Her note started off nicely enough. Then I read her feedback, including a challenge I didn’t know what to do with.
Bettina had heard about WOL Circles at a conference and liked the idea. “I started my first Circle directly. With great success!” She said she is working as a Change Manager in a large non-profit healthcare organization in Germany, and that she wanted to spread Circles. But she made it clear that WOL, in its current form, would never work.
“The nurses, doctors, and other professionals do not have 60 minutes a week for WOL, there is too much text, the examples have to refer to the health sector…”
Ouch. She even said the German translation wasn’t acceptable, as the informal pronoun (“du”) simply isn’t used in her organization’s “official papers.”
I knew she was right. I asked if we could speak on the phone.
The challenges in Healthcare
Healthcare organizations suffer from the same cultural issues that plague many large companies. The hierarchical structures limit information flows in ways that are bad for individuals, the organization, and the patient. Too often, nurses don’t question doctors and medical technicians don’t question the ambulance manager. (Atul Gawande, surgeon, author, and CEO of the recently-formed healthcare venture formed by Amazon, Berkshire Hathaway, and JP Morgan Chase, captured these challenges in dramatic fashion in The Checklist Manifesto.)
The same is true across the hierarchy as well. People in a given role are not in the habit of of sharing problems and solutions to improve quality, and in many cases there may be no mechanism to do so. So the same mistakes get repeated, and innovations don’t spread.
On top of such challenges, all of this takes place in an environment that is extraordinarily demanding. It’s busy, stressful, and unpredictable - and the stakes are extremely high.
Of course, not all healthcare organizations have the same cultural issues. Buurtzorg, for example, has over 10,000 professionals in “a nurse-led model of holistic care” that emphasizes “humanity over bureaucracy.” They are portrayed in Reinventing Organizations as a model of self-organization and self-management. But for every Buurtzorg, there are thousands of traditional companies.
How could WOL help?
I told Bettina how we had already adapted WOL for leaders by making it shorter and simpler, and by integrating it into a reverse mentoring program. Perhaps we could do something similar.
Together, we decided that Bettina’s colleagues could also meet in pairs (perhaps one with more experience and one new to the organization), and we could limit meeting to no more than 30 minutes. Then we identified eight different exercises over eight weeks - eight contributions they could make that would help them find their voice, improve their craft of patient care, and enable them to re-connect with the sense of purpose that inspired them to join the profession in the first place.
What would you do?
The challenges faced by people in healthcare environment are similar to those in other operational environments, be it manufacturing, retail, transportation.
As different as those jobs may be, the people doing them all share the same human needs for control, competence, and connection. And all of the organizations they work in need to improve quality for their customers and for their own sustainability. The future of work isn’t limited to people working in offices.
Bettina and I will meet in Frankfurt this week to work on details of a pilot. Whatever the outcome, we’ll surely learn something that can help us take a next step and try again.
If you were Bettina, what would you do? What could WOL for Healthcare look like?