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"Our job as leaders is to engage our staffs and our communities, acknowledge their struggles, persist with them, and collaborate to best utilize all of the assets available to us."
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Why Today’s Leaders Need to Embrace Change and Uncertainty

By Derek Feeley | Monday, March 6, 2017
Why Today’s Leaders Need to Embrace Change and Uncertainty

In 2017, I believe it’s safe to say that change and uncertainty represent the new normal for health care. While some may argue this isn’t new, I think we can all agree that the multiplicity of changes in the world — economic, political, demographic, and epidemiological, just to name a few — add up to a complex web of interrelated challenges for health care.

With all of these simultaneous changes, sometimes it feels like we’re all running faster to keep up, but we’re less clear about the destination. Today, “more of the same” simply isn’t an option; instead, we have a great opportunity to respond by being creative, being innovative, taking risks, and thinking differently.

Today’s leaders have a choice: We can take shelter and wait for the storm to pass, or we can take control of what we can, and see the rest as a contribution to innovation. We can seize the opportunity to engage our staffs in discussions about the future. We can accept that the world is complex and learn to embrace it.

Three Recommendations for Leading Through Change

My best advice to leaders at this time would be to do three things: listen, persist, and collaborate.

First, listen. If you are feeling overwhelmed by the pace of change and uncertain about your organization’s future direction, imagine how the nurse or the physical therapist or the housekeeping staff in your system are feeling right now. Listen to these people not necessarily to respond, but to understand. People aren’t expecting you to have all the answers, but they are expecting you to hear their concerns.

One of the high-impact leadership behaviors IHI recommends is to be an authentic presence at the point of care. This is the time for that, above all else. If you’re already available and visible to your staff, be more available and more visible. Remind people of your organization’s purpose: to help and heal people. Engage them emotionally as well as rationally.

Second, persist. It’s very easy in these uncertain times to chase after novelty, but this is the time to hold your course: Stay loyal to your mission, and keep your promises to patients and staff.

You’ve likely made certain decisions about where your organization is headed while transitioning from volume to value, for example. You’ve had to take calculated risks. Take the advice of members of IHI’s Leadership Alliance, and put your patients at the center of your calculations. Do the best you can with the information you have.

Third, collaborate with others. Health care leaders need spaces in which they can share their struggles and celebrate their successes. With the magnitude and pace of change around us, none of us have all the answers. We’ll only be able to find more answers by facing today’s challenges together.

This is why IHI created the Leadership Alliance, a collaboration of health care executives working to deliver care better than we have ever seen, health better than we have ever known, at a cost we can all afford. There’s a camaraderie that comes from being together in this period of change and uncertainty that I find invigorating: Camaraderie allows for candor, which leads to curiosity, which multiplies our opportunities for shared learning.

An Example of Learning to Embrace Change

Let me give you one example, which shows the different ways we can react to change. You often hear people talk about the aging of the population in dramatic, even frightening, terms: It’s the “demographic time bomb” or the “silver tsunami.” These kinds of descriptions trouble me for two reasons. First, that’s me they’re talking about! I’m part of this this increasingly gray demographic, as are my family and friends. Second, more importantly, this negative language stems from a “deficits mindset.”

Instead, we ought to look at those people who are part of this aging population in a positive light, as assets. These people are not burdens we must bear: They have important experience and ideas to share if we ask. We should acknowledge that many older adults provide essential health care — especially as caregivers for their loved ones — in many of our communities.

When I was in Scotland, we found that people aged 65 or older actually gave many times more care than they received. They were the informal caregivers for their spouses, or they were visiting their neighbors, checking up on them, making sure they were OK, and having a cup of tea. Without these informal caregivers and crucial social connections, many more people might be in long-term care facilities.

I’m not trying to minimize the simultaneous and significant challenges facing health care. It is true that an older population puts real strain on our health systems and on these informal caregivers. But in this example, instead of seeing a group of people as a collective “time bomb,” we need to think creatively about how to engage and support a group of individuals that are often deeply experienced and motivated to help.

Our job as leaders is to engage our staffs and our communities, acknowledge their struggles, persist with them, and collaborate to best utilize all of the assets available to us. Sometimes the most creative ideas come during the most turbulent times.

Derek Feeley (@derekfeeleyIHI) is IHI President and CEO.

You may also be interested in:

The IHI Leadership Alliance

IHI white paper - High-Impact Leadership: Improve Care, Improve the Health of Populations, and Reduce Costs

Civility Is Everyone’s Responsibility

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