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Today’s health care leaders need to learn from people with a wide range of experiences because they may have knowledge that could save time, money, and lives.
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“You Will Be Wrong”: Four Leadership Lessons I’ve Learned

By Derek Feeley | Friday, July 11, 2014


The truth hurts, but here it is anyway: No one knows all the answers to today’s health care challenges. In my previous position as Director General for Health and Social Care and Chief Executive of the National Health Service (NHS) in Scotland, my team asked many questions about how best to improve the health and health care of a small (but mighty) country. And now, as Executive Vice President of the Institute for Healthcare Improvement (IHI), I’m looked to for answers on ways to overcome the many health care obstacles in this country. Leaders today are running through a storm. And that storm is hailing questions that can permeate even the strongest of raincoats.
Now, here is the good news. Somewhere, someone is facing exactly the same range of challenges as you, and has made some progress on one or more of them — just not on all of them, all of the time. To help leaders find and share solutions together, IHI has announced our new Leadership Alliance. It brings together ambitious executives working to drive down cost, optimize patient outcomes, and improve the health of key population segments. At the first gathering of the IHI Leadership Alliance in September, I’ll be sharing the lessons that have helped me weather the toughest challenges. Over the years, these four concepts have served me well:

1. Be generous with power.
Many of the great things we accomplished in Scotland — from making significant strides in our system-wide patient safety levels to co-production of healthy communities — were only possible because of strong teams comprising professionals dedicated to achieving results who partnered with patients and families willing to lend their voice. Leaders need to take the time to build high-performing teams and then give them the authority to make decisions. I learned that delegating responsibilities was not only critical for my teams, but also enabled each endeavor to move faster and more efficiently than if I was trying to lead each one myself.

2. Get comfortable with complexity.
There’s no cut-and-paste solution to risk-based contracting arrangements, ways to partner with patients, or population health strategies that will work for every organization, everywhere. There are, however, best practices in each of these endeavors that will take time to understand and apply in your specific context. Every solution is complex and requires intricate thought, research, and testing — now’s the time for leaders to be humble enough to learn from others, to let solutions emerge, and to see our primary role as sense-making rather than all-knowing.


3. Rely on help from your friends — or even those who aren’t, yet.
At IHI, we work closely with organizations that have:
  • Tested ways to reduce sepsis (our partner North Shore-LIJ has reduced sepsis mortality rates by 50%); 
  •  Become an NCQA-certified patient-centered medical home (Kaiser Permanente); and 
  •  Reduced homelessness, a key determinant in health (Community Solutions used IHI improvement techniques reach their goal of housing 100,000 people.)

Together, we learned big lessons on what works, and relied on each other’s experiences to determine next steps. Today’s health care leaders need to hear from the CEO at the 2,000 bed hospital across town, the President of a rural practice with 15 beds, and the community leader who knows what matters to the neighborhoods we serve. All have important lessons to share that could save you time, money, and lives.

4. You will be wrong.
Here’s some more inconvenient truth, poking holes in any health care executive’s armor of ego. You will make decisions that turn out less than ideal; you’ll try things that don’t work. That’s ok. What’s most important is that you make clear to your organization that you will be trying, trying again and learning from every attempt. At IHI, we use the Model for Improvement and PDSA cycles for our tests of change. The great thing about these models and methods is that you learn as much from what doesn’t work, as from what does.

What leadership lessons have you learned on your journey? I’d love to hear them and look forward to reading your thoughts in the comments below. 

Derek Feeley is Executive Vice President at IHI. He invites you to follow him on Twitter @DerekFeeleyIHI.

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