Are Healthcare Organizations Healthy?

Modern health care organizations need to consider how to become healthy organizations themselves. New work from McKinsey provides a useful set of thoughts about how organizations can achieve success in their core business as well be ‘healthy’ organizations internally. (full article)

Healthcare organizations are among the most complex institutions of modern society, experiencing a constant stream of internal and external pressures.  External forces include the rapid pace of change in medical knowledge, cost pressures, heightened stringency in regulations, intermittently tense industrial climates (in unionized environments) and escalating community expectations.  Internally, leaders of health care institutions face difficulties in recruitment and retention of key professional staff, outdated professional cultures for the modern context of team based care and the constant pressure to do more work with less resources.

How then, midst all these pressures, can healthcare organizations survive, flourish and be healthy?  For some time, commentators on organizational dynamics have pointed to the importance of ‘organizational learning” as one of the hallmarks of institutions which can survive under pressure and evolve to new success and sustainability.

Recent work from McKinsey & Company provides a fresh look at these issues, discussing a framework for thinking about how organizations can do better in managing themselves with the sorts of pressures which many organizations face. These ideas are laid out in the new text “Beyond Performance: How Great Organizations Build Ultimate Competitive Advantage” (Wiley 2011). A central theme in this work is that organizations will do well, improve and survive if they attend to the health of their people, i.e. health in the broadest sense.

The authors surveyed several thousands of workers in hundreds companies across the globe and attempted to a) measure the organization’s health, and b) correlate organizational health with the performance in traditional sharp-ended business terms (EBITDA margin, growth of net income to sales etc.).

The results show that there is a correlation and the authors propose that achieving a balance of organizational health AND performance at the same time is crucial and often will involve significant change to news ways of operating.

They propose an interesting framework with activities (and presumably metrics) to consider organizational health AND performance in lockstep. These steps are presented as “frames”:

  1. Aspire – where does the organization want to go?
  2. Assess – how ready is the organization to move?
  3. Architect – what steps are needed to get make the change and arrive at the desired result?
  4. Act  – what is the step-by-step process to make it all happen?
  5. Advance – what has to be put in place to allow this cycle to begin again and become continuous?

For each frame, deliberate attention would be devoted to performance AND organizational health.  In broadly cataloguing the activities required to improve and sustain the organization’s health at the same time as performance, this study identifies useful steps that organizations need to consider in order to tackle these problems.

If we apply this framework to modern healthcare organizations, some key early steps would include:

  • Defining what is actually meant by a healthy organization for the relevant culture and context
  • Widely promulgating the organization’s commitment to the notion of ‘orgnizational health’ through concern for the ‘health’ of individuals
  • Identifying the deep-seated barriers to change within the organization, which opens up the whole set of issues around entrenched professional cultures in medicine.

The above framework from McKinsey is a useful addition to models to consider in defining a path to improve and sustain ailing and poorly performing healthcare institutions.  We should consider at least the following:

  • deliberate attention to the health of healthcare organizations internally not just the health outcome of patients, i.e. defining what actually makes a healthcare organization healthy in and of itself?
  • continuing the trend of working in teams and breaking down the historically entrenched cultural barriers of specific health care disciplines.
  • constant attention to developing professionally credible leaders who can interpret complexity and champion new paradigms of work

The recent McKinsey contribution is a useful addition to the wide variety of approaches for organizational development in healthcare organizations.