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Strategic Adaptability in the Face of Change

In late 2019/early 2020, the Division of Environmental Health Science and Practice (DEHSP) developed a comprehensive strategic plan that outlined the key focus areas, objectives, and milestones the division planned to accomplish by 2024. The strategic plan was being disseminated right as the world was grappling with the uncertainty, fear, and panic of the COVID-19 pandemic. Like so many other businesses and organizations, almost overnight we faced a monumental disruption to the ways we had to think about our division’s priorities and resources. While we had an intricately crafted and thoroughly researched strategic plan, we soon learned we would need to be flexible and adapt to the unexpected changes resulting from COVID-19.

Within any project, business, or organization, the imperative of crafting detailed roadmaps is clear: you need them to achieve your goals and to prioritize resources while maximizing efficiency. Without a clear definition of how you will achieve success or get from point A to point B, projects or organizations can face delays, cost overruns, or an end result that isn’t desired.
Following the completion of the division’s strategic plan, the concept of lift points was developed by division leaders to identify the work that would successfully lift the reach and impact of the entire division. The lift point concept provided leaders with a framework for implementing the strategic plan in a way that attempted to remove silos across the division, highlighted the cross-cutting nature of division-wide priorities, and further prioritized strategic plan objectives through 2024. With CDC’s response to the COVID-19 pandemic, however, DEHSP staff availability became limited, resources were stretched to capacity, and the strategic plan implementation efforts were temporarily halted. After six months of dedicating resources almost exclusively to the pandemic response, leadership revisited the lift points with a renewed understanding of the importance of establishing and implementing clear-cut, focused priorities. We recognized the value in strategically directing division resources to strengthen programming and maximize efficiencies. Division leaders chose to re-focus their energy on clarifying and addressing the lift points, despite the challenging resource constraints.

Charting the Path Forward: Establishing Lift Points

To determine the right mix of lift points, division leadership needed to prioritize the most impactful, yet attainable, areas of the division—in project management terms, essentially the initiatives with the best return on investment. With the COVID-19 response in full swing, we saw that our staff, resources, and time were limited even more than usual. We knew we would need to work towards goals that would create the largest impact for the entire division, without burning out our staff.
To do this, we needed the right perspectives at the virtual table—strategic thinkers who could push the group to think bigger, policy and communications leaders who know how to communicate impact, scientists and subject matter experts to drive evidence-based practice, and programmatic leaders who could lead the effort to operationalize the lift points. This group was spearheaded by my colleague, Amy Cordero, M.P.A., Associate Director for Policy, who was instrumental in shaping the entire lift point concept and creating buy-in among senior leadership and division staff members. With this group together, we set some clear boundaries on how to determine the lift points:

  • Focused: We limited the final number of lift points to six—any more than this would spread our resources too thin.
  • Cross-cutting: We prioritized identifying cross-cutting initiatives that could break down silos across the division and create more collaborative, innovative solutions.
  • High leverage: We focused our attention on the areas of the division that had the means to significantly move the entire division forward.
  • Attainable: We considered division resources (e.g., time, funding, and personnel) as we prioritized lift points.
  • Policy impact: We reviewed the policy landscape and considered the political will and interest for division priorities.\

Through a series of prioritization working sessions, the group finalized the six lift points and their corresponding goals:

  • Develop a division-wide data modernization strategic action plan by December 2021
  • Finalize a DEHSP science agenda by March 2022
  • Develop a division-wide prioritized partnership plan by December 2021
  • Publish an Environmental Health Best Practices Playbook by June 2023
  • Demonstrate Controlling Childhood Asthma and Reducing Emergencies (CCARE) impact and clinical integration by August 2024
  • Implement the DEHSP brand by September 2021

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Mission Coordination Team Implementation

Now that we had the lift points identified, the next step was to map out how we would achieve them, especially given the additional constraints brought on by COVID. We developed Mission Coordination Teams (MCTs), which we clearly distinguished from the idea of a traditional workgroup. At CDC, workgroups are groups of people who are responsible for conducting all key activities related to a specific project or goal. MCTs, on the other hand, have a different scope than workgroups because members serve as the project managers/coordinators of the lift points. These teams would help determine the strategy and process of the work, establish timelines and action plans, coordinate staff members across the division to conduct key activities, and monitor progress toward the lift point goals. We decided the MCTs would be cross-cutting, collaborative groups with representatives from all four DEHSP branches (Emergency Management, Radiation, and Chemical Branch; Asthma and Community Health Branch; Lead Poisoning Prevention and Environmental Health Tracking Branch; Water, Food, and Environmental Health Services Branch) and the Office of the Director (OD).

To facilitate the work of the MCTs, we focused on several different, soon-to-be ‘old school’ Project Management Body of Knowledge (PMBOK) process groups and knowledge areas. The PMBOK sets standard terminology and guidelines for project management. In particular, we leaned on concepts around:

  • Integration Management: Allocating resources to support the MCTs; outsourcing contractor support to provide project management, strategy, and facilitation support to all MCTs
  • Scope Management: Defining the purpose, audience, and scope of the MCTs; identifying the requirements and process for generating final MCT deliverables
  • Resource Management: Defining roles within MCTs and leveraging a diverse portfolio of skills; ensuring each team consists of members with different strengths, capabilities, and backgrounds (e.g., scientific SMEs, strategists, project managers, etc.)

Maintaining Momentum

After mapping out the approach for the lift points and MCTs, we quickly realized the lift point process would be cyclical in nature; once outcomes for an individual lift point have been achieved, the lift point can be ‘retired’ as it becomes institutionalized as standard operations. Then, additional lift points can be identified. Division leaders will identify future potential lift point areas by several different factors, including political, social, and cultural forces; changes in funding; interest from partners; and internal momentum. During the ‘lift point staging’ process, division leaders will identify the vision, strategy, and goals related to a particular program or effort. Once a program or topic area has gone through lift point staging, and depending on the outcome of the staging process, an MCT may be established to make progress toward the lift point goals.

The only way to determine if individual lift point goals have been successfully completed is to build a robust evaluation framework. For an organization like CDC, the importance of demonstrating impact to external audiences cannot be emphasized enough. In fact, the division is actively working with the Program Performance and Evaluation Office to develop a strategic performance management framework (e.g., processes, measures, tools, reporting cadence, etc.) for all MCTs. This performance management framework will help ensure all stakeholders are working toward well-defined, achievable goals and that successful practices are institutionalized to achieve the greatest impact.

A New Way of Organizational Thinking

While our implementation of these practices remains a work in progress, as all good management processes necessarily are, and as we continue to respond to a changing landscape, there are a few noteworthy observations we can already identify. As I look back on the past year and a half, I realize how much progress we’ve made, and appreciate how much important work remains. I’m reminded of a quote by John F. Kennedy: “The time to repair the roof is when the sun is shining.” As we were developing our comprehensive strategic plan, the sun was shining, and we were looking towards the next four years for the division. When COVID-19 completely upended our initial deployment of the strategic plan, leadership chose to adapt our initial implementation of the lift points and reprioritize our efforts, despite our resource challenges. That experience has fundamentally shaped the way we think here at DEHSP. Given this shift in division leaders’ mindsets, and the lessons we learned from remaining agile and adapting our strategic planning framework, this will undoubtedly become the norm moving forward. The DEHSP lift point staging process and implementation of MCTs has helped the division shape its strategic priorities and better articulate how all the different offices and branches fit into the overarching goals of the division. It will be extremely interesting to see how the division continues to adapt as our experiences advance and more lessons are learned. Isn’t that the whole point of agility—to continue to practice it in an increasingly dynamic world?

F.E. Harrison

F.E. Harrison serves as the Deputy Director for the Division of Environmental Health Science and Practice (DEHSP) at the Centers for Disease Control and Prevention (CDC). She Manages an annual budget of over $100 million has more than 15 years of experience directing multi-disciplinary project teams, implementing domestic and international evidence-based interventions, and developing communication campaigns and partnership strategy for federal and state agencies, local ministries of health (MOH), and non-governmental organizations (NGOs). In her past position, F.E. Harrison served as a Deputy Branch Chief at the Centers for Disease Control and Prevention (CDC). She managed an annual budget of $16 million for Vaccines Preventable Diseases. She managed domestic and international programs with multilateral organizations, such as WHO, GAVI, and the Bill and Melinda Gates Foundation. From 2016 to 2019, F.E. served as a project officer for the Haiti office supporting PEPFAR and Global Health Security program activities. During this time, she also served as the Acting COAG Team Lead, implementing a program budget of $52 million annually. F.E. led various health informatics projects including Haiti’s national electronic medical records (EMR) called iSantè, bio-metric coding, and the patient linkage and retention tablet system. F.E.’s international experience began in 2012 when she spent three months in Mozambique as part of the International Experience and Technical Assistance (IETA) Program. In 2015, she was deployed to Liberia to work on the management and operations team assisting in the Ebola relief. During her deployment, she worked closely with the country director on managing the office’s cooperative agreements and contracts, the office’s budget, and post held funds. F.E. began her federal career in 2005 as a part of the Emerging Leaders Program (ELP). The ELP program was a competitive two-year fellowship within Health and Human Services. She joined CDC in 2006 as a Health Communication Specialist. Her experience in communications includes conducting formative research, monitoring and evaluating communication channels, writing speeches, performing user-centered analysis, leading message development, planning content strategies and web digital strategy, and managing social media and communication campaigns. F.E.'s formal education includes a Master of Business Administration (MBA) from the University of Central Florida and a Bachelor of Science in Public Relations from Florida A&M University. She is also certified as a Project Management Professional (PMP).