Try the Google Way to es­tab­lish a cul­ture of in­no­va­tion in health­care or­ga­ni­za­tions

Modern Healthcare - - COMMENT - By Dr. Alis­tair Aaron­son

Health­care lead­ers are con­stantly chal­lenged by chang­ing reg­u­la­tions and new tech­nolo­gies, so the or­ga­ni­za­tions they run must be ag­ile enough to adapt to th­ese chang­ing cir­cum­stances.

How­ever, the cul­ture of many health­care or­ga­ni­za­tions is tra­di­tion­ally both siloed in prac­tice and hi­er­ar­chi­cal in na­ture, mak­ing it dif­fi­cult for or­ga­ni­za­tions to spur in­no­va­tion. A seis­mic shift in health­care cul­ture is there­fore needed for health sys­tems to not just keep up, but ex­cel in the con­tin­u­ously chang­ing health­care land­scape.

Health­care has sought guid­ance from the au­to­mo­tive in­dus­try to im­prove op­er­a­tions man­age­ment through wide­spread adop­tion of the Toy­ota Way, and this has her­alded sig­nif­i­cant im­prove­ments in op­er­a­tional ef­fi­ciency and qual­ity of care. How­ever, in seek­ing guid­ance for the de­vel­op­ment of a cor­po­rate cul­ture that spurs con­tin­u­ous in­no­va­tion, health­care lead­ers should look no fur­ther than the tech­nol­ogy in­dus­try, with Google as the tacit and de facto leader. Much in the same way the Toy­ota Way has in­flu­enced health­care op­er­a­tions and process im­prove­ment, the Google Way could pos­i­tively in­flu­ence the health­care cul­ture.

What ex­actly is the Google Way, and how can health­care sys­tems im­ple­ment it? And what, if any­thing, is hold­ing health­care back?

Google and other suc­cess­ful tech­nol­ogy com­pa­nies are nim­ble, adapt­able and in­no­va­tive be­cause they en­gage and em­power front-line em­ploy­ees. In­deed, front-line em­ploy­ees of­ten no­tice in­ad­e­qua­cies in daily op­er­a­tions, and they are the ones best equipped to de­velop and im­ple­ment so­lu­tions for the prob­lems they en­counter.

Health­care or­ga­ni­za­tions can be equally nim­ble and in­no­va­tive, but they must first have an or­ga­ni­za­tional cul- ture that val­ues and pro­motes front-line em­ployee en­gage­ment. In many health­care or­ga­ni­za­tions, the ideas that are im­ple­mented come from lead­ers in the or­ga­ni­za­tion, who then en­list the help of man­agers to gather con­sen­sus and en­cour­age align­ment. If health­care lead­ers di­rectly en­gaged their front-line em­ploy­ees, such as by sup­port­ing the im­ple­men­ta­tion of qual­ity-im­prove­ment projects de­vel­oped by the em­ploy­ees them­selves, their or­ga­ni­za­tions could more rapidly ad­dress mul­ti­ple salient is­sues at any given time, and po­si­tion them­selves to be in­dus­try in­no­va­tors.

Google and com­pa­ra­ble com­pa­nies also foster a col­lab­o­ra­tive en­vi­ron­ment by im­ple­ment­ing a flat or­ga­ni­za­tional struc­ture, where man­agers are seen more as re­sources, and less as bosses. This en­cour­ages open com­mu­ni­ca­tion among team mem­bers, and pro­motes a col­lab­o­ra­tive ap­proach to prob­lem­solv­ing in which in­di­vid­u­als feel free to voice ideas, no mat­ter how rad­i­cal or non­tra­di­tional those ideas may seem.

In this flat man­age­ment struc­ture, fail­ures are not seen as er­rors that re­quire pun­ish­ment or re­me­di­a­tion, but rather as nec­es­sary steps to­ward de­vel­op­ing trail­blaz­ing ideas.

In many health­care cul­tures, sig­nif­i­cant ef­forts are be­ing made to pro­mote in­ter­dis­ci­pli­nary teams. How­ever, it can be chal­leng­ing to cre­ate true teams when hi­er­ar­chies are deeply en­trenched, and the con­stituent team mem­bers do not fully ap­pre­ci­ate or un­der­stand the other team mem­bers’ roles and skills. In ad­di­tion, health­care cul­ture also per­ceives fail­ure as un­ac­cept­able un­der any cir­cum­stances. This, un­for­tu­nately, sti­fles team­work and hin­ders adapt­abil­ity, in­no­va­tion and qual­ity im­prove­ment.

If the Google Way of utliliz­ing flat man­age­ment were ap­plied to health­care, in­ter­dis­ci­pli­nary team mem­bers would be more amenable to shar­ing their ideas, re­gard­less of how non­tra­di­tional they might seem. The in­creased open­ness in com­mu­ni­ca­tion and will­ing­ness to fail with­out fear of ret­ri­bu­tion would po­ten­tially lead to more rapidly im­ple­mentable im­prove­ments in pa­tient care. In ad­di­tion, if ef­forts were made to al­low in­ter­dis­ci­pli­nary team mem­bers to learn more about one an­other’s roles, this would en­gen­der more mu­tual re­spect, re­duce hi­er­ar­chi­cal bar­ri­ers and im­prove col­lab­o­ra­tion.

While health­care lead­ers are right­fully seek­ing mod­els for ef­fi­ciency and qual­ity in the au­to­mo­tive in­dus­try in the form of Lean prin­ci­ples, they also are look­ing to the avi­a­tion in­dus­try to em­u­late its suc­cesses in sys­tems in­te­gra­tion and safety. How­ever, we should not for­get that when it comes to a cor­po­rate cul­ture of sus­tained in­no­va­tion, the tech­nol­ogy in­dus­try may be our best re­source.

Google and com­pa­ra­ble com­pa­nies foster a col­lab­o­ra­tive en­vi­ron­ment by im­ple­ment­ing a flat or­ga­ni­za­tional struc­ture, where man­agers are seen more as re­sources, and less as bosses.

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Dr. Alis­tair Aaron­son is a clin­i­cal in­struc­tor of medicine at the Stan­ford Univer­sity School of Medicine.

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