In the November issue of Harvard Business Review, John Kotter makes his latest contribution to an already authoritative body of work on organizational change management in the article, Accelerate! I found the article to be very insightful and particularly well timed in lieu of my post earlier this week on the Healthcare Value Equation.
In that post I wrote about the importance of healthcare organizational leadership being able to manage through transformational change as a condition of future survival in an era of Healthcare Reform. In our practice at Artower we are already witnessing an acceleration of meaningful efforts to explore, understand and promote clinical integration by and between acute and post-acute/long-term care providers.
For me, an analogy of what this process looks like so far is two American Indian tribes from the 18th century, each living peacefully in adjoining valleys – communicating good wishes now and again for decades via smoke signals. Then one day the leaders from the two tribes decide to meet face-to-face and find they can no longer communicate because of not sharing the same language.
Those familiar with Kotter’s work will recall his seminal article and then book, Leading Change, and the eight steps of an effective organizational change process. Now, in Accelerate! Kotter introduces eight accelerators that form the backbone of a strategy network, which he suggests should work in parallel with an organization’s existing operations. The accelerators differ from the eight steps in their being nonlinear, more organizationally encompassing and ideally facilitated independent of the traditional organizational hierarchy.
Kotter argues that for an organization to maintain the highest levels of operational performance and efficiency while concurrently being able to resiliently embrace and adapt to an increasingly complex environment what is required is a, “dual operating system – a management-driven hierarchy working in concert with a strategy network.” The applicability of this model to healthcare organizations desiring to survive the burgeoning maelstrom seems rather self evident; thinking strategically isn’t sufficient – acting swiftly will also be necessary, and that typically requires a significant change effort.
So what Kotter has done in this article is tie together two concepts that I have argued for the past decade must be more effectively merged within and by organizational leadership if planning efforts are to result in tangible results: that is, the critical connection between strategy and organizational change management. Specifically, he notes that, “strategy should be viewed as a dynamic force that constantly seeks opportunities, identifies initiatives that will capitalize on [those opportunities] and completes those initiatives swiftly and efficiently.” I tried to make this point in my white paper earlier this year and have sought to reinforce it in presentations on strategic planning and positioning for Healthcare Reform.
The key takeaway here for healthcare providers – and particularly for providers of post-acute and long-term care – is that organizational leadership must sponsor and promote both operational efficiency AND strategic flexibility. Achieving both requires being able to look at the same organization from unique perspectives. One is a structural framework that aligns individual performance incentives with the organization’s top line goals of improving outcomes while reducing costs (remember: VALUE), while the other is a network framework that is able to leverage the organization’s group genius in ways that facilitate rapid strategy deployment.
The same people in your organization can be high level performers under both frameworks – and can do so concurrently, with the right leadership. I have seen it accomplished in the organizations we have worked with – and I have observed the tangible results those leadership teams have achieved.