For this post, I thought I would discuss SMART goals and use them for my blog for 2017. It is quite common for each executive in a healthcare organization to create management goals for the coming year. Then the CEO and the senior executive team discusses and approves them. All of the divisional goals are ultimately presented to the Board of Directors.

target smart goals

Your directors will create their goals as well, as we discussed in SWOT Analysis and Goal Setting. You will then review their goals and help adjust them as needed.

Using the SMART acronym will help you to identify appropriate goals. And they will ensure that you continue to remain indispensable to your CEO and board.


Various words have been used for each letter in the SMART Goals acronym. I prefer to use the following.


Each SMART goal should be written in a way that is not ambiguous or inexact. You must avoid any lack of clarity, for the reasons discussed in my post on Clarity. An example of a nonspecific goal might be: “Our unit will improve our patient safety scores this year.” A much more specific goal would be: “Our unit will achieve a central line-associated blood stream infection (CLABSI) rate below the national average rate for the coming calendar year.”

Rather than use an outcome measure, you could also define completion of a project, such as “Our unit will put in place a multidisciplinary team to reduce CLABSIs, which will achieve 100% compliance with completing the AHRQ central line maintenance checklist and audit form on each patient, and will achieve 100% compliance with placing the central line under ultrasound guidance.”

folding rule smart-goals


It is easier to track goals that lend themselves to measurement. It is clear when they have been succcessfully completed. The preceding example demonstrates this principle well.


This is usually not a major problem. Most of the time, our direct reports are going to think carefully about attempting to achieve a goal that is not within reach. This is especially true if there is some type of salary increase or bonus attached to achievement of the goal.

But there needs to be balance. I have had pharmacy directors who thought they could make remarkable improvements in inpatient drug utilization. Then they experienced the intense resistance to restrictions on the formulary that physicians demonstrated.


Management goals should be REALLY relevant. You and your staff are going to spend significant amounts of time and energy trying to accomplish these goals. They therefore need to be the top priorities for your division or department for the coming year.

Try to weed out the peripheral, “nice to have” goals and focus on the “must have” goals. These are teh goals that will advance the mission and vision of the organization.

For example, consider a facility that is addressing the patient safety issue of CLABSIs as mentioned above. Accuracy of documentation and codingis very important, since there are very specific inclusion and exclusion criteria being applied. Your CLABSI measures may be calculated and published inaccurately if coding mistakes are made.

Therefore, a relevant goal for the Nurse Documentation Specialists might be: “Put in place a process to review all charts of patients with a discharge diagnosis that meets CLABSI ICD-10 codes prior to final coding.” A less relevant goal might be something like: “Achieve 100% pre-discharge chart review by Nursing Documentation Specialists for patients with catheter associated urinary tract infections.” The latter might be an important goal, but it is just not relevant to the more pressing issue of CLABSIs in this case.

time smart goals


Every goal must have a deadline. After all, a goal without a deadline is just a dream. (Sorry, I have no original attribution for this quote. It has been quoted in various forms by many authors and speakers, including Robert Herjavec on an episode of the TV show Shark Tank!)

One Bonus Requirement

It is also very helpful to add milestones to each goal. These are the steps that must be completed or reached along the path to achieving the goal. Starting with the goal in mind, the milestones can be developed by working backward to the present state. It is helpful if the milestones generally follow the same SMART format, but it is not always necessary.

My Turn

Now, I am going to use these guidelines for smart goals to set some goals for this blog. That will allow me to use another tool to achieve accountability: publishing my goals to the world (or at least my blog readers!). Here are a few to begin the year…

1. Add a new blog feature – interviews with successful physician leaders – by the end of January, 2017.

The interviews will start out in written format. I will include answers to a series of questions about the path a leader or executive took in the journey from clinician to formal physician leader. The final question will address advice for the fledgling physician leader. These interviews will be posted once each week.

Milestones: create the interview template; identify the first five interviewees; contact those colleagues to enlist them to participate; send out the survey(s); collect responses; prepare them for publication; begin publishing the completed interviews.

ebook smart goals

2. Write an e-book about hospital patient safety, and make it available for free to my audience by the end of March 2017.

This is intended to be a practical guide for any hospital executive involved in understanding, supporting or improving patient safety. It will focus on the recognized components of patient safety that are currently being measured and reported. The e-book will include advice on how to improve patient safety in the hospital setting. I will also provide guidance on improving safety rankings published by HealthGrades and Truven (Top 100 Hospital).

Milestones: complete the background research for the book, create the outline, design the layout, write each chapter, compile the complete e-book, post the e-book, publicize the e-book on Facebook, LinkedIn, my email list and through guest post on other blogs.

3. Write a second e-book by the end of June 2017, topic to be determined.

Milestones: select topic, complete research, etc., etc.

4. Compile a list of physician-authored blogs and post on LinkedIn by the end of January, 2017.

I am personally fascinated by the blogs being written by my colleagues in medicine. I enjoy reading the breadth of blogs being produced. But I am surprised that some topics, such as physician leadership, are not well represented in the blogosphere. I believe other physicians might find this list of interest, so I have slowly been compiling the list in order to share it. I will do so on various social media sites and my own blog in the near future.

Milestones: search other physician-authored blogs for blogrolls; complete additional searches; compile and organize list; publish list.

Start Using SMART Goals

Go ahead and give it a try. Write down your goals for 2017 now. Use these guidelines to rewrite old goals.

Let me know what you think of my new goals for the beginning of 2017.

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