Targets Culture…

I found myself thinking about metrics a great deal this last week. Every organisation I have ever worked in has used metrics – measurements designed to assess some quantifiable component of performance. The logic is simple – data captured and collated on the correct parameters will provide an accurate view of what’s going on in an organisation and will encourage the right (and improved) performance. The key to success, of course, is choice of ‘correct parameters’.

Unfortunately there are all sorts of examples – in and out of our industry – where this focus on metrics has actually led to worse performance…more waste…disengaged colleagues…or all three!

A classic example took place in the National Health Service few years back when UK Government decided that no patient should have to wait more than 48 hours to see their primary care physician. So convinced was Government that this measure would be a route to improved performance that budget, bonus and salary was tied up in medical centres achieving this metric. 

And sure enough, waiting times decreased rapidly. Success! Maybe…maybe not?

More detailed analysis revealed that many medical centres introduced policies preventing appointments being booked in advance; policies that forced patients to attend on the day they rang up.

So the metric was achieved – medics had space in their calendars to see people within 48 hours and waiting lists were effectively eliminated. On the other hand, with so many people calling to make a booking every day, it became virtually impossible to get through to a practice on any specific day to get an appointment. And – needless to say – anyone who liked to plan ahead was similarly ill-served.

Things have got better more recently, but this ‘targets culture’ had a negative impact on patients and healthcare alike, through a focus on the wrong metric – in this case waiting times rather than quality of care. Culturally we can be addicted to metrics – we deliver what is measured…especially if it’s measured by our leaders and if it feeds into our performance assessment.

In our own industry, many of us have experienced periods when individual units or departments succeeded in achieving their own annual metrics…but the organization as a whole fails to deliver.

So now focus is not just on metrics but also on the search for that elusive ‘correct metric’ – a metric that provides an accurate view of what’s going on and that drives the right performance. A metric that is easy to collect and collate!

And the cultural dimension remains strong. Performance will always be dependent on the practices and values embedded in any individual organization – how things are done around here. But a culture of transparency will always help…a culture where colleagues feel able to speak out – to critique or to praise alike. Where mistakes are not hidden but are reviewed for learning and improvement. Where successes are celebrated…and are reviewed for learning and improvement.

We are all moving from being ‘product or service based’ to being focused on ‘outcomes or overall experience’. This is a change to celebrate. But it is also a change that requires even better (and simpler) metrics…and fewer metrics. We all know that trying to measure everything is a sure-fire route to decreased productivity and increased frustration.

A quality metric has to be accurate – it should measure what it says it will measure. A quality metric has to be aligned with an organisation’s goals. A quality metric has to be aligned with individual goals. Making any number go up, or come down, through our actions and reactions, has little real value unless those numbers are related to why we come to work each day.




About Steve Street

I have worked in R&D within the Pharmaceutical industry for over 30 years. Up until April 2012 all of my career had been with one company, but that has now changed. I left that company and took up a new role on May 1, 2012 - still very much within the Pharmaceutical industry and again based in the UK. I have been blogging every week now for over 10 years but only on an external site since January 2012. Email updates of the blogs can be requested using the ‘follow’ option within Wordpress. The blogs are only ever my personal view of what I see, think and feel. I am delighted if you agree and find value; happy if you disagree with my views and overjoyed if you feel motivated to comment. Most of all I am simply grateful that you read. Cheers Steve
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8 Responses to Targets Culture…

  1. Leslie Sloan says:

    Well said Steve. We have to measure what really counts rather than count what is easy to measure. Easier said than done, I know, but still vital to our success.

  2. Thanks Steve, you make very good points when you talk about reviewing for learing and improvement.
    To my mind, ANY metric that is used for reward or punishment is a source of risk in the process and should be treated with extreme caution. As you say, the fewer the better, and if reward/punishment is involved they should directly measure the thing you are trying to accomplish – which would mean for example, no targets for numbers of candidate drugs because you can’t sell a candidate!

    • Steve Street says:


      Great to hear from you and you make an excellent point about the reward/punishmenst aspect of metrics. both aspetcs are open to as much misuse as eachother.

      Cheers, and thanks again


  3. Graham Baker says:

    We all know that “What gets measured is what gets done” but as you so rightly point out it does not always get done in the intended way unless you are working in an organisation that understands the intent and will work with the same values. The NHS is hardly an organisation that works like that especially when doctors are self-employed in the NHS and out to get what they can from the system.
    That’s the beauty of the net promoter core system. Raising the metric to what matters (customer satisfaction) should show real improvement rather than work arounds and short cuts. NPS can be improved in lot of different ways and as as long as none of the other important measures of performance are impacted (budget, work completed) then so much the better.
    Imagine what the NHS might look like if dcotor surgeries used NPS as their measure of success

    • Steve Street says:


      Excellent to hear from you and thank you for your comments. I do believe you are onto something with your insight onto the NHS…and i am absolutley with you on the amazing influence that Net Promoter Score can and does have because it is based on the view of the customer.



  4. Chris Barber says:

    So true… In truth performance management is really a simple process – understand what people do, how they do it and the value and impact that they create both directly and indirectly as a consequence. Set clear expectations and review them regularly, openly and honestly and not just once a year. That also provides the mechanism to rapidly respond to results that challenge the initial plan or opportunities that should deflect people onto an alternative, more valuable path.
    Those who cling most tightly to abstract performance metrics merely because they are measurable (“SMART”) often do so because it’s safe and easy, not because it is right. Such managers can have a truely damaging effect on their company by defining boundaries that supresses innovation, and disuading reports from taking the initiative and identifying opportunities. This disengages individuals and increases the chance of missing truely company-changing opportunities.
    A good manager is an enabler for his/her reports – defining their direction, providing space for individual contributions, delegating responsibility and giving guidance and support to keep them appropriately focussed.

    • Steve Street says:


      Alwasy good to hear from you…not least because you make such great points. A desire to hang onto SMART metrics becasue they are ‘safe and easy’ is both accurate and thought provoking. Someone once said that a Manager has thier eye on teh bottom line…a leader has their eye on the horizon.



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