Organizational Assessment and Implementation Roadmap
- The company has grown fast and something is clearly not working, but nobody can name what
- Initiatives get announced and then quietly die in the field
- Decisions stall because it is not clear who owns them
- Clinical staff are leaving and the exit interviews do not explain it
- You are heading into a board meeting and you need a real diagnosis, not another list of symptoms
The assessment was structured across four domains and grounded in direct evidence rather than assumption.
I conducted individual interviews with more than twenty people spanning the executive team, regional leadership, center management, clinical directors, and direct care staff. I reviewed organizational structure, reporting lines, spans of control, job descriptions, and performance management practice. I assessed the technology and data environment. And I examined how initiatives were actually rolled out to the field, from announcement through adoption.
A central diagnostic was an accountability mapping exercise: function by function, who owns this. Large portions of the map came back blank or contested. That result was itself one of the most important findings of the engagement.
Structural issues, including accountability gaps across nearly every function and clinical staff reporting to operational managers with no clinical background. Operational issues, including major initiatives launched without playbooks, field readiness, or defined ownership. Technology and data issues, including mismatched numbers across functions and no live reporting capability. And workforce issues, including productivity expectations that did not reconcile with the underlying math, reactive compensation decisions, and no standardized onboarding.
Accountability has to exist before anything else can be enforced.
A prioritized implementation roadmap with named owners.
A prioritized implementation roadmap that sequenced structural change first, since accountability has to exist before anything else can be enforced. It included a revised organizational design with defined ownership at every level, spans of control targets, a training plan for center managers and clinical leadership, and a phased rollout methodology with readiness criteria built in.
Leadership went into the board meeting with a specific, sequenced plan and named owners rather than a general sense that something was wrong.