June 20, 2023

Key Leadership Competencies: Strategic Ability

Leadership Development

Reading Time: 5 minutes

MEDI Leadership Competencies: Strategic Ability

One yardstick of effective leadership is the ability to see beyond current or imminent circumstances to create conditions for sustained success and long-term revenue. In healthcare, that’s increasingly hard to do, given the massive pressure, ambiguity, and speed of change in our industry. And yet, that big-picture thinking is critical to your impact as a leader — not to mention your reputation and career trajectory.

Seven out of 10 times, failure stems from flawed strategy decisions, note researchers. On the flip side, a 10-year study by the Harvard Business School showed that organizations with clear and well-articulated strategies outperformed competitors by 304% in profits, 322% in sales, and 883% in total return to shareholders. There’s a lot riding on your strategic ability!

How strategic are you, really?

  • 90% of directors and vice presidents have no strategy training.
  • 67% of surveyed leaders believe their organization is bad at developing strategy.
  • 43% cannot state their own strategy.
  • Only 30% of managers in 154 companies were found to be strategic thinkers.

“It’s a dirty little secret: Most executives cannot articulate the objective, scope and advantage of their business in a simple statement. If they can’t, neither can anyone else.”

Strategic Thinking Institute

Are you a strategic leader, or an emergency manager? We all like to think of ourselves as strategy-minded, but our habitual practices may tell a different story. How can you tell?

Join me for a moment in considering a couple of questions:

  • Do you consistently devote time to the bigger picture, exploring diverse perspectives and unconventional solutions? Or are most of your efforts focused on immediate matters and quick wins? 
  • How easily can you adapt to changing conditions, versus sticking to a rigid plan?

Strategic leaders are future-oriented, combining their knowledge and intuition with that of others to co-create solutions. They also model adaptability.

Strategic thinking is both necessary and hard, and there’s always room for growth.

What strategy is or isn’t

First, it’s helpful to clarify what strategy is, considering 48% of surveyed leaders don’t understand it, reports the Strategy Thinking Institute (STI). That’s true even at the highest levels of leadership. 

“Perhaps due to its abstract nature, strategy tends to mean different things to different people. It’s often confused with mission, vision, goals, objectives, and even tactics,” researchers write: “Too many organizational leaders say they have a strategy when they do not… A long list of things to do, often mislabeled as strategy or objectives, is not a strategy. It is just a list of things to do.”

Your goals and objectives are WHAT you want to achieve. Your strategy and tactics are HOW you will achieve them and how you will allocate resources to succeed. 

“Strategy is the general resource allocation plan. The tactics are specifically how you will do that,” according to STI’s Strategic Thinking Manifesto.

Put another way, strategy is your roadmap or the bridge that allows you to cross over to the finish line. A tactic is a vehicle to get you there. “With no strategy in place, it’s easy to fall into a game of tactical roulette, where you continually chamber a new tactic and pull the trigger, hoping something hits its target. But sooner or later, you’ll be looking at a dead plan,” the authors explain.

Growing your strategic ability

Thankfully, anyone can learn to be strategic. We trust the following practices will build your strategy “muscle”:

Practice heads up time

When you’re walking through unsteady or unfamiliar terrain, you naturally alternate looking up and looking down to avoid tripping up, hurting yourself or others. If you never look down, you could step into a hole and twist your ankle. If you never look up, you miss the scenery, a detour or better path. Likewise, leaders need to alternate heads up and heads down time if they’re going to avert risks and spot opportunities before it’s too late.

Lee Angus, MEDI’s president and executive coach, expanded on heads up time in an earlier post. As Lee describes it, heads down time refers to the time and effort we put into performing the next step. “It’s focused on deadlines and delivery, avoiding distractions and influence from your surroundings,” he explains. 

Heads up, on the other hand, happens when you slow down, scan your surroundings and observe what’s changed. “During heads up time, we’re focused on possibilities with curiosity and awareness. We’re questioning things, welcoming outside influences, and considering what could be,” Lee writes.

With immediate to-dos crowding our brain, it’s important to schedule time for activities that help you relax and switch to slow-thinking mode, which is when new ideas and creative solutions tend to emerge. Those activities might include running, fishing, or taking a stroll through your neighborhood. (For Lee, it’s taking a walk at sunrise.) Figure out what works for you and schedule a few minutes each week for that slow-brain activity. You’ll find it transformative. (More on heads up here.)

▷ Prioritize flexibility vs rigid plans

Strategic plans are typically developed, reviewed and approved over several months, and then executed over 3-5 years. Then the cycle repeats. And yet, a lot can change in that timeframe.

The pandemic was a crash course in how quickly conditions can change and the importance of being nimble, especially in times of great hardship or transition. When crises hit, a rigid strategic plan can become a shackle, locking you to a path that’s no longer relevant. 

This is a common challenge for organizations that have achieved high degrees of efficiency and standardization. My colleague, Michael Hein, wrote about the importance of adaptability in an earlier installment of our Key Leadership Competencies series.

As he explained, supply chains spent decades maximizing efficiencies: consolidating, streamlining, favoring single suppliers and on-time inventory. And they broke precisely for those reasons when the pandemic hit. “Efficiency was so high, it made organizations brittle,” Michael wrote. “We weren’t able to adapt fast enough, and when [change] hit, it broke us.” Efficiency and well defined plans matter, but can backfire without adaptability.

▷ Seek out & share trends

Strategic leaders pay attention to both internal and external trends. Likewise, you’d do well to pay attention to issues that bubble up again and again in your organization, and discuss them with your teams. It’s also smart to connect with cohorts at other hospitals or health systems to understand how they’re tackling similar obstacles.

Seek and share information with your peers on industry developments, evolving patient behaviors, competitors and new technologies that affect your business. Having broad and relevant market intel is a prerequisite of strategic leadership.

▷ Invite different perspectives.

Strategic thinking can’t be done in isolation. Having diverse people with diverse opinions who help you consider potential paths, threats and opportunities is both helpful and necessary. Diversity of thought in a safe space leads teams to the best options and outcomes.

Internally, engage cross-functional teams and create psychological safety so staff feels comfortable taking risks and asking tough questions. Research shows that organizations that reward risk and tolerate failure progress faster than those that don’t. “If people are criticized for failing, they’re less likely to take risks; in a crisis, this can be fatal,” the Harvard Business Review (HBR) warns.

Instead, reward curiosity and experimentation — particularly “why,” “when” and “what if” questions. You won’t be able to uncover new possibilities and approaches otherwise.

Finally, be mindful that objective input is just as important as stakeholder input. An unbiased sounding board that’s not hindered by internal politics or agendas can help broaden your perspective, identify blind spots, and clarify next steps. This is why many of your peers seek out MEDI Leadership coaching — not just for their own development, but also for other leaders and teams under their care.

In closing, I hope you’ll take an idea or two (or several!) from this post and begin practicing it this week. Don’t hesitate to contact us if we can answer questions, share lessons learned, or point you to relevant resources. Here’s to your growth as a strategic leader.


These are turbulent times in healthcare. Today’s leaders need an expanded set of competencies to manage growing ambiguity, uncertainty, and risk. MEDI’s new blog series is a masterclass in Leadership Competencies we’ve found most critical for driving meaningful transformation in 2023 and beyond.

Series shortcuts:

Begin the conversation

Share this!

About the author

William M. Barnes, Ph.D., MBA, PCC

William M. Barnes, Ph.D., MBA, PCC is a multi-faceted healthcare executive who brings diverse perspectives from successful leadership and clinical responsibilities. As a clinical psychologist, William spent more than 20 years simultaneously providing direct service and executive leadership at Children’s National Health Systems, where he served as Director of Community Based Adolescent HIV Research and Director of HIV Support Services.

Related content