Helen Bevan on transformational themes in healthcare

The Missing Ingredient from Healthcare Transformation

And How to Get Your Hands on Some Magic

As a healthcare administrator, you know there’s a missing ingredient from the proclamations about the Future of Healthcare Delivery™ emanating from conference stages, press releases, and white papers.

The magic to make it all happen.

Until now.

Introducing: Healthcare Transformation Magic Crystals

I was once a let’s-make-this-better, imagine-the-possibilities, nobody-can-stop-us real-life healthcare administrator.

It’s that perspective that gives me levitating excitement for the future of healthcare delivery — the future predicted by the technologists, consultants, and thought leaders: an innovative, data-driven, value-based, machine-learned, digital nirvana.

But there’s a secret every healthcare administrator knows and every disruptor is learning: changing healthcare delivery requires work. A lot of it.

It’s that perspective that makes me think magic is the missing ingredient preventing the promised future from being pulled out of a hat like the promises that come with it.

So I know we’re solving a wide array of healthcare provider execution challenges with a product perfect for boards of directors, executives, and administrators wishing to make healthcare transformation appear in their organizations: Healthcare Transformation Magic Crystals.

Mined from the deepest, richest, and most magical gem source in the world, Healthcare Transformation Magic Crystals can make any strategy appear out of thin air — no matter where the strategy originates including, but not limited to, conference stages, consultant deliverables, technology vendor promises, and even the hopes, dreams, and wishes of an internal planning session.

They’re easy to use. No wand required. Previous experience with magic isn’t necessary.

Just combine a copy of a shredded project plan document with an ounce of the Healthcare Transformation Magic Crystals into a 9×12 manila envelope. Seal. Place on a shelf. Wait.

Abracadabra.

You could be amazed with the results.

Ignoring the Required Work

Healthcare transformation is real. It’s happening. It will continue to happen. We’re complete believers.

But without magic it’s not arriving via moonshots, grandiose op-ed think pieces, or generality-plagued conference talks. Because without magic those pronouncements, platitudes, and prognostications are going to require a lot of work.

And, from the back of the theater, it seems the future is arriving much too quickly for anyone to be bothered with real, actual work.

That reality is completely irrationally understandable.

Just think about the sheer amount of work that must be accomplished to operationalize a single transformation strategy in a single healthcare provider organization. It’s striking!

This Harvard Business Review article about a completely logical way of involving clinicians in managing the cost of care is a great example.

How long would an initiative like that take in your organization? Think about how much work — how many projects — are required to actually make it happen. It’s a lot. Like a lot a lot.

But at least the thinking is manageable. Ask the same question for this completely sensible way to transform an entire healthcare delivery organization, also in the Harvard Business Review, and you’re likely to struggle just figuring out where to start.

It’s obvious why ignoring the work is such a tempting detail to overlook: it gets in the way of overpromise, hype, and illusion.

The Fine Print and Some Free Advice

It’s here that I must inform prospective buyers that the Healthcare Transformation Magic Crystals come with no product guarantees.

But they do come with this piece of rock-solid advice: Get started and do the work.

It may not be as immediate, it may not be as sexy, and the projects may not be as fun as the promised near-future would lead us to believe.

But it will be successful.

In fact, it’s the only way transformation happens. Project by project.

Of course, looking back, it will have arrived in part through those pronouncements, platitudes, and prognostications, too. But the journey is likely to be much longer than the future-is-coming-sooner-than-you think dogmatists would lead us to believe.

It’s okay to be realistic about making change happen. It’s okay to be content with the day-to-day activities of doing the work. Not only do we think it’s okay not to subscribe to a dramatic vision of the future, we believe it’s pragmatic and practical and the path to real progress.

However, if you’re looking for a shortcut, definitely give these Healthcare Transformation Magic Crystals a try. We’ll send you a free sample if you’re interested. Fill out this form and we’ll drop them in the mail.

They’re real.

Well, as real as magic can be.

But if they seem to have lost their magical powers before you can use them: call us.

We’re ready to work.

With you.

And we know where to start.

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 improve operations, execute strategies, and try new ideas. We know healthcare, Salesforce, and how to get things done. Get in touch to get your project started.

That new innovation center could make the innovation problem worse in your healthcare organization

And why what you need instead is an innovation workshop

“It’s hard. It’s just too difficult,” a healthcare administrator recently shared with me, “But we have a new CEO starting soon and he wants to create an innovation center.”

Healthcare delivery’s innovation problem has become apparent when those managing in the middle of the organization — where strategy is executed — are beginning to express concern.

Innovating inside a healthcare delivery system is difficult. Existing structures and systems (how the work gets done) are designed to say no to new ideas. They are designed to promote profitability, efficiency, and reliability — all great pursuits for an organization but too often prevent innovation from even getting started.

So it’s no wonder the idea of carving out innovation from the rest of the operation is so appealing: without the distractions and barriers of the operation, innovators are freed to innovate!

“Innovation isn’t a core competency of many healthcare organizations,” said a respondent to a recent innovation survey from the American Hospital Association and AVIA, “The industry needs help identifying options for advancing meaningful innovation and building the structure needed to support it.”

It’s the second half of that statement that is so revealing of the report’s finding that “72% of hospitals with over 400 beds are planning to or have already built an innovation center.” An innovation center is a direct answer to the innovation core competency problem in healthcare delivery organizations.

But will it be an effective response?

The Appeal and a Paradox

The difficulty of innovation has led a growing number of healthcare delivery providers down the path of creating innovation units separate from the operation. An innovation center is usually a dedicated space outfitted with all the creative necessities. It’s often set-up and managed outside the normal org chart and management requirements. It is staffed by employees with skills to fulfill the center’s innovation model.

The appeal of the innovation center idea is apparent — by design it overcomes the distractions and barriers that often prevent innovation. Innovation centers create innovation. They produce innovative things. And they do so because of their deliberate focus on innovation.

But the experiences of some early corporate diffusors of an idea similar to the innovation center — the innovation lab — prove cautionary and may be an indicator of what’s to come. Nordstrom, Coca-Cola, The New York Times, Disney, Microsoft, among others have all scaled back or eliminated their once promising innovation lab efforts.

It seems that translating innovation back into the operation proved more difficult than originally anticipated.

“It’s time to ditch your innovation lab,” was the title of a VentureBeat commentary assessing the downscaling announcements.

“Rather than just a team focused on innovation, it’s now everyone’s job,” said a Nordstrom spokesperson at the time of Nordstrom’s decision to shut down its lab.

In fact, one observation from a report compiled by digital product studio Made by Many might end up being the definitive conclusion on innovation labs: “… we found that the innovation lab model often promises a lot without delivering quite so much in terms of tangible success.”

Producing Enabling Innovation

These thoughts are indications that innovation centers might exacerbate the innovation problem in healthcare delivery organizations, not solve it. And if that’s the case what’s an innovation-hungry healthcare delivery organization to do?

It’s not the innovation center (or lab) that is the problem in my estimation — it’s the type of innovation it focuses on that proves problematic. And it’s only problematic because the innovation being pursued in the innovation center isn’t the type of innovation organizations were seeking when the strategy was created.

An innovation center produces emerging innovation — futuristic technology, what-if scenarios, pioneering business models, and the like. The issue in an innovation-poor environment is that most of the organization (departments, service lines, administrators, etc.) isn’t searching for those things. Let’s go back to the survey respondent’s comments, “The industry needs help identifying options for advancing meaningful innovation and building the structure needed to support it.”

Most of the organization is on the hunt for enabling innovation — innovation that makes a job easier, an experience better, moves an operating strategy forward, and the like.

Emerging innovation may be important to the future of the business. Enabling innovation is essential to making healthcare better for patients, providers, and employees right now. It’s critical to the operational leader meeting and exceeding job expectations. It’s necessary to the step-by-step nature of how healthcare transformation actually happens.

It also creates the structure that will allow emerging innovation to become useful in the future.

So instead of innovation centers I think healthcare delivery organizations need innovation workshops to bring innovation where it’s needed most: directly to the operation.

The Innovation Workshop

A workshop is a place to produce useful things. It has similarities to a lab: experiments, investigations, observations, and such. But a lab does those things to discover. A workshop does those things to solve problems.

The innovation workshop embraces projects directly connected to solving problems and executing operational strategy.

There’s no one-size-fits-all approach to innovation workshops. They can be permanent or temporary. They can live in a department or be placed on wheels and move around to where they’re needed next. They may employ in-house resources, or be operated by a partner, or a mixture of both.

They are required to have capabilities (facilitation, technical, domain expertise skills, and the like), resources (agency over people, process, and technology decisions to prototype solutions), financial support, be commissioned to navigate the bureaucracy, and exist as part of the operation.

Innovation workshops would give administrators a path forward to solving real and immediate business problems. The work would build on itself, identifying new needs and implementing new solutions along the way. They could deliver innovation at scale throughout an organization by making innovation available to everyone that needs it.

Innovation workshops would produce the enabling innovation required for healthcare transformation by embracing the constraints and affordances present in the operating environment.

Because when innovation is part of the operation it can answer specific questions, solve real problems, and foster strategy execution. That doesn’t happen when something has been conceived in a lab’s sterile environment. The best place for enabling innovation is right there where it’s needed as a part of the operation.

And that place is in an innovation workshop.

Wouldn’t you know it? We just launched a new solution we’re calling Innovation Workshop designed to overcome the organizational inertia preventing you from innovating. Learn more here.

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

Transformation on your plate? Pick a project. Start. Execute. Repeat.

Healthcare delivery organizations, and departments or service lines in particular, need an approach to adaptation that matches the volume of change within the industry.

The refrain “It’s coming at us all at once” is echoed in organization after organization after organization. The demands of transformation are constant and unrelenting.

Since projects are how organizations change, and change is constant, projects should be constant, too.

Start. Finish. Repeat. It’s the only way to transform.

Constant projects? But how?

Keep it short. Limit the scope of any project to a timeframe that is manageable, keeps participants engaged, and quickly produces an outcome. A twelve-week timeline is a respectable benchmark. Is the initiative larger than the single project? Do another one! More than that? Do another project! What’s that old project management adage — when’s the best time to start another project? Right after you finished the last one! (Oh, maybe that came from sales…)

Ditch the meetings. Instead of using meeting time to update project status or badger slowpokes for the work they promised or manage pending risks or etc., use that time to work on the project. Limited scope projects have timelines that demand constant action. Project participants will actually show up and participate if you get actual work done during a reoccurring calendar block. Save the weekly status updates for the end-of-the-project celebration!

Think real time and show progress. Try new functionality — changes in people, process, and technology — first in the meetings-where-work-is-done and then in the real world. Review it! Validate it! Encourage participants to provide input — “yes, I like this;” “no, I don’t like that” — and make decisions to adjust or move forward — “yes, thanks for your opinion and that’s a great addition;” “yes, thanks for your opinion and we’ll save that for a future phase.”

Enhance! Enhance! Now it’s time to improve. To iterate. No project is ever, ahem, finished. Of course it will be introduced into the world and become the new way of doing but that doesn’t mean it can’t be improved or altered or added to. A solution should be adjusted as the project outcome meets the real world and feedback is received. Add small things. Add big things. Try new things.

Believe in temporary. Maybe something drastic changed and the project outcome needs to be eliminated just a year later — that’s okay!, it was such a short project and great utilization of resources that the project outcome did what was needed. It was the bridge from there to here. And if we really go macro on it: every solution ever has been temporary. Things change. All the time. Projects that help departments move from one state to another are successes. Time to get started on the next project.

Increase the execution rate. Do projects. Lots of them. All the time. Finish projects. Keep going. It’s been said many different ways but the only known way to succeed is to try lots of things. Embrace the 10,000 Experiment Rule.

Train. Train. Train. Train. Train. Train. Projects go off the rails at this most important juncture: the translation of the new project into a live environment (and this advice isn’t only for technology projects). Resource-constrained organizations, most all of them, find that training is a convenient place to trim costs. Trimming costs is a fine objective — but don’t skimp on training time and resources. All that hard work of making a project happen shouldn’t go down the drain at the climax of execution.

Big transformation on your plate?

Pick a project.

Start.

Execute.

Repeat and keep going.

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

This originally appeared over here.

Do the Work: A pragmatic approach to transformation that makes healthcare better for patients…

Part three of many in the ongoing series: The (in)complete definition of healthcare transformation

Part One | Part Two

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 shit 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, that 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 and 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, in the moments of now, 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.

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 two of many

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.

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

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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A planning tool to help healthcare organizations get started on the next project

Healthcare delivery’s competitive, regulatory, and operating environments are in constant transition. The result is constant change to how the work of healthcare delivery gets done. So it’s no wonder that leaders in these organizations are identifying project needs to keep up with change of continuing industry transformation.

Knowing that progress in today’s organizations requires crossing boundaries, navigating bureaucracy, and collaborating with multiple partners, it can be difficult to even get needed projects started, let alone implemented.

We’ve heard the frustration. It sounds like this: “We need to break down silos.” “We need to be innovative.” “We need to move faster.” “We need to make better decisions.”

And: “How can we get started quickly?”

That’s why we created the Project Building Blocks framework. Click here to download.

Over the past five years, Status:Go has developed the Project Building Blocks framework to help clients navigate answers to these difficult questions.

Healthcare leaders require a way to capture the complexity of a project while simultaneously identifying a path toward execution. An approach that embraces the value of planning while acknowledging urgent timelines require faster responses than organizations have become accustomed to.

Our customers use the Project Building Blocks framework to launch new programs, improve departmental operations, and deploy innovative technology solutions — all while relying on projects.

The Project Building Blocks uses the details of a proposed project to tell a story. That story captures the vision of the project while illuminating the details necessary for successful implementation.

A completed Project Building Blocks framework creates a broad, shared understanding for those involved in the project; serving as a map to execute any project.

The framework was designed to be used by anyone and our team is here to help. Reach out to us for advice on completing this framework or executing a project at your organization.

Download the Project Building Blocks here.

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