impact stories

Top-Down Monthly Operating Review Drives Accountability & Action to Reduce Variances

April 21, 2021

This organization drove results and impact

Created leadership-led Quarterly Business Review to boost financial accountability

Leveraged automatic email reminders to strengthen accountability

Encouraged productive conversations on variance, leading to cancellation of physician scribe vendor contract


Leadership Lacks Forum to Engage Stakeholders on Performance Variances

To address financial performance variance and develop strong resolution plans, organizations need a consistent forum for conversation and engagement between leadership and cross-functional stakeholders. To improve accountability, this organization aimed to increase documentation and formal reviews of variances that exceeded their established thresholds. To exceed their goals in adopting StrataJazz® Management Reporting, they partnered with Strata Advisory Services and drove real change in their organization.


Document, Communicate and Execute a Standard Monthly Review Process

To enhance their Monthly Operating Review (MOR) process, they established a two-month pilot involving key leadership: the SVP of Operations, Chief Nurse Executive, Executive Directors and Assistant Chief Nursing Officers. These leaders now discuss significant variances in what has become a regular, prioritized meeting each month. Engaging leaders from the start helps the organization set the cultural tone for financial accountability, demonstrate expected behaviors and reinforce department-level expectations.

As the MOR pilot evolved, the organization executed a robust change readiness plan to align bottom-up reporting with top-down expectations. Conversations with SVPs in the MOR helped leaders return to Managers with more clarity on how to improve variance commentary within their StrataJazz® Management Reporting tool. They now focus on creating the resolution plan rather than providing explanations alone. Taking it one step further, Finance Operations established critical “office hour” periods where Managers could ask questions during variance commentary submission, which is now a valued part of their process.


Implement a Cascading Review Process to Aggregate Root Cause Info

Building this MOR process has sparked detailed, ongoing conversations between leadership and cross-functional stakeholders, empowering them to not only better understand unnecessary variance but take action to change it. Today, a combination of automatic email reminders and Finance-led office hours empower Managers to enter detailed commentary, knowing it will be reviewed by each level and then the select leadership team. MOR meetings are now seen as an opportunity to move through challenges together. Anecdotally, staff had previously observed that the use of scribes from one vendor was expensive and often inefficient; but these conversations were always charged and political, never leading to change. As part of the new MOR process with leadership involvement and cascading commentary and review, conversations became more productive. The organization decided to cancel the expensive vendor contract and change their workflow to no longer require use of scribes from this vendor. Today, all managers and leadership continue to participate in the MOR as a forum to discuss challenges and have real conversations, helping the organization to drive accountability and positive outcomes.