How San Diego Blood Bank Transformed Strategic Focus with OKRs and Profit.co

Doug: “We rely on our raw materials, our volunteer donors. There’s a challenge, particularly with lower birth rates throughout the US and a lower percentage of younger people becoming blood donors. So, there’s a big marketing and education aspect around the importance of blood donation. The population is aging, resulting in an increasing demand for blood. That’s a big challenge we have to solve across the country.”

Q: How did the idea of adopting OKRs come about at San Diego Blood Bank?

Doug: “I read the book Measure What Matters and started thinking about how that would work in our organization. We have numerous things going on, including changes in FDA regulations and challenges in recruiting donors, which can make it difficult to know where to focus. The idea was to simplify and really drive prioritization, starting with our leadership team and then cascading down through the organization. That was really the driver.”

Q: How has the OKR journey been so far? What’s worked well, and what challenges have you faced?

Doug: “It’s been a learning experience, but good to really focus on the top items. We understand that ongoing work is still in progress, but these are our current priorities. It’s helped us identify those focus areas and establish key metrics. Challenges include aligning other departments so they understand how their work contributes to the OKRs, and distinguishing between tactics and strategy. It’s an educational process through the organization.”

Q: How do you differentiate between strategic initiatives and day-to-day work?

Doug: “There’s some confusion at first, if something isn’t an OKR, does that mean it’s not important? However, we still need to keep the lights on and keep the blood flowing in hospitals. These are the specific strategic areas where we’re focusing, but day-to-day work continues.”

Q: What are the top three challenges you’ve faced in implementing OKRs?

Doug: “One is dialing in appropriate measurements, a combination of leading and lagging indicators. We aimed for aspirational goals, like this year’s OKR for ‘exceptional blood supply’ going beyond just ‘adequate.’ We’ve had to perfect how we measure that over time. Another challenge is communication, making sure departments don’t feel siloed and see how their work fits into the big picture. Lastly, consistent reporting that’s clear, understandable, and concise.”

Q: When did you decide to use a tool like Profit.co to support your OKR implementation?

“We explored several software solutions and even used templates, but manual tracking quickly became overwhelming. Once we discovered Profit.co and started working together, the collaboration was excellent. Your team took the time to understand our business and goals, which made all the difference. It’s truly been a strong and productive partnership.”

Q: How was the onboarding experience for your team?

Doug: “At first, it was probably a little overwhelming, like any new software, there are a lot of options. But as we dove in and got our feet wet, we started understanding how to utilize the software better. Your team’s deep dives and training were very helpful. Now, we have subject matter experts that department heads can reach out to for help.”

Q: How did your team overcome the initial bumps in using the tool?

Doug: “Through training, repeated use, and iteration. We participate in quarterly business reviews to walk through performance and identify where we’re missing the mark. We’ve adjusted things like check-in frequency to better match how we measure progress. After three quarterly reviews, we’ve tightened how we use the software.”

Q: How often do you review and update your OKRs?

Doug: “Leaders look at their OKRs weekly. The leadership team reviews monthly and quarterly, with deep dives at quarter-end. We break work into 90-day segments to avoid overanalysis and focus on what can be accomplished in that timeframe.”

Q: Are you tracking employee performance reviews within Profit.co?

Doug: “We’re not doing employee reviews in Profit.co, but we track manager-employee one-on-ones happening regularly. That’s a key metric for our ‘destination employer’ OKR, making sure managers are having frequent conversations and hearing directly from employees.”

Q: How has adopting OKRs and Profit.co impacted your organization?

Doug: “It’s helped us focus on priorities amid many projects. For example, marketing checks if requests align with one of our four critical OKRs. If not, it’s not ignored, but deprioritized. We’ve seen improvements in key metrics, such as day-to-day blood supply. We also developed better KPIs for our lab processes. Overall, it’s been a good journey.”

Q: How has your team’s familiarity and comfort with Profit.co evolved over time?

“As we’ve learned and dialed in the software, it’s definitely gotten easier. For example, should check-ins be weekly, or would monthly check-ins be more sensible? These conversations and adjustments have made the process feel less demanding.

Over the past year, we have also established an executive-led OKR group, focusing on key areas such as becoming a destination employer and ensuring an exceptional blood supply. Having executive leadership overseeing these groups has been really helpful. They meet periodically to reassess: Are we missing any important metrics? Should we update our approach as we move into the next year?

Overall, as we’ve refined our process, the time commitment has lessened significantly.”

Q3: How do you conduct monthly and quarterly reviews to keep OKRs on track?

Doug: “Each leader reviews their OKRs weekly. Our leadership team takes a broader look monthly and quarterly, unless an issue arises that requires immediate attention. At the end of each quarter, we do a deep dive because we’ve structured our work into 90-day segments.

The goal is to avoid the trap of over-analysis, especially in our highly regulated environment, where it’s easy to get stuck trying to plan the perfect approach and never move forward. Instead, we focus on what we can realistically accomplish in the next 90 days, setting aggressive yet achievable goals.

And then, it’s about being honest and transparent when measuring our achievements. That’s the purpose behind our quarterly deep dives.”

Q4: How do you ensure issues or “off-track” progress are surfaced early during reviews?

Doug: “I obviously focus on things that are listed as off track. When check-ins are happening, that would kind of raise the awareness of it. And that’s our expectation that having an executive sponsor who’s overseeing each of these OKRs would be able to raise a red flag to the leadership team there for a while, if something is off track with something. We’re really well aware of the other KPIs, so nothing really would be a surprise, but that’s the process.”

Q5: What impact has the OKR process had on celebrating successes and maintaining momentum?

Doug: “I think, for a while, the opportunity to celebrate success on a quarterly basis and some of the simple dashboard kind of visuals is helpful. And again, as your team has joined us, because we don’t have any insight outside of our organization, necessarily on OKRs. So, as your team shares with us how we’re doing in relation to other entities you’ve worked with and where we’re at in our maturity level, that’s been encouraging. To get a little bit of a third-party perspective to say, yeah, actually, you’re doing pretty well there. Because we’re always aiming for perfection. So I think that’s been good to celebrate those small wins as you go to keep the momentum going.”
“Otherwise, it’s really about walking it down through the entire organization. Ideally, we want to get to the point where it’s really bottom-up. But as individual staff members are looking at what they’re doing, they want to understand how those things bubble up to the mission of the San Diego Blood Bank.”

Q6: What advice would you give to other nonprofits about starting their OKR journey?

Doug: “I think starting with some education on what an OKR is or how it differs from the typical KPIs, maybe that they’re working with. For us, the idea that we want these OKRs to be aspirational is where we’re trying to get to. If we don’t push ourselves, we’re not going to get there. Which means that if you’re being aspirational in your goal setting, you’re likely to miss. And this is something I took away from a book that I read: at some level, you have to be okay with not being 100% all the time. Because if you’re setting goals that you know you’re going to hit 100% of the time, then you’re not stretching yourself. So I think that education, depending on the organization, is being comfortable with the fact that we’re going to stretch a little bit. And if we only get to 95% of that stretch goal, that’s still better than we were going to be if we were just sitting at our original goal at 85% or whatever. But again, I think that’s just education depending on the organization.”

Conclusion

San Diego Blood Bank’s OKR journey highlights how even mission-driven, resource-conscious nonprofits can scale focus, drive strategic alignment, and embed a culture of continuous improvement. With the support of Profit.co’s intuitive platform and a leadership team committed to education and growth, they’ve not only navigated a complex regulatory and operational environment but also set a foundation for long-term, sustainable impact. Their story is a testament to how the right frameworks and tools can empower organizations to meet today’s challenges and tomorrow’s possibilities head-on.