How many times have you been to a seminar, congress or meeting and heard a great idea – jotting it down with the intention of implementing the idea in your practice – only to realise weeks or months later that you just didn’t get around to it?

Yep, we’ve all done it.  Life and business just gets in the way.

The ‘4 Disciplines of Execution’ (4DX) refers to this phenomenon as the ‘Whirlwind’.  4DX was devised by Sean Covey, Chris McChesney and Jim Huling

When we consider how many plates we need to spin each day, it’s little wonder we often fail to find time to introduce new concepts.  I imagine these are all these items that require attention each day?:

  • Staff
  • Patients
  • Suppliers
  • Cash Flow
  • Marketing
  • CET
  • Time

‘The 4 Disciplines of Execution, or 4DX, is a simple, proven method used by businesses throughout the world to get stuff done!

Not just any stuff – but the stuff that really matters to your business

Going back to the question I asked a moment ago, how many fantastic ideas do you estimate you’ve wanted to adopt in your business….but, for whatever reason, have failed to?

I know my lifetime number would be in the scores, if not hundreds!  That all changed after I read the book ‘The 4 Disciplines of Execution’.

Wildly Important Goals

At the heart of 4DX are ‘Wildly Important Goal’s (WIG’s).  Your initial reaction is probably “Oh, that is so American”  True, as 4DX originated in the USA.  However, WIG is as good a description of the objectives that, above everything else, you wish your business to achieve as any other phrase.

Having WIG’s doesn’t mean that you can’t have other goals – but the WIG’s take precedence over any other objectives.

Whenever your practice team meets, the top agenda item will always be your WIG, or WIG’s.  The entire team understands the WIG and is committed to its achievement.  It is absolutely crucial that the business owner or leader consistently displays devotion to reaching the WIG.

“There will always be more good ideas than there is capacity to execute”

Most businesses have too many goals and too little focus on achieving those objectives.    4DX overcomes this tendency!

Progress towards the WIG’s is reviewed regularly and consistently.  In practice team meetings, WIG’s are the top agenda item.

The entire team understands the WIG and are committed to its achievement.  It is absolutely crucial that the business owner or leader consistently displays devotion to reaching the WIG.

Lag v Lead Measures

All successful businesses measure their performance against targets.  However, most businesses concentrate on the end result – or the final score.  4DX calls this final score the Lag Measure.

The key feature of the Lag Measure is that once you’ve reached the point of knowing the final score, or Lag Measure, it’s too late to do anything about it.

In 4DX, we focus on measurement of Lead Measures – these tell us how likely we are to achieve the Lag Measure, or final score.

E.g. If your WIG is for your car never to break down, having it regularly serviced (the Lead Measure) is an accurate predictor of the likelihood you will achieve that WIG.

Each WIG can have a number of Lead Measures, which your practice team contribute to – although we recommend no more than 3 Lead Measures for each WIG.  Lead Measures should be reviewed at least weekly!

Let’s look at an example of Lead v Lag Measures:

Your WIG for 2017 is to improve conversion (eye exams into dispensings) from 45% to 60%.  Your Lag Measure is 60% conversion.

Of course, achieving the Lag Measure won’t happen unless you implement new actions (Lead Measures) that you believe will achieve your Lag Measure.  So, you might decide to:

  1. Perform all handovers in the consulting room
  2. Send a letter with a voucher to all patients who did not purchase eyewear on the day of their exam
  3. Ensure your most experienced D.O receives at least half of all handover

In your weekly team meetings, your focus will be on:

  1. What percentage of patients received a 3-way handover in the consulting room? What prevented us achieving 100%? What do we need to change to achieve this Lead Measure?
  2. How many px’s did not purchase on the day? How many of these did not receive a letter and voucher? Why not? What needs to change?
  3. How many patients were tested last week? How many were handed over to our more experienced D.O?  What prevented him/her taking more patients?

Within your team meetings, be sure to validate the efficacy of the Lead Measures and, if necessary adjust, or even replace them.


If you are going to involve the team in achievement of the Lead Measures, which will ultimately ensure you hit your WIG, you need to let them see our progress!

The type of scorecard you use will depend upon your WIG.  Many financial performance WIG’s will allow you to automatically produce scorecards (reports) from your Practice Management System.  However, we advocate that production of your Scorecard is manual wherever possible.

More automation = less engagement.

The ideal place to display your Scorecard is the staff room noticeboard.  Remember, simple is best!

Ideally, all Lead Measures for the same WIG should be displayed on the same Scorecard.

Culture of Accountability

4DX is not just for the practice owner (i.e you!).

In truly effective 4DX, many members of the team will be highly engaged in pursuit of the WIG – and acting upon the Lead Measures.  By creating a focus on the Lead Measures, your practice’s prospect of reaching the desired Lag Measure, or WIG, will greatly improved.


In our experience 4DX is a highly effective means of channelling focus, energy and activity into achievement of your overriding business objectives, or WIG’s.  Activeyes incorporates 4DX into our PRISM Pathway business growth programmes.

Why not use 4DX to achieve your practice objectives?  Start by considering:

  • Where do you want your business to go?
  • Which WIG’s will take you there (max 3)?
  • For each WIG (Lag Measure) what should be the Lead Measures be (again, max 3)?
  • What scorecards will you need to track my Lead Measures?
  • How do you get the full buy-in of the team?
  • Who will be accountable for each Lead Measure?
    • Do they need training in these new responsibilities?
    • Should you give incentives?

Need help?  Please contact us to schedule a confidential discussion on your WIG’s and how Activeyes could help you achieve them.