1. Oakwood Healthcare
System
Industry: Healthcare
Website: www.oakwood.org
CUSTOMER OVERVIEW
Oakwood Healthcare System, a regional health care
network, is one of the most comprehensive health care
delivery systems in southeastern Michigan. The Oakwood
system serves over 1 million people in 35 communities over
a 500-square-mile area and operates four acute care
hospitals, several health centers, and offers a vast number of
specialty services including four centers of excellence. More
than 1,300 physicians representing nearly every medical and
surgical specialty and subspecialty are affiliated with OHS.
Customer PROFILE
Dearborn, MI
“We selected ActiveStrategy because we
felt that they had a unique combination of
software that supports our management
framework plus a true understanding of
how to apply performance excellence
methodologies. I believe they will be
an important partner with us in our
ongoing performance journey,”
- Corporate Director,
Annette Zwerner
In 2007, Oakwood—like organizations across all industries—
found itself mired in very difficult economic conditions. But
hospitals in the Detroit area were in an especially tough
situation since it was among the hardest-hit cities in the
country. Its unemployment rate had risen—and stayed—
above 14%. This meant that the region’s hospitals were
seeing an ever-increasing number of uninsured patients. In
fact, Oakwood’s rate of uncompensated care was now twice
what it had been five years earlier. To compound the
problem, those patients who still had insurance were
postponing non-urgent and elective procedures, driving
down profits significantly. A 2008 study found that
healthcare systems across the Detroit region in aggregate
lost $77.4 million and had an average operating margin of
minus 0.8%. The Oakwood team quickly realized that they
needed to develop and adhere to a new strategy to deal with
these unfortunate truths.
When trouble struck, Oakwood was already a high-
performing organization. In fact, they were a 2007 recipient
of the Michigan Quality Leadership Award and had been
named six times to the list of Top 100 Integrated Healthcare
Networks. However, Oakwood had what is a very typical
disconnect between their strategic plan and their
performance measures, which limited their ability to quickly
address the economic crisis. At the time, senior leaders
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BACKGROUND
reviewed a handful of metrics that were not connected to
the strategic plan in any obvious way. Nor was there any
regular review process for the metrics. In addition, they
had to be manually pulled from a multitude of
spreadsheets that were housed within organizational
silos.
The leadership team decided that it needed to get a
better handle on critical business metrics as a first step
to address the challenging business climate. To do so,
they formed an Informatics Group to be led by Corporate
Director Annette Zwerner, who was charged with
developing a holistic view of performance across the
regional healthcare system.
TAKING THE NEXT STEP
To help inform their decisions on how to proceed,
representatives from the new Informatics Group attended
the Institute for Healthcare Improvement National Forum
in late 2007. This annual event brings together some of
the nation’s best-respected healthcare leaders and
thinkers to discuss ideas to improve quality and

2. Customer PROFILE
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STRATEGY
outcomes in healthcare. While there, the Oakwood team met
with a variety of vendors from the performance management
and measurement field. Standing out among these was
ActiveStrategy, an organization that provides performance
excellence consulting and performance management
software. The Oakwood team left wanting to learn more
about how ActiveStrategy solutions could help Oakwood
align the organization to their strategic priorities, provide a
common view of key metrics and initiatives, drive
accountability across organizational silos, and establish a
consistent review process to identify areas for improvement.
The initial meeting at the conference led to two others with
ActiveStrategy, after which executives at Oakwood
determined that the combination of their expert consulting
services and their powerful and mature performance
management software made them the right company to help
Oakwood take control of their organizational performance.
IMPLEMENTATION
In light of the harsh economic situation, Oakwood had
redefined its strategic priorities, focusing on operational
excellence and areas that would drive profitable growth even
during tough economic times. To help align the organization
to these priorities and begin to execute the strategy,
Oakwood engaged ActiveStrategy’s strategic consulting
team in 2008 to help identify the right top-level performance
measures and strategic initiatives, as well as to ensure
organizational readiness for building scorecards.
Once these foundational steps had been completed, newly
aligned scorecards were developed and deployed in
ActiveStrategy Enterprise (ASE) software, beginning with
the Board of Trustees Scorecard in the first quarter of 2009,
followed by an Executive Council Scorecard in the second
quarter. In the third quarter, Scorecards were implemented
for the Operations Council, as well as for directors of key
focus areas in the organization.
In the fourth quarter, Oakwood began developing and
implementing 90-day action plans within ASE. These
focused improvement efforts were designed to cluster
employee efforts around specific performance gaps that
were now very apparent on the Oakwood scorecards (those
measures whose stoplight indicators were either red or
yellow, indicating performance was below targets). By
managing these improvement initiatives within the same
system as the scorecards and performance measures,
the teams were able to drive cross-silo accountability for
achieving budget and timing milestones, to quickly see if the
projects were having the desired impact on the correlated
measures, and to make changes to the action plans as
needed.
KEY RESULTS
• Scorecards are currently cascaded four-levels deep into
the organization, driving alignment from the Board through
to Director-level contributors to the strategically-important
issues, such as profitable growth
• Measures that had previously been disconnected from the
strategy and stored in disparate systems are now selected
based on the strategic plan of the organization and housed
in ASE where all contributors may access them
• Oakwood leaders may now drill down into measures in
ASE to see additional detail at each level, historical trends,
information about who owns the measure, as well as aligned
improvement activities, including the 90-day Action Plans
While ASE was initially used primarily by Senior Leadership,
the use of the system is expanding, driving ever greater
alignment and collaboration. Oakwood currently has 200
active ASE users and will expand to 300 by the end of 2010.
Example of a Scorecard in ASE
Example of a Briefing Book in ASE