Improving patient outcomes through OKRs and KPIs

A new approach to strategy execution

Established in 1962, Hjerteforeningen's workstreams have expanded over time to now offer everything from prevention work for those at high risk of heart disease, to research and collaboration with the Danish health authorities.

Due to the specialized nature of the organization’s work, it always made sense to have distinct functions focusing on their particular area, eg Research. The downside of this is that it's all too easy to miss opportunities to take a more holistic approach to the full patient journey. A more coherent, collective approach focused around shared learnings could be far more impactful for patient outcomes. So the team decided to review its strategy execution practices to develop a more transparent, cross-functional approach.

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Tying OKRs and KPIs to strategy to deliver measurable results

Hjerteforeningen created distinct programs for each type of person that they aim to benefit. For example, one for “children with heart disease” and another for “children at risk of heart disease”. They set these up in their OKR platform, Perdoo, as distinct Groups so that they can organize the goals associated with each program. Looking on each Group’s page gives a quick overview of how the organization is performing in that particular area.

With the programs defined, they needed a way to measure success. This is where KPIs came in. The organization developed a set of strategic KPIs for each program and added them into Perdoo to actively monitor progress. And then to execute the strategy, the organization uses OKRs in a four-month cadence, also managed in Perdoo.

A four-month OKR cadence is not as common as a quarterly cadence. Jannik Zeuthen, one of Hjerteforeningen’s program managers, explains: “We want to embed a culture of learning into our OKR program, so we’ve extended the cadence to allow extra time for reflection and development. A quarterly cadence also doesn’t work so well in Europe, with holiday seasons impacting pretty much every cadence, so you always either start late or end early – something we can remedy with a four-month cadence.” The team also chose to only work at this four-month cadence (instead of adding an annual cadence on top) as this allows them to remain agile. Jannik outlines that “the outcome [what impact really looks like for each patient cohort] is frequently being revised due to the learning process that happens after each set of OKRs.”

A "program forum" meets once a month to align and review the program’s OKRs, as well as decide on the three or four top priorities for the next four months per program. When creating OKRs, they think about the main areas of impact that they'd like to have in each area. They ask themselves questions like "what are the biggest barriers to high quality of life for children at risk of heart disease?" This collaborative work, bringing in people from different functions, helps the organization to align on the most important pieces of impact that they hope to have for each patient cohort.

When reviewing progress, the organization makes use of Perdoo’s traffic-light Status feature. If something is set as red (off track), the program manager can instantly see that there are blockers that need their attention.

Lots of the outcomes that Hjerteforeningen would like to measure are difficult to get a hold of. Take “quality of life” for example. Although, as Jannik states, they have developed a way to build this learning into their OKR program:

The aim is to have ‘result-focused’ OKRs – those that are measured by strong quantitative Key Results. Where it’s not possible to find a metric for our ideal Key Result, we use proxy measurements that those involved in the OKR believe should push us toward the impact this OKR aims to have.

The organization also sets ‘learning OKRs’ which hope to fill in some of these gaps. As Jannik outlines, "They have Key Results which gauge how much validated learning we attain in that given period.” An example of a Key Result for one of these learnings OKRs could be to "(in)validate X hypotheses in the four months."

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Understanding purpose and how to get there

It’s undeniable that Hjerteforeningen has put learning at the heart of its OKR process. It’s also taking a holistic approach to strategy execution, understanding that OKR alone isn’t a magic bullet. The organization also uses KPIs to monitor the health of each program and its impact. When some of those KPIs are unhealthy, that’s useful input for the next four-months’ OKRs.

But what about the effect that this change has had on the organization and the impact it can have on patients? Jannik highlights that this new approach, using OKRs, has certainly accelerated their strategy execution. Indeed, this is something that many organizations find when moving from traditional annual planning cycles.

Strategy execution is also much more visible now at Hjerteforeningen. They’ve seen a real boost in alignment now that everyone understands the top priorities across the organization. They’re also further along their journey to understand their purpose more clearly, thanks to OKRs focused on validated learning.

With each round of OKRs, we learn more about patient needs and how we can impact it, as well as how we can improve our OKR-system to keep us focused and make tangible change happen fast.

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Are you a non-profit interested to speak to Jannik and the team at Hjerteforeningen? Drop us an email and we'd be happy to put you in touch.