Some healthcare organizations are struggling with change. They never anticipated the speed with which the transition from volume to value would become a crisis, with declining inpatient admissions occurring much faster than expected.
As anthropologists, we work with organizations that need to change. We know that the brain hates change. Added to that, people are driven by the power of habits. We realize the demands on our time and energies have changed and doing the same old thing is, in a very Darwinian sense, mal-adaptive. You don’t want to find you and your institution extinct, do you?
As the research clearly shows, few people are taught how to innovate or respond to changing times with appropriate solutions. Most people are looking to mimic best practices from others who have experimented before them. If you are going to change you need to focus on creating a shared vision and developing the necessary skills, on the social network and of the individual performer—a lot of things all at once.
In today’s fast changing healthcare environment, that is just not happening. You are now going to have to create your own best practices and hope that they work before your competitor mimics them and out-competes you for the same customers or services or patients.
To make this simple and easy, hospital leaders should pretend they are in a theatrical production and have been for many years. They have been playing, for example, “Macbeth” (think healthcare) for decades. They know their roles well, the scripts and how to perform each day as if they are on a stage. They are clinical and administrative experts and can truly perform brilliantly. The only problem is that no one is coming to the play anymore. No audience is like no patients.
How do you find a new audience? Write a new play? “Hamlet”? “Romeo and Juliet”?
You are improv theater. In fact, you have to write your own script and figure out where to stand on the stage and direct yourself to perform the new play.
The metaphor may seem far fetched. But indeed that is exactly what is taking place. What is the new script about the new story you are writing as you perform? How can you draft one to start rehearsals? Who should be in the play?
Let me share five easy things that might kick-start you in the right direction:
- Understand your business from the audience backwards. Stop thinking about this from your organization outwards. You have to start backwards from your customers—whether they are hospitals, patients, physicians or nursing homes or all of them. What are they struggling with through this change in healthcare? Go out and talk to them. Do something different and engage them in the solutions. Help them and you will help yourself.
- Go exploring. Get out of your office and go spend time listening to your customers: patients, physicians, employers. Conduct Innovation Games®. Serious play might help. They are going through changes of crisis-like proportions. Together you can invent better solutions than either of you can do alone. Even work with your competitors.
- Get everyone involved. Try to avoid the organizational antibodies that suck new ideas out of the organization. Get everyone engaged in the change process. Listen broadly. You will find great ideas in unexpected places. Put them all into the new play and see how improvisation actually could work.
- Focus on “fuzzy” goals. Like Columbus circumnavigating the globe, the goals are very fuzzy. And full of risks. And you are really risk-adverse to say the least. But you do know how to test, apply science and develop rigorous methods to evaluate good ideas and sort the really good ones from the rest. Rehearsals like practice help.
- Know metrics matter. The metrics of success can help direct the scope and ambition of behavior. In changing times, you need to think metrics. They can allow for the agility that brings truly disruptive innovations. Metrics are essential if you are going to initiate changes and keep them going. You better know what is working and why, or what is not and how to keep adapting.
Most of all, watch out for what we call the FUGs: Fear, uncertainty and greed. The times they are a’ changin’, whether we want them to or not. Better to create a new healthcare system that works than compete in an old one that is fast-moving into extinction.