Small Steps to Win in Healthcare

Change is hard in any industry. In healthcare it's excruciating. The problems we see plaguing traditional health systems today are huge, but they are overshadowed by these organization's inability or unwillingness to innovate their way out of messes. In other words, the status quo in healthcare may be broken, but the barriers to change may, in fact, be the tougher nut to crack.

These challenges to change are significant because healthcare organizations rarely suffer from a shortage of good ideas or committed individuals. The gap lies in focusing and acting decisively on a few meaningful ideas in a way that creates lasting impact. Many folks blame this paralysis on an unwillingness to change, but it's equally true that the changes needed are sometimes so overwhelming and unclear that folks simply don't know what to do next.

When the path forward is obscured by ambiguity we've seen healthcare organizations react by throwing lots of small, incremental solutions at the problem. The result is a patchwork of tiny bandages on a broken system. Process improvements and newly designed patient rooms are important and improve patient experience, but they don't solve the real problems stifling healthcare.

On the other end of the spectrum, some health systems press forward with enterprise-wide care delivery models or patient experience protocols that assume a complete answer from the start. This particular approach often suffers from attempting to implement at a large scale too quickly when it is difficult to know the precise steps or critical moves you need to take to achieve a lasting, successful solution.

The magnitude and complexity of wicked problems in healthcare render them impervious to sporadic, incremental tweaks, and equally immune to large-scale, silver bullet solutions. A different approach is needed. To achieve impactful and sustainable solutions, healthcare leaders need to think big, but start small.


The trick is to scale the whole system to a manageable size.

When health systems we work with successfully prepare for the future, they leave no stone unturned when it comes to designing the scope and ambition of their care delivery and business models. thinking big means envisioning ways to significantly change the way you do business and provide care. But when it comes time to implement these big ideas, successful organizations won't just issue a sweeping yet inert mandate. They start small.

Starting Small however, does not mean slicing up your idea into digestible pieces that fit neatly into a Gantt chart. It means scaling the application of the whole idea to a manageable size. For instance, if your big idea cuts across multiple organizational domains don't try it within just one particular silo. Prototype it with a small selection of folks across all domains before scaling up to the entire organization. Successful innovators will take every opportunity to discover new, unforeseen challenges and opportunities. They do so by building an effective ground-game, recruiting and mobilizing their employees to the cause at every level in the hierarchy – from top executives to front-line staff – and along the way learning what is needed to take the next step.

This requires a prototyping spirit. And one we've seen recently in an unlikely place...the state of Oregon. While politicians and pundits feverishly argued over what a Medicaid expansion would do to the nation, Oregon put its money where its mouth was and tried it out. Not by expanding coverage to the entire state, but to a randomly selected sample of its population. Then they rigorously monitored the results. For better or for worse, Oregon gained a metric ton of insight compared to the echo chamber of political and ideological debate.

This strategy may seem counter-intuitive, but implementing big, systemic solutions at a small scale sets you and your organization up for success at the outset. It gives you the organizational momentum to move the ball forward while providing insight on how to get where you're going.


Unfortunately, there is no miracle elixir that can deliver an instant cure for many of the problems that burden our healthcare system. But the challenges standing in our way can be overcome by thinking big and starting small. Small wins today will lead to the momentum and insight that will put your healthcare organization on a path to achieving big wins tomorrow.

Image from flickr.