Health care's epic battle.

• Author: Studer, Quint
• Position: Medicine & Health

WORKING in health care today can feel like being adrift in uncharted, highly treacherous waters. Thanks to health reform and other disruptive forces, it is hard to know what lies over the horizon and tough to predict and plan for next month, let alone next year. Whether you are a leader or a staff member, this uncertainty generates massive stress. The antidote is realizing that health care people have what they need to navigate this storm of constant change.

While it is true that many things have changed, and that the changes are quite dramatic, many other things--which ultimately may be the most important things--have stayed the same. It is these constants that will pull us through--the deeply held values that drive the typical health care professional.

We have to get better at providing quality care, but the good news is health care professionals already want to do that. The solution is to create organizational cultures that harness and maximize that hunger for continuous improvement. When people have the right structure and tactics, they can create miracles. Hospital systems, medical practices, and organizations can create and perpetuate such a culture, but first the big changes shaking the industry need to be identified, as do the "constants" that will bring us safely through to the other side.

The nature of change itself has changed. The biggest and most profound challenge health care organizations have had to deal with--and the one that is requiting the biggest adjustments--is the industry's move from episodic to continuous change.

Think about the annual budget process. This always has been a tedious and grueling endeavor but, in the past, when the budget was done, the organization had a good, solid 12-month game plan in place. Today, that game plan can change very early in the new fiscal year. Payments may change, volume may not be what was projected or expected, or supply costs may be higher than what was anticipated. In essence, a budget now merely is a guideline that requires continuous monitoring and alterations.

Another example is how Joint Commission visits are handled. In the past, the Joint Commission would tell a hospital or health system that it was coming for a look-see. To ready themselves, the organization would prepare rigorously by testing knowledge, auditing processes, checking records, and so forth to ensure compliance. This is episodic change. Now, the Joint Commission will show up unannounced, so an organization always is expected to...