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Saturday / January 20.

Do The Work: A Pragmatic Approach to Healthcare Transformation

There’s a lot of work required to transform healthcare delivery organizations from where they are now to where they need to go. That work doesn’t happen at a single point in the near future — there is a long and winding path, not necessarily linear, that must be traveled.

That work is why healthcare transformation calls for constant motion that moves organizations closer to where they need to go. It calls for a pragmatic approach to doing the work. It calls for taking action.

It’s easy to get caught up in contemplating, discussing, and proclaiming the future of healthcare delivery. Because the future of healthcare delivery is going to be great. Really.

In an industry with widespread agreement about the utility of sweeping transformation, it is exciting to ruminate about the power of health promotion, machine learning, digital health, patient centeredness, universal access, personalized medicine, service systemization, blockchains, partnerships, and the rest of our transformational aspirations.

Since transformation appears generally a desirable ideal and given that transformation is only visible from the future, it seems worth reaching a transformed state as quickly as possible.

But how?

Taking Action

Market responsiveness is what propels transformation. Strategies of expanded access, population health, network integrity, and the like are in direct response to emerging market forces.

But simply desiring transformation does not make it so.

No, that requires action.

The healthcare transformation discourse too often undervalues the present. It skips over the reality of how critical now is to enabling the aspirations the transformation rhetoric desires. That’s understandable — the future we desire is better than what we have — yet unfortunate, because the present is critical to arriving to that desired future.

The present, over and over, is filled with moments to transform.

There’s a deeply held management belief that strategy is superior to execution. Sure, if your organization has poor strategy, it just might be in trouble. But, now that markets steer organizations, most healthcare providers of a similar type are pursuing homogenous strategies.

And that means that execution has become a competitive advantage.

But how does an organization execute on any specific transformation strategy? When should an organization get started? How quickly should a strategy be implemented? How, exactly, does an organization improve patient access, increase provider network integrity, establish a robust population health program, or the like?

Those questions have countless solutions making them nearly impossible to answer definitively. Answers, though, are much more easily revealed.

The specific tactics of executing on any single strategy are often uncertain. That’s not because great thought hasn’t been applied to what must be accomplished. It’s because the tactics of new strategies are uncharted territory for organizations. Replicating others, relying on adjacent experience, or the generalities of big consulting firms get an organization only so far. These uncertainties too often result in failed strategy execution.

William Owen, founder of digital product firm Made by Many, writes it best.

“The best way to deal with the uncertainty involved is to move towards big goals in small steps, at progressively finer definition and with ever greater confidence.”

In other words: projects.

Do the Work

Let’s make it a thing.

Do the work: Administrators execute strategy by creating change through projects using resources as a result of taking action, again and again.

Execute Strategy: The Result

This is what we’re after. It’s the outcome — or rather, a series of outcomes. Strategy execution is an intentional ongoing endeavor. Its success builds on itself and informs what comes next. It’s a rare moment when an entire strategy can be declared fully implemented because there is (almost) always another available tactic that furthers the strategy.

That “one more thing” idea represents a real twist to management dogma: execution is strategy. Somewhere, at some time, strategy was separated from execution. But it was Jack Welch, a noted strategist himself, who said, “In real life, strategy is actually very straightforward, pick a general direction … and implement like hell.”

In William Owen parlance: the big goal is the “general direction” and the small steps are the “implement like hell.” Implement the small-steps-like-hell by continuously creating change.

Creating Change: The Job

Strategy: executives declare it, administrators bring it to life. They do it by creating change: the job they were hired to do.

Writing a policy. Starting a new department. Implementing a new technology solution. Creating a training program. Designing a new service. Analyzing a capital investment. The units of healthcare transformation. There are many, many, many ways to create change. All of them happen as a result of a project.

Projects: The Units of Work

We live in a project-driven world. The work is projects. Projects are the tactics of strategy.They are the containers of work. They lead to promotions. They lead to notoriety. Most importantly, projects transform healthcare delivery.

And they are implemented using three resources.

Resources: The Inputs

Every administrator has three resources available to implement projects: people, process, and technology. Some projects call for people changes (hiring, training, etc.), some call for process changes (how work gets done to serve a customer), some call for technology (the systems used to do the work). Most call for a little of all three.

Historically, administrators have only had true agency over people and process decisions. Technology has been strictly the domain of the CIO and the IT department. That mentality is shifting as technology has become critical to enabling organizational change as both healthcare delivery and technology tools evolve.

A fully empowered administrator has decision-making authority over all three: people, process, and technology. That opens the door for administrators everywhere to start Taking Action.

Taking Action: The Attitude & Approach

Taking Action is an attitude and an approach. It’s a commitment to the reflexive habit of doing. Nothing happens without action. Doing creates and maintains momentum.

The pragmatism of actual action is critical to the future of healthcare delivery.

Taking action is how healthcare delivery is transformed.

It’s how a healthcare delivery organization overcomes uncertainty and reveals the answers to the question of “how” for any specific transformation strategy.

The future is going to be great. But we undervalue the present in our transformation ideals. It’s much too easy to forget the time-tested truth that, for the future to become reality, a number of successive nows must happen first. It’s in those moments that a tremendous amount of work must be done.

Taking action ensures the work happens. It’s the only way to transform.

Do the Work. It’s a pragmatic approach to transformation that makes healthcare better for patients, providers, and employees today, tomorrow, and yes, in the future. And the only way transformation happens.

 

Drew Weilage is the VP of Design & Direction at Status:Go. Read more of his articles at Central Management.