Connecting the Dots: How a BOS Creates Clarity and Motion

Every organization has pieces of a system. Weekly meetings here, annual planning there, maybe a dashboard or two scattered around. But the difference between pieces and a system is the difference between noise and music. Over a year ago, I had the opportunity to help a healthcare organization move from “pieces” to a true Business Operating System (BOS).

This wasn’t about layering in another management fad. It was about clarity, rhythm, and tying the critical parts of the business together so that leaders weren’t constantly fighting fires, but could step back and steer.

Here are the steps that worked, along with some considerations for introducing a BOS in your own organization.

1. Start by Observing, Not Fixing

I’ll admit it: my instinct is often to dive right in and start making changes. But when I walked into this healthcare organization, I knew the first move had to be restraint.

For two months, I watched. I listened. I asked questions in every department I could. From frontline staff to senior leaders, I wanted to understand not just the “what,” but the “why.” Why were meetings run this way? Why did KPIs exist in one pocket of the business but not another? Why was the SWOT analysis tucked away after the annual discussions, never to be seen again?

That period of curiosity built trust. It also gave me the map of where the gaps really were. The tools existed, but they weren’t connected. Performance reviews didn’t line up with the strategy. The strategy didn’t align with the execution. Meetings were happening, but with no real rhythm.

If you’re introducing a BOS, resist the urge to jump into solutions. First, learn how the organization is wired today. After all, culture is a significant aspect of making a BOS successful in a company.

2. Revisit Structure and Team Strength

Any system is only as strong as the people who run it. Early on, I spent time reviewing the organization chart and asking: Does this reflect where the company is headed, or just where it’s been?

We elevated several people into new roles to build a more balanced and effective senior team. That single move did more than shuffle reporting lines. It created clarity. Suddenly, there was a table where the right people were present, decisions could be made, and accountability had a home.

Too often, organizations try to build a BOS on top of a shaky structure. That’s like trying to hang a chandelier from a ceiling beam that doesn’t exist. You know what’s going to happen eventually! Get the structure and leadership team right first.

3. Introduce an Operating Rhythm

One of the most powerful changes was deceptively simple: setting a cadence.

We introduced three distinct review points:

This rhythm created a drumbeat across the organization. Everyone knew when they’d be heard, when decisions would be made, and when results would be reviewed. It replaced ad-hoc conversations and one-off escalations with a predictable flow.

If you’re building a BOS, don’t underestimate rhythm. It’s not about meetings for the sake of meetings. It’s about consistency, clarity, and reinforcing focus at the right levels.

4. Elevate Strategy Beyond the Annual Retreat

Historically, this organization conducted a SWOT analysis annually. A helpful tool, but not much more than a checkbox when it lived on paper alone.

As the new fiscal year began, we refined our strategy process. This time, we brought in multiple lenses:

The result was a strategy that wasn’t just top-down. It was co-created. That made it stickier. People could see their fingerprints on the direction we were setting, which meant they were more committed to executing it.

For your BOS, strategy can’t be an annual event that dies in a binder. It must be dynamic, participatory, and closely tied to execution.

5. Translate Strategy into Goals, Ownership, and KPIs

The next challenge was moving from strategy to execution. We set new annual goals, but with one important distinction: ownership was defined. Every major goal had a name attached, not just a team. That subtle shift changed accountability.

To track progress, we introduced a Balanced Scorecard with fewer than 10 KPIs. These were the critical signals of organizational performance. Too many KPIs can lead to drowning in data. Too few and you miss blind spots. We struck the middle ground.

Each department then layered in its own supporting KPIs (yes, or KRs). These weren’t for senior leadership; they were for the teams themselves. The idea was simple: provide people with the feedback they need to course-correct in real-time. And yes, we tied those KPIs to individual performance management, ensuring that strategy, execution, and evaluation were finally aligned.

When designing your BOS, remember that KPIs aren’t about tracking everything. They’re about creating focus, ownership, and visibility at the right levels.

6. Keep Connecting the Dots

Here’s the real lesson. A BOS isn’t a one-time project. It’s a way of tying things together:

When these links are missing, you end up with silos, confusion, and wasted effort. When they’re connected, you get clarity. And clarity, in my experience, creates motion.

Final Thoughts

Eighteen months later, the healthcare organization had moved from scattered efforts to a system. Not a perfect system, those don’t exist. But a functioning, adaptive BOS that gave leaders the ability to look forward, not just backward.

The key steps were simple, but not easy:

If you’re considering implementing a BOS, start with clarity. Ask: where are the pieces already in place, and how can I tie them together into something coherent? Because when structure, rhythm, and focus align, the organization moves faster and with purpose.