According to some researchers, hospitals are among the most hierarchical, rigid organizations in existence, just a notch below the military. And if so, it’s not much of a surprise.
After all, in one way–and I know clinicians hate to think about what they do this way–hospitals are factories which attempt to produce extremely consistent results. It’s no surprise that models borrowed from manufacturing, like the Toyota Production System, can be very valuable for hospital execs. And of course, it’s no surprise that hospitals are hierarchical, since they, like the military, must react quickly to life-and-death situations.
That being said, hospitals lack one of the military’s great strengths, the capacity to deploy their forces quickly and change direction on command. While armies are set up to make swift strategic changes, hospitals are far more static. Too often, it takes a whack on the head from the Joint Commission or a major financial loss to get them moving in a new direction.
nextHospital executives will have to drop the 50s-era management philosophies, root them out from their subconscious if necessary, and become more fluid and their forces deployable as community needs change.
The hospital industry’s’ response to the H1N1 virus is a perfect illustration of what’s possible. With a many-tentacled threat looming, hospital leaders are moving quickly to deploy off-site screening centers, develop new triage procedures to sort the sick from the worried well, change their visitation policies and more. In some cases it’s not clear which approaches make sense, since we don’t have a pandemic lashing the U.S. every week, but execs aren’t waiting for an engraved invitation.
What’s interesting is that hospitals have attacked the H1N1 pandemic with such vigor rather than showing such alacrity wish, say, infection-control efforts. Yes, I know many readers are working very hard on this issue, and moving cautiously is certainly smart, but let’s face it, industry-wide things aren’t changing quickly enough. My feeling is that the difference is rooted in human nature; for most of us, it’s far easier to respond to a short-term crisis than change the way we work every day.
But nextHospitals–the hospitals that respond to a world powered by high-tech, global travel and rapid cultural shifts– will not have the luxury of separating critical problems into those we can address and those we can ignore. And hospital leaders will need to build flexible, even fluid, organizations capable of making that leap.
How can we make this happen, readers?