• tjohnson00

setting company priorities: rocks vs. OKRs

Rocks are a great tool. Objectives and key results (OKRs) are even better.

***The following blog was initially written as an internal email.***

If you’ve been in the Advaita ecosystem for a while, you’ve probably heard about rocks or OKRs. In last week’s update, I discussed that an operating system consists of vision, data, people, issues, process, and traction. Our vision consists of a long-term strategy (and associated 10-year vision), a three-year picture of what things will look like, and a one-year plan. But how do we get from ideas to reality? Traction is how we stay on track with our goals – it’s the discipline and accountability component; it’s about coming up with goals and then marching towards them through thick and thin. One of the main traction tools is the quarterly process of setting rocks.

Concepts are taken from Gino Wickman's book, Traction.

Simply put, rocks are the very important projects we are working on outside our day-to-day job responsibilities. Rocks are essentially SMART (specific, measurable, attainable, relevant, and time-bound) goals for the organization for which one person is ultimately responsible. Rocks are a great tool. Objectives and key results (OKRs) are even better. An objective is what is to be achieved, and key results are tangible benchmarks that measure progress towards an objective. Typically for every objective, there are 3-7 key results which are written in a SMART format. I’ve attached the company’s OKRs and included two examples below – these emails are long enough…

OKR concepts are taken from John Doerr's book, Measure What Matters.

OBJ2: Establish consistent operations tempo throughout AHV.

  • Each department will run on EOS (weekly level 10 meeting, rocks, scorecard, and quarterly planning) by August 31st.

  • Deliver a company-wide team calendar that schedules all weekly, monthly, and quarterly meetings, department-level reporting, and company-wide cultural events by August 26th, 2022.

  • Deliver a campus schedule that provides for an efficient weekly schedule of all client-facing services by September 1st, 2022.

  • Deliver a manager’s handbook that serves as a core process for the basic management of team members by September 15, 2022.

  • Train all managers on the manager's handbook by September 30th, 2022.

  • Deliver an ‘Operations Playbook’ that describes the AHV operations tempo for the AHV Raleigh leadership team by September 31, 2022.

OBJ4: Onboard an information technology provider and implement a facilities management system throughout Advaita Health.

  • Present three outsourced IT alternatives to the leadership team by August 3rd, 2022

  • Begin Onboarding IT provider on August 10th, 2022

  • Finalize office facilities handbook & subcontractor database by August 17th, 2022

  • Catch up / close out all old maintenance tickets by August 30th, 2022

  • Train team on IT handbook and fully onboard IT provider by September 15th, 2022.

  • Conduct team on facilities training & do first quarterly facilities day on September 15th, 2022.

(Note: these OKRs are for the organization as a whole. A well-run healthcare organization has masterful administrative abilities that support the providers' work. Administrators and leaders work diligently to make quality service easy on providers and provide a smooth patient experience. An OKR for the clinical/medical department is the successful launch of TMS.)


Quotes + Random Thoughts

The work we’re doing is really important. While you probably don’t wake up to “fix healthcare,” we are collectively working towards a thesis on how healthcare can be fixed, along with many tangible examples and lessons learned. We spend more and feel like we get less than any other developed country. I’d rather have clinicians focused on honing their skills over ranting against the system's failures; however, I am committed to using the knowledge accumulated to make quality care more accessible and affordable. Here’s a good article with many graphs that looks at healthcare spending from the 1970s to the present day (e.g., in 2020 dollars, we spent about $1,800 per person in 1970 compared to about $12,000 in 2020).


  • How fast can you make good decisions? The world is uncertain, and you can't be an expert at everything; however, understanding specific frameworks or mental models can help you generalize effectively. Here’s a really cool resource on “decision-making razors” (i.e., rules of thumb for making good decisions with imperfect information).

  • “People don’t care what you know until they know you care.” – Diane Adams in It Takes More than Casual Fridays and Free Coffee

  • The Microdose: A newsletter from the U.C. Berkeley Center for the Science of Psychedelics

  • “Management is about coping with complexity. Leadership, by contrast, is about coping with change.” – John P. Kotter in “What Leaders Really Do

  • "Most successful people are just an anxiety disorder harnessed for productivity.” – Andrew Wilkinson


  • What’s it like to experience the world without filtering experience through language-based ideas? I can tell you: it’s pretty amazing. Humans are meaning makers. We feel the need to have concepts. We are masters of emergent properties, and we tend to overlook what’s intrinsic in our experience. What is the connection between flow states and the default mode network? Are we our happiest when concepts fall away? I sure think so.

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