This is a guest post by Dr Mark Lavercombe. He is a specialist physician and medical educator, and the author at The Productive Physician. He writes about personal productivity as well as clinical education and leadership.
Wildly Important Goals.
Big Hairy Audacious Goals.
5-, 10- or 25-Year Goals.
As productivity nuts, we all know what these goal-setting strategies are. There are numerous schemas for creating and achieving goals, from the venerable SMART goal construct all the way through to Objectives and Key Results (OKRs) – the hot new kid on the block.
The choice of a trusted goal-setting strategy is individual. I’m not going to say it isn’t important: it’s critical. However, readers of Asian Efficiency will already have strategies they are familiar with, or access to ideas if they don’t.
I am going to argue that it doesn’t matter so much how you set your goals, however, as long as you use a structured approach. I believe that the biggest impact on whether we achieve our goals is the metrics we choose to measure our progress towards success.
Background
A few years ago I was adrift. I had achieved a fair amount in my career and personal life, although a lot of it felt like it had happened through turning up rather than any special effort on my part. I didn’t especially enjoy my work and had no specific goals other than to make it to the weekend.
I am a specialist physician in Australia, working in Respiratory & Sleep Medicine. Qualifying in this area took me seven years in medical school and then ten years after graduation. During that time I also hand-coded and wrote for a film criticism website, and became a member of the Australian Film Critics Association.
I have now been working as a specialist for seven years. I work at a busy teaching hospital, where I have responsibilities for inpatient care as well as supervision of trainees and several outpatient clinics each week. I also work in medical education and clinical research, and have had a busy private practice.
In addition, I have a young family that brings me great joy!
On the surface, I have achieved much across different domains of my life. The amazing thing about my story, however, is that I’ve achieved more in the past twelve months than for many years previously.
The difference during the past year for me was defining goals with specific outcomes in mind (“what will success look like?”) and then measuring my progress to their completion.
Finding some help
So what changed?
I began reading again, after a long period of not making the time to read. I still don’t know why I chose the books that I did, but they included Stephen Covey’s The 7 Habits of Highly Effective People, a couple of books by Charles Duhigg and Cal Newport, The Slight Edge by Jeff Olsen and The Compound Effect by Darren Hardy.
Eventually, I read The 12 Week Year (12WY) by Brian Moran and Michael Lennington and The 4 Disciplines of Execution (4DX) by Chris McChesney, Sean Covey, and Jim Huling.
For anyone who hasn’t read the 12WY or 4DX books, I strongly recommend them. The principles they teach have changed my life for the better.
Finally, here was a scientific approach to getting things done that effectively ensured I would succeed, as long as I put the measurement structures in place.
Scientific? As a doctor, I wouldn’t dream of starting a patient on a new treatment without knowing the following:
- Why am I starting this treatment? What is the goal of treatment?
- How will I know if it helps? What is the outcome I want to achieve?
- Are there any markers I can use to track progress to the desired outcome?
For example, I want to start an antibiotic for a patient with pneumonia. My goal of treatment is the cure of the patient’s pneumonia. The outcomes are the patient’s return to good health and the resolution of chest x-ray findings. Unfortunately, the chest x-ray might not be normal for up to 6–8 weeks after pneumonia, and I advise patients that it could take weeks or months to recover fully.
So, if the outcomes aren’t going to be evident for weeks or months, how do I know the patient is improving on my treatment? I can track markers such as:
- Decrease in the symptoms of cough, breathlessness, sputum, pain and fever
- Examination findings including resolution of fever
- Biochemical markers of resolution of infection measured by blood tests.
I like to think that my approach to my patients is guided by science. The appeal of the measurement strategies of both 12WY and 4DX is that I can apply these scientific principles to my personal goals.
The 4 Disciplines of Execution
The 4 Disciplines of Execution outlined in 4DX are:
1. Focus on the Wildly Important
“The first discipline is to focus your finest effort on the one or two goals that will make all the difference, instead of giving mediocre effort to dozens of goals. Execution starts with focus.”
2. Act on the Lead Measures
“The second discipline is to apply disproportionate energy to the activities that drive your lead measures.”
Lag measures are those of the result you’re trying to achieve. Lead measures are defined as being predictive and influenceable.
Predictive means that “if the lead measure changes, you can predict that the lag measure also will change.” Influenceable means that you have control or influence over it.
The authors provide several examples of the distinction between lag and lead measures in the book. Regarding weight loss, for example, the lag measure is the weight showing on the bathroom scale. The lead measures include diet (calories, fat content, sugar, etc.) and exercise (minutes active, steps, workouts, etc.). Both are predictive of the lag measure, and both are influenceable by you.
3. Keep a Compelling Scoreboard
“The third discipline is to make sure everyone knows the score at all times, so that they can tell whether or not they are winning.”
It is for this Discipline that metrics are so important – both defining the right metrics (lead measures) and how you measure them (scoreboard).
4. Create a Cadence of Accountability
“The fourth discipline is to create a cadence of accountability, a frequently recurring cycle of accounting for past performance and planning to move the score forward.”
Accountability in 4DX means assessing compliance with metrics.
The 12 Week Year
The 12 Week Year structure is quite similar in many ways. Moran and Lennington define five disciplines:
1. Vision
“A compelling vision creates a clear picture of the future. It is critical that your business vision aligns with and enables your personal vision. This alignment ensures a powerful emotional connection that promotes a sustained commitment, and continual action.”
2. Planning
“An effective plan clarifies and focuses on the top-priority initiatives and actions needed to achieve the vision.”
3. Process Control
“A set of tools and events that align your daily actions with the critical actions in your plan.”
4. Measurement
“Measurement drives the process. It is the anchor of reality. Effective measurement combines both lead and lag indicators that provide comprehensive feedback necessary for informed decision making.”
5. Time Use
“If you are not in control of your time you are not in control of your results. Using time with clear intention is a must.”
My first 12 Week Year was a wonderful experience, and I achieved most of my goals by the end. I even surpassed my expectations in many ways.
The one goal I didn’t achieve was the one that was least measurable. The pre-defined outcome was fuzzy and non-specific, and the metrics weren’t appropriate lead measures: they weren’t predictive of success. It is not surprising that it was this goal I failed to execute.
Why Measurement is Important
Both 12WY and 4DX emphasize measurement as critical for achieving your goals. Why is it so important?
Measurement enhances Focus
Peter Drucker is one of the preeminent management thinkers, and one of the most famous quotes attributed to him is:
“What gets measured gets managed.”
One of the reasons that measurement is so helpful is that it keeps our goals at the front of our minds.
If I want to achieve something but only ever think about it at a quarterly review, is it very likely I will get it done? If I am regularly reviewing my progress towards my goal, however, it is far more likely I will remember to take the important steps to achieving the goal, and to prioritize their completion.
Measurement provides Feedback
Well-defined lead measures allow you to obtain constant feedback on your progress. At any moment, you should be able to look at a chart or spreadsheet and see where you are in relation to where you want to be.
Feedback was originally an engineering concept, although it has more recently become a management and educational idea. In adult education, the conceptualization of feedback has changed in recent years. My preferred definition is by Boud and Molloy:
“feedback is a process whereby learners obtain information about their work in order to appreciate the similarities and differences between the appropriate standards for any given work, and the qualities of the work itself, in order to generate improved work”.1
If you think about metrics and how they provide feedback, you can see that regular review of metrics allows you to obtain information about how you are progressing towards your goal (‘obtain information about their work‘). You can also assess whether or not the tactics you are using are working (‘the qualities of the work’).
This allows you to adjust your strategy (‘in order to generate improved work’) at the time when adjustment is most important (responding to lead measures), rather than after the fact in response to failing to meet your goals (lag measures).
As an example, if you want to develop a meditation habit, one metric might be your number of meditation sessions each week. You might see that you missed your meditation session on Monday and Wednesday, and this can encourage you to set aside time to complete your session to meet your weekly goal. At the higher level, you can note that you failed to meet your target last week but did achieve the target for the two prior weeks.
As another example, if you know that you have eaten 200 calories more than your target intake for the past two days, you can eat less to make up for that and get back on track.
Measurement tells us when we are finished
It is important to know when you have achieved your goal. Parkinson’s law tells us that “work expands so as to fill the time available for its completion.” Without a clear end-date, some goals could stretch on forever.
Measurement of metrics toward achievement of a goal, however, encourages you to decide what complete looks like and to recognize when you get there. You can then avoid the trap of wasting time finessing things if you do happen to finish early, especially useful if you have a tendency towards perfectionism.
Your Scoreboard
The 4DX requirement for a scoreboard is matched by the 12WY suggestion about tracking ‘tactics’ (tasks or steps) each week and then reviewing weekly to see if you’ve met a certain threshold (greater than 85% is recommended).
You might choose a chart on a pin board, or a spreadsheet or some other electronic document. Whatever you choose to track progress on, it should show you where you are in relation to your goal at any minute of the day.
Nate Lowrie shared a spreadsheet for tracking his 12WY progress that provides everything you need if you’re trying that system. You could modify his spreadsheet to allow for longer or shorter time periods if quarterly goal planning isn’t your thing.
The best practices suggest that you need something that is:
- Highly visible – you need to be able to see your progress
- Easy to understand – you need to be able to understand your progress at a glance
- Easy to update – you want to spend time working on your goals, not your system
Example 1: Improve my driving to increase my fuel efficiency and decrease my costs
I think I’m a good driver, but I am also aware of research that suggests I could be mistaken. Kruger and Dunning published an article in the Journal of Personality and Social Psychology in 1999 that shows us how bad people are at estimating our abilities.2
The authors describe several studies in which they recorded participants’ self-assessments of competence in various domains. These included recognizing humor, logical reasoning, and grammar.
The participants whose scores placed them in the lowest quartiles for performance rated themselves far more generously. The disparity between performance and self-assessment was greatest in those who performed the worst. In other words, those who performed most poorly were least capable of assessing their performance.
Keeping this in mind, I decided that I needed hard data to inform my progress. After purchasing a Bluetooth OBD-II adapter for my car on eBay for only $6.47, I installed Dash on my phone and started collecting data.
Dash gave me all sorts of warnings about sudden braking and rapid accelerations and how these would affect my fuel efficiency. It also constantly translates readings from the On-Board Diagnostics into average kilometers/liter. By measuring the frequency with which I received warnings and the measured fuel efficiency of the car I could adjust my driving.
The outcome? I have increased my distance per volume by 10–15%. Thus, I fill up 10–15% less frequently and save 10–15% of my fuel costs. All because I had measured data that allowed me to modify my driving.
Example 2 – Reduce my caffeine intake
For a long time, I have had a problem with caffeine. I have never liked coffee or tea, so for at least twenty years I’ve drunk a lot of Coca-Cola. This has significant potential health effects related to the large amount of sugar.
Additionally, the amount of caffeine per volume in Coke is much less than that of coffee. The Mayo Clinic reports the following data:
8 fl.oz. cup of brewed coffee 95–200 mg of caffeine
8 fl.oz. brewed black tea 14–70 mg of caffeine
12 fl.oz. Coca-Cola 23–35 mg of caffeine
It is easy to see that to get the same amount of caffeine from Coke requires a much larger volume. All of this means I have been drinking more than two liters of Coke most days to keep myself going.
After deciding that I wanted to reduce my Coke intake and replace it with water, I created a simple log of Coke intake and cups of water on my phone. I also bought a water bottle to carry with me at work.
Every time I have a drink I record the volume in a note. My ‘morning coffee’ drink of Coke Zero is around 500ml. My water bottle measures 600ml.
After a few months of measuring my daily intake I am drinking around 500ml (17 fl.oz.) of Coke Zero and around 1.8–2 liters of water each day. This is a vast improvement on my prior habits and is likely to convey future benefits.
Conclusion
I hope by now you will understand my conception of measurement and why it is so important as part of your goal-setting and achievement strategy.
Both The 12 Week Year and The 4 Disciplines of Execution contain a lot of information about setting goals and how to achieve them. This brief overview hardly does either book justice, and I recommend reading one or both before you start to plan your next major goals.
Finally, I encourage you to think hard about setting metrics when you set your goals, as this will help you both define and achieve them.
Do you agree about the pre-eminence of measurement? Would you emphasize other parts of goal-setting strategies? I welcome your comments below.
Footnotes / References:
- Molloy E, Boud D. Seeking a different angle on feedback in clinical education: the learner as seeker, judge and user of performance information. Medical Education. 2013;47(3):227-229.
- Kruger J, Dunning D. Unskilled and unaware of it: How difficulties in recognizing one’s own incompetence lead to inflated self-assessments. Journal of Personality and Social Psychology. 1999;77(6):1121-1134.
This is a guest post by Dr Mark Lavercombe. He is a specialist physician and medical educator, and the author at The Productive Physician. He writes about personal productivity as well as clinical education and leadership.