If COVID-19 Doesn’t Force Change, What Will?
Sumatra, Indonesia. North Pacific Coast, Japan. Lisbon, Portugal, Krakatau, Indonesia (Phillips 2011). Each of these four regions has experienced one common, but extremely destructive, reality. And they are not alone. They will not be the last. There have been many other areas around the world that have experienced the same devastating reality over the last few hundred years – catastrophic tsunamis!
Hundreds of thousands, if not millions, of lives have been lost to tsunamis. Millions of survivors have been affected for a lifetime. Why can’t tsunamis be predicted so that the targeted population has enough time to effectively prepare and survive? Scientists have learned a great deal over the last few decades and are constantly trying to learn and innovate new ways to predict the precursors of future tsunamis. Unfortunately, most of the data is generated only after the damage has happened (Valdes et al. 2019). Thankfully, that is changing as scientists have made significant strides in both monitoring and predicting the ongoing threat of potential tsunamis.
Like tsunamis, pandemics are neither easy to control nor stop once they are in motion. COVID-19 has provided more than enough evidence of the devastation caused by the pandemic, as witnessed in the many lives lost, and by the many people who have suffered from the complicated respiratory virus, who fortunately, through the dedication and skills of healthcare providers, have recovered from their ordeal.
COVID-19 has also performed an unexpected stress test on our economies, including that of our healthcare systems. The outcomes have, on most counts, been discouraging. Similar to the aftermath of a tsunami, the data collected from the COVID-19 pandemic has provided a significant database to develop and build the information required for change. This information is the foundation for the knowledge required for meaningful and measurable change. But change to what and why? Who will benefit from this change and who won’t? And do we really, really need to change our healthcare systems?
The answer is as complex as it is simple. If we accept and are comfortable with the present outcomes of our healthcare systems, having now experienced the consequences of COVID-19, then let us simply continue on the course we have been on. But if the outcome of COVID-19 has been a dramatic wake-up call, then meaningful and measurable change in healthcare is non-negotiable. But how do these required changes get developed, implemented and, most importantly, get accepted?
Successful change has always had a few key components.
The first is change to what? If where we are is not acceptable, then what is? To answer this critical question, one needs a vision. This vision, or desired state, effectively communicates where we need to be and why. The “where”, for healthcare systems, is to constantly deliver meaningful, measurable and timely value to the community of stakeholders – providers, payers and especially patients/consumers. The “why” is based on the delivered outcomes of our present healthcare system. Have we, for example, delivered the desired outcomes of value-based healthcare (VBHc) that will achieve the vision of the Quadruple AIM (Bodenheimer and Sinsky 2014)? Have we delivered the desired outcomes of a consumer/patient-centric system? If not, might that not be the desired vision for tomorrow’s healthcare system?
The next success factor is the leadership for change. Change for those impacted is sometimes a difficult process to understand and adapt to. With the past, present and future stresses of COVID-19 on individuals, we need to hold leadership responsible for, and accountable to, a more proactive person-centric approach to change. True leadership understands that change will never occur without the committed involvement of people. Change under normal conditions is difficult enough. Change in a post COVID-19 world will be even more challenging. Focus, transparency, collaboration, integrity and passion will be the required tenets of leadership. And the required leadership must be found at all levels of an organization for change to occur. Anything less is irresponsible and not the leadership tomorrow’s healthcare system requires.
The next important, and critical, success factor is people. Change will affect people in many different ways for many different reasons. If the vision is not compelling, people will resist change. If the leadership is not effective, people will not follow. But once they understand the vision and appreciate the rationale for change, the required motivation for adoption can be found. The other component to this key success factor is that people be early and active participants in the required change. Without this, people will erect significant barriers to change – and rightly so!
You will have noticed that technology has not yet been mentioned in the discussion for change. I previously mentioned how critically important the data is to generate the information that creates the required knowledge, and healthcare is a knowledge-based industry. There is no doubt that technology will play an important role in the change management process. An important and key consideration, though, is that technology can, and should, accelerate the process and momentum of change, but not create it.
As inevitable as the reality of the next tsunami, the next pandemic will provide evidence to what we have learned from our COVID-19 experience, what our actual commitment to change was and what was actually implemented that addressed and delivered timely value to the community of healthcare stakeholders. Or will it be, regrettably, simply a continuation of the same old story? It is up to all of us to accept the challenge, take those decisive steps and embrace the path to meaningful change.
About the Author(s)
Ron Kaczorowski is Managing Director of Mareka Alliance, President of Securlinx (IBO) and the former Chair of the Kensington Health Centre. He can be reached at firstname.lastname@example.org.
Bodenheimer, T. and C. Sinsky. 2014, November. From Triple to Quadruple Aim: Care of the Patient Requires Care of the Provider. Ann Fam Med 12(6): 573–576. doi: 10.1370/afm.1713.
Phillips, C. 2011, March 6. The 10 Most Destructive Tsunamis in History. Australian Geographic. Retrieved July 2, 2020. <https://www.australiangeographic.com.au/topics/science-environment/2011/03/the-10-most-destructive-tsunamis-in-history/>.
Valdes, R., N. Halabrin and R. Lamb. 2019. How Tsunamis Work. HowStuffWorks. Retrieved July 2, 2020. <https://science.howstuffworks.com/nature/natural-disasters/tsunami6.htm>.
Toronto ND wrote:
Posted 2020/07/07 at 11:38 AM EDT
Rahm Emanuel, the former Mayor of Chicago, once stated, “You never let a serious crisis go to waste. And what I mean by that it's an opportunity to do things you think you could not do before.”
It has been said that if Ontario had implemented the recommendations forwarded by the SARS Commission in 2006, our response to COVID-19 would have been much more proactive and successful.
Ron Kaczorowski’s article is a compelling and clarion call for “meaningful and measurable change in healthcare.” Not only does he spell out the reasons for this, but he also highlights the roadmap of critical components to implement necessary improvements to the healthcare system.
Goals need to be set; leadership has to be strong and focused; people must buy in to making necessary adjustments, and technology should be harnessed to accelerate the process.
Following Ron’s prescriptions, we will definitely be much better prepared for the next, inevitable pandemic.
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