Leaders are in a position to create programs and initiatives that could continue with the organization for 100 years, but building durable programs can be tricky.
Here, seven leaders offer advice on how to build programs that will last decades.
Note: Responses have been lightly edited for length and clarity.
Tanya Content. System Vice President of Talent at UNC Health (Chapel Hill, N.C.): Build programs to be flexible. They have to be able to adapt to changing circumstances and needs. What works today isn't always going to work in a few years, which is why we really believe in having strong pillars that can adjust or adapt to anything that might come across generations. My advice would be to build your programs to have flexibility for evolution.
John D'Angelo, MD. Senior Vice President, Chief of Integrated Operations and Regional Executive Director for Northwell Health (New Hyde Park, N.Y.): Whether building a new program, innovating an existing component of your operation or attempting to evolve the culture, there are critical elements to mitigate evolving challenges and ensure the highest likelihood of long-term success. At the foundational level, building and creating within complex organizations requires effective change management, which recognizes the change fatigue that leaders and team members are experiencing as a result of increasing workload and heightened financial and regulatory pressure. To combat these challenges, leaders must truly understand improvement science and the anatomic structure of change, which starts with clearly defined goals, strong executive sponsorship, continuous tests of change, monitoring, learning, iteration and effective communication.
In addition to the anatomical components of change management, leaders also need to consider the physiology of change required to build legacy programs and drive sustainable impact. This requires momentum and buy-in from both leaders and front-line staff who ultimately need to be motivated by purpose. As leaders, it is our responsibility to align change with the intrinsic values of our teams and create a meaningful call to action that inspires those teams to march toward the same goals. Often in healthcare, we can find common purpose by asking two questions: 1) Are we doing what is best for our patients? and 2) Are we doing what is best for the people taking care of the patients? By answering these questions and working toward value-driven change, we can develop legacy programs that last for generations.
Tracy Feiertag. Executive Director at Lenox Health Greenwich Village (New York City): One of the most complex aspects of leadership is change management. We often put a lot of time and effort into the creation of a change plan and the implementation phase, but after that, we frequently lose momentum. This results in the change initiative falling flat and ultimately not meeting the initial intention or goal. A leader needs to start thinking about sustenance from the beginning of the plan. A well-thought out "loop plan" is a required component of lasting change. This means consistently looping the message into everything you do, until, at least, the change is being performed without thought or reminder. Talk about the initiative in all of your speaking opportunities, include it in all of your written communications, discuss it while rounding and, most importantly, make sure your middle-level managers are doing the exact same practice. When defining the needed resources at the start, ensure they are continued well after the change is implemented.
Peter Fine. CEO of Banner Health (Phoenix): Any program that can last for decades in the face of the many environmental changes that will occur in that time frame needs a highly ethical approach and a culture built on that approach that focuses on serving the needs of the customer.
Given that, I see several foundational elements for a program that will have longevity:
- It must have a clear, well-conceived mission that shapes all aspects of the program and defines what success looks like now and well into the future. And regardless of the program's focus, its mission must put customers first.
- It needs clearly articulated, frequently communicated goals. Aligning the program's team and its stakeholders to these goals will keep everyone rowing in the same direction.
- It must have commitment from the team and organization to the program's mission and goals. This is crucial to be able to weather the inevitable setbacks.
- It must be adaptable — able to evolve in step with advances in the industry and the organization.
- It requires a commitment to continuous improvement, to seeking opportunities that further the mission and to applying the right technology to streamline processes and document progress toward the goals.
- It must have a culture that fosters communication and seeks input, from internal and external stakeholders and experts. The culture must also prioritize listening to the program team's needs and investing in their development.
Dougal Hewitt. Executive Vice President and Chief Mission and Sponsorship Officer at Providence (Renton, Wash.): Commitment to core values should be the foundation of programs that are intended to last. By ensuring a connection to the mission and values, leaders go beyond themselves to something greater. Long-lasting programs have a solid core but are flexible enough to adapt and adjust to the signs of the times.
David Lundgren. Executive Division Director at Virginia Mason Franciscan Health Center for Neurosciences and Spine (Seattle): To ensure we are developing programs that provide long-term, high-quality care, we start with understanding the services most needed in our communities. One example is our comprehensive stroke program. With our patients at the center of our approach, we designed a 24/7 stroke center that includes a multidisciplinary team who begin work quickly, in many cases even before the patient arrives at one of our facilities, to ensure the appropriate care is provided upon patient arrival at the hospital, all the way through treatment and recovery. We also invest in community education to increase awareness of stroke signs in our region and how to best respond to achieve necessary care as soon as possible. By collaborating with colleagues across multiple specialties, we holistically care for our stroke patients today and can continue to do so for generations to come.
Mitchell Weinberg, MD. Chair of the Department of Cardiology at Staten Island University Hospital (New York City): Outstanding, durable programs are founded upon a well-developed concept and finely crafted teams, motivated by a powerful and stable sense of mission. Thoughtful team design drives long-lasting change. In the healthcare space, teams must be infused with an adaptive, worldly group of thinkers and operators. Much of healthcare innovation today is less about novel idea formulation and more about incorporating in healthcare recent nonmedical advances. Thus, curious individuals that are broadly mindful of nonmedical innovations, who can creatively incorporate such advances into healthcare, become vital. This group of more worldly creatives must be partnered with operationally talented team members to bring novel concepts to tangible products. Imagine, with the right organizational structure, a team could absorb the customer service lessons of an Apple store, the individualized client centered approach of a Disney, the operational excellence of an Amazon, the engineering strength of a Boeing, or the convenience of an Uber or Instacart and then bring it all to a healthcare concept.
Yet, to be truly long-lasting, a team must be resilient, cohesive and constantly iterative. Sufficient long-term financial support must be allotted for reinvestment, repeated talent infusions and gap filling. But perhaps more important than programmatic design or the team attributes is the collective sense of mission that must be present to fuel resilient programs. Teams that wake up energized to impact humanity, improve quality of life and, even maybe, save lives will catapult forward and sustain truly great programs.