Unlocking the healthcare growth mindset

1. Get Operational

According to Dawn, a great place to start is in Operations, the backbone but also the brain of a hospital and where a range of departments and disciplines come together and where strategic and structural change can be most effective.

In fact Operations, she believes, has the ability to be the driver of change if it can build the new capabilities and behaviors that modern healthcare needs. This is why she and her teams have worked with healthcare partners to develop a methodology and mindset – known as Operational Intelligence - for operational innovation that helps facilitate the change management required to break down silos, embed new ways of working alongside process and technology to help make transformation stick.

2. Pursue a new Procurement mindset –  Literally, thinking ‘out of the box’

As health technology companies continue to partner with healthcare systems to develop solutions, a blocker to integration can be procurement, as often existing procurement processes and models are designed to purchase single items of equipment – a CT scanner for example - rather than tender for wider, more integrated, vendor neutral solutions.

Dawn Bruce explains: “A positive, value-based approach to procurement could, instead, help procurement experts to explore ways of unlocking more value by disrupting their approach. Procurement could instead focus not only on the price of a particular product or service but also on the overall value the solution could create, to encourage more collaborative tender approaches.”

According to reports, the Dutch Healthcare Authority is advancing this type of value-based contracting as a central concept throughout the Dutch health care supply chain, in tandem with the shift toward outcomes-based health care. Denmark is also considering how to standardize health technology procurement while other countries, such as Ireland, are reported to be moving away from lowest price procurement.

The challenge here is to help procurement teams harness this new mindset and build the appropriate expertise and infrastructure to measure patient-relevant outcomes and total cost of care in order to demonstrate the real-world quantitative and qualitative benefits over traditional procurement methods. Similarly, procurement incentives should align with long-term value, rather than with just the upfront purchase price or financial rewards for hitting short-term budget targets.

3. Rethink Governance – From closing down to opening up innovation

Instead of being a starting point for risk, worry and closed thinking, however, Dawn Bruce believes –  from experience – that a modern, innovated  governance model is central to the formation of  any good relationship and is integral to realising  change management.

When embarking on a new external relationship, framing the governance process and adopting an innovative model from the start can make or break relationships, priming for success rather than failure. Dawn Bruce explains: “Many external partners will come to a healthcare organization and say, ‘we will do this for you and the process is this. The card is marked, the field is set before the match has even started.’ And yet operational challenges can’t be solved off the shelf.

This is where a different approach to partnership comes into play which starts with a new approach to governance. A growth minded, positive governance model and process opens conversations within the context of a confidentiality wall, provisional guidelines and the like, but also enables both partners to be less transactional and more solutions focused and coaching. An innovated governance approach becomes a virtuous circle of continuing learning and optimization.”

4. Integrate Clinical, IT and Operations –  “Great teams think unalike”

While Operational teams may have more exposure to responsible business and disruptive innovation practices, clinical and IT teams can tend to be siloed. IT professionals can feel disconnected from the delivery of care while studies highlight that clinical hierarchies can isolate clinicians from communication.

In fact, in the opening address of the 2018 BMJ/IHI International Forum on Quality and Safety in Healthcare in Amsterdam, Wim Helbing, highlighted this problem stating, “I’ve been a professor in a university hospital, leading one of the largest departments in the university children’s hospital. I never get any feedback.”

Dawn Bruce explains: “Clinical and IT teams within hospitals come from different worlds, talking different languages and with completely different objectives and goals. Interoperability isn’t just about getting technology, from PACs systems to telemetry and patient monitoring, talking, it’s about breaking down siloes within the hospital. Bringing together multi-disciplinary teams lets specialists and generalists learn from each other and solve from a 360 degree perspective.”

Multidisciplinary teams is a way of working that is so successful that many papers, including NICE guidelines, have been written on the subject, outlining how working this way limits adverse events, improves outcomes and contributes to patient and employee satisfaction. And yet, it’s often under-utilized in healthcare.  If brought together effectively, people who think differently have a lot to contribute to one another.”

In his book Rebel Ideas, the innovation expert Matthew Syed highlights that times of unprecedented change demand a need to think differently.

He argues that solving of complex problems can sometimes only be achieved by assembling a group consisting of differently minded people and then getting the group to work on the difficulty using each individual’s particular talents to provide some part of the solution. By combining different perspectives, insights and thought processes, sometimes even the most challenging of obstacles can be overcome.

What the author refers to as ‘cognitive diversity’, i.e. diversity in the way a problem is looked at, the usefulness of any pre-existing knowledge of the problem and the thought processes that could be used to solve the problem, highlights the importance of bringing together people who think differently, such as clinicians and IT technicians to break down the invisible and visible barriers within healthcare systems.