Juggling “Business As Usual” with New Business Strategies

How to effectively balance the importance of the day job, with implementing new business strategies

The Day Job… 

The company I work for is in the final transition stage from “start up” to “fast growing medium sized organisation”. It has been a tremendously successful few years, with the company growing from 10-20 patients per day in one small Outpatient & Diagnostic Treatment Centre (ODTC), to now seeing in excess of 200 outpatients per day across two ODTC’s, and up to 25 same day surgeries in a specialist built Ambulatory Surgical Centre (ASC). The organisation also partners with a local specialist hospital to field all complex non same day surgery volume.

The ASC has been open for one year, with lots of lessons learnt during this period. A year later now the centre is well established and operating well, inefficiencies have crept in, and lack of cost control. The impact has been much lower profit margins than budgeted. A detailed turnaround project is now required, in effect to “start from scratch” in terms of determining what is required to run an efficient, established ASC.  This will understandably take a significant amount of management time to undertake.

New Business…

At the same time, the organisation is continuing to expand. A new ODTC location has been identified and approved, and construction is about to commence. This project will require significant project management.

Secondly, the organisation is about to expand internationally and partner with an organisation to open a new hospital overseas. This is a huge project, and one which needs in depth project management to ensure implementation is a success, which is of major importance to the brand.


As a small organisation, all of the above fall under my remit. How do leaders effectively juggle the day job (which is currently in need of additional management support) and ensuring new business developments are implemented successfully, without adding unnecessary additional workforce or costs into the business?

Having done the usual restructuring, hiring of effective leaders etc, resources are still stretched. Sadly, according to the recent staff survey, staff are beginning to feel less valued, and less part of the company’s vision for the future.


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Participant comments on Juggling “Business As Usual” with New Business Strategies

  1. Hi Nicola. Congratulations on the success you have already seen. On a smaller scale, my practice has faced very similar challenges. We have grown from 4 docs in one clinic with 20 employees, to 16 providers, 75 employees, 3 clinic locations, an ASC and an MRI. We used to have a very tight knit staff who were committed to our vision. As we have grown we have dealt with all of the challenges you list. We continue to struggle with these exact issues, so I don’t think there is one clear solution. But one recent change we have made has been helpful. Because our employees are spread out geographically, there are some that we (physicians/owners) never see. It is hard for them to understand our vision and be vested in our practice. We have started to bring everyone together on occasion. It is difficult, because this means all clinical care stops for a short period of time (it was hard for some owners to swallow the idea that the MRI would not be running for 1 hour!), and we really don’t have a good space to bring this many employees together. So we basically close the clinic and get together in the waiting room. It seemed a bit awkward at first, but the feedback has been outstanding…well worth the 1 hour of productivity “lost”.

    1. That’s a really great idea, and one I think the organisation would support. I will give it a go!
      Thanks for your feedback.

  2. Hi Nicola-
    When growth such as this occurs, many times, staff are concerned about how the potential changes will affect them, their role, and their overall value. One small suggestion that might have a beneficial impact would be to empower leaders, with traditional set parameters, scope, and role, with leading the charge of a new project from start to finish, empowering them to utilize other resources across the teams as needed. This could be within the current operations, branching them out within, (and freeing up other leaders to take on added responsibility to handle the growth), and will also engage other staff members (non-managers, etc.) to be a part of the growth and/or existing business success. Shuffling around roles, responsibilities, or giving them oversight of an initiative outside of their normal day jobs might create a sense of ownership to the overall success of the business (current and future). Good luck! -Laura

  3. Hi Nicola

    It is great to hear you have this new strategy. Any new strategy requires an excellent change management piece with it and without this, the risk of failure will be high. my advice to you based on my experience is, establish a new team to manage the strategic planning and implementation but the team should work very closely with the business as usual team (this is very important) because if the later didn’t feel they own the change the resistance will be a risk. The other advice is to engage staff early on and communicate the new strategy with them carefully.
    best of luck

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