Editor's Notes

A Teachable Moment?

Reform may be a journey not an event, but it will be a quick trip with much to learn—and teach

Let's face it. We all spend a lot of time managing up. It is the fine business art of figuring out what your boss expects of you. And equally important, doesn't want from you. Generally, unless you are a particularly annoying and irresponsible individual, it all works out. After all, someone has to be in charge.

But one of the interesting initial organizational cultural fallouts from health care reform is that up and down the organization, no one is exactly sure what to do or how to approach the situation. There seems to be a sense of a level playing field of uncertainty.

However, there is one clear direction. From the board of trustees to the CEO to the C-suite and beyond, there is general recognition that this is not the time to build it without first carefully reading the directions. (Which was essentially one of the approaches to managing health care organizations in the late 1980s and early 1990s.)

This time everyone seems intent on learning as much as they possibly can—be it simple definitions to the experience of others—before hatching the le grande strategy. The sessions I attended at the AHA Annual Meeting in April were standing room only and the audiences were intensely focused. Registrations for the Health Forum–AHA Leadership Summit, with the hopeful theme of "Hospitals Leading Health Care's Transformation," to be held later this month in San Diego, are on the rise. And the AHA has created Hospitals in Pursuit of Excellence as a strategic platform to circulate real-world-tested best practices to facilitate learning and accelerate performance improvement (see "Other Voices" Q&A with Maulik Joshi on page 12 and visit www.hpoe.org).

While some have pointed out that reform is a journey, not an event, as journeys go, this one may be a pretty quick trip and will require a new level of governance and leadership. Health care leaders and trustees will come to understand the range of ramifications, responsibilities and options and decide what strategy makes the most sense for their particular marketplace and their particular community. Then it will be time to become teacher and help others learn.

Sometimes we are so consumed by all the blocking and tackling that needs to take place on a daily basis just on core processes that we don't feel there is time to communicate the big picture to employees and explain why and how the institution is changing. Down-the-line learning just doesn't happen.

But they are the ones who make the institution run on a daily basis and they are the ones who touch the patients. They are the face of the hospital to the community and they are in the best position to help the community at large understand how the hospital is changing and why it is for the better. And any transformation will be very short-lived if they do not understand—or even know about—your plans.

Benjamin Franklin once said, "Never confuse motion for action." In periods of change, we can't confuse talking with communication.

This article 1st appeared in the July 2010 issue of HHN Magazine.

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