No industry in the American economy is undergoing more change at the present time than health care. The same might be said for other countries such as the United Kingdom, Canada, Italy, and Germany. Underfunded health delivery systems with large increases in patient demand, combined with workforce shortages and inflationary forces driving up costs are spurring an unprecedented period of disruption in how care is delivered, reimbursed, and assessed. The next decade in U.S. health care will see continued transformation, some of it unpredictable and most of it requiring new ways of thinking and acting on the part of providers, patients, organizations and—importantly—health care leaders.
Health care leaders face a number of change management imperatives within this turbulent environment. Business as usual for these individuals, which traditionally has involved monitoring relatively stable business models and organizational dynamics, massaging thin but reliable profit margins, is being turned on its head as existing assumptions about how to compete effectively hold less and the need to innovate becomes greater.
What must these people be good at to succeed? Two primary things. First, they have to increase the ability of their organizations to learn. To do this, health care leaders must create and support architectures (policies, structures) within their organizations that push for and reward “fast failure.”
Easier said than done. There is perhaps no more risk averse industry than health care, and perhaps with good reason since the services being delivered are often tied to important outcomes like preventing or healing illness. No one wants anything in health care to fail given what is often at stake. That said, however, failure abounds in health care normally in every corner of the business, whether it is acknowledged or not, and it’s often covered up by organizations rather than used as a chance to understand cause and effect, improve a work process and, ultimately, reduce the rate of failure occurrences in specific areas of the business.
Health care leaders need to assure that their organizations have the resources, systems, and capabilities to identify failure, with the goal to study and learn from it. Perhaps more important, these leaders need to act as the “failure champions” for the rest of their workforce. There are too few leaders in any industry willing to embrace such a role. In health care, it is now a basic requirement of the job, because it is one of the tried and true ways to build both resilience and mindfulness—key attributes that give any work setting its capacity to improve, innovate, and recover from mistakes. To navigate the uncharted waters ahead, health care organizations like hospitals and insurance plans must become more resilient, and develop a systemic capacity for handling change.
Being a culture manager is the second key thing today’s health care leaders must embrace. Change management is primarily about facilitating meaning systems among employees that support fast failure but also are comfortable with uncertainty; buy into a shared vision for change; and recognize the insufficiency of the status quo. As much research shows, change events are both traumatic and fearsome for employees. Health care professionals in particular see change often in negative ways, given their own beliefs that how they have been taught to do things is the right way, and that it is they who should control how change moves through the organization. But the U.S. health care system is testing these experts by giving them situations and work contexts that are fluid, unpredictable, and where the professional voice is less able to be heard. This is why health professionals of all types are facing job morale, satisfaction, and burnout issues.
It is the health care leader’s primary role to promote cultural beliefs and values within the organization which allow everyone to better understand and navigate their fears, feel supported, accept giving up some control where needed, and take risks to improve how they do their work. Managing culture is also about being the person who serves as the symbolic face of change and innovation—showing others through your example that the mindsets and behaviors you want employees to portray are already embedded in the leadership structure of the organization. The days of health care leaders only being good stewards of their organization are over. Now, in addition to that role, they must be the catalysts for significant transformations of health care work, professional thinking, and organizational culture.