I didn’t expect a film could teach me anything about strategic thinking. As I watched on, this trauma consultant was certainly thinking strategically. He was looking on from the foot of the bed, observing the patient, and listening to his colleagues as they told him what they had done. He glanced up – checking the patient's vitals on the monitors above the bed. Digesting all of this, he then gave orders on what his team should do next. It’s curious, seeing a strategic thinker at work.
Curiosity drew me in – why was the consultant thinking strategically? Here was a busy trauma room, with a team battling to save a life, and the senior doctor wasn’t even treating the patient.
Studying the film, and seeing the same actions in use repeatedly, allowed me to see what was going on. The trauma room had a process. In emergency care, the strategy is condensed – with extra attention focused on the first hour – the golden hour. The analysis of data, along with better skills, has shown how critical this hour is. What happens can make the difference between life and death. And so, with the focus on saving lives, a process of care has grown that enables strategic thinking.
Strategic thinking in a trauma room
In the trauma room, time shrinks, but that doesn’t lessen the need for the consultant to think strategically. As I considered it, if anything, it intensifies it, for there is no greater burden than trying to save a person’s life. The drama of saving a life was there to see – but I wasn’t interested. It was the strategic approach I was observing.
I could see the strategic mindset of the consultant at work. As I watched, so he held a position at the foot of the bed. He could see the patient, the monitors – and his team as they worked on the patient. All the time, he was watching, listening, and thinking about the patient’s condition. New information appears as the patient either responds – or doesn’t. The consultant's job is to make sense of this continuous cycle of data.
As I observed from watching a stream of new patients, the process was always the same. Studying this led me to see the consultant was thinking strategically with three principles in his mind.
- A clear goal – to preserve life.
- Be an active part of the feedback loop – to learn and adjust.
- To maintain a high-level view of what’s going on – aligning actions to goals.
Away from the drama of the trauma room, the definition of strategic thinking gives us an insight into the way the consultant works.
What is thinking strategically?
Thinking strategically is the process of thinking about what we might do now and how it will impact our future goals.
A definition of thinking strategically would explain how we use our minds to think about how we would achieve a goal – or set of goals. We believe that strategic thinking applies to activities like chess or business – but it’s a skill we should use all the time.
Thinking strategically in the trauma room
The trauma consultant never moved. He was always at the foot of the bed – far enough away to avoid treating the patient directly – but close enough to see what was happening. His positioning was quite deliberate and served two purposes.
Thinking strategically requires a high-level view of what’s going on. No longer should the consultant be directly treating the patient. Instead, he should be working on the patient at a higher level.
Secondly, the consultant is the leader of the nurses and doctors. Obvious, but being a leader – and leading are two different vocations. A leader might choose to get stuck in – to lead from the front. But here, working strategically, the goal is to use the skills of the team. Therefore, his guidance – formed from his unique position and strategic view – helps direct the staff on their next steps. To achieve this, the consultant needs feedback. From the foot of the bed, the consultant can receive feedback and then adjust his path towards his overriding goal – to save a life.
What can we take from the trauma room to the board room?
Accepting the lessons from the film, it was clear the consultant was following a proven process. His positioning, his lack of hands-on care, and his focus on achieving a strategic objective made it clear this process worked. My interest left me with a question. How could I learn from this to improve the strategic approach in other areas – say in business?
Of course, some will argue there is a huge difference between saving lives and running a successful business. It’s true, understanding how to treat a punctured lung is different to selling products. The larger argument though is likely to focus on the issue of time.
Time is the critical factor in a trauma room - especially during the golden hour. In a business setting, strategies evolve over months and sometimes even years. Regardless of the time dimension, though, the importance of thinking strategically is vital. In the trauma room, the shortness of time makes it even more crucial. Without a strategy. Without feedback and a high-level perspective, decision-making becomes unstructured and deadly.
Under the microscope of the trauma room, not having the capability to think strategically has cost countless lives. In a board room, time only exacerbates the failure points of a business with no strategic thinking. As a result, the underlying skills matter only in fine detail. What matters is the framework that empowers strategic thinkers. It is a competitive advantage to operate with such a process.
The 3 Principles of Effective Strategic Thinking
Developing strategic skills is essential. Improving your strategic thinking skills can help you with problem-solving. It can also help with strategic planning – and help you achieve your goals. As I reflected on my notes, three constant actions formed the great strategic thinking I’d observed.
1. Have a strategy.
2. Have a clear feedback loop.
3. Maintain a high-level perspective.
These three steps form a foundation for great strategic thinking. In the film, I could see the consultant had a strategy in place. The long-term aim to preserve life. The feedback loop was a constant theme. The consultant received feedback, assessed it, and then - by thinking strategically – adapted the treatment to fit the strategy.
The consultant maintains a high-level perspective by not working directly on the patient. Staying away from the patient keeps him focused on the big picture.
These three steps form a foundation for strategic thinking and an efficient way to make decisions and lead others.
Applying strategic thinking in your business
The three principles of strategic thinking can be useful in any situation, including business. This seems obvious once you strip away the fluff that surrounds the dynamics of strategy.
Let’s look at each of the principles in more detail.
1. Have a strategy.
Many businesses have a poorly thought-out business strategy. Some decide to chase goals without the context of a problem. Seeking growth is not a strategy. Aiming to defeat a competitor is not going to be easily achieved. These are by-products of a good strategy. The trauma care strategy is clear. It focuses on solving a problem – preserving the life of someone seriously ill or injured.
Creating a strategy means starting with an assessment. Richard P. Rumelt calls it a diagnosis. It means looking at your customers and thinking about their pain points. Can you provide them with a solution? That's where a strategy should start.
2. Have a clear feedback loop.
When the trauma consultant is treating a patient, where he stands is vitally important. His position gives him immediate access to the patient, the monitors, and the team that is treating the patient. Each of these, including the consultant, is cogs in a feedback loop. He receives information, then, using his strategic thinking skills, he checks it against his strategy. Once he has decided on the next steps, he then communicates them to the team.
How does this work in a business? The strategic thinker – often the MD – must expose themselves to more than dashboards of data. They need to review performance with others to assess the progress. They also need to check new information – alongside performance indicators – and adjust plans as required.
3. Maintain a high-level perspective.
A high-level perspective isn’t found working in a business. In the trauma room, the consultant achieves this by not treating the casualty directly. The positioning – at the foot of the bed – is quite deliberate. It keeps the consultant away from the detail of treatment and gives him the mental and physical space to think strategically about what happens next.
In business, especially a small business, this can be almost impossible to achieve. But the small business owner must find his ‘foot of the bed’ position. Strategic thinking means working on the business, not working in it.
An MD can easily remove themselves from the detail, a small business owner less so.
Saving lives is intense. The film left nothing out, as the trauma consultant and his team battled to save every patient. Pools of blood, plenty of tears - and even a few smiles appeared along the way. Some survived, some didn't. That is the ugly truth of trauma care. Stepping beyond some of those challenging scenes, I took several lessons with me.
Using first-principles thinking, the fundamental elements of what was happening with each patient became clear. Three principles formed a foundation for a strategic thinker to thrive and have an impact. Having a strategic mindset is one thing, but it is quite another to have a framework to exploit it. In trauma care, they achieve this brilliantly.
Seeing these three principles gave me an understanding. It was one I hoped true strategic thinkers see as well. It was a framework to apply when thinking strategically. I trust it is one you can use too.