The Ultimate Measure of Workplace Trust: You Decide What to Work On


It’s a panic-striking emotional state: I’m not contributing! I’m not on the career trajectory I need to be on! I’m not learning the skills I need to be learning!

That “I’m not a contributing member of this organization” feeling can be vicious.

My first healthcare job was as an administrative fellow, a sort-of management training program intended to provide exposure to the breadth of administrative positions throughout an integrated delivery system. It was a terrific experience and the people I worked for and with get credit for creating the foundations of my management style.

But there was a point early on, maybe a month or two in, when I felt exceptionally useless. The program wasn’t particularly organized — which turned out to be a great thing over two years — and resulted in open days with little to do early in my tenure.

I was gripped by the feeling of uselessness for months and didn’t know what to do about it.

Somewhere, somehow the thought struck me to find projects to work on.

It didn’t come from my boss — the last thing I wanted to share was that I wasn’t busy enough.

It didn’t come from colleagues — I wasn’t close enough with anyone at the time.

It didn’t come from friends or family — “this new job is great!”

I just started finding projects: some were participation only, some allowed me to make small contributions, and some allowed me to explore my interests in the organization. But nothing was particularly useless.

There was no one breathing down my neck. No one looking over my shoulder. No one assumed the burden of becoming my task finder. I was just trusted to find work to do.

[A quick aside.]

Don’t get me wrong, it’s entirely possible that no one gave a shit about me as my status hovered around the level of “intern,” but I take solace in maintained professional relationships with the people in that organization.

[Back to it.]

Trusted to find work. A novel concept.

By my second year I was finding projects to work on that were of strategic importance to the organization. More projects began to appear: from my boss, from the CEO, from managers throughout the system. The feeling of contribution! It’s a drug.

I’ve been coming back to that story lately because I recently started asking my employees to choose what they work on. Initially there was shock — a seemingly normal reaction to a different approach from any other previous school or job experience. After wading through initial resistance and a smidgeon of bewilderment, the experiment seems to have improved two persistent management problems left behind by industrial models of production.

The first is related to trust. We’ve been taught that employees must be managed. Create tasks. Fill their days. Ensure output. But management, in the traditional sense, left me with questions. What is an appropriate level of production in a workplace dominated by intangible things? How do you measure what someone should be producing when much of it is novel and creative thought? How do you trust that what employees do produce is the appropriate amount when no widgets are actually created? How much time should be spent in the office during the week?

The second is engagement. We’ve long abided by the idea that work must be cascaded down a hierarchy — that seems to be the secret to accountability: tell everyone what they work on and what the measure will be. Bosses know best. Do as I say. Why aren’t annual objectives being met? How do you rate an employee’s performance when the annual objectives set at the beginning of the year aren’t actually important any longer?

It turns out that everyone — me as a manager and they as an employee — benefits when employees get to choose what to work on. Here’s what we’ve found so far.

Employees choose work that interests them. We hire job candidates because of their experience and skills, which are manifested interests with documented results. The work that interests them is the work they are good at. It’s why they are working for the organization. It’s the work they want to get better at, too.

Employees choose work that helps the company. Employees deserve more credit for their instincts. They don’t need managers telling them what is the highest priority, although prioritization conversations can be helpful in figuring out what to work on first. Management, if anything, is creating the framework for knowing what is important and what isn’t. Employees know what needs to be created and improved because they work every day for the company. They see what the company needs.

Employees are engaged with the work. When employees lead the objective setting for the work they are demanding of themselves, highly accountable for results, and completely engaged in the work itself. Coaching becomes about helping each employee deliver the work. Reviews are about lessons learned and developed skills.

For managers it’s a win-win-win: trust comes easily, engagement happens naturally, and everyone is striving to move the company forward.

Engagement surveys continue to tell companies the same thing every year: employees aren’t. After years of failed engagement improvement initiatives, perhaps it’s time to point the finger at the organization’s structures and systems (i.e., how we do things around here…) as the culprit for low engagement. And perhaps it’s time to start experimenting with new structures and systems that create the workplaces we all desire. Maybe there are better ways.

Here’s to finding all of them.


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Status:Go creates software for healthcare delivery organizations so they can try new ideas, improve operations, and execute strategies. We know healthcare, Salesforce, and how to get things done. Get in touch to get your project started.

The (in)complete definition of healthcare transformation, part two of many

Photo by Jakob Owens on Unsplash


Healthcare is transforming. It’s become a mantra for consulting companies, a maxim for strategic plans, a rallying cry for vendors, and the go-to buzzword for conference content. Our website isn’t immune to the idea, either.

All that hype must mean there is some level of exaggeratory bullshit attached to the concept. There is.

But an ear-piercing bullshit detector alarm doesn’t mean it isn’t happening. Because it is. In fact, the industry has always been transforming: Paul Starr wrote a comprehensive 528-page, Pulitzer Prize-winning, delightful treatment of the topic published way back in 1982 that is truly worth your time.


In a book that offers many lessons, the most useful in this context is that it is only possible to see healthcare transformation from the future, looking in reverse, after it has occurred. It’s acceptable to desire healthcare transformation and discuss the possibilities: expectations for the future, extrapolations from what we know, and assurances about the direction of change. But projections, predictions, and forecasts can turn out to be true just as often as they miss the mark.

So healthcare transformation — before it has happened — is just a set of possibilities. Of potential. Of hope. Of promise.

https://centralmanagement.work/the-in-complete-definition-of-healthcare-transformation-part-one-of-many-e5197cd68226

That’s because healthcare transformation is not a strategy, it’s an outcome. Healthcare transformation won’t happen until it’s happened no matter how much industry thought leaders desire it. Transformed healthcare delivery is a result of executed strategies.

It is the effect of action.

Present-day activities are not in themselves transformative. It is the accumulation of many actions and many adjustments, over time, that produces transformation. Any current work deemed to be transformative is just the required work of adjusting a healthcare delivery organization to effectively operate within its market environment at this moment.

Because markets steer organizations.

Over the last forty years there has been a significant transition in how healthcare provider’s determine strategic policy: from an organization’s productive capacity (e.g., acute care beds!, inpatient knee replacements!) to one guided by market trends and customer needs (ambulatory strategy!, care navigation!, access!). Market pull steers all organizations now.

Executives create strategies in direct response to problems and opportunities uncovered by shifting market conditions. Market conditions that are created by a complicated mixture of government policy, third-party payers, patients, social and economic conditions, technology diffusion, competitors, suppliers, and a host of other factors.

So healthcare transformation is really happening on two different levels: an industry plane and an organization plane. The industry definition for healthcare transformation: the evolving market forces that cause organizations to change.

For organizations, healthcare transformation is the outcome of the collective response, over long periods, in the form of successive activities, undertaken by an organization to adjust to shifting market forces and effectively serve a customer. It’s the major change “that emerges from the aggregation of marginal gains.” It’s the hard work of incremental daily progress.

So healthcare transformation is most certainly not bullshit. It’s not just industry jargon psychobabble. It needn’t be an explicit strategy. Healthcare transformation is happening to organizations: it’s not about the future, it’s about how organizations get to the future.

Healthcare transformation is the project-by-project changes to an organization’s structures and systems to ensure market responsiveness.

It’s the effect of action.


This is the second installation in an ongoing series of essays attempting to define healthcare transformation. There’s a lot of bullshit in transformation rhetoric. But it’s also real.


Every month we deliver an email with project ideas, healthcare insights, and tips to help you do your job better. Sign-up here.

Status:Go creates software for healthcare delivery organizations so they can try new ideas, improve operations, and execute strategies. We know healthcare, Salesforce, and how to get things done. Get in touch to get your project started.

The (in)complete definition of healthcare transformation, part one of many

Photo by freddie marriage on Unsplash


Healthcare transformation is happening now. It’s been happening since the time of Hippocrates, likely before. And it will continue to happen.

Healthcare transformation involves: patients, physicians and providers, nurses, administrators, patient care staff, support staff, community leaders, employers, government, social and community services, vendors, partners, technology companies, consultants, among others.

Healthcare transformation is happening in healthcare delivery systems, hospitals, physician offices, clinics of all types, communities, homes, digital venues, places of worship, schools, workplaces, in New York City, in Denver, in Los Angeles, in Seattle, in Nashville, in Miami and in many, many, many other places.

Healthcare transformation is happening because markets are shifting and organizations are responding. The healthcare delivery industry is becoming more competitive, more lucrative, and more opportunistic.

Thankfully, healthcare transformation is the effort to reorient the entire delivery system around the user of the industry’s services: the patient. That’s a gargantuan endeavor that requires action toward a broad reinvention of just about everything the industry does and the creation of many new things — with the vast majority of activities occurring multiple degrees removed from, but always in support of, the patient experience.

Thankfully, healthcare transformation is the effort to reorient the entire delivery system around the user of the industry’s services: the patient.

For example, healthcare transformation is the creation of a care coordination department. And then it’s everything that is required to make that service a reality: the repurposing of a contact center to focus on specific populations; the human resources activities of job description writing, recruiting, and training; the creation of processes and policies; the redesign of care to include coordination services; deploying the technology necessary to support the operation; finding internal collaborators and external partnerships; the iteration and evolution of the service once it’s launched; and a whole lot more.

Healthcare transformation is the care coordination example repeated ad infinitum. It’s the many, many projects in many, many areas, across many, many organizations, to reorient the healthcare delivery system around the patient in response to market changes.


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Status:Go creates software for healthcare delivery organizations so they can try new ideas, improve operations, and execute strategies. We know healthcare, Salesforce, and how to get things done. Get in touch to get your project started.

Formalizing The Way We Work — An Organized Way of Working


For at least the last decade — perhaps longer — companies have been explicitly trying to adapt to a VUCA world.

Volatility.

Uncertainty.

Complexity.

Ambiguity.

Volatility refers to the speed and turbulence of change. Uncertainty means that outcomes become less predictable. Complexity refers to the growing interdependence of social and economic forces. Ambiguity indicates the haziness of reality.

These are the general conditions of our industry (professional services) and the industry we serve (healthcare delivery).

In short, it’s crazy and uncertain out there.

Awareness and readiness become paramount when VUCA is the prevailing reality. Awareness and readiness allow a company to respond to problems and take advantage of opportunities, both of which are in abundance in a VUCA world.

To respond to problems and take advantage of opportunities a company must be organized.

Being organized becomes essential to existence and scaling.

Being organized is a competitive advantage. That’s the key to existence.

Being organized allows more work to be completed. That’s the key to scaling.

Being organized allows decisions to be made by the most appropriate employee. That’s the key to creating a responsive company.

Responsive to customers. Responsive to the market. Responsive to each other.

To become organized, we must:

  1. Share, process, and make as much information available to as many people as possible
  2. Turn knowledge into learning and improvement
  3. Encourage everyone to contribute

With the goal of creating reliable, repeatable, and adaptable ways of working.

Reliable, repeatable, and adaptable ways of working provide exponential benefits.

All of them can be summarized with the “Beamed to Mars” principle. It asks, if a co-worker happens to be beamed to Mars tomorrow, could someone in the organization step-in and fulfill their current responsibilities?

Sadly, Mary was beamed to Mars.

Mars excursions happen all the time: weeks of vacation, a series of sick days, family emergencies.

The red planet is not a lonely place.

Perhaps the greatest benefit of organization is that which rolls up to the individual employee: it allows for greater autonomy and creativity by routinizing the work that can be routinized and creating slack to work on more interesting and difficult problems.

That’s our operating goal. To organize the company, the work our employees do, and how that work is informed and created.

Becoming organized starts with the company’s intention:

  • Help middle manager administrators transform healthcare delivery.

It continues with outlining our company’s principles, the foundational beliefs that drive our behavior and reasoning:

  • Start Now. Go Fast. — as in moving appropriately quickly and efficiently with a willingness to experiment our way to the best solution
  • Know-How — as in expertise and skill in everything that we do
  • Execute. Start Again. — as in getting things done is our ultimate outcome

Then it continues with our performance expectations of every employee:

  1. Be Curious — to explore, to learn, and to improve.
  2. Be Flexible — in your approach, acceptance of responsibilities, and in providing assistance.
  3. Be Ready — be prepared, be responsive, and be aware.
  4. Take Initiative — to get started, to communicate effectively, and to make things better.
  5. Contribute to the Whole. The responsibilities specific to your role are important. We also request that you contribute to building a company.
  6. Commit to the Approach. We have designed a way of operating. Follow along or help us find a better way as everything is open to improvement.

Every month we deliver an email with project ideas, healthcare insights, and tips to help you do your job better. Sign-up here.

Status:Go creates software for healthcare delivery organizations so they can try new ideas, improve operations, and execute strategies. We know healthcare, Salesforce, and how to get things done. Get in touch to get your project started.

Rethinking the Role of IT in Strategy Execution for Healthcare Providers

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We were speaking with a customer recently who asked, “Does IT even matter anymore?”

And we stumbled over each other to be the first to exclaim, “Yes! More than ever!”

The entire organization is completely dependent on IT’s minute-to-minute successful management because the entire organization operates on technology.


And that’s important because, in many ways, the business has become technology — a major transition since the advent of mainframe computers in the 1960s. Where technology once supported healthcare delivery workflow, that same workflow has come to depend on technology. Nearly every process of the modern healthcare delivery organization has come to rely on technology.

So it’s no wonder that enterprise attention has shifted to strategic information technology concerns such as system uptime, enterprise deployments, network security, and the like. IT is rightfully focused on these very important — the business-stops-operating-if-any-of-it-goes-haywire — activities.

However, as a result, there has been a divergence in prioritization between strategic technology issues and operational technology realities. At the same time that strategic issues have been given increased attention, there has been an explosion in operational needs for additional technology — the specific technology needs required to carry out the work of healthcare delivery.

Organizations have long relied on the electronic health record and enterprise point solutions to address these emerging use cases. But we meet daily with individuals in healthcare delivery organizations whose needs are not being met by the technology currently available to them.

That is important because, at nearly every turn, there are business processes (services, projects, service lines) that struggle to deliver needed results because they are dependent on less than ideal technology deployments.

For example:

  • The case manager that begged and pleaded for six months for a change in the Epic interface, finally got it, and 30 days later is making due with workarounds because a new business requirement came along.
  • The call center manager wholly dependent on outdated telephony and customer database that makes it difficult to report any measure of value.
  • The marketing director that knows they need CRM help, doesn’t know exactly what marketing programs they want to deploy, and knows that whatever does get approved is going to require a lengthy solution selection process.
  • And the population health manager that relies on spreadsheets, email, documents, post-its, home-grown reports, etc., and spends the first week of every month creating reports.

These are small business problems and pale in importance to any strategic IT need.

But they are significant and they are everywhere in the organization. And as such, the sum of these technology needs is actually quite large and has become a barrier for organizations seeking to execute on their growth, revenue, and value strategies.

Given IT’s appropriate focus on strategic imperatives, healthcare leaders are now turning to external assistance to enhance or create their technology deployments.

These leaders are seeking support in solving explicit business problems that are dependent on technology. They desire urgent, affordable, and personalized solutions.

But they also must be secure, supportable, and integrated.

Some of our customers come to us as a result of pent-up frustration with their IT departments. And we understand why. They’ve been told — or ignored — that their idea, their department, or their project which is deeply in need of technology support doesn’t rise to the level of being a priority for IT.

It becomes tempting for business leaders to exclude IT as a result of that frustration. But urgent, affordable, and personalized solutions can turn into problems when that happens. It is the definition of Shadow IT.

Yes, IT is busy. But it’s better for all involved when IT knows all technology deployed throughout the organization. Avoiding Shadow IT should be as high a priority for the business as it is for IT.


The most successful projects require an organizational partnership between strategy, IT, and the business leaders doing the implementing. During this time of urgency, a period that is melding strategy, business, and technology problems like never before, strong alignment between all three has become a competitive advantage.


Every month we deliver an email with project ideas, healthcare insights, and tips to help you do your job better. Sign-up here.

Status:Go creates software for healthcare delivery organizations so they can try new ideas, improve operations, and execute strategies. We know healthcare, Salesforce, and how to get things done. Get in touch to get your project started.