Tuesday, April 24, 2012

Strategy Implementation for the ONAP

The theme for the readings this week was strategy implementation and what are the  necessary steps to ensure successful adoption of a strategy. These steps reminded me of the strategies for addressing health problems in the United States created by not-for-profit or government health organizations that I have been studying extensively in my health policy classes. I was interested in investigating if or how implementing strategy might change if your strategy is not business focused or profit generating but rather a new approach to addressing a specific health problem- like eliminating health disparities. 
Recently the White House Office of National AIDS Policy (ONAP) announced a new strategy for addressing HIV/AIDS in the United States. [1] This new policy focused on a three pronged approach to the problem:
    1. Reducing the number of people who became effected with HIV
    2. Increase access to care and optimize health outcomes for people living with HIV
    3. Reducing HIV- related disparities.
Luckily for me the ONAP also released their federal implementation plan and I was able to see if the organization utilized any of the implementation strategies discussed in our readings or even in our classes like ODI. In the article “The Secrets to Successful Strategy Execution” one of the primary success secrets is considering decision rights and how they will be impacted by a new strategy. The idea behind this step is that by ignoring the former decision rights of your employees you could see the implementation of your strategy grind to a screeching halt as a series of turf wars are waged between your middle managers. In a organization like ONAP this a slightly different situation but the principle remains the same. There are many organizations not formally affiliated to ONAP that due meaningful work addressing HIV. If ONAP was to initiate their strategy without recognizing the jurisdiction (for lack of a better word) of existing organizations it would not only be weakening the effectiveness of their own strategy but missing an critical opportunity for pooling resources and capitalizing on different organizations’ competitive advantage.  Thankfully, ONAP has built this collaborative framework into their implementation strategy by reaching out to other HIV not-for-profit organizations and government organizations. ONAP then created specific roles for federal departments, HHS Office of the Secretary, State/Local Government,  and Nongovernment Partners that includes them in the implementation of their strategy while also preventing future redundancies. 
Another key factor when implementing a new strategy that was discussed in my ODI and Health IS classes was the importance of articulating how to measure success. It is not enough to simply tell people to implement a new strategy and expect motivation and employee buy-in to remain high. Instead organization need to clearly articulate how the company will measure success of the new strategy and set up a series of goals for the organization. This solidifies the nebulous idea of strategy and frames it as a set of goals to be achieved thereby increasing employee motivation. The ONAP has also addressed this by setting a series of targets related to their three primary goals-reducing HIV infection rates, increasing access to care, and addressing HIV related disparities. For example the ONAP has set a goal for 2015 increase the proportion of HIV diagnosed gay and bisexual men with undetectable viral load by 20 percent. This goal is clear cut and concise. By 2015 ONAP and associated organizations will know if they have reached this goal and employees will have that number in their back of the head as they work to implement this new strategy.
After reading the rest of the implementation plan I saw a number of other instances where the ONAP was using techniques for  implementing strategy that were propagated by the private sector. For the sake of brevity I focused on the two discussed above- assigning decision rights and articulating strategy goals- but I think as the implementation plan shows these success steps are transferable across different types of organization with different aims. As we move on to our own jobs we should definitely brainstorm how to adapt these proven strategies to ensure equal success. 
[1] http://www.whitehouse.gov/files/documents/nhas-implementation.pdf

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