now, I feel
I’m just doing my job.” Casey shared a similar ambivalence:
I don’t know. I need to articulate it better. I guess I’m uncertain at times around whether
I’m really being valued. I don’t know if I can point to anything specific, but I definitely
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 32
hold with me some insecurities around whether or not I’m seen as being valued or, in the
organization in particular, beyond my own immediate circle.
Dale had similar sentiments:
I just want to make sure that, if I’m needed and appreciated for the work I do, then tell
me, and tell me if I’m not. Tell me. I hate to be in a situation where I’m going 100 miles
an hour and I’m being ignored and then not given that direction to say, “Hey, you’re
going the wrong direction you got to go—you got make a left her or reverse at the right
or you can even slow down.” And that happens every once in a while.
Max answered the question succinctly, “I would say there have been times where I feel like that
is not the case.” [They] did add that “sometimes, it’s always nice to be recognized regardless of
what level you’re at.”
Jordan noted that [they] had always felt recognized at the company. [They] shared, “I
personally do, I think that we work very hard, but I think that’s something that’s acknowledged
and valued by the leadership team. I may be in a unique position here.” Lindsay answered that
[they] absolutely felt recognized and attributed it to a very supportive boss and a great team. Lou
answered similarly, noting that [their] direct superior recognized [them] in a positive way. Max
felt recognized as well but attributed it to the contact [they] had with the company’s [senior
leader] who was very supportive. [They] also praised [their] direct manager for “publicly and
privately recognizing your efforts.” Taylor also answered “yes” and noted that [their] boss was
supportive. Randy, the one AVP with the clearest understanding of the strategic plan, answered
in the most nuanced way of all respondents:
I would say yes. I would say I am. I guess, sometimes, you do. I’m not sure if you feel
this at all, but there’s obviously sometimes when you feel like you’ve gone putting the
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 33
extra effort and you’ve gone above and beyond, and, sometimes, they fall short from a
recognition perspective. But then there’s other times when you get recognized for that.
The majority of AVPs who felt recognized attributed it to one individual, a person of higher rank
in the company, who made them feel special or valued.
Only two of the AVPs had a high confidence level of being able to contribute to the
company hitting or exceeding its goals on the strategic plan when there are competing priorities.
Casey shared that, as long as “I’m in sync with my direct manager, I’m confident that she’s
going to give me the right direction to ultimately make the biggest impact.” Lindsay was
confident as well, but slightly equivocated when pressed on keeping up with all the work. Taylor
noted that [they] often worked 12 hours a day, but, sometimes, unclear direction hindered [them]
from hitting [their] own goals, and, therefore, [they] were uncertain of [their] ability to help the
company hit its plan. Jordan was more animated in [their] response:
I think my answer would be I don’t have confidence; I think that we have a lot of great
ideas, and all of the ideas are right, but we try to throw a lot on the wall and see what
sticks and I think it’s very difficult. It’s difficult to be able to feel that you’re doing an
optimal job when everything feels rushed or incomplete in some fashion.
Dale lamented that “I’m just wary how much we can keep pushing at this level, this high level.”
Blair described [their] frustration: “If I commit to doing something and it’s on my watch, I
probably will kill myself to do it. The overall strategy is muddled, and I usually end up taking a
step back.” Andy had no confidence: “You can’t just keep adding people or keep adding projects
and expect everything to get done.” Lou shared that [they] leave work prioritization decisions to
[their] boss and lets [them] decide what to do: “I will wave it to my boss for re-prioritization”
and, therefore, assumes that work that is left unfinished must not be vital to the strategic plan.
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 34
Max detailed how [they] prioritize but refrained from characterizing [their] confidence level in
concrete terms:
If I had more visibility to the specifics of the strategic plan and the direction, then I
would know. Sometimes our priorities are in conflict, but you just have to balance it all. I
know that the clients come first and then efficiency.
Max noted that balancing can be challenging, “but I think, sometimes, we do have competing
priorities, and it’s not always clear which is the highest priority.” Taylor shared, “I will work
long hours but am not really sure we can achieve everything that’s expected.” Randy provided a
more elaborate response:
That’s a great question. It becomes extremely challenging, right? You have these multiple
priorities, whether or not it comes down to trying to figure out how do we support these
competing strategies and ensuring that we’re getting the best result from the resources
that get [stretched], but it definitely does become a little bit more challenging when you
have competing priorities.
Eight of the AVPs felt empowered to achieve their goals. Many of the respondents did
not elaborate much on their answer other than saying yes. Casey shared [they] definitely felt
empowered to do what was necessary. Randy added that [they] also felt empowered: “I feel the
leadership has built or has trust in me that, you know, has trust in my ability. I guess I would say
yes. They know that I will ensure that the organization isn’t put at risk.” Taylor commented that
[they] were empowered by virtue of the team in the organization. Blair, by contrast, was starker:
“I don’t know. I think, before, I would have been more excited. They keep me in the dark now. I
used to feel like I was part of the bigger picture. Now I’m just doing my job.” Andy shared that
there was too much “swirling and unclear direction” to feel empowered. Max felt that “we’re
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 35
sacrificing speed for quality and we need to fit into [those] dates [dictated by management]
regardless of the scope of the project. So that’s part of what I have a concern on.”
Organization
There was unanimity that the directors-and-above meeting was one way the company
ensured alignment with the strategic plan. Randy thought the company did a nice job promoting
the strategic plan, but [they] were in the minority. The majority of the interviewees focused on
organizational gaps. Andy observed, “I don’t know if all other leaders push that down to their
staff. People want to understand why, and I’m not sure we actually take time to do that.” Taylor
shared, “I think that the company is always thriving. I don’t know what our 2018 objectives are,
but we’re always driving towards them.” Casey elaborated on what [they] perceived as the
opportunity:
I don’t know that the company has hindered me necessarily, but, as I’ve said initially, I
wonder if we couldn’t apply a little bit more discipline around how we intend to deliver
on those objectives because, especially right now, it feels like the kind of strategy are is
off in a—in a silo.
Dale expressed dismay about the lack of organizational alignment:
Folk aren’t really—they’re not really aligned with the work operationally. I did—I
remember telling [my manager] the other day, probably a month ago, I said, why is it that
[a senior leader] not connected with us anymore. It felt as [they] just stepped away.
Jordan noted that the company “does not appropriately support initiatives that are intended to
drive the strategic plan because it’s very difficult to project a short-term value with them.”
Lindsay thought that the company’s efforts to promote the strategic plan were “quite weak, I
think. I think it’s a high level, but I’m not sure that I’d do a very good job about how that
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 36
resonates across the company.” Max thought the strategic plan was “put out probably once a
year. As far as promoting it, it seems like, at the highest level, it gets handed down to the next
levels of management. I don’t know if they really promote it beyond that point.” Blair noted that
the organization takes a “knee-jerk” reaction to strategy: “What hinders you is these fire drills
often and this panicky [behavior] and then there’s mass hysteria.” Dale expressed [their] concern
regarding work load:
I felt that we bit way more off that we can chew, and we jeopardized [the company’s
strategy] and, obviously, burned people out and all the other stuff that comes with that. I
felt that we could handle this more elegantly. But I don’t know if we’re aligned
organizationally to do that.
Lou shared that people were often pulled from their day jobs to complete tasks aligned to the
strategic plan but were never given a reprieve from their normal work, so it piled up and there
was no expectation or allowance for the conflict.
Although every interviewee acknowledged the organizational challenges, only two felt
there was a paucity of teamwork. Andy shared, “there’s a lack of teamwork, and I think it’s
because, and this is just my opinion, a lot of times people just don’t want to do the work.” Blair
noted that teamwork was hindered because of unrealistic expectations:
So, I think I know what [senior leader] wants, but it changes, and [they]want a unicorn.
They don’t just want a unicorn but a pink one, and it keeps changing. Then, they want
one that dances and speaks French.
Blair continued that [they] see the organization as fairly siloed causing conflict and a lack of
teamwork.
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 37
The other nine AVPs acknowledged teamwork and the company’s efforts to encourage it.
Casey noted there was good collaboration between [their] team and others. Dale attributed the
teamwork to the “right attitude on a project” along with an open mind. Jordan felt there is good
teamwork despite what [they] saw as organizational dysfunction. Lindsay was offered praise,
noting [they] were inspired by teamwork and, therefore, actively promoted it. Lou noted that
[their] team worked collaboratively with other departments to hit [their] objectives. Max noted
that the “organizational structure really aligns us well.”
The AVPs who participated in this study were unanimous that a failure to prioritize
created havoc and misalignment. Andy characterized it thusly:
It’s let’s see how much we can put in the bag before it explodes. Or you’re working on
something, [and] then the direction changes. So, stop working on that, and work on this.
You start working on that and, no, wait, work on this. Here is…work on that. So, you pull
somebody off something else to work and that’s…Well, how come you couldn’t get that
done? Well, that person has to work on something else.
Blair mused that each executive had his or her own priority list and insists [they] juggle work to
accommodate the latest priority. The leadership team was not aligned on where the focus should
be, so there was constant shift in focus. Casey noted “fractures of strategic orientation,” and, if
“we had three things instead of twelve,” the teams would be able to better focus. Dale shared, “I
just don’t think we’re structured enough to really focus, so, time and recourses, yeah, I need
both.” Jordan elaborated on [their] observation of the root cause of the resource issue:
I think it’s just that we have a fairly single-threaded approach to knowledge that often
rests with senior people with very busy schedules. Maybe to my earlier point about my
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 38
lack of trust in people more junior, but we do not have the service experts necessary to
drive a lot of the things we want to do.
Lindsay said, “I don’t’ know if this [initiative] is a priority any longer. So, that could be
confusing. I don’t know if it’s a sense of confusion or we just need to determine if it’s a priority
or not.” Lou noted prioritization was a daily challenge:
I just had that conversation this morning about another project. So, yes, I face it every
day, and I consider it my number one challenge. Sometimes, it is about prioritization.
Sometimes, it’s trying to get another to agree with our prioritization because my priority
is not necessarily their priority, and you have to spend a lot of time getting them to
understand the value to them as well so that they can free up resources to work on it.
Max shared that [they] believed failure to prioritize would continue to be a challenge. Randy
elaborated,
It’s confusing. It has been confusing from that perspective. Understanding the resources
that we have, what’s the most important thing that you have wanted to be done. I know
you want to get both of the done. So, there’s definitely been times where we got some
challenging understanding of priorities.
Randy felt compelled to add that “there is a level of frustration where your priorities get changed
because of an event. We have a meeting with this client in two days. When did we learn about
this meeting?” Taylor added, that, at times, there were disconnects with [their] manager on
prioritization, but [they] did really feel it was a significant issue for [them].
The AVPs also elaborated on their concerns regarding the dearth of resources and subject
matter experts. These were specifically spotlighted as causing organizational abrasion. Andy
shared that “I don’t have enough talent in people; I don’t have enough of the type of resources
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 39
needed to keep up with how much work there is.” Blair shared teasing out the difference between
resources and subject matter experts is difficult: “I think the problem is that they don’t have time
either, and I think it’s hard to tell which it is.” Casey attributed the gap to “a boy who cried wolf
mentality” (i.e., the key resources and subject matter experts ignore requests as there are too
many competing priorities and fire drills to take any single one seriously). Dale declared,
We need more resources. I think we need to make sure you have the right mix. The level
of resources, that skill level you want that needs to be there, but you need to make sure
that they’re invested in—the company invested in them as well. I need quality people not
just at the top, but I need to call the people at the hands-on the ground.”
Dale continued that [they] needed those “Captain American soldiers who are really good and will
go into battle.” Jordan’s perspective was similar: “I’ve almost never felt that the time or
resources were proportionate to the level of focus, the level of rigor [required] by the
organization.” Jordan continued, “We’re moving really fast, and I don’t think anyone has the
time or resources necessary to achieve complete success in all categories.” Lindsay noted both
resource constraints and that knowledgeable workers were in short supply. Lindsay practiced
“mindfulness to stop [themselves] from working too much.” Lou continued with a similar theme
on this question:
My number one challenge in the organization is resources and time. When we talk about
resource contention and time, when it appears to be consistently with the same
department, that, to me, screams that we need to really do a resource assessment and how
they’re utilizing their time.
Max identified one department as being the primary source of resource and skill gaps.
Max noted specific individuals who had many responsibilities and was concerned about the
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 40
company’s ability to meet its obligations unless it addressed this gap. Max shared resource and
skill opportunities were the largest challenge for [them]. Max noted, “I think it required, at least
for me, to put in a lot of extra time outside of the normal workday to accomplish all of my
objectives for the end of the day. There is a lot of demand for my time.” Randy noted that [they]
had resource challenges over [their] time with the company, partly because a significant part of
[their] team departed for different opportunities. [They] said [they] remained hopeful that [their]
replacements would stay at the company, therefore helping relieve his resource gaps. Taylor had
a similar observation: “We’ve always had these resource constraints and, now, we’re trying to
work with these team to say, hey, we need to resolve the resource issues. I do think, sometimes,
we have bottlenecks, however.”
Solutions and Recommendations
The knowledge influences in Table 4 represent the complete list of validated knowledge
influences consistent with the interviews and supported by the literature for the stakeholders to
achieve their goals. Clark and Estes (2008) suggested that declarative knowledge is generally a
predecessor to procedural knowledge, as in this situation where AVPs often focus on what they
view as critical work without having a comprehensive understanding of the company’s strategy.
Metacognition, literally meaning beyond knowledge, is a learner’s ability to transcend the
written word or protocols and adapt depending on the circumstances. (Looman, 2003).
Krathwohl (2002) added that metacognition is awareness of one’s own cognition. AVPs should
be educated on metacognitive techniques, as the ability to adjust real time to challenging and
fluid circumstances is a requisite skill for leaders in today’s healthcare environment. Table 4
shows that these influences have a high priority for achieving the stakeholder’s goals. It also
shows the recommendations for these influences based on theoretical principles.
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 41
Table 4
Summary of Knowledge Influences and Recommendations
Assumed Knowledge Influence: Cause, Need, or Asset*
Assumed Knowledge Influence:
Cause, Need, or Asset*
Principle and Citation Context-Specific Recommendation
AVPs do not have a clear,
consistent understanding of the
company’s strategic plan. (D)
Procedural knowledge increases
when declarative knowledge
required to perform the skill is
available or known. (LeFrere &
Jones, 1997; Clark et al., 2008).
Reinforcement and practice
enhance recall and learning
(Mayer, 2011; Schraw &
McCrudden, 2006).
Provide informational pamphlets,
emails, and tent cards of strategic
planning benchmarks.
Record and distribute a video message
from the CEO on the strategic plan.
The strategic plan will be included in
the company’s newsletter.
Include questions in the existing
employee survey on knowledge of the
strategic plan.
Ensure that the strategic plan is woven
into the discussions at the directors
and above meetings.
AVPs do not reflect on how their
own goals and objectives tie
broadly to the strategic plan. (M)
Krathwohl (2002) describes
metacognition as “strategic
knowledge” (p. 214). The
reflective leader who uses
metacognition can craft strategic
plans that create a “self-
actualizing environment”
(Looman, 2003, p. 219).
Educate the AVPs to become more
self-reflective practitioners.
SVPs will conduct skip level meetings
to encourage self-reflection and self-
actualization.
AVPs will detail on their weekly
status report how they prioritized their
work in concert with the strategy.
*Indicate knowledge type for each influence listed using these abbreviations: (D)eclarative; (P)rocedural;
(M)etacognitive
Knowledge Recommendations
In terms of declarative knowledge solutions, AVPs could not articulate the company’s
strategy and were unaware that it gets updated. As Table 4 shows, declarative knowledge is the
scaffolding upon which more complex knowledge influences evolve. The company’s strategy
should eventually become part of the AVP’s active memory available for recall with virtually no
effort. The executive team, therefore, needs to explain how the overall strategy fits into the
AVP’s objectives and help them rationalize their role in achieving the company’s goals. Since
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 42
they do not have a clear understanding of the strategic plan, one recommended, easy-to-
implement remedy would be to publicize it with job aids, emails, and tent cards. This collateral
material would be ubiquitous at the disposal of AVPs when needed. The AVPs will be able to
include how they have prioritized work in their weekly status reports.
The interviewed AVPs praised the monthly meeting hosted by the CEO, noting it allows
for sharing rich information about important company initiatives and provides an opportunity to
ask questions on a variety of topics. The perceived prestige of being included in an audience with
the most senior leader resonated with them; the CEO’s presence adds gravitas to the discussion.
These meetings, therefore, should incorporate how accomplishments, both individual and
department, relate to the company’s strategy. The CEO should also take the lead to personally
record a narrative describing the strategic plan. Finally, the employee survey, which is
introduced and distributed with an email from the CEO, will include questions to gauge
knowledge of the strategic plan.
The literature shows that reinforcement is essential during the assimilation process
(Mayer, 2011). Practice promotes automaticity, thus reducing the need for memorization
(Schraw & McCrudden, 2006). The optimal state would be for the strategy to become a cultural
model, meaning it becomes so familiar that it is unnoticed and taken for granted (Gallimore &
Goldenberg, 2011, p. 47). Organizations have an obligation to share objectives if they wish to
avoid confusion and dysfunction (Wunder, 2005). Quintas, LeFrere, and Jones (1997)
underscored the importance of knowledge being ubiquitous and available on demand. The onus
is clearly on the sender to ensure the clarity of the message (Fitsimmons, 2014).
Metacognitive knowledge solutions. Baker (2005) averred that metacognitive
knowledge encourages learning. Once the company’s AVPs have a common understanding of
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 43
the company’s strategy and its underlying principles, the next step is to be able to synthesize the
declarative knowledge and apply it to different situations. The executive team, therefore, needs
to educate the AVPs on metacognitive knowledge. Adopting a metacognitive frame is vital if the
company’s AVPs are going to successfully tie their own objectives to the company’s strategic
plan. Part of the training should include modeling the kind of thinking that helps learners
contextualize knowledge and apply it to different situations. Leaders should also give AVPs time
to reflect on what they do not understand. Acknowledging that being bewildered is part of the
process of enhancing metacognition should encourage more questions, skepticism, and even
creativity. SVPs will, therefore, conduct skip-level meetings with the AVPs to prompt self-
reflection through a series of open-ended questions. The AVPs will also be asked to explain, on
their weekly status reports, any competing priorities and how they resolved them, thus enabling
metacognition.
Schraw and McCrudden (2006) emphasized the benefits of underscoring important points
by providing concrete examples of how to apply metacognitive knowledge. Looman (2003)
argued, “the metacognitive system alerts cognitive subsystems to initiate corrective action
whenever there is a dissonance between affect and reasoning, as when something just does not
feel right” (p. 218). Metacognition empowers individuals to challenge preconceived notions and
contemplate different perspectives (Tush, 2011). It is predicated on knowing where, when, and
how it can be used (Garofalo & Lester, 1985). Geiwitz (1993) added that these metacognitive
skills allow leaders to “monitor and direct to obtain the greatest possible success (p. 1)”.
Metacognitive knowledge is critical for successfully solving unstructured or particularly
daunting problems (Davidson, Deuser, & Sternberg, 1994). Geiwitz (1993) found that creativity
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 44
is encompassed in metacognitive knowledge, an attribute that is oft-times lacking when
employees have neither the time nor skill to reflect.
Motivation Recommendations
Table 5 represents the motivational influences that were validated during the qualitative
interviews with the AVPs at Forward Health. Clark and Estes (2008) underscored that positive
emotional environments support motivation. The majority of the AVPs interviewed expressed
some frustration with competing priorities and their inability to effectively sequence their work
based on shifting direction. The emotional environment is often viewed as less than encouraging.
The phrase “fire drills” permeated the interviews, a shorthand term meant to explain unplanned
and unexpected work monopolizing one’s day. While a fire drill can range from a defect in
production that can take hours to resolve to a new market opportunity that eclipses prior work,
the day-to-day objectives still need to be accomplished, sometimes after hours or on weekends.
Table 5
Summary of Motivation Influences and Recommendations
Assumed Motivation Influence:
Cause, Need, or Asset*
Principle and Citation Context-Specific
Recommendation
AVPs feel that “fire drills” (i.e., the
emergence of unexpected issues) impact
their ability to complete their normal
work within clearly defined timelines.
(Self-Efficacy)
People are more likely to achieve goals
if they have an inner locus of control
(House, 1971)
People give up on goals when they are
perceived as too hard to achieve (Rueda,
2011)
Bandura (2000) showed that people with
higher self-efficacy were more likely to
complete their goals.
SVPs and VPs will provide
clear instruction to AVPs
when goals need to be
shifted because of
unexpected circumstances
and help them re-calibrate
the expectations as needed
on their existing work. They
will also be clear on
performance expectations.
Senior leaders need to
continue to help calibrate
expectations and model the
expected behavior.
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 45
Table 5, continued
Assumed Motivation Influence:
Cause, Need, or Asset*
Principle and Citation Context-Specific
Recommendation
Executive leadership will use
the employee survey as an
instrument to gauge
increases in self-efficacy.
The majority of AVPs interviewed
identify monetary benefits as their
primary motivator. Given the annual
performance management process (i.e.,
compensation is adjusted only once a
year for the most part), it is important to
identify other effective motivational
mechanisms. (Expectancy Value
Theory)
Motivation is enhanced if a person
values the task (Clark & Estes, 2008;
Pintrich, 2002).
Tying the noble mission of the company
(“others interest”) to the stated goals of
employees can inspire them to achieve
their goals (Guillén, Ferrero, &
Hoffman, 2014; Eccles & Wigfield,
2002)
Focus on mastery-level goals
which tie the work of the
AVPs to the company’s
strategic plan and the noble
mission to transform
healthcare. Senior leaders
need to connect individual
level tasks and achievements
to tie assignments to
bringing humanity to
healthcare.
Self-efficacy. In terms of self-efficacy, AVPs find it difficult to prioritize, as unplanned
work monopolizes too much of their day, thus causing them to fall behind. The phrase “fire
drills” was used extensively as a catch phrase representing how they emotionally experienced
these disruptions. Most interviewees only had a vague understanding of the company’s strategic
plan and often comingled the organization’s values to make up the gap. It is noteworthy that
although AVPs said they felt empowered to complete their work, their frustration surfaced
around prioritization. The examples were of situations where they did not feel in control. Senior
leaders need to clearly articulate expectations to their subordinates. Once the AVPs understand
the strategic framework and rationale, they should be afforded the latitude to regulate their own
work thus feeling empowered to make decisions based on their new-found knowledge. AVPs
should also be encouraged in weekly meetings with their managers to confirm they are
progressing as expected and be recognized for demonstrating self-regulating behaviors. The
leadership team will also help their AVPs succeed by modeling coping mechanisms vis-à-vis
their own work and goals. These specific steps should increase the AVPs sense of control and
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 46
make them feel less victimized by external factors. Furthermore, the executive team will add
questions to the engagement survey to evaluate whether the AVPs are benefiting from the
implementation plan.
That the majority of AVPs acknowledged that they had only a vague and inchoate
understanding of the company’s strategy yet felt sanguine that their ability to achieve it might
suggest overconfidence. Pascal (2008) cautioned that overconfidence can be hazardous with
people underestimating the impact of their actual uncertainty. Kahneman (2011) averred that
those who exhibit exaggerated confidence using “pretend knowledge” are often doing what is
expected of them (p. 263). Mamassian (2008) shared that overconfidence may be naturally
imbued in human decision making. Therefore, senior leadership should emphasize the difference
between frenzied activity resulting from a lack of feedback and actual achievement to help AVPs
better calibrate self-perception.
Denler et al. (2009) suggested that modeling helps learners acquire new behaviors. Shute
(2009) noted that timely feedback is a precursor to improved performance. Locke and Latham
(1990) found that those with high self-efficacy are more likely to strive for higher goals than
those without. Deci (1971) underscored the inverse relationship between an external locus of
control and an individual’s feeling of empowerment. People tend to surrender when tasks are
viewed as unreachable and too difficult (Rueda, 2011). Furthermore, emotional experiences are
tied to an individual’s perception of control (Pekrun, 2006). Bandura (2000) showed that
people’s perceptions of their ability to complete their goals affects outcomes (i.e., those imbued
with a high self-efficacy are more likely to exert the concomitant effort to achieve a goal).
Ghoshal and Brush (2003) warned that companies often introduce distractions that can confuse
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 47
employees, thus hindering action. The authors argued, however, that volitional managers can
positively influence their environment thus curbing negative energy.
Expectancy value theory. Every AVP interviewed identified some kind of extrinsic
reward as the primary benefit achieved for aligning with the strategic plan. Since compensation
and bonuses are generally handled annually, the company should continue to explore other more
immediate motivators. Some interviewees commented on the futility of trying to achieve their
goals as expectations are sometimes fluid and imprecise. The senior leadership needs to
emphasize how AVPs are integral to the company achieving its aspirational goal to injecting
humanity to healthcare. Most AVPs conflated the company’s mission with its strategy, yet it was
apparent that the company’s mission resonated with these stakeholders. That emotional
attachment to reimagining healthcare can be a powerful intrinsic motivator. Leveraging the
elements of expectancy theory, the senior leadership should collaborate with AVPs to help
organize their work thus reducing that sense of futility while framing goal achievement more
broadly (e.g., transforming healthcare by installing a revolutionary new product). Their
confidence and motivation should increase as they will now view their role through a more
nuanced, sanguine prism. And valence, the value the AVPs put on achieving outcomes, will be
higher as the nobility of achieving their own goals will clearly link to the company’s mission and
strategy.
Expectancy value theory explains that people will be motivated if they believe they can
perform the work, are confident that their efforts will produce a certain outcome and equate the
successful completion of the task with something beneficial (Northouse, 2016). Guillen, Ferrero,
and Hoffman (2014) suggested that a strong sense of purpose can be a powerful motivating
catalyst. Chamberlain (2017), for example, surveyed over 615,000 Glassdoor users and found
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 48
that workplace culture and values trumped pay and benefits in driving employee satisfaction.
Vroom’s (1964) theory is predicated on the notion that people have disparate goals and can be
motivated by the following: expectancy, instrumentality, and valence. Task value beliefs are
generally divided into four categories: intrinsic, utility, importance, and cost (Eccles & Wigfield,
1995; Pintrich, 2002; Vroom, 1964; Wigfield, 1994; Wigfield & Eccles, 1992). Intrinsic interest
is how engaged an individual is while undertaking an assignment. Utility, by contrast, is the
usefulness an individual gleans from completing an assignment. Importance, or attainment value,
is a measure of how critical the task or goal is to the individual. The cost is an evaluation of
whether goal attainment is worth the effort.
Organization Recommendations
Table 6 presents the complete list of assumed organization influences based on the most
frequently mentioned organization influences to achieving the stakeholders’ goal during informal
interviews and supported by the literature and the review of organization and culture theory.
Clark and Estes (2008) suggested that organization and stakeholder goals are often not achieved
due to a lack of resources, most often time and money, and stakeholder goals that are not aligned
with the organization’s mission and goals. Gallimore and Goldenberg (2001) proposed two
constructs about culture: cultural models or the observable beliefs and values shared by
individuals in groups, and cultural settings, or the activities in which performance occurs. Thus,
cultural models and settings must align throughout the organization’s structure to achieve
strategic and organizational alignment. As such, as indicated in Table 6, these organizational
influences were validated as being required for achieving the stakeholders’ goal. Table 6 also
shows the recommendations for these influences based on theoretical principles.
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 49
Table 6
Summary of Organization Influences and Recommendations
Assumed Organization
Influence: Cause, Need, or
Asset*
Principle and
Citation
Context-Specific Recommendation
There is a lack of clear
communication on the
strategic plan between senior
leaders and AVPs causing
prioritization confusion and
stress. (CM)
Open
Communication is
critical to the
effectiveness of a
business (Boswell,
2006; Schiller &
Cui, 2010; Watson
& Noble, 2014)
Senior leadership should conduct
strategic review sessions with AVPs to
resolve prioritization conflicts and
explain the company’s broader plan for
achieving success.
Questions on the quality of
communication between the leaders
and AVPs will be included in the
engagement survey to identify trends
and opportunities.
There are not enough
knowledgeable SMEs to
complete the work assigned
to the AVPs. (CS)
Resource allocation
should ensure that
each function is
equipped to achieve
its goals (Rummler
& Brache, 2013;
Clark & Estes,
2008; Abdallah &
Langley, 2014).
Senior leadership needs to conduct a
thorough inventory of the portfolio to
identify resource and competency gaps.
This review will lead to
recommendations to either pause
initiatives and/or recruit the appropriate
talent to meet the demands of the
business.
Cultural model. AVPs shared that there is virtually no communication on the strategic
plan leading to prioritization ambiguity and stress. The interviewees reiterated the company’s
mission and values and many remarked that it was disconcerting that they were unaware of the
strategy and how their own work tied to it. These stakeholders speculated that this lack of
understanding might explain why their priorities and objectives seemed to change frequently.
One AVP, for example, underscored that other departments might not interpret the strategic plan
in a consistent way thus causing organizational misalignment. The underlying theme was that
there was no shared cultural model orchestrating the work amongst the AVPs. The senior leaders
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 50
should share how individual objectives relate to the strategy as it helps illuminate the broader
company goals and creates a sense of harmony. The strategic prioritization needs to be
communicated by the leadership team so AVPs can ensure they are working on the highest
priority initiatives. Moreover, the AVPs will be afforded the opportunity to evaluate the quality
of communication and its effectiveness on the employee engagement survey.
Gallimore and Goldenberg (2001) defined cultural models as “the shared mental schema
or normative understandings of how the world works, or ought to work” (p. 47). Open
communication is critical to clearly communicating business objectives (Schiller & Cui, 2010).
Without clear direction and communication on the expected outcomes, the planning will be both
meandering and even counterproductive (Temple, 2002). Fitsimmons (2014) observed that the
sender shoulders the primary responsibility for the success of effective communication; in
sharing the strategic plan, the senders are the senior management team. Boswell (2006) shared
that developing a clear line of sight to the strategic plan with employees involves clear
communication and often gets misconstrued the further employees are from the executive team.
One informal litmus test as to whether there is improved alignment with the AVPs would
be for senior leaders to actively observe how successes are framed. Forward Health actively
encourages everyone to share good news, so seeing if it is contextualized within the strategic
framework would be one indication of improvement. Katzenbach, Steffen, and Kronley (2012)
noted how stories, interaction amongst peers, and observations of ad hoc conversations can be
used as informal yardsticks to gauge cultural change. Denning (2005) also explained that
storytelling is instrumental in communicating change and codifying abstractions. Therefore, once
the CEO, a respected leader and healthcare visionary, weaves a narrative that synthesizes the
relationship between strategy and tactics, AVPs and other leaders need to become active
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 51
evangelists. AVPs, for example, should start describing their accomplishments and failures using
the strategic narrative as a framework.
Cultural settings. Rummler and Branche (2013) stated that resource planning must
ensure that each function within an organization can achieve its goals. The AVPs who were
interviewed shared that there are not enough knowledgeable subject matter experts to ensure
timely completion of assigned work. One AVP framed recruiting staff for project work as
analogous to adopting a going into battle frame of mind; another noted that [they] never felt
resources were proportionate to the work. Some might argue that this cultural setting is a direct
result of the cultural model reflecting the company’s inability to instill a shared set of
assumptions. The leadership team needs to proactively evaluate the organizational portfolio
against resource availability and SME competencies. This should help inform the prioritization
decisions of the AVPs.
Maslach, Schaufeli, and Wilmar (2001) elaborated that employee exhaustion is directly
attributed to job demands leading to burnout which leads to lack of accomplishment. In addition,
a paucity of empowered and knowledgeable resources can create job strain and poor health
(Boyd et al., 2011; Fernet, Austin, & Vallerand, 2012). Bakker, Demerouti, and Schaufeli,
(2003) found that excessive job demands and resource scarcity predicted burnout and
commitment. In their empirical study of a Dutch call center, employee turnover was higher
where resources were scarce (although the fact that employees who are overwhelmed are more
likely to become ill was identified as a contributing factor). Abdallah and Langley (2014) shared
that companies oft-times promise additional resources but then fail to meet their commitments
causing project failure and employee frustration. Clark and Estes (2008) emphasized the
importance of communicating candidly as it drives both performance and alignment. Appendix E
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 52
outlines the recommended tactical implementation and evaluation plan based on the New World
Kirkpatrick Model (Kirkpatrick & Kirkpatrick, 2016).
Limitations and Delimitations
I have taken great care in allowing the interviewees to expound on their thoughts by
being non-judgmental and reassuring them of our confidentiality agreement. However, these
findings are not generalizable and do not necessarily characterize the sentiments of all AVPs at
the company. In addition, these interviews were conducted over an eighteen-day period in
October and November 2017. The organization may have been undergoing leadership changes
and year-end challenges that could have skewed the results of this research.
Great care must be taken to distinguish what AVPs can articulate in a semi-structured
interview on assessing their own knowledge of the strategic plan from what they actually know.
The AVPs may have had a more robust understanding of the strategic plan but failed to articulate
it because of time constraints, nervousness, or other factors. In addition, the AVPs could be
acting quite rationally given the shifts in the healthcare marketplace while the strategic plan
might be inadequate.
Furthermore, achieving perfect harmony between the strategy of the company and the
tactical objectives of the AVPs (or any other level for that matter) might not deliver the desired
results. There are many factors which can affect the organization’s performance, such as further
marketplace consolidation, thus altering the company’s relationship with its legacy clients,
prospects electing to provide the services themselves, and start-up enterprises focused on
siphoning off business by creating irrational price competition for an opportunity to enter this
market.
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 53
The study was delimited in that it is not a statistically significant representation of this
population. I did not interview any other level in the company, so no inferences should be made
as to the sentiments of others. Their answers could also have been influenced by memory recall
bias. They may have exaggerated events and ascribed certain outcomes to their own behavior
(Connelly, 2013). There are other problems of practice which others may view more critical than
the one explored in this research.
There was also no attempt in this research to gauge the alignment of the executive team
on their understanding and agreement with the strategic plan. Whether there is full executive
alignment with the strategy is unknown, but research suggests that there is a lack of alignment at
the top levels of organizations (Sull, Sull, & Yoder, 2018). Therefore, investigating the extent to
which the strategy is understood and shared amongst this stakeholder group might yield
actionable results.
Recommendations for Future Research
This research did not include interviews with the executive team or personnel at any level
other than self-selected AVPs in the company. Research suggests that there is often a lack of
alignment and disagreement amongst the senior leadership on the strategic plan (Sull, Sull, &
Yoder, 2018). Therefore, future research may want to explore how different executives interpret
the plan in the context of their own division’s objectives.
Future research should explore additional ways to achieve holistic alignment and
endeavor to find other impediments to accomplishing it. This should include how to identify and
partner with informal influencers, those in the company who may lack formal stature but are
important purveyors of information. The research should explore the benefits of forming
engagement communities with these influencers, forums for them to meet and brainstorm on how
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 54
to become alignment ambassadors. This group may also help identify additional knowledge,
motivational, and organizational opportunities.
There was evidence in the interviews that AVPs felt confident in achieving the objectives
on the strategic plan, although most of them were unable to verbalize its components. This
discontinuity between lack of knowledge and high self-efficacy might be attributed to a number
of factors including overconfidence, sub-optimal communication, and an assumed faulty
correlation between attendance at meetings and hitting key deliverables. Future researchers
should further explore this paradox as it may illuminate better ways to align AVPs to the
company’s strategy.
The research was qualitative, consisting of a convenience sampling of eleven AVPs.
Since AVPs are important information conduits to other leaders in the company, future
researchers may wish to recruit a larger sample with representatives from every department in
the company. They may evince different or richer data with variations based on division or other
exogenous factors.
Conclusion
It is clear that successful companies devote substantial time and resources to developing
strategic plans. Studying how to communicate the plan in innovative ways to different audiences
so it resonates with all stakeholder groups is a subject ripe for further research. The mission,
vision, and values are foundational elements, but should be parsed and distinct from the strategic
plan. In addition, future researchers may consider how to quantitatively measure the penetration
and stickiness of a company’s strategy to its employees.
This qualitative research evinced an opportunity for Forward Health to evaluate the
effectiveness of its communication around strategic alignment with its AVPs. The executive
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 55
team may also wish to reflect on the importance and weight it gives to the strategic plan
compared to the organization’s vision and mission. If the data suggest more inquiry into strategic
alignment, there may also be other communication opportunities to share key messages with
AVPs and others with respect to sales prospects, new market opportunities, and the leaders’
views on consolidation in the industry.
And finally, Clark and Estes’ (2008) gap analysis should be leveraged beyond the
problem of practice explored here. There is an opportunity to challenge hide-bound assumptions
and dispel urban legends by demanding a more evidence-based, reflective approach to problem
solving. This includes spending the time to ensure problems are clearly articulated without
jumping to immediate solutions and devoting time to teaching critical thinking skills to others.
This research should not only inspire leaders to consider ways to align strategy with objectives,
but more broadly on how to apply some of the evidence-based rigor to solving other vexing
problems facing the company.
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 56
References
Aaron, B. C., Phillips, J. J., & Phillips, P. P. (2013). Survey basics. Alexandria, VA: American
Society for Training and Development.
Abdallah, Chahrazad, and Ann Langley. The double edge of ambiguity in strategic planning.
Journal of Management Studies 51, no. 2 (2014): 235–64.
https://doi.org/10.1111/joms.12002.
Ambrose, M. L., & Kulik, C. T. (1999). Old friends, new faces: Motivation research in the
1990s. Journal of Management, 25(3), 231–292.
Anderman, E., & Anderman, L. (2009, December 23). Attribution theory. Retrieved from
http://www.education.com/reference/article/attribution-theory/
Anderson, L. W., & Krathwohl, D. R. (2001). A taxonomy for learning, teaching, and assessing.
New York, NY: Longman.
Baker, L (2005). Development difference in metacognition: Implication for metacognitively-
oriented reading instruction (Pp. 61-79). Mahwah, NJ: Erlbaum
Bakker, A., Demerouti, E., & Schaufeli, W. (2003). Dual processes at work in a call centre: An
application of the job demands – resources model. European Journal of Work and
Organizational Psychology, 12(4), 393–417. https://doi.org/10.1080/13594320344000165
Balogun, J., & Johnson, G. (2004). Organizational restructuring and middle manager
sensemaking. Academy of Management, 47(4), 523–549
Balthazard, P. A., Cooke, R. A., & Potter, R. E. (2006). Dysfunctional culture, dysfunctional
organization. Journal of Managerial Psychology, 21(8), 709–732.
https://doi.org/10.1108/02683940610713253
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 57
Bandura, A. (2000). Exercise of human agency through collective efficacy 12. Current
Directions in Psychological Science, 9(3), 75–78. doi:10.1111/1467-8721.00064
Bandura, A., & Locke, E. A. (2003). Negative self-efficacy and goal effects revisited. Journal of
Applied Psychology, 88(1), 87-99. doi:10.1037/0021-9010.88.1.87
Barley, M. (2012). Learning from reflective practice and metacognition – An anesthetist’s
perspective. Reflective Practice, 13(2), 271–280. doi:10.1080/14623943.2012.657792
Biggs, A., Brough, P., & Barbour, J. (2014). Strategic alignment with organizational priorities
and work engagement: A multi-wave analysis. Journal of Organizational Behavior, 35,
301–317. https://doi.org/ 10.1002/job.1866
Blumberg, P. (2009). Maximizing learning through course alignment and experience with
different types of knowledge. Innovative Higher Education, 34(2), 93–103.
https://doi.org/10.1007/s10755-009-9095-2
Boddy, C. R. (2016). Sample size for qualitative research. Qualitative Market Resarch: An
International Journal, 19(4), 426-432.
Bolanos-Medina, A. (2014). Self-efficacy in translation. Translation and Interpreting Studies,
9(2), 197-218. doi:10.1075/tis.9.2.03bol
Boswell, W. (2006). Aligning employees with the organization’s strategic objectives: Out of
“line of sight”, out of mind. The International Journal of Human Resource Management,
17(9), 1489–1511. https://doi.org/10.1080/09585190600878071
Boswell, W. R., & Boudreau, J. W. (2001). How leading companies create, measure and achieve
strategic results through “line of sight.” Management Decision, 39(10), 851–860.
doi:10.1108/EUM0000000006525
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 58
Boyd, C. M., Bakker, A. B., Pignata, S., Winefield, A. H., Gillespie, N., & Stough, C. (2011). A
Longitudinal Test of the Job Demands-Resources Model among Australian University
Academics. Applied Psychology, 60(1), 112–140. https://doi.org/10.1111/j.1464-
0597.2010.00429.x
Brinkmann, S. (2013). Qualitative interviewing. New York, NY: Oxford University Press.
Buchanan, D., Denyer, D., Jaina, J., Kelliher, C., Moore, C., Parry, E., & Pilbeam, C. (2013).
How do they manage? A qualitative study of the realities of middle and front-line
management work in health care. Health Services and Delivery Research, 1(4), 1–248.
https://doi.org/10.3310/hsdr01040
Bumann, M., & Younkin, S. (2012, Annual). Applying self-efficacy theory to increase
interpersonal effectiveness in teamwork. Journal of Invitational Theory and Practice, 18,
11.
Cameron, Kim S. and Quinn, R. E. (2006). Diagnosing and changing organizational culture. San
Francisco, CA: John Wiley & Sons.
Catanzaro, D., Moore, H., & Marshall, T. R. (2010). The impact of organizational culture on
attraction and recruitment of job applicants. Journal of Business Psychology, 25, 649–662.
https://doi.org/10.1007/s10869-010-9179-0
Chamberlain, A. (2017). What matters more to your workforce than money. Harvard Business
Review, 3–6.
Clark, R., & Estes, F. (2008). Turning research into results: A guide to selecting the right
performance solutions. Charlotte, N.C.: Information Age.
Collins, J. C. (2001). Good to great: Why some companies make the leap... and others don't.
New York, NY: HarperBusiness.
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 59
Connelly, L. M. (2013). Limitation section. MedSurg Nursing, 22(5), 325–26. Retrieved from
http://www.medsurgnursing.net/cgi-bin/WebObjects/MSNJournal.woa.
Cook, C. (1991). The Age of Alignment. https://doi.org/10.1007/978-1-349-02139-0
Covey, S. (1994). First things first. New York, NY: Simon & Schuster.
Creswell, J. W. (2014). Research design: Qualitative, quantitative, and mixed methods
approaches. Thousand Oaks, CA: SAGE. doi:10.1007/s13398-014-0173-7.
Davidson, J.E., Deuser, R., & Sternberg, R.J. (1994). The role of metacognition in problem
solving. In J. Metcalf & A.P. Shimanura (Eds.), Metacognition: knowing about knowing.
Cambridge, MA: MIT Press.
Deci, E. L. (1971). Effects of externally mediated rewards on intrinsic motivation. Journal of
Personality and Social Psychology, 18, 105–115.
Denis, J.-L., Dompierre, G., Langley, A., & Rouleau, L. (2011). Escalating indecision: between
reification and strategic ambiguity. Organization Science, 22(1), 225–244.
https://doi.org/10.1287/orsc.1090.0501
Denler, H., Wolters, C., & Benzon, M. (2009). Social cognitive theory. Retrieved from
http://www.education.com/reference/article/social-cognitive-theory/
Denning, S. (2005). The leader's guide to storytelling: Mastering the art and discipline of
business narrative. San Francisco, CA: Jossey-Bass.
Detert, J. (2015). Get the boss to buy in. Harvard Business Review, (February), 72–79.
DiCicco-Bloom, B., & Crabtree, B. F. (2006). The qualitative research interview. Medical
Education, 40(4), 314–321. doi:10.1111/j.1365-2929.2006.02418.
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 60
Dizik, A. (2016, February 21). The relationship between corporate culture and performance. The
Wall Street Journal. Retrieved from https://www.wsj.com/articles/the-relationship-
between-corporate-culture-and-performance-1456110320
Eccles, J., & Wigfield, A. (1995). In the mind of the actor: The structure of adolescents’
achievement task values and expectancy-related beliefs. Personality and Social
Psychology Bulletin, 21, 215-225
Eccles, J.; & Wigfield, A. Motivational beliefs, values, and goals. Annual Review of Psychology,
2002(53), 109–32.
Embertson, M. K. (2006). The importance of middle managers in healthcare organizations.
Journal of Healthcare Management, 51(4), 223–32. Retrieved from
http://www.ncbi.nlm.nih.gov/pubmed/16916116
Enzioni, A. (1975). A comparative analysis of complex organizations. New York: Free Press.
Fernet, C., Austin, S., & Vallerand, R. J. (2012). The effects of work motivation on employee
exhaustion and commitment: An extension of the JD-R model. Work and Stress, 26(3),
213–229. https://doi.org/10.1080/02678373.2012.713202
Ferry, N. M., & Ross-Gordon, J. M. (1998). An inquiry into Schön’s epistemology of practice:
Exploring links between experience and reflective practice. Adult Education Quarterly,
48(2), 98–112. https://doi.org/10.1177/074171369804800205
Fitsimmons, G. (2014). The challenge of exceptional communication. The Bottom Line, 27(2),
57–59. https://doi.org/10.1108/BL-04-2014-0009
Finkelstein, S. (2006). Why smart executives fail: Four case histories of how people learn the
wrong lessons from history. Business History, 48(2), 153–170.
https://doi.org/10.1080/00076790600576727
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 61
Fishman, E. J., & Husman, J. (2016). Extending Attribution Theory: Considering students'
perceived control of the attribution process. Journal of Educational Psychology.
doi:10.1037/edu0000158
Gallimore, R., & Goldenberg, C. (2001). Analyzing cultural models and settings to connect
minority achievement and school improvement research. Educational Psychologist,
36(1), 45–56. doi:10.1207/s15326985ep3601_5
Gallup, Inc. (2017). State of the American workplace. Retrieved from
http://news.gallup.com/reports/199961/state-american-workplace-report-2017.aspx
Garofalo, J., & Lester, F. (1985). Metacognition, cognitive monitoring, and mathematical
performance. Journal for Research in Mathematics Education, 16(3), 163–76.
Geier, B. (2015, September 22). Everything to know about Volkswagen's emissions crisis.
Fortune. Retrieved from http://fortune.com/2015/09/22/volkswagen-vw-emissions-golf/
Geiwitz, J. (1993). A conceptual model of metacognitive skills (Technical Report 51-1, contract
number MDA903-93-C-0109). Alexandria, VA: U.S. Army Research Institute.
Ghoshal, S., & Bruch, H. (2003). Going beyond motivation to the power of volition. MIT Sloan
Management Review, 44(3).
Gibson, J. W., & Nurius, P. S. (1992). Procedural Knowledge in education for direct practice:
Definitions, baselines, and recommendations. Journal of Teaching in Social Work, 21–
40.
Griffith, J. R. (2007). Improving preparation for senior management in healthcare. The Journal
of Health Administration Education, 24(1), 11–32.
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 62
Guest, G., Bunce, A., & Johnson, L. (2006). How many interviews Are enough? An experiment
with data saturation and variability. Field Methods, 18(1), 59–82.
doi:10.1177/1525822x05279903
Guillén, M., Ferrero, I., & Hoffman, W. M. (2014). The neglected ethical and spiritual
motivations in the workplace. Journal of Business Ethics, 128(4), 803–816.
https://doi.org/10.1007/s10551-013-1985-7
Harper, S. C. (2009). Removing dysfunction. Industrial Engineer, (February), 45–50.
Holmstrom, B. (1999). The firm as a subeconomy. Journal of Law, Economics, and
Organization, 15(1), 74–102. https://doi.org/10.1093/jleo/15.1.74
House, R.J. (1971). A path-goal theory of leader effectiveness. Administrative Science
Quarterly, 16, 321-338.
Jamieson, J. C. (2003). Retaining good managers. Behavioral Health Management, 23(6), 20–24.
Jensen, O. B. (2012). The engagement of employees as a key to corporate success. DRMJ
Dynamic Relationships Management Journal, 1(2), 45–56.
Johnson, B., & Christensen, L. B. (2014). Educational research: Quantitative, qualitative, and
mixed approaches. Thousand Oaks, CA: SAGE.
Kahneman, D. (2011). Thinking, fast and slow. New York, NY: Farrar, Straus, and Giroux.
Katzenbach, J., Steffen, I., & Kronley, C. (2012). Cultural change that sticks. Harvard Business
Review, 90(7/8), 110–117.
Kaplan, R. S., & Norton, D. P. (2001). The strategy-focused organization: How balanced
scorecard companies thrive in the new business environment. Boston, MA: Harvard
Business School Press.
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 63
Kirkpatrick, J. D., & Kirkpatrick, W. K. (2016). Kirkpatrick's four levels of training evaluation.
Alexandria, VA: ATD Press.
Krathwohl, D. R. (2010). A Revision of Bloom ’ s Taxonomy : Theory Into Practice, 41(4), 212–
218. https://doi.org/10.1207/s15430421tip4104
Lee, R. T., & Ashforth, B. E. (1996). A meta-analytic examination of the correlates of the three
dimensions of job burnout. Journal of Applied Psychology, 81(2), 123–133.
doi:10.1037/0021-9010.81.2.123
Lent, Robert; Maddux, J. (1997). Self-effiacy- Building a sociocognitive bridge between social
and counseling psychology--Lent and Maddux.pdf. The Counseling Psychologist, 25(2),
240–255.
Locke, E. A., & Latham, P.G. 1990a. A theory of goal setting and task performance. Englewood
Cliffs, NJ: Prentice-Hall.
Looman, M. D. (2003). Reflective leadership: Strategic planning from the heart and soul.
Consulting Psychology Journal, 55(4), 215–21. doi:10.1037/1061-4087.55.4.215.
Lunenburg, F. C. (2011). Self-efficacy in the workplace: Implications for motivation and
performance. International Journal of Management, Business, and Administration, 14(1),
1–6.
Mamassian, P. (2008). Overconfidence in an objective anticipatory motor task. Psychological
Science, 19(6), 601–606.
Maslach, C., Schaufeli, W.; & Leiter, M. (2001). Job burnout. Annual Review of Psychology, 52,
397–422.
Mayer, R. E. (2011). Applying the science of learning. Upper Saddle River,
NJ: Pearson.
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 64
McConnell-Henry, T., James, A., Chapman, Y., & Francis, K. (2010). Researching with people
you know: Issues in interviewing. Contemporary Nurse, 34(1), 2–9.
McEwan, E., & McEwan, P. (2003). Making sense of research: What’s good, what’s not, and
how to tell the difference. Thousand Oaks: Corwin Press.
Merriam, S. B., & Tisdell, E. J. (2016). Qualitative research: A guide to design and
implementation. San Francisco, CA: Jossey-Bass.
Miller, T. M., & Geraci, L. (2011). Training metacognition in the classroom: The influence of
incentives and feedback on exam predictions. Metacognition and Learning, 6(3), 303–
314.
Milliken, F. J., Morrison, E. W., & Hewlin, P. F. (2003). An exploratory study of employee
silence: Issues that employees don’t communicate upward and why*. Journal of
Management Studies, 40(6), 1453–1476. https://doi.org/10.1111/1467-6486.00387
Mintzberg, H. (1983). Power in and around organizations. Englewood Cliffs, NJ: Prentice-Hall.
Moore, S.; Ellsworth, J., & Kaufman, R. (2008). Objectives--Are they useful? A quick
assessment. Performance Improvement, 47(7), 41–47. https://doi.org/10.1002/pfi
Morgan, G. (1986). Image of Organization. Beverly Hills, CA: SAGE.
Mumford, M. D., Baughman, W.A., Supinski, E.P., Costanza, D.P., & Threlfall, K.V. (1993).
Cognitive and metacognitive skill development. Alternative methods for predicting
leadership potential. Bethesda, MD: Management Research Institute.
Nelson, R. M., Beauchamp, T., Miller, V. A., Reynolds, W., Ittenbach, R. F., & Luce, M. F.
(2011). The concept of voluntary consent. The American Journal of Bioethics, 11(8), 6-
16. doi:10.1080/15265161.2011.58331
Northouse, P. G. (2016). Leadership: Theory and practice (7th ed.). Los Angeles, CA: SAGE.
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 65
Nicu, I. E. (2012, July). Human resources motivation - an important factor in the development of
business performance. Annals of the University of Oradea, Economic Science Series,
21(1), 1039-1045.
Nohria, N., Groysberg, B., Lee, L. (2008). Employee motivation: a powerful new model.
Harvard Business Review, 86(7 8), 78–84, 160.
O'Reilly, M., & Parker, N. (2012). ‘Unsatisfactory saturation’: A critical exploration of the
notion of saturated sample sizes in qualitative research. Qualitative Research, 13(2), 190–
197.
Mamassian, P. (2008). Overconfidence in an objective anticipatory motor task. Psychological
Science, 19(6), 601–606.
Pappas, J. M., Flaherty, K. E., & Wooldridge, B. (2004). Tapping into hospital champions--
strategic middle managers. Health Care Management Review, 29(1), 8–16.
doi:10.1097/00004010-200401000-00003
Patton, M. Q. (2015). Qualitative research & evaluation methods: Integrating theory and
practice. Thousand Oaks, CA: SAGE.
Pekrun, R. (2006). The control-value theory of achievement emotions: Assumptions, corollaries,
and implications for education research and practice. Eductional Psychology Review, 18,
315-341. Doi: 10.1007/s10648-006-9029-9
Phillips, L. D. (2011). What is strategy? Journal of the Operational Research Society, 62(5),
926–929. doi:10.1057/jors.2010.127
Pintrich, P. R. (2002). The role of metacognitive knowledge in learning, teaching, and assessing.
Theory Into Practice, 41(4), 219-225. doi:10.1207/s15430421tip4104_3
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 66
Prins, S. J., Bates, L. M., Keyes, K. M., & Muntaner, C. (2015). Anxious? Depressed? You
might be suffering from capitalism: Contradictory class locations and the prevalence of
depression and anxiety in the USA. Sociology of Health & Illness, 37(8), 1352-1372.
doi:10.1111/1467-9566.12315
Quintas, P., Lefrere, P., & Jones, G. (1997). Knowledge management: A strategic agenda, 30(3).
https://doi.org/10.1016/S0024-6301(97)90252-1
Rai, R. K. (2011). Knowledge management and organizational culture: a theoretical integrative
framework. Journal of Knowledge Management, 15(5), 779–801.
https://doi.org/10.1108/13673271111174320
Rajagopal, S. (2014). Challenges faced by middle-level managers- Business News. Retrieved
March 5, 2017, from http://www.businesstoday.in/opinion/deep-dive/challenges-faced-by-
middle-level-managers/story/204596.html
Ravitch, S. M., & Riggan, M. (2017). Reason and rigor: How conceptual frameworks guide
research. CA: SAGE.
Roberts, J. (2010). Designing incentives in organizations. Journal of Institutional Economics,
6(1), 125. https://doi.org/10.1017/S1744137409990221
Rodgers, C. (2002). Defining reflection: Another look at John Dewey and reflective thinking.
Teachers College Record, 104(4), 842–866. https://doi.org/10.1111/1467-9620.00181
Rueda, R. (2011). The 3 dimensions of improving student performance: Finding the right
solutions to the right problems. New York: Teachers College Press.
Rummler, G. & Brache, A. (2013). Improving performance: Managing the white space on the
organization chart (3rd ed.). San Francisco, CA: John Wiley & Sons.
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 67
Sandberg, W. R., Robinson, R. B., Jr., & Pearce, J. A., II. (2001). Why small businesses need a
strategic plan. Business & Economic Review, 48(1), 12–15.
Schein, E. H. (2010). Organizational culture and leadership (4
th
ed.). San Francisco, CA: Jossey-
Bass.
Schiller, S. Z., & Cui, J. (2010). Communication openness in the workplace: The effects of
medium F2F and IM and culture. Journal of Global Information Technology
Management, 13(2), 37–75.
Schneider, B. (1987). People Make the Place. Personnel Psychology, 40, 437–453.
https://doi.org/10.1097/00006247-199305000-00001
Schneider, B., Brief, A., & Guzzo, R. (1996). Creating a climate and culture for sustainable
organizational change. Management Science Letters, 681–690.
https://doi.org/10.5267/j.msl.2016.10.002
Schon, D. A. (1983). The reflective practitioner: How professionals think in action. New York,
NY: Basic Books.
Schraw, G., & McCrudden, M. (2006). Information processing theory. Retrieved from http://
www.education.com/reference/article/information-processing-theory/
Shute, V. J. (2008). Focus on Formative Feedback. Review of Educational Research, 78(1), 153–
189. https://doi.org/10.3102/0034654307313795
Silveira, A. (2013). The Enron Scandal a decade later: Lessons learned? Homo Oeconomicus,
30(3), 315–347.
Skinner, B. F. 1969. Contingencies of reinforcement. New York: Appleton-Century-Crofts.
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 68
Sonenshein, S. (2010). We’re changing — or are we? Untangling the role of progressive,
regressive, and stability narratives during strategic change implementation. Academy of
Management Journal, 53(3), 477–512.
Spee, A. P., & Jarzabkowski, P. (2011). Strategic planning as communicative process.
Organization Studies, 32(9), 1217–1245. doi:10.1177/0170840611411387
Sull, D., Sull, C., & Yoder, J. (2018, February 12). No one knows your strategy--not even your
top leaders. Retrieved from https://sloanreview.mit.edu/article/no-one-knows-your-strategy-
not-even-your-top-leaders/
Taylor, B. (2015). A performance-based development system. Nursing Management, 54(5),
28037. https://doi.org/10.1002/pfi
Temple, K. R. (2002). Setting CLEAR Goals: The key ingredient to effective communications
planning. Public Relations Quarterly, 32–34.
Tharp, R. G., & Gallimore, R. (1988). Rousing minds to life: Teaching, learning, and schooling
in social context. Cambridge, England: Cambridge University Press.
Tobak, S. (2012). 7 signs of a dysfunctional company - CBS News. Retrieved March 3, 2017,
from http://www.cbsnews.com/news/7-signs-of-a-dysfunctional-company/
Traphagan, J. (2017). We ’re thinking about organizational culture all wrong. Harvard Business
Review.
Tuch, R H. (2011). Thinking outside the box: A metacognitive / theory of mind perspective on
concrete thinking. Journal of the American Psychoanalytic Association, 59(4), 765–89.
doi:10.1177/0003065111417625.
Tuttle, H. (2015). Volkswagen rocked by emissions fraud scandal. Risk Management, 62(10), 4–
7.
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 69
Valentino, C. L. (2004). The role of middle managers in the transmission and integration of
organizational culture. Journal of Healthcare Management, 49(6), 393–404. Retrieved
from http://www.scopus.com/inward/record.url?eid=2-s2.0-9144259227&partnerID=
tZOtx3y1
Velzen, J. H. (2012). Teaching metacognitive knowledge and developing expertise. Teachers
and Teaching, 18(3), 365–380. doi:10.1080/13540602.2012.629843
Vroom, V. H. (1964). Work and motivation. New York, NY: Wiley.
Wang, C., Walker, E., & Redmond, J. (2007). Few companies hit their corporate objectives.
International Journal of Organisational Behaviour, 12(1), 1–16.
Want, J. (2003). Corporate culture - illuminating the black hole. The Journal of Business
Strategy, 24(4), 14–21. https://doi.org/10.1108/02756660310698542
Watkins, M. (2013). What is organizational culture? And why should we care? Harvard Business
Review, (May 15), 2013. https://doi.org/10.1017/CBO9781107415324.004
Watson, T., & Noble, P. (2014). Evaluating Public Relations: A Guide to Planning, Research
and Measurement (3rd ed.). London, UK: Kogan Page.
Weiss, R. S. (1994). Learning from strangers: The art and method of qualitative interview
studies. New York, NY: Free Press.
Wigfield, A. (1994). Expectancy-value theory of achievement motivation: A development
perspective. Educational Psychology Review, 6, 49–78
Wigfield A., & Eccles J. (1992). The development of achievement task values: A theoretical
analysis. Developmental Review, 12, 265–310.
Wilson, J. (2008). Reflecting-on-the-future: A chronological consideration of reflective practice.
Reflective Practice, 9(2), 177–184. doi:10.1080/14623940802005525
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 70
Wunder, T. (2005). New strategy alignment in multinational corporations. Strategic Finance-
Montvale, (November), 35–42.
Zenger, J., & Folkman, J. (2014). Why Middle Managers Are So Unhappy. Harvard Business
Review, 2–6. Retrieved from https://hbr.org/2014/11/why-middle-managers-are-so-unhappy
Zhou, H., Collier, D. A., & Wilson, D. D. (2008). The relationship of strategic business
alignment and enterprise information management in achieving better business
performance. Enterprise Information Systems, 2(2), 219–237.
https://doi.org/10.1080/17517570802095226
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 71
Appendix A
Participating Stakeholders with Sampling Criteria for Interview
Participating Stakeholders
The primary stakeholder group for this study was middle management, defined as area
vice presidents. This was a qualitative study where the sampling techniques were purposeful
(Meriam & Tisdell, 2016). The participants were self-selecting (i.e., volunteered based on an
email solicitation) and represented different departments in the organization. AVPs are the tether
between the executives and the workforce, so understanding their perceptions and challenges
illuminated how they are communicating to their subordinates. This approach was purposive to
obtain rich data on how these leaders viewed their work and the barriers to staying in consonant
with the strategic objectives of the organization. AVPs may become more anxious and depressed
than those at the top or bottom of the organizational hierarchy so understanding their frame of
mind and psyche is important, especially since they influence so many others (Prins, Bates,
Keyes, & Muntaner, 2015).
Interview Sampling Criteria and Rationale
Given the time constraints on the AVPs’ time, I used a convenience sample based on
interest from an email solicitation. Convenience sampling is as the name suggests: picking
respondents based on their availability (Merriam & Tisdell, 2016). Determining the right sample
size for qualitative studies is dependent on the kind of investigation (Merriam & Tisdell, 2016).
Scholars have argued that saturation is one way to determine when enough data have been
collected (Boddy, 2016; Guest, Bunce, & Johnson, 2006; Merriam & Tisdell, 2016; O’Reilly &
Parker, 2012;). However, there is no one determinant or definitive perspective on when
saturation has been reached (O’Reilly & Parker, 2012). Guest et al. (2006) found, for example,
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 72
that six to twelve interviews can be enough to reach saturation, but caution to consider the type
of research to determine the right sample size. Since the interviews was purposeful amongst the
AVP ranks, I interviewed 11 respondents, which aligned with the number of interested
respondents and other considerations. The participants were asked to respond to questions on
their normal work routine and its alignment, if they were aware, with organizational strategy
along with inquires on K, M, and O influences. The interviews were predicated on the conceptual
framework, which guided the formation of the questions. I conducted all the interviews with an
understanding that none of their identities would be disclosed to anyone else and the contents of
their feedback would be anonymized so nothing could be tied back to them. I assured them
nobody would view the transcripts or other notes and that the recordings would be destroyed
afterwards.
Criterion. AVPs must have been with the company for at least one year to be selected
for interviews. This was to filter new employees who may not have had time to learn about the
strategic plan or reflect on the company’s success at communicating it.
Explanation for Choices
Brinkmann (2013) argued that qualitative interviewing is effective in decoding the
complexities of the human experience. Interviews give people the opportunity to relate their own
experiences and thoughts (Banner, 2010). AVPs are the leaders most responsible for ensuring the
successful execution of the objectives on the strategic plan. AVPs face a number of competing
demands for their time so a distillation of how they cope and struggle to organize their work in
relation to the strategic plan was informative.
Neither document analysis or observational data were part of this process. In this study,
there were no readily available data to validate the AVPs’ responses or a way to independently
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 73
verify their statements. Even noting the availability of recognition programs that promote
teamwork does not mean that they resonate with the interviewees. Observational data is gathered
in the field with the researcher taking careful notes on behaviors (Patton, 1987). This was
virtually impossible in this environment for a couple of reasons. The first is the Hawthorne
effect: the tendency for individuals to behave differently if they know they are being watched.
The second is that the behaviors were not easily observable; it was not possible or practical to
watch even a small subset of AVPs all day. Many of them work remotely and are not accessible.
Finally, it would be obvious which AVPs agreed to participate in this study, which would be
counter to the confidentiality they were guaranteed.
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 74
Appendix B
Interview Protocols
Interview Protocol
Interviewee (Name and Title): ______________________________________________
Identifier [Use numbers 1-20 to identify interviewees]: _____________________________
Date: ________________________________________
Introduce the interview as follows: “Would you mind if I recorded our discussion?”
Proceed:
“Thank you for taking the time to chat with me today. I am focused on helping the
organization figure out how to better support AVPs. Please know that this conversation is
completely confidential and no personally identifiable information will be made available
to anyone else. The only caveat to this assurance is that I cannot safeguard illegal activity. I
have taken extra precautions to keep these conversations private such as using my own
laptop for data collection. In addition, the recordings of these interviews will be destroyed
after my work is completed. Do you have any questions?”
Answer any questions and then begin.
Background:
1. When did you come to work at [……………………]?
a. Why did you choose to come here? [Icebreaker question: you may glean
something interesting or noteworthy about the M or O influencer.]
2. Please describe your academic background.
Part 1 (Knowledge + M/O):
1. In your own words, would you please describe your job at the company? In other words,
what do you do every day?
a. Please describe a typical day.
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b. What tasks are you most interested in? (motivation question)
2. What adjectives would you use to describe the company’s strategic plan?
a. Do you feel you have a clear understanding of the company’s strategic plan?
b. Are there mechanisms/feedback loops to confirm your understanding?
(organizational question)?
c. Would you please describe your understanding of the strategic plan?
3. Please discuss the overall process you use for learning about the company’s strategic
plan.
a. What procedures or mechanisms do you follow when the strategic plan is
updated?
4. Please describe the tactics you use to align the strategic plan with your area of
responsibility? [Note: “Tactics” in this question should be how (procedural knowledge)
the interviewee applies the strategic plan].
a. What tactics, if any, does your department use to ensure alignment with the
strategy?
Part 2 (Motivation):
1. Please describe how confident you are in your ability to translate the company’s strategy
into clear actionable objectives.
a. Please provide some examples of how you achieved this.
2. Please explain the benefits you achieve when the company meets its strategic plan?
[Note: if the interviewee mentions salary, bonus, etc., please note it but probe for non-
material benefits as well.]
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 76
3. Do you feel recognized for your contribution to Forward Health? Kindly elaborate on the
kinds of recognitions you have received. Are they commensurate with your
contributions?
4. Please describe --even when there are multiple, competing priorities, your confidence in
your ability to contribute to the company hitting or exceeding the objectives on its
strategic plan.
5. Do you feel empowered to achieve your goals? Please explain why or why not? Or, if it is
more nuanced, kindly elaborate.
Organization:
1. Please consider ways the company helps you in aligning with the strategic plan. Please
provide specific examples.
a. Please describe examples of when the company hindered you from hitting the
goals in the strategic plan. What do you think were the reasons?
2. Please describe the extent of teamwork and collaboration you have with other
departments in meeting the company’s strategic objectives.
a. Please describe at least one example where the company encouraged teamwork
resulting in close collaboration.
b. Please describe at least one example where teamwork was lacking even though
the company encouraged it. What factors hindered it?
3. How do you feel about the company’s efforts to promote the strategic plan?
a. Please elaborate on the availability of resources and time to complete your own
objectives.
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 77
4. Does the company ensure there are enough subject matter experts to support you in
achieving your objectives consistent with the strategic plan?
a. Please describe a situation where you felt confused on what do work on first.
What was the cause of this confusion?
Other
1. As you know, the purpose of this study is to assess the alignment of the strategic plan
with the objectives and actions of our area vice presidents. This has been a busy year with
new implementations and a full portfolio of projects. Please share with me anything that
we didn’t directly discuss that you feel may help inform this study.
Note: Stop the recording and thank the participant for his or her participation. Please reassure
that nothing identifiable will be disclosed to the company.
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 78
Appendix C
Credibility and Trustworthiness
Qualitative interviews are an ideal way to generate rich data when the study is limited to
only a few participants (Merriam & Tisdell, 2016). Semi-structured interviews are grounded by a
set of pre-determined questions but allow the researcher the latitude to stray from the questions
to probe themes and sentiments (DiCicco-Bloom & Crabtree, 2006). This study focused on
AVPs with questions framed to determine how the company’s strategy is being understood and
communicated. They were also questioned on what techniques they use, if any, to stay aligned
with the organization’s strategic goals and any impediments to doing so.
Given the time constraints, availability of the subjects, and the necessity to maintain
confidentiality, there were no follow-up discussions. A convenience sample, only those AVPs
who specifically expressed a willingness to participate were interviewed using a semi-structured
format, thus allowing for a discursive discussion. Experts have posited that saturation is a way to
determine when enough data have been collected (Boddy, 2016; Guest et al, 2006; Merriam &
Tisdell, 2016). This means that further interviews would likely not reveal anything new.
However, there is no definitive touchstone as when saturation is reached (O’Reilly & Parker,
2012). Guest et al. (2006) concluded, for example, that six to twelve interviews suffice to reach
saturation, but the investigator should ponder his or her own circumstances. Interviewing up to
12 participants allows flexibility based on selection criteria, candidate availability, and timing
constraints. I was able to identify 11 AVP volunteers to inform this research.
In semi-structured interviews, the questions are flexible and open-ended, allowing the
researcher to probe when appropriate (Merriam & Tisdell (2016). My interview protocols
allowed me to probe on emergent themes. The interviews were conducted telephonically, as the
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 79
AVPs were located in geographically disparate areas, many working remotely. This was also
another confidentiality safeguard as nobody would see me speaking with the AVPs.
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 80
Appendix D
Ethics
Weiss (1994) exclaimed that respondents in interviews “will not be damaged or
disadvantaged because of the respondent’s participation in the interview” (p. 85). It is akin to the
oft-quoted Hippocratic Oath taken by doctors: Do no harm (Maxton, 2015). In addition, it is
required that the researcher keep his or her promises, whether these pertain to confidentiality or
assurances of anonymity (Aaron, Phillips, & Phillips, 2013). Researchers are not therapists or
judges and do not have the protections afforded journalists and members of the clergy (Maxton,
2015, p. 495). Therefore, researchers should neither try to solve problems they uncover nor
expect any special judicial protections should they be subpoenaed. The parameters and
framework of the study were made very clear to all interviewees. Since I contacted only
participants who expressed interest in being interviewed, there was no coercion. Voluntary
consent ensures research subjects have “the free power of choice without undue inducement or
coercion” (Nelson et al., 2011).
The stakeholder group were area vice presidents, middle managers responsible for
executing on the company’s strategic plan consistent with their spheres of responsibility. The
mechanism for obtaining consent included an email from me asking for volunteers. The purpose
of my study, the alignment between middle and senior management, was clear with the
additional context that it was part of a USC doctoral program. In addition, I reiterated that
participation was voluntary and no individually identifiable information would be included in
this research. Confidentiality was guaranteed in a few ways: (1) before beginning the study,
executive leadership agreed not to ask or try to obtain individually identifiable information from
the study; (2) names were be replaced by pseudonyms and only the third person pronouns were
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 81
use; (3) the audio of conversations were de-identified during the coding process; (4) the email
invite was masked so others who have access to the respondent’s calendar were not able to
determine the purpose of the discussion (e.g., “catch up as discussed”)
Merriam and Tisdell (2015) underscored that both the interviewer and respondent have
biases, and it is the role of the skilled researcher to account for them when analyzing data. The
leadership team at Forward Health, for example, would love to learn that the strategic plan is
resonating with AVPs. Some in the higher echelons of the company suspect that too much time
is wasted “spinning” rather than reaching a decision and committing to a plan. In order to avoid
response bias, my own views were shielded from the participants as I coaxed the AVPs to give
me their true insight with the security that the conversation was confidential. The questions were
all framed in a neutral manner to allow for a rich exploration of the interviewee’s experiences
and interpretations.
McConnell-Henry, James, Chapman, and Francis (2010) contended that interacting with
people you have a relationship with requires special considerations. The researcher may feel a
special elation at uncovering information gleaned from people with whom they have regular
interaction (p. 6). As the primary investigator, I took the responsibility seriously to avoid
relaying my reactions to the responses, even when they were very close to my own. Ensuring that
participants were treated respectfully and felt no pressure to massage their answers was
instrumental in gathering the rich data.
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 82
Appendix E
Integrated Implementation and Evaluation Framework and Plan
The model that informed this implementation and evaluation plan is the New World
Kirkpatrick Model (Kirkpatrick & Kirkpatrick, 2016), based on the original Kirkpatrick Four
Level Model of Evaluation (Kirkpatrick & Kirkpatrick, 2006). This model suggests that
evaluation plans start with the goals of the organization and work backwards and that, by doing
so, the leading indicators that bridge recommended solutions to the organization’s goals are both
easier to identify and more closely aligned with organizational goals. Further, this reverse order
of the New World Kirkpatrick Model allows for a sequence of three other actions: first, the
development of solution outcomes that focus on assessing work behaviors; next, the
identification of indicators that learning occurred during implementation; and, finally, the
emergence of indicators that organizational members are satisfied with implementation
strategies. Designing the implementation and evaluation plan in this manner forces connections
between the immediate solutions and the larger goal and solicits proximal buy-in to ensure
success (Kirkpatrick & Kirkpatrick, 2016).
Organizational Purpose, Need and Expectations
Area vice presidents need to fully comprehend the company’s strategy, so they can
appropriately align their, and their team’s, own work. Their goal is to craft and adhere to detailed
performance objectives that further the company’s strategy. AVPs should de-prioritize requests
not directly aligned with the company’s strategy. In addition, they should reflect on why such
requests are made and the potential distraction in both time and effort to separate critical from
non-critical work. AVPs are one of the conduits by which information is communicated and
parsed to the organization, as they have the most interaction with the more junior roles in the
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 83
company. Some expressed concerns at senior leadership meetings that prior failures to
effectively execute on the company’s strategic plan rests with an inability to align strategy to
actionable behaviors and create a climate that promotes critical thinking skills. An executive
noted there is an inability to stay focused on the key initiatives critical to the company’s success.
Good strategic leadership involves prioritizing and saying no. A senior executive opined that the
company may be overtaxing some of the same AVPs for multiple projects. If Forward Health
fails to effectively communicate and prioritize the work of its AVPs, it risks client exodus and
potential failure.
The proposed solution includes measuring the time from the inception of an agreed-upon
strategic goal and its time to execution, wide publication of the speed-to-market metric, creation
and distribution of a stop-doing list, quantifying the amount of unplanned work, level-setting
with AVPs on whether the time allotment for critical work is sufficient, and reinforcing the
strategic plan and monthly meetings by having the AVPs discuss how their own objectives tie to
the company’s strategic plan.
Level 4: Results and Leading Indicators
Table 7 shows the proposed results and leading indicators in the form of outcomes,
metrics and methods for both external and internal outcomes for Forward Health. If the internal
outcomes are met as expected as a result of stopping initiatives not tied to the company’s
strategic plan or impossible to achieve given the resource allocation or skill gap, then the
external outcomes should also be realized.
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 84
Table 7
Outcomes, Metrics, and Methods for External and Internal Outcomes
Outcome Metric(s) Method(s)
External Outcomes
Increase speed-to-market
consistent with the
strategic plan to exceed
the expectations of new
clients.
The number of days it takes to
implement a new client or
product.
Measure time from when a
decision is made to proceed,
requirements are finalized,
and the new program or
product is installed.
Internal Outcomes
Align the number of
initiatives and projects in
the company’s portfolio
with available resources to
get them completed with
quality and on time
consistent with the
strategic plan.
Every user role required to
complete a project will be
assessed a weekly and total LOE
(level of effort). Reasonable
FTE (full time equivalent)
expectations will be set by the
leadership (e.g., 50 hours work
week).
Weekly reviews with the
assigned SMEs to gauge
whether their aggregate time
on all work-related items is
sufficient.
Create a stop-doing list for
those projects unaligned with
the strategy or not supported
with the available resources.
Rationalize “fire drills”
(i.e., unexpected and
unplanned work) that
interfere with performance
and strategic alignment to
gauge whether this finding
is generalizable.
The number of new client
requests, emergency tickets,
unplanned outages, and last-
minute meetings occurring
weekly.
Require the senior leadership
team to include unplanned
work in their weekly status
reports and how they plan to
help their teams compensate.
Increase the number of
knowledgeable SMEs to
reduce reliance on the
same individuals.
The number of up-trained SMEs
who can perform specific job
functions without support.
Develop a list of knowledge
deficiencies from project
leads and senior leaders.
Submit either requisitions for
new talent or leverage the
stop-doing list to free up time
to cross-train.
Level 3: Behavior
In terms of critical behaviors, the stakeholders of focus are the AVPs at Forward Health.
The first critical behavior is that the AVPs must review the strategic plan at their own staff
meetings and include a synopsis of those discussions in the weekly status reports to senior
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 85
management. The second critical behavior is that the company must develop a resource
resolution process so AVPs have a mechanism for identifying and resolving resource gaps, so
they can competently complete their work consistent with the requirements and timelines
established by the leadership team. The third critical behavior is that every AVP involved in a
new cross-functional initiative clearly indicate how it is tied to achieving the company’s strategic
plan. The specific metrics, methods, and timing for each of these outcome behaviors appears in
Table 8.
Table 8
Critical Behaviors, Metrics, Methods
Critical Behavior Metric(s) Method(s) Timing
1. Review the
strategic plan and its
applicability to each
department’s
objectives at VP staff
meetings.
100 % of AVPs will
demonstrate strategic
alignment consistent
with their own
objectives.
The AVPs will be
polled on their
understanding and
alignment of the
strategic plan as part of
the engagement survey.
They will also be asked
to elaborate on this
alignment on an
impromptu basis at staff
meetings.
Quarterly as part of
the engagement
pulse surveys and at
monthly at staff
meetings.
2. Tie and clearly
identify an element of
the strategic plan to
every cross-functional
initiative sanctioned
by the company.
100 % of the
Chartering documents
will include the
strategic plan and how
the individual project
relates to it.
Audit of all portfolio
projects to ensure the
strategic imperative is
documented.
During the
“Chartering Phase”
of the SDLC
(System
Development Life
Cycle).
3. Identify resource
gaps on all “mission
critical initiatives”
(i.e., those which have
been specifically
identified by the
executives as have top
priority to achieve the
organization’s
100% of projects that
cannot be fully
supported will either
be deferred or re-
prioritized.
The company will create
a resource contention
resolution process to be
used whenever a SME
or “mission critical”
initiative cannot be
completed as
committed. Resources
will be allocated
Reviewed bi-
weekly at Operating
Committee.
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 86
strategy). consistent with the
supply/demand balance.
In terms of required drivers, AVPs need mechanisms to reinforce and update them on the
company’s strategic plan. This means that the management committee must model the expected
behavior and weave the strategic imperatives into their narrative. Rewards should be established
to spotlight AVPs who implement objectives consistent with the strategic plan with quality and
within budget. Monitoring is the final step to ensure that AVPs are better positioned to do their
jobs and allows senior management to pivot accordingly as gaps surface. Table 9 shows the
recommended drivers to support the critical behaviors of area vice presidents.
Table 9
Required Drivers to Support Critical Behaviors
Method(s) Timing
Critical Behaviors
Supported
1, 2, 3 Etc.
Reinforcing
Job aid including a synopsis of
the strategic plan will be
distributed to the AVPs.
Ongoing 1, 2, 3
Members of Management
Committee will model
behavior to reinforce how new
initiatives or prospects
specifically tie to the strategic
plan.
Ongoing 1, 2, 3
New AVPs (whether hired
externally or promoted) will be
reminded of the strategic plan
and how their role directly
connects with it. It will include
an organizational chart and a
discussion with their manager.
Ongoing 1, 2, 3
AVPs will proactively
schedule a discussion with
their manager if there is
Ongoing 3
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 87
confusion on prioritization.
Encouraging
Coaching AVPs on how to
better self-regulate and
prioritize their work.
Weekly 2
Rewarding
Performance incentive when
strategic initiatives are
completed on time with
minimal client disruption (as
measured by feedback from
the client).
Project Based 1, 2, 3
Public acknowledgement, such
as a celebration at bi-annual
leadership meeting for those
leaders who completed
strategic initiatives on time and
within budget.
Monthly 2, 3
Monitoring
VPs and SVPs can informally
ask their AVPs to discern
their self-efficacy on
explaining how their work is
tied to the company’s
strategy.
Bi-weekly 1, 2, 3
SVPs should ensure they are
reviewing in-progress and
completed work with a lens
on alignment with the
strategic plan.
Monthly 1, 2, 3
SVPs should touch base with
AVPs to determine whether
they are comfortable with
understanding and
implementing the strategic
plan.
Tri-weekly 2
Organizational support for the critical behaviors needs to start at the top: the executive
committee. This committee comprises the top five executives in the company. They will be
educated on the critical behaviors and how they all support the cascade of the strategic plan. The
impetus will be their discussing the strategic plan at their own leadership meetings. They will
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 88
model the behaviors they expect of others. In the objective setting process, the strategic plan will
not be just printed at the top of the form, but, rather, clearly tied to every goal. Reframing the
strategic plan as relevant to every stakeholder will encourage AVPs to contextualize their work
and more easily identify non-value-added tasks.
At the monthly management committee meetings, the members will comprehensively
review the portfolio and identify only those initiatives critical to achieving the strategic plan. The
company cannot necessarily manage by consensus here, so, if there is not agreement, the senior
executive will be asked to make the final decision. Then the SVPs will collaborate to create a
resource plan specifically outlining which knowledge workers will be required to successfully
complete the work within the specified timeframes. If there is contention, the organization will
either recruit additional experts or redact the portfolio accordingly.
Level 2: Learning
The learning goals are that, following completion of the recommended solutions, the
stakeholders will be able to
1. Correctly state all elements of the updated strategic plan. (D)
2. Articulate the relationship between the company’s values and its strategic plan. (D)
3. Describe how the strategic plan relates to one’s own work. (M)
4. Define their work priorities based on the strategic plan. (P)
5. Identify how their own accomplishments fit with the strategic plan. (M)
6. Survey AVP’s direct reports to ascertain their understanding of the strategic plan. (D)
7. Indicate confidence that the organization is well-positioned to hit its strategic plan.
(Confidence)
8. Articulate the value of the dissemination and clarification of the strategic plan. (Value)
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 89
9. Report high self-efficacy in decision making and problem solving. (Value)
The learning goals listed in the previous section will be achieved through a concerted
focus by all senior executives to emphasize how the company’s strategic plan aligns with the
company’s values and portfolio of initiatives. The focus will be on the organization’s AVPs, as
they are the funnel through which most information is synthesized and cascaded. Learners grasp
information in a variety of ways, so the strategic plan will be communicated in a number of
different formats (e.g., posters, emails, and a video message from the CEO). The language will
be free of jargon and acronyms. The company will make a small investment to produce visually
appealing graphics and a professionally crafted video to present the possibilities of achieving the
strategy. The messaging will remind AVPs of their unique role in helping the company realize its
strategic goals. The plan is to have the consent of the executive team by end of Q2, timed with
when AVPs are asked to update their objectives. The CEO will send a targeted email to the
AVPs with a consolidated view of the company’s strategic goals and a reminder on how they are
distinct from the company’s vision and values. The plan will be to produce a video and graphics
no later than August 2018.
The company will regularly include information on the strategic plan in one of its
existing newsletters. As part of the on-going promotion, employees will be encouraged to answer
a relatively straight-forward question on the plan and submit the response, so it can be entered
into a monthly lottery for a nominal prize, a tchotchke which affords bragging rights. The prize
winner’s answer will be published as another way to communicate the strategy in a fun way. The
AVPs will be encouraged to have their employees enter the contest. This has three goals: it
provides a forum to educate employees on how the strategy hinges on their role; it helps identify
knowledge gaps where AVPs and others can spotlight facts to a broader group; it may provide
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 90
some insight into unproductive or unsanctioned work which should be paused or stopped (e.g.,
AVPs reflecting on the strategy and productively questioning their own priorities).
The engagement and pulse surveys which are administered to the entire company will
also be leveraged to quantify the extent AVPs and others really understand the company’s
strategy. The questions on the survey will measure whether participants can define the strategic
plan and also gauge their own confidence in achieving it. Since the engagement survey can be
parsed by role, the AVP responses will be collated to determine whether there is a spike in their
perceived self-efficacy and confidence.
Senior vice presidents will be required to conduct skip level meetings with their AVPs to
both inquire about the effectiveness of the communication and solicit feedback for other ways to
clarify the message. These skip levels will also be an opportunity to determine whether the
company’s focus on the prioritization of portfolio projects consistent with the strategy and
availability of knowledge workers is producing the desired results.
Components of learning. Demonstrating declarative knowledge is often necessary as a
precursor to applying the knowledge to solve problems. Thus, it is important to evaluate learning
for both declarative and procedural knowledge being taught. It is also important that learners
value the training as a prerequisite to using their newly learned knowledge and skills on the job.
However, they must also be confident that they can succeed in applying their knowledge and
skills and be committed to using them on the job. As such, Table 10 lists the evaluation methods
and timing for these components of learning.
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 91
Table 10
Components of Learning for the Program.
Method(s) or Activity(ies) Timing
Declarative Knowledge “I know it.”
Knowledge checks at the VP’s regularly-
scheduled meetings with their AVPs.
Monthly to ensure alignment.
Knowledge checks via the “pulse engagement
surveys”.
Quarterly as part of the Employee Survey.
Procedural Skills “I can do it right now.”
During the directors-and-above meetings using
specific examples tied to each division’s
objectives on how they are applying the
strategic plan.
Monthly directors-and-above meetings.
Individual application of prioritization acumen
as reflected in the AVPs’ status reports.
Weekly status reports showing deprioritized
work.
Quality of the feedback on the strategic plan
and prioritization from AVPs during skip level
meetings with senior leadership.
Monthly during skip level meetings.
Attitude “I believe this is worthwhile.”
Discussion of the value the strategic plan adds
to defining the AVP’s work.
During the directors-and-above meetings
once a month.
AVP’s assessment that prioritization is clearer
with the introduction of a stop doing list.
During weekly staff meetings and monthly
team meetings.
Confidence “I think I can do it on the job.”
Employee survey items using scaled items Quarterly as part of the pulse survey.
Ad-hoc discussions with AVPs.
Throughout the year.
Commitment “I will do it on the job.”
Discussions during staff meetings and
department gatherings.
Weekly and monthly.
Highlighting resource and knowledge gaps on
AVP’s status reports.
Weekly.
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Level 1: Reaction
Table 11 shows the methods or tools and timing pertaining to reaction. These methods
are the ways the organization will determine the degree to which AVPs found the new behaviors
and drivers engaging, relevant, and framed in a user-friendly way.
Table 11
Components to Measure Reactions to the Program
Method(s) or Tool(s) Timing
Engagement
Observations by the senior leadership team
during directors-and-above meetings.
Monthly following the formalized re-launch
of the strategic plan.
Informal checkpoints with AVPs. Ongoing after re-launch of plan.
Unprompted feedback on AVP status report. Weekly after re-launch.
Relevance
Highlights noted on the AVP’s status report. Weekly after re-launch.
Interview select AVPs to determine initial and
subsequent feedback.
On-going after re-launch.
Customer Satisfaction
Summative evaluation included on the
organization’s Engagement Survey.
Q4 2018
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 93
|Evaluation Tools
Level 1 and Level 2: Likert questions as part of the quarterly engagement survey:
Questions Strongly
Disagree
Disagree Neutral Agree Strongly
Agree
I understand how the strategic plan
ties with my daily work.
I have a clear understanding of the
organizational priorities and adjust my
own work accordingly.
I think I can execute on the strategic
plan without more clarification.
I am committed to the strategic plan as
it is critical to the company’s success.
Immediately following the program implementation. Forward Health has invested in
tools to conduct pulse surveys, which are more frequent iterations of a subset of questions crafted
to gauge the attitudes and concerns of the employees. The updated tool allows the data to be
parsed by department and role. After the re-launch of the strategic plan as outlined above,
questions regarding the strategy will be included in the next pulse survey.
For Levels 1 and 2, the pulse check will include questions similar to those in Appendix F
as a Likert scale. While every employee will be asked these questions, the results from the AVPs
will be anonymously curated and analyzed. These responses will be a bellwether as to the
effectiveness of the strategic communication plan.
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 94
Evaluation Tools B
Questions Strongly
Disagree
Disagree Neutral Agree Strongly
Agree
I understand how the strategic plan ties
with my daily work.
I have a clear understanding of the
organizational priorities and adjust my
own work accordingly.
I think I can execute on the strategic
plan without more clarification.
I am committed to the strategic plan as
it is critical to the company’s success.
The job aids are helpful reminders of
the strategic plan.
My manager and I speak regularly
about how my work ties to the
company’s strategic plan.
When there is a shift in prioritization, I
am given the time to adjust
accordingly.
The company does not hesitate to
pause or defer work when there are too
many competing priorities.
ALIGNMENT OF STRATEGIC AND TACTICAL GOALS 95
(Example of Aggregated Results)
Likert Scale Survey Results (n = 40):
Delayed for a period after the program implementation. In Q1 of 2019, the employee
engagement survey will be administered again using a Likert scale to measure the participants’
self-reported understanding of the strategic plan (Level 1), confidence in executing on the
strategic plan (Level 2), the organizational tactics used to reinforce the strategic plan (Level 3),
and the extent to which the organization has made prioritization of deliverables consistent with
strategic plan meaningful to the participants (Level 4).
Abstract (if available)
Linked assets
University of Southern California Dissertations and Theses
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Asset Metadata
Creator
Benyacar, Jeffrey Bruce
(author)
Core Title
Maintaining alignment between strategic and tactical goals in an innovative healthcare organization
School
Rossier School of Education
Degree
Doctor of Education
Degree Program
Organizational Change and Leadership (On Line)
Publication Date
06/28/2018
Defense Date
04/12/2018
Publisher
University of Southern California
(original),
University of Southern California. Libraries
(digital)
Tag
gap analysis,innovation,Knowledge,Motivation,OAI-PMH Harvest,organization,organizational communication, culture, cultural model. cultural setting,organizational influences,qualitative study,resource planning,strategic alignment
Format
application/pdf
(imt)
Language
English
Contributor
Electronically uploaded by the author
(provenance)
Advisor
Hirabayashi, Kim (
committee chair
), Canny, Eric (
committee member
), Lynch, Doug (
committee member
)
Creator Email
benyacar@usc.edu,JBENYACAR@YAHOO.COM
Permanent Link (DOI)
https://doi.org/10.25549/usctheses-c89-13974
Unique identifier
UC11672287
Identifier
etd-BenyacarJe-6360.pdf (filename),usctheses-c89-13974 (legacy record id)
Legacy Identifier
etd-BenyacarJe-6360.pdf
Dmrecord
13974
Document Type
Dissertation
Format
application/pdf (imt)
Rights
Benyacar, Jeffrey Bruce
Type
texts
Source
University of Southern California
(contributing entity),
University of Southern California Dissertations and Theses
(collection)
Access Conditions
The author retains rights to his/her dissertation, thesis or other graduate work according to U.S. copyright law. Electronic access is being provided by the USC Libraries in agreement with the a...
Repository Name
University of Southern California Digital Library
Repository Location
USC Digital Library, University of Southern California, University Park Campus MC 2810, 3434 South Grand Avenue, 2nd Floor, Los Angeles, California 90089-2810, USA
Tags
gap analysis
innovation
organization
organizational communication, culture, cultural model. cultural setting
organizational influences
qualitative study
resource planning
strategic alignment