My ideal healthcare organization

When I envision the ideal health care organization, I picture six characteristics.

It is so patient-centered it is patient-driven. This has two components.

  • First, the key question that serves as a prime directive for every process and group is “How will this benefit individual patients and/or patients as a group?” 
  • Second, patients must be part of every planning and building process from the beginning.

It is full of top-notch people. I don’t mean only clinicians, but at every level. The goal is to hire the best people, support them, and get out of their way while they do their jobs. If the organization has to micromanage its employees and constrains them with protocols that define rather than inform behavior, they have either hired the wrong people or are squandering their greatest resource. 

The culture is geared to solve problems, not to do jobs.  Consistent with the prime directive, where every action is evaluated based on how it will benefit individual patients and/or patients as a group, everyone understands that local optimization must never be allowed to trump patient care.

It recognizes and builds on the value of individuals and their work at the margin.  This requires a culture of respect and trust, where management supports rather than controls members of the organization.

Tools and infrastructure and are seen as servants of patient care. The tail does not wag the dog.  Workflows and policies are driven by the needs of patient care. Clinical processes and patient care are not expected to adapt to tools and infrastructure. Information is not owned or compartmentalized, but readily available where and when it is needed. Communication is unconstrained by hierarchy, user-friendly, and barrier free. Networks are more important than hierarchy, and collaboration is based on function and need rather than departmental structures or committees.

Because it understands that it exists in a state of perpetual beta, where change is the only constant, it actively solicits alternative perspectives, and embraces criticism and experimentation. In a rapidly changing environment, the status quo is always adapted to yesterday and less than ideal for today, so learning from variability and experimentation are necessary for adaptive innovation and growth.



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