After Focus Comes Alignment

If you have your team(s) agreed on a very few focal changes, congrats! You have a good start on your leadership role. And your work is just beginning.

Agreement on change or improvement focus must be followed quickly with alignment to that focus of everything the team is and does. Speed here is important. You want to capitalize on the goodwill and sense of accomplishment that will be created by the focus agreement. Don’t squander that energy. Go slow incrementalism will be suggested by the nay-sayers and foot draggers. Incrementalism will prove them right. Remember that people are busy doing their jobs and will forget about new initiatives quickly unless the initiatives become part of everyday work very quickly.

Everyone, including the most frightened foot-draggers, will agree that daily work systems must be optimally aligned so that they can work in concert to achieve organizational goals. No one wants to waste their time and effort. Where to start?

In a recent editorial* about successful innovation in health care, Jennifer Zelmer writes: “So what did the successful innovations have in common? Most were complex interventions that reflected best practices in change management. They were about transforming cultures as much as changing technologies or techniques, about making the right thing to do the easy thing to do. Which doesn't mean that healthcare transformation is easy. The examples identified tended to reflect an understanding that for a new approach to become the accepted 'way we do things around here' involves a collective effort with thought to governance and leadership, stakeholder engagement, communications, training and education, workflow analysis and integration, and monitoring and evaluation.”

There is a lot that must be aligned across most organizations of any complexity: all the above plus organizational structure, legacy operating systems, cultural practices, building layout, HR structure (hierarchy, recruitment patterns, job design, pay, rewards and incentives), measurement and accounting systems, training, documentation, reporting and supervisory systems. Even the tactics chosen to initiate and sustain desired change must be added to this list for consideration and alignment.

Each facet must be examined in order to thoroughly understand and communicate the present work process and outcomes. Those outcomes, processes and indeed the facet itself must be critically appraised for fit and value contribution to the new goal. Needed changes must be noted or invented and agreed to within and across the affected work teams. The change leader and team must then knit all these together so that they are mutually reinforcing and collectively serve the new organizational goal.

Change is not a job for the impatient or the faint-of-heart. No wonder we see so little of it.

*Healthcare Policy, 11(2) November 2015: 8-12.doi:10.12927/hcpol.2016.24452

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