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Boiling It Down: Conveying Complexity For Decision-makers – LifeSciVC

By Ankit Mahadevia, former CEO of Spero Therapeutics, as part of the From The Trenches feature of LifeSciVC

Drug development is complex. So is running a business. Sometimes, the work of doing both can make your head spin. In my career as a CEO and Board Chair, I’ve found that one of the most important things a team can do  is convey this complexity clearly and efficiently when it’s time to decide.

Boiling down complexity takes real work; time is usually limited, Board and senior team decision-makers are not always in the weeds and may have different facility with key issues.   Stakes are high: the right strategic decisions are the oxygen for your enterprise.  These decisions are only as good as the context on which they stand.  So, how should teams navigate setting the stage in the Boardroom and for leadership teams?

Prioritize what to communicate:  It’s helpful to prioritize topics and be selective about what to cover.  Generally, priority issues have an outsized impact  and require balancing risk and benefit across parts of the business  (for example, a program choice that requires shifting resource away from other programs).  Such decisions typically aren’t ones that individual teams are empowered to take themselves.  While it’s human to want to show your senior team and Board all of your work, not prioritizing can leave less time for the guidance you really need.

Plan ahead to set the scene: The regular leadership cadence (Board meetings, senior team meetings) is important to build common understanding before a priority issue becomes emergent. It’s natural to want to push “scene setting” off for more urgent items; I’ve learned through experience that we’ll either invest the time upfront, or when we’re on the clock for such topics.  A former C-team colleague of mine used the phrase  “watch this space” to get our C-team and Board up to speed on topics in his domain that may require a decision in the future.  As a matter of process he built in a bit of this into meetings with me and C-team/Board interaction when appropriate.  When it came time to decide, we had a common background and in many cases a draft plan of action.

Focus on the fulcrum issues when deciding: A former Board Chair I worked with often use the term “fulcrum issue” to guide how to focus a time-sensitive decision.  While most decisions have a number of moving parts, most involve navigating a specific  strategic pivot point (speed vs. quality of data for example).  An efficient review of the issues builds out from the key tradeoffs.  For example, one recent Board discussion debated size and complexity of a future patient  study. The fulcrum was strength of the study vs. the cash required to power the study and the company until top line data.  This was a guide for where the team needed to set the stage before we reviewed their recommendation. 

Make it personal in the team setting:  There’s an additional layer of context to provide for teams relative to Boards: team members are responsible for and to their colleagues and usually have a specific function to drive.  We’ve made better decisions as a team when we’ve taken intention to lay out what an issue means for key functions.  Sometimes, the implications may seem too obvious to discuss.  In my experience, they aren’t as obvious as one might think.  Further, the process of personalizing the implications allows individuals/ to be heard  and speeds up the time from understanding the issues to deciding and executing.  There are different ways to have this conversation depending on time sensitivity and company culture. Often, this was an explicit discussion in a group meeting. Other times, senior managers were empowered to assess the impacts with their team between decision and implementation (see the 24 hour rule below).

Watch for the rebound: I live by the saying of one of my former co-founders: There are no slow deciding successful companies. When moving fast, though, there is the risk of incomplete understanding. A key lagging indicator of this is “the rebound.”  On rare occasions, I’d notice an issue being relitigated in side discussions among C-team members or Board members after I thought we’d decided.  This is not typical of either the teams or Boards I’ve been a part of, so when it did happen, it was a sign that we needed to do a better job of setting the scene. We took the time to check in about whether there was true understanding, and to get together and get it right if not.

The time immediately after taking an important decision is one to listen carefully for the rebound; when at all possible I counsel teams to have a “24 hour rule” before a key decision is implemented in case we got the process of setting the scene wrong. There are also leading indicators that you’ll face the rebound – for example, if there is surprisingly little discussion about what you think is a complicated issue.

How an organization makes decisions reflects the results it will achieve.  Good decisions need the right context; some intention about what you convey, how you convey it, and how you assess understanding can be instrumental in getting things done.  The issues we address in developing medicines aren’t always clear, but conveying the issues effectively can make all the difference.

My thanks to current and former colleagues at Spero and other companies for their contributions to this article