Domino. Tasler Nick

for a new target market that we've consciously avoided for as long as I've been with the company. To succeed, we really need our best people on the front lines thinking creatively every day about the new direction so they can spot the opportunities you and I can't see from our vantage point.”

      “Absolutely,” Glen confirmed. “No question that we'll have to shift our focus.”

      “But…are we?” Priya's eyes shifted upward as she searched again for the right words. “Does our plan truly reflect a change in focus?”

      Glen looked puzzled as Priya let her question hang there. “I think so,” he said with a twinge of uncertainty in his voice.

      “Glen, you know that I fully believe in our new direction. It's just that we produce so many new features and products every year that I'm afraid our people won't fully grasp why this one is different. This product fundamentally alters the terms of our relationships with customers. The margins will be different. The value proposition will be different. And James and Caroline don't fully comprehend how this plan changes much about what they do each day. They believe that their basic goals and priorities are the same as last year and the year before, plus with only the small addition of a couple of more priorities.

      “And to be honest, Glen, I believe they are disappointed. James and Caroline can see the same opportunities that those of us on the leadership team identified at the planning retreat. They know how much healthcare reform is going to change the way we need to do business. And I think they were actually hoping for something a bit more…radical than the plan we produced. A plan that is undeniably different from previous years. They want to see a change as much as we do, but…well, they just aren't seeing it in the plan we've presented to them.”

      Glen felt his cheeks turning crimson. A decade or so ago, Glen might have snapped back with a pithy defense of the plan. He would sharply suggest that perhaps Priya just hadn't articulated the plan correctly. But with years of conscious effort Glen had trained himself to take a deep breath first in order to give his rational brain a chance to grab the tail of his lizard brain before it spewed out a conversation-killing rebuttal. After a moment, he realized that even if Priya hadn't presented the plan clearly enough, the failure was still his failure because it meant that he hadn't articulated it clearly enough to her.

      “Hm. That's interesting,” he said. To buy himself a few moments for collecting his thoughts, Glen reached for the fettuccine bowl and scooped some onto his plate. As he dug the spoon back into the pile of pasta, the untouched quinoa (pronounced “KEEN-wah”) dish in the center of the table caught his eye. Then it hit him. Quinoa, he thought to himself. His wife had just recently introduced him to this so-called ancient grain that looked a lot like rice to him. But she explained that it was a healthier alternative to most of the standard pastas for which he had a lifelong weakness. He determined that a little extra quinoa would probably do his diet some good. So, tonight Glen had ordered quinoa in addition to the lasagna, the fettuccine Alfredo, the spaghetti bolognese, and the other staple Italian dishes.

      That was the problem.

      Glen slowly shook his head. “You're absolutely right. The changes to our plan are like the quinoa.”

      Priya raised a curious eyebrow and cocked her head to the side.

      “The strategic shifts we've made are going to get lost in the smorgasbord of ongoing initiatives. We'll get things done this year, efficiently and effectively, just like we always do. But they won't be the right things…or at least not enough of the new things that are going to move us in that new direction.” Glen paused and let out a big exhale. “I just assumed that simply ordering the quinoa would not only make me eat it, but that everyone else would notice something new on the table, and also dig right in.

      “But they won't, will they?” Glen asked rhetorically. “Purely out of habit, they are going to reach for the stuff they have always reached for – the quality assurance guidelines, the margin increases, the supply chain improvements…all the stuff we talked about last year. And I won't be able to blame them, because a few months ago those were the right answers.”

      Priya nodded. “That's what I'm afraid of, yes.” She dug a serving spoon into the quinoa dish. “Somehow we have to get our people to instinctively reach for these new key objectives first. And I'm afraid that six to eight months from now will be too late. As quickly as things are changing, Glen, I'm afraid we might have to pursue another new set of priorities two or three more times before this year is even over.”

      Now, 35,000 feet into the night sky somewhere over the black abyss of the Pacific Ocean, Glen Peterson sat in silence. His conversation with Priya played on repeat in his mind. Every time, like a scratch on a disc, the dialogue stops at the same spot: six to eight months from now will be too late.

      He looked out the window at the darkness. “What are we missing?” he thought. All the pieces were in place. All the dominoes were lined up. What else could he possibly do to get them to start falling?

      Glen slipped on his reading glasses and scrolled through his strategic planning documents on his iPad. After briefly flipping through the slide deck he had presented to the corporate planning committee, he scrolled down the projections spreadsheets looking for some kind of clue, some sort of hint about where to go next. When his eyes drifted down to the spreadsheet's twelfth row titled “inPulse acquisition” he paused.

      inPulse was the flagship product of a startup device maker that Davis Medical had just acquired. It was a good product that had already passed nearly all its clinic trials. But Glen and his team realized it could be much more than that. The inPulse products were designed for an altogether different customer group than Davis' traditional customers. Unlike virtually all of Davis' hundreds of other devices, inPulse was a product that fell squarely on the value-side of the so-called “volume-to-value revolution” in healthcare. That meant that the inPulse project could be a powerful symbol of the new direction in which Glen wanted to take his division.

      Yet James and Caroline – the canaries in his division's coal mine – barely even noticed it on the plan. How much clearer could he make it? After a few moments staring at the words “inPulse acquistion” Glen looked up from his tablet.

      “Could it really be that simple?” he wondered to himself.

      His squinted eyes slowly began to open wider as the answer took shape in his mind. He was beginning to feel that old, familiar surge of dopamine flood his brain – the one that so often transformed his anxiety into excitement, and reminded him why he loved his work.

      He quickly slid his iPad over to the edge of the tray table, and leaned ahead to reach under his seat for the pen and the yellow legal pad that he always carried in his tote bag.

      At the top of the legal pad, he scribbled “quinoa = inPulse” and circled it.

      Then a few lines below that he wrote “Fettuccine = _______.” He paused for a few more seconds to think before scribbling down “market intell.” on the blank line. Then he wrote “supply chain effic. proj.” and then “X-cath. quality enhancements” underneath that.

      quinoa = inPulse fettuccine = market intell.

      supply chain effic. proj.

      X-cath. quality enhancements

      That was it. If he could just make it clear that not only was the inPulse acquisition a top priority for the next year, but then call out the specific projects that were now a lower priority it might just send the unmistakable message to his team that something important had changed. And his decision might just trigger a domino effect of decisions that would shift the focus of his entire division in a matter of weeks, if not days.

       The Leader With a Thousand Faces

      To paraphrase the writer Joseph Campbell, Glen Peterson is the leader with a thousand faces. Glen's story is your story. Whether you run a Fortune 500 company, lead a hospital unit, manage a project team, own a small business, or temporarily preside over a parent-teacher association, you have almost certainly faced the challenge of inspiring a group