Execution: Where Healthcare Strategy Succeeds or Fails
Larry Bossidy and Ram Charan's Execution makes a point every hospital board should hear: a strategy that is not delivered is only a promise. Execution is a discipline, and it belongs to the leader.
Healthcare is not short of strategies. Every hospital I have known had a plan, a vision and a set of priorities. What separated those that improved from those that did not was rarely the quality of the plan. It was the discipline of carrying it out.
What the book argues
Bossidy, a former industrial chief executive, and Charan, an adviser to many boards, argue that execution is the real difference between organisations that succeed and those that fail. It is not a set of tasks to delegate but a discipline that must be built into the culture, and the leader must own it personally.
They identify three core processes that leaders must run themselves:
- People: choosing and developing the right leaders.
- Strategy: setting a direction grounded in reality.
- Operations: turning that direction into daily work, with clear accountability.
Execution, in their account, means rigorous discussion of what will be done and how, persistent follow-through, and honest dialogue in which problems can be raised without fear.
What it means for healthcare
Hospitals are complex, and complexity is a convenient excuse for slow delivery. The book's lessons apply directly:
Link strategy to operations. Every strategic priority should translate into specific actions, owners and dates that appear in operational reviews, not only in board papers.
Choose leaders who deliver. The most important strategic decision a chief executive makes is who leads each part of the organisation.
Follow through relentlessly. A short daily huddle and a disciplined monthly review do more for execution than an annual strategy retreat.
Make candour safe. Plans fail when bad news travels slowly. Leaders must reward people who raise problems early.
Questions for leadership teams
- Can every member of our executive team name the three actions they personally own for this year's strategy?
- How quickly does bad news reach us, and how do we respond when it does?
- Which strategic priority from last year was never delivered, and why?
Strategy is decided in the boardroom. It succeeds or fails on the ward.
Related: The Daily Huddle Is a Management System.
Dr Fatih Mehmet Gul is a physician and healthcare executive who has built, commissioned and led hospitals across the Gulf and Türkiye. He is an Honorary Professor at UCL Global Business School for Health, author of Connected Care, and host of The Chief Healthcare Officer podcast.
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