The Seattle Cancer Care Alliance is a partnership of three different powerful, highly skilled cancer treatment and research facilities – the Fred Hutchinson Cancer Research Center, the University of Washington Medical Center and Seattle’s Children’s Hospital. Organized in 1998, the SCCA coordinated structures and programs of the three, culminating in bringing the treatment of patients covered by the partner institutions under one roof in 2001.
By its design, SCCA is complex, with multiple stakeholders who, in many cases, wear multiple hats. Faculty at SCCA serve at both FHCRC and UW. The governing board is comprised of representatives of each partner organization as well as 7 community members.
The SCCA provides treatment in 23 distinct cancer research programs. The organization seeks to be the premier cancer treatment facility, leading the way in clinical trials, clinical expertise and global prominence.
Thus, the SCCA is not an organization with a single or small set of products that it is trying to grow with a small set of stakeholders. Each of the twenty-three distinct research programs is competing for investment dollars in order to grow their clinical trials, their clinical expertise and their global position in cancer research and treatment.
Therefore strategic planning for the organization is a complex and complicated endeavor. Each program must have an opportunity to be heard and considered, and each must feel that the final distribution of investment dollars determined during planning is equitable and unbiased, aimed at the growth of the organization as a whole, but also fair to their unique program.
Critical IssueThat is the situation SCCA was in in 2008 when they sought a consultant to lead strategic planning. The first go round for planning, soon after the organization opened its doors in 2001, left many faculty feeling the process was arbitrary, political and not defensible, largely because the faculty had not been involved or included in defining the process. This second planning process needed to reverse that.
Specifically, the needs this planning process needed to address included:
Answering these questions became the focus of the Vision Navigation® strategic planning process that Professional Growth Systems completed with the SCCA. PGS was charged to design and execute a planning methodology that created broad support for the investment decisions made by the SCCA and a plan for how the SCCA would grow strategically as a cancer center. PGS’ approach was a unique design that incorporated inclusion of all 23 programs in the decision making process.
- How were investment dollars to be spent to best grow and establish SCCA in the international community, i.e. what is the best strategy for advancing cures for cancer and for growth?
- How were all faculty going to come to agreement and support the investment decisions?
- What could SCCA bring to a highly competitive marketplace that would enable them to successfully recruit new faculty and secure new grants and funding?
Essentially, SCCA is an organization with 23 different “product lines”. Therefore, the approach PGS designed needed to evaluate the potential return on investment in each program using a common set of criteria. In short, to provide a rational, data-based, consistent basis for comparing a diverse set of programs.
PGS worked with the Project Steering Committee, made up of representatives from the three institutions, to develop a set of criteria and standards that could be applied to all the programs and enable them to be scored numerically for their potential contribution to organizational success. Defining both the criteria and the standards for each criterion took tremendous effort to get right and to ensure acceptance by program leaders, which was a key to success. Says Bill Dann, lead PGS consultant on the project, “It was a big, very tough slog. It forced a level of thought that the group had never confronted before. They had to create an objective way to assess the programs that would have the buy-in from all 23 program leads.”
Next, after distributing the criteria and standards to the programs, in-depth interviews were conducted with program leads as well as members of their teams to assist them in making the best objective case for investing in the growth of their program. Data gathered included the competitive advantage of the program, i.e., the position of the program as regionally, nationally or internationally prominent, upcoming clinical trials, competitive position, strength of the research bench, and their ability to attract quality researchers.
Additionally, programs were asked to define organizational improvement issues that, if resolved, would contribute to program and organizational success. This data had not been gathered in the initial strategic planning process.
As the interview data piled up, the process to integrate all the pieces into a cohesive product began. There were two necessary components:
- Condense the range of organizational improvement issues into a short list of internal projects that had the greatest potential for improving SCCA as a whole.
- Look strategically at each program’s data to assess its promise and growth opportunities, and to create a presentation promoting their potential.
First up was the internal improvement data. Whereas this was the first time the organization took a critical look at its performance, confronting the data from the programs was challenging, but ultimately successful. The board gained an understanding of the breadth of some of the concerns throughout all 23 programs, e.g., “moving from research to clinical trials is too slow” was an issue cited by most teams.
The end result of the internal assessment was board commitment to resolve three improvement projects: patient flow through the system, the process to get clinical trials approved and space constraints. These projects gave assurance to the programs that their voices were heard, their concerns valued and their programs important.
Having grappled with internal issues, the team then turned their attention to growing programs strategically and allocating investment resources. An intricate prioritization tool was developed and vetted by a large strategic planning steering committee made up of representatives from throughout the organization.
Programs were afforded the opportunity to present the case for investment in their programs to the board and SCCA management. Programs scored themselves on the criteria and standards that had been established, and there was extensive Q&A around the basis for their self-reported scores.
The steering committee then developed 3 main buckets for the most promising programs. Though all programs received funding, those in one of the buckets showing the most potential were ranked higher in the distribution of funds. Yes, there was still squabbling. But also, yes, there was agreement that the process was fair, inclusive and justifiable.
When it was time for the next iteration of strategic planning, the team at SCCA had the tools and the buy-in from programs. The leads wanted to be included, understood the time and commitment involved, and knew the value.
In all, the SCCA entered a new era in its growth. Understanding of internal challenges was clear, with processes to address them in the works. Transparency of how investment dollars were distributed was established. Each program stood on equal footing, had an equal voice in the process, and was accepting of the results.