At the Helm

Why success with 'systemness' is a lot like weight loss

by David Willis

It's that time of year when many people are trying new diets and hitting the gym in search of the most sought-after of all New Year's resolutions: weight loss.

As we all know, many of them will fail by the time Valentine's Day rolls around, mostly because their goals lacked a deep enough motivation. I know because I used to make the same promises every year and would inevitably fail—that is, until my good friend had a heart attack.

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It was a remarkably painful experience, and one that had a deep impact on me emotionally and physically. Seeing the possible consequences of extra weight made my motivation to lose it far stronger. Crucially, my personal "why" had changed. The "whys" of my past—to feel better about myself, fit into my clothes, etc.—paled in comparison to the far deeper and more meaningful "why" of not wanting to leave my children without a father. The new "why" was so salient, so strong, and so real that it drove me to drop 25 pounds in 12 months. (I'll spare you the before and after pictures, but rest assured that even with the weight loss, no one is asking me to model for GQ.)

Bear with me here, but I see many parallels between my weight loss journey and the goals that health care organizations set every year when drafting their strategic plans. They often make goals to improve operational efficiency, streamline the services provided, and, above all else, improve "systemness." But just like weight loss, many of these goals fall flat.

That's because acting like a true "system" requires a complete shift in mindset. It's not the result of superficial organizational changes, like changing a job description, altering a reporting line, or giving your organization a catchy new name. Rather, it requires fundamental changes in how everyone in the organization thinks and acts: How they make decisions, how they view other parts of the organization, how willing they are to break down silos to collaborate, and that they see doing so as critical to both their and the organization's success. It's a culture change—and changing culture is one of the most difficult of all organizational tasks.

To succeed in acting like a system, everyone within the organization must understand the "what" (what changes do we need to make), the "how" (how are we going to make those changes), and most importantly, the "why" (why do we have to change at all). The "why," as with weight loss, is always the hardest (and the most important).

Seeking the 'why'

In my experience, leaders too often take the "why" for granted, in several ways.

First, while they, as leaders, can see why it's so important for the organization to adopt changes, others may not be looking from the same vantage point. Leaders see changing demographics, regulatory requirements, margin pressures, and disruptive competitors—but for those on the frontline, these market-level and industry-level forces are obscured by the day-to-day realities of care delivery. Those who wake up every day to provide great patient care or who manage the realities of running a surgical unit rarely experience these larger forces—or if they do, it's through gradual shifts which are often imperceptible at any given moment.

Second, leaders often conflate the "why" with the mission. The vast majority of people who choose health care as their profession are deeply motivated to provide the best patient care possible. All the organizations I work with have a compelling set of values and an endless stream of stories, awards, and accolades to highlight them. But it is too easy to conflate the "why" of choosing health care as a career with the "why" of needing to change individual and organizational behavior. Worse, when we just assume that everyone will understand the need for change and go along with it "because of our mission and values," we risk taking everyone's engagement for granted. It's incredibly disrespectful and comes off as though leaders are saying, "We're not going to bother explaining why you need to do things differently, we're just going to assume you're a good team player who will go along with it."

In sum, when leaders implement broad organizational initiatives that disrupt staff's daily status quo, many on the frontline don't understand the "why" (or haven't fully bought into it). Just like a diet, you need a "why" powerful enough to drive behavior change. But, almost without fail, I find that the organizations I work with underestimate the need for deep conversation with their people about why they need change.

This is such an important issue for our industry, and so near and dear to me personally, that I want to share with you the most exciting innovation at Advisory Board in years. It's one that is directly intended to help galvanize deep conversations about "why."

Meet the Root Learning Map Experience

Advisory Board has partnered with Root Inc. to reimagine our annual State of the Union presentation in a highly-interactive, visual format.

Rather than outline the market forces that are reshaping health care in a PowerPoint deck, the Root Learning Map experience involves everyone in the room in a dialogue about those forces. Working in teams of eight to 10 people, participants use a colorful visual metaphor, a structured set of dialogue questions and exercises, and their own shared experience to discover the "why." And some magical things happen when they do. When allowed to reach their own conclusions based on the data, their retention and understanding of the information goes up dramatically, and their willingness to take action is much greater.

We've begun offering this exercise as a complimentary service to our members—both as an onsite experience and as an optional part of our Health Care Advisory Board national meeting series. And we've been blown away by the results. We've had so many participants tell us that they understand the state of the industry in a whole new way and that they were able to meaningfully connect the dots back to their own organizational strategy. Tools like this can be a critical part of redefining the "why" in health care, and I invite you to take advantage of it.

To learn more about the Root Learning Map experience, watch my recent interview with Root's Managing Director of Health Transformation, Kalen Stanton. Then, to sign up for this experience at select locations in our upcoming national meetings—including Atlanta, Denver, and White Plains, New York—please register here. And if you can't attend in those locations, or are interested in bringing this experience onsite for your organization, please contact our team directly. I promise we won't talk about weight loss.

Editor's note: Learning Map is a registered trademark of Root Inc.

Next, learn more with our expert perspectives on 'systemness'

Many health systems are only scratching the surface of the potential their scale offers. But today’s market leaders are leveraging purposeful integration and cohesive effort—what we call "systemness"—to streamline operations, deliver more reliable and coordinated care, rationalize fixed costs, and even transform entire delivery models.

Download our report for expert perspectives on how your organization can achieve "systemness."

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