Are your leaders, doctors and board members aligned with your organization’s mission?

Diane Miller

Diane Miller
Executive Director, Virginia Mason Institute
Vice President, Virginia Mason Medical Center

The gives and gets needed to achieve a strategic plan

 The value of leader and board compacts

“The compact serves to ensure alignment with a shared vision.”

- Diane Miller

In two recent blog installments (Part 1, Part 2), we discussed how valuable the physician compact has been at Virginia Mason. Compacts between the organization and its leaders, as well as a compact between VM and its board, have proven equally valuable.

“The three compacts are aligned really well with one another and they are tied directly to achieving the Virginia Mason strategic plan,” says Diane Miller, executive director, Virginia Mason Institute. And that strategic plan is embodied in this pyramid.

Virginia Mason Strategic Pyramid – Click to Enlarge

“The strategic plan was the driving document when we put the compact together,” says Miller. “We felt we needed to be explicit on the gives and gets to achieve our strategic plan. We felt like we needed to engage in a deep conversation with leaders just as we had done with physicians because things were changing so much and so fast. We were going in a new direction with the Virginia Mason Production System and it required leaders throughout VM to be completely aligned with our vision.”

Although it was put together a decade ago, the leadership compact has remained unchanged. “The compact serves to ensure alignment with a shared vision,” says Miller.

That is also the case with the Virginia Mason board compact.

Lynne Chafetz
Senior Vice President and General Counsel at Virginia Mason

Lynne Chafetz, senior vice president and general counsel at Virginia Mason, supported the effort to write the board compact and it, too, has remained remarkably durable through the years. Both documents are used regularly and actively. At the beginning of management meetings there is a reference to the leader compact while board sessions begin with a review to remind members of their responsibilities (and a copy of the compact is sent to board members with the packets prior to board meetings).

Not long after the board compact was approved by trustees, the chair of the governance committee at the time emphasized the compact was designed be a “living document.” Chafetz says that through the years it has proven time and again to be a current, useful guide. “It is absolutely a living document,” she says.

“A lot of the benefit of adopting any compact is the discussion and process you go through to get to what is important.”

- Lynne Chafetz

“A lot of the benefit of adopting any compact is the discussion and process you go through to get to what is important,” she says. “The intense discussions about the essential responsibilities board members or leaders have toward the organization and vice versa are really at the heart of the process of developing a compact. Those conversations – honest, challenging, sometimes difficult – are just as important in many ways as the result.”

It is fair to ask whether three different compacts are necessary in a single organization. And at least at VM, there is no question all three have real value over time. There is often overlap, of course, since many physicians are leaders, for example. Yet the compacts are immensely powerful because they ensure alignment of physicians, leaders and board members with Virginia Mason’s strategic plan.

Who would benefit from a compact – for doctors, leaders and/or board members?

“Any organization where the behaviors of leaders – or physicians or board members – are not explicitly aligned with achieving your vision can benefit greatly from a compact,” says Miller. “If behaviors are not matched with what you are trying to accomplish, it can really help.”

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