Create a 4DX Company


How to set up a goal and accountability system to improve results and employee morale.

By Jeff Jankowski, PT

Have you ever come to the end of a week, month, or even a year and become frustrated because even though you felt like you were working yourself to death your key metrics didn’t move? If so, you are not alone. This type of activity without success can lead to low employee morale and cause them to look outside your organization for fulfillment at work.

Around a year ago I was exposed to Chris McChesney, Sean Covey, and Jim Huling’s book The 4 Disciplines of Execution: Achieving Your Wildly Important Goals (Free Press, 2012), and it has helped to dramatically turn around our company. We have a company of 15 locations, but the principles in this book will work from single locations all the way to huge corporations. The 4 Disciplines of Execution (4DX) are simple but powerful: (1) Focus on the Wildly Important, (2) Act on the Lead Measures, (3) Keep a Compelling Scoreboard, and (4) Create a Cadence of Accountability.

Focus on the Wildly Important In Discipline 1, Focus on the Wildly Important, we see that basically the more you try to do, the less you actually accomplish. Selecting one (or, at the most, two) extremely important goals instead of trying to improve everything at once helps provide clarity to the team that this is the goal that matters most. Remaining focused on the wildly important goal can help you and your team avoid getting caught up in the whirlwind of activity that is tossed at us every week and not accomplishing anything.

Act on the Lead Measures Discipline 2 teaches us to Act on the Lead Measures. In this Discipline we learn that all actions are not created equal. The authors teach that lag measures are the “tracking measurements of the wildly important goal, and they are usually the ones you spend most of your time praying over.” In our therapy clinics these could be revenue, profit, customer satisfaction or employee satisfaction scores. In other words, by the time you get a lag measure, it is history and you can’t fix it (hence it “lags” behind). In contrast to the lag measure, the lead measures are the high-impact things that your team must do to reach the goal. A good lead measure will be predictive of achieving the goal, and it can be influenced by the team members. Examples of lead measures in physical therapy would be visits/week or new evals/week. Again, the lag measures are what you are trying to accomplish, but the lead measures will help you get to the lag measures. In looking at my own company’s history, I realized that we had been pretty good at tracking lag measures but had missed the important step of acting on lead measures. Once we shifted the focus to a 4DX model earlier this year, every one of our metrics has improved, along with employee morale.

Keep a Compelling Scoreboard Discipline 3 is to Keep a Compelling Scoreboard. We know that people are instinctively competitive, and it is important to keep a running scoreboard in front of us so that we can measure our success. For our clinic this is done with a simple Excel sheet with either green, yellow, or red colors. If we are meeting the goal for the week the color is green, if we are within 95 percent of the goal the color is yellow, and if we are 85 percent or below of our goal the color is red. It is an easy way to identify if we are hitting our mark that week or not.

Create a Cadence of Accountability Discipline 4 is to Create a Cadence of Accountability. The authors make the point that “The first three disciplines set up the game, but until you apply Discipline 4, your team isn’t in the game. It is based on the principle of accountability: that unless we consistently hold each other accountable, the goal naturally disintegrates in the whirlwind [of our day].” For our team we set up weekly 15-minute meetings in which each clinic manager shares what one or two action items they commit to take the next week to change their colors toward green. The manager then reports on whether they met the previous week’s commitments, how well they are moving the lead and lag measures on the scoreboard, and their commitments for the coming week, again all in only a few minutes. Covey shares that “the reason this Discipline is so important is that it allows the team member to create their own commitments which allows them to take ownership of them. We know that team members will always be more committed to their own ideas than they will to orders from above. We also know that making commitments to their team members, rather than solely to the boss, shifts the emphasis from professional to personal. Simply put, the commitments go beyond their job performance to become promises to their team.” Research shows that this type of corporate culture produces far better results than a traditional corporate culture in which the rules are always given from the top-down.

The book provides examples of how great companies incorporate the 4DX principles and provides steps on how to implement this culture into your own company. One of my favorite quotes from the book is “There will always be more good ideas than there is capacity to execute.”

Jeff Jankowski, PT, is a PPS member and chief executive officer of Redbud Physical Therapy in Oklahoma. He can be reached at

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