The Culture to Support Transformation In Healthcare

Culture is at the heart of any transformation. Without a concerted effort by the highest levels of leadership, the chances of a successful transformation are slim. The hardest part of transformation is not the people doing the work because they recognize the deficiencies. The hardest part is middle management understanding that the traditional role they’ve played changes forever.

Hierarchical systems of leadership will not support the transformation of healthcare. Doing more with less is what drives both progress and wealth. Transformation, as I’ve stated, morphs the organization in a new direction, and takes it to an entirely different level of effectiveness. In doing so, it changes both the character and the structure of the organization.

Flatter organization structures are where we’re headed. Capital seeks to eliminate low productivity jobs. We’ve seen this repeatedly over the last 30 years with bank tellers, travel agents, and institutional traders to name a few. A research study conducted by McKinsey & Company suggests that while 45% of activities individuals are paid to perform can be automated, only 5% can be entirely automated.

So what does all this mean??? Layers of middle management will augment the efforts of those delivering the service. They now become doers and because of their experience, potential team leads. Accountability will gravitate downward where it should be. The question is can middle management come to grips with this new role, or will it fight to save itself from extinction. My “Captain Quality” experience tells me that there will be a fight but leadership must prevail.

Every traditional organizational structure we currently have in healthcare must change. From the Boards that steer the IDN to the maintenance crew, every role, every responsibility has to be reviewed for the value it adds to the patient experience. More importantly, regulations that are now overwhelming every aspect of our daily lives have to be reigned in. The freedom to improvise should be demanded and encouraged as long as patient safety isn’t compromised.

While all of this sounds easy, in practice it is not. Look no further than the US auto industry and it’s travails. Once the dominant force in the auto world, we lost that position because we lost a sense of the customer, while pursuing better earnings per share. Complacency in the industry led to an erosion of basic skills of manufacturing. This led to atrocious quality issues that allowed foreign manufacturers to gain a foothold in a country that built the first assembly line at Ford.

Certainly you’ll never confuse making cars with taking care of our fellow human beings. That said, the lack of high quality at an affordable price, the lack of transparency, the utter disregard for the patient experience should tell us that healthcare is at the same tipping point the auto industry was all those years ago. The good news is that the US auto industry managed to survive albeit not as the dominant force it once was. The question we have to answer is will healthcare figure out how it will survive and what has to happen to make that feasible???

The transformation starts with the realization that business as usual must end. The good news for healthcare is that it is filled with people who work with a higher purpose in mind. Healthcare people see their careers through a prism of helping their fellow man in time of need. Yes, everybody works for wages including healthcare workers. But the ones I have known over the last 35 years get up every morning to try and make a difference.

Healthcare’s exposure is that asking people to do more with less has to be balanced with granting these people the ability to change their work dynamic. We tend to be too prescriptive in healthcare because we’re organized around not getting sued and how to maximize re-reimbursement. That fact is not lost on the folks that render the service. Every caregiver I encountered in my last exposure to our healthcare system, tried to make a positive difference. Unfortunately, they’re shackled by a system that does not give them the flexibility to react to the circumstances they find themselves in. For aspirational people, how much money you make while important, is secondary to how you impact the patients assigned to you.

That’s why my “Captain Quality” days were like the first line of the Dickens’ book  “a Tale of Two Cities”. “It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness”, etc. While we were successful at training 1800 employees on the concepts around “Total Quality Management”, we failed to change the culture of the company. Earnings per share became our mantra, our bible, and our way of life. The 1800 good folks who embraced the movement, experienced a let down when they realized their doing more with less just meant more work, not a better company.

Healthcare faces the same challenge. I’m hoping that G2, and the series of partnerships we intend to develop can help lead the way toward transition. I know from experience that the people in this industry are up to the challenge. Can we get leadership both in the industry and politically, aligned to move us forward??? The Mylan/ EpiPen news of this week brings our industry into the spotlight in a negative way. We need a dialogue built around bringing sanity back to the healthcare industry that we all love…