“The compact serves to ensure alignment with a shared vision.”
– Diane Miller
At Virginia Mason, the physician compact has been crucial to the organization’s success. The subsequent leadership and board compacts have proven equally valuable.
“The three compacts are aligned really well with one another and they are tied directly to achieving the Virginia Mason strategic plan,” says Diane Miller, Virginia Mason Institute’s executive director. “The strategic plan was the driving document when we put the compact together. We felt we needed to be explicit on the gives and gets to achieve our strategic plan. We felt like we needed to engage in a deep conversation with leaders just as we had done with physicians because things were changing so much and so fast. We were going in a new direction with the Virginia Mason Production SystemTM and it required leaders throughout Virginia Mason to be completely aligned with our vision.”
Although it was put together a decade ago, the leadership compact has remained unchanged. “The compact serves to ensure alignment with a shared vision,” says Miller.
That is also the case with the Virginia Mason board compact. Lynne Chafetz, senior vice president and general counsel at Virginia Mason, supported the effort to write the board compact and it, too, has remained remarkably durable through the years. Both documents are used regularly and actively. At the beginning of management meetings there is a reference to the leader compact, while board sessions begin with a review to remind members of their responsibilities. Additionally, a copy of the compact is sent to board members with the packets prior to board meetings.
Not long after the board compact was approved by trustees, the chair of the governance committee at the time emphasized that the compact was designed be a “living document.” Chafetz says that through the years it has proven time and again to be a current, useful guide. “It is absolutely a living document,” she says.
“A lot of the benefit of adopting any compact is the discussion and process you go through to get to what is important,” she says. “The intense discussions about the essential responsibilities board members or leaders have toward the organization and vice versa are really at the heart of the process of developing a compact. Those conversations – honest, challenging, sometimes difficult – are just as important in many ways as the result.”
It is fair to ask whether three different compacts are necessary in a single organization. And at least at Virginia Mason, there is no question all three have real value over time. There is often overlap, of course, since many physicians are leaders, for example. Yet the compacts are immensely powerful because they ensure alignment of physicians, leaders and board members with Virginia Mason’s strategic plan.
Who would benefit from a compact — for doctors, leaders or board members?
“Any organization where the behaviors of leaders — or physicians or board members — are not explicitly aligned with achieving your vision can benefit greatly from a compact,” says Miller. “If behaviors are not matched with what you are trying to accomplish, it can really help.”