"You cannot scale a mission like ours without OKRs, and you have to use them consistently and correctly."

Inteleos has decades of healthcare personnel certification heritage. Before OKRs, what was the real problem you were trying to solve as you looked at the future of the organization?

Inteleos certifies the healthcare professionals the world depends on, and we have been doing it for the better part of 50 years. Our mission is patient safety and equitable access to quality care for people in every economic environment. A certification is how we codify an individual’s knowledge, skills, and abilities, and, most importantly, the trust between a clinician and the patient in front of them.

To scale our mission’s global impact, we had to stop measuring ourselves by how much we produced. We had to evolve, and start building operational and governance systems that measure what actually changes for the patient.

Confusing outputs with outcomes is a trap most organizations fall into. A certification body, for example, may count the tests it delivers and call that an outcome. It is not. The outcome is a life changed by an appropriately certified clinician.

Why OKRs, and why bring in help rather than going it alone, given the expertise did not exist inside the certification field?

We had been on an OKR culture and systems journey for a few years, and I was not happy with the pace. We kept sliding back into counting outputs, because the hard part was never the definition. It was the change management that shifts the culture. Our people had been enculturated to function by checklists and outputs. That is understandable, but we had to try something new to move the needle toward a consistently executed OKR program.

You cannot scale a mission like ours without OKRs, and you have to use them consistently and correctly. The operational expertise to run OKRs well was the driver of that change.

So we went outside our own walls and found people who do this for a living. That is why we brought in OKR Quickstart. If I have one regret, it is that we did not bring them in sooner. We would have saved ourselves a few years of learning the hard way.

What was working with the OKR Quickstart team actually like, and what surprised you?

They did not hand us a framework and leave. They embedded with us, quarter after quarter, through the ceremonies, the OKR weeks, the direct coaching of our champions, the unglamorous repetition that actually makes this stick and evolves a culture.

Honestly, they became less like a consultant we hired and more like part of our own ecosystem.

I now hear our people talk more naturally about outcomes than they did a year ago. I will say it plainly: building an OKR culture is long-tail work, and if it were not for OKR Quickstart, we would not be on the path we are on today, a deeply entrenched OKR system. We are accelerating our mission growth because of the OKR infrastructure we built together, and the results are positive.

What is one change you can point to and say, “that happened because of OKRs”?

Plenty, and I credit the coaching for it. We cut the number of goals we carry by more than half, from thirty-one objectives down to fifteen, and sharpened the intent at the same time.

Of the five seven-year impact goals we built the whole organization around, four are landing ahead of the 2027 deadline. We passed our target of 500,000 education sessions early, and we are on track to double our assessments, from thirty thousand to sixty thousand. Every quarter, outcome thinking sits deeper in the organization.

But the change I value most is watching the culture evolve around OKRs, and seeing that evolution translate into substantial mission growth.

It meant building a real product capability, not just talking about one. OKR Quickstart has coached our teams toward a genuine OKR product operating model. That, in part, gave us the discipline to separate mature products from the brand-new markets we are exploring. Those two need different skills and different outcomes, and we manage them that way now.

That is how we are standing up our digital wallet, Impera, as its own product, and, before long, its own company. It is the biggest value expansion we have on a global basis. None of it scales on output thinking. It scales because our leaders have learned to own outcomes and to collaborate across divisions, which is the harder discipline and the one that matters.

Many leaders assume a mission-driven, legacy, regulated organization cannot move like this. What would you say to a CEO who thinks OKRs are only for fast-moving tech companies?

I would tell them they have it exactly backwards. A mission-driven organization is not the exception to this. It is the strongest case for it.

Let me give you a real one. Diagnostic medical ultrasound equipment used to cost around $250,000 USD and was the size of a washing machine. Today, hand-held ultrasound devices are made for less than $5,000 USD. They plug into a phone, and they go anywhere, including rural Kenya, where too many mothers and babies still die in childbirth.

We worked with the Kenyan Ministry of Health, midwives, ultrasound imaging expert societies, and more than a dozen related stakeholder groups. Through those convenings, the stakeholders put a national policy in place: the people using those devices in obstetrical care must be properly educated, trained, and certified proficient. Getting the devices into the field is an output. A mother and her baby surviving the delivery is the outcome. If all you ever count is the devices, you will never know whether you changed anything.

Ninety-five percent of impactful change cannot be done alone, and outputs only build toward the objective, the outcome. You get there by putting the right culture in place to manage growth. It is clear to me that OKRs are the tool that does that. That is as true for a 50-year-old nonprofit as for any technology company. More true, in our organization, because patient outcomes are on the other side of it.

What would you tell another certification, testing, or association CEO who is considering this but has not committed?

Take the time to review your operations and determine what is an output and what is an outcome. It is common to conflate the two, but clarity of operational intent to drive outcomes will lead to organizational growth. In my research and experience, OKRs are the tool that drives that change and growth.

Diagnose the barriers to a successful OKR program early. They usually center on culture, and on a lack of clarity about outcomes versus outputs. More than likely, the expertise you need is not inside your organization. Go find experienced experts who can help you evolve into an OKR success story. Commit to it properly, and give it time to embed. Be aggressive, but patient.

Do not wait, the way we waited. The sooner you start, the sooner an OKR culture becomes embedded in your organization.

In one sentence, what did OKR Quickstart do for Inteleos?

They taught a certification body built over nearly 50 years to manage toward outcomes instead of outputs through OKRs, and that is the catalyst that lets us scale our mission to the people who need it.

Dale Cyr

CEO and Executive Director, Inteleos