Plotting and maintaining a long-term plan calls for persistence and courage as doubts will prevail from all sides, and new fashions will come and go. Naturally, new ideas can enhance the change process, but only in the context of a wider, constant purpose. Patience is as important as persistence. Trying to change too much, too soon can overstretch and disillusion people.
Lt. Gen. Dr. Mandeep Singh – Director Medical Services, Apollo Hospitals Group, India
Plotting and maintaining a long-term plan calls for persistence and courage as doubts will prevail from all sides, and new fashions will come and go. Naturally, new ideas can enhance the change process, but only in the context of a wider, constant purpose. The success of organizations such as the Geisinger Health System in the US and Apollo Hospitals Group in India are built on decades of consistent strategies, overseen by leaders that have not wavered from their vision.
Initially, it is staff and patients that are most opposed to change. According to Dr. Anna van Poucke, KPMG in the Netherlands, this is not unusual. “There is a strong feeling on the front line that ideas cooked up in the Boardroom do not stand up to the test of day-to-day clinical practice. Yet it takes time to get ideas across and win hearts and minds – if you’re in too much of a hurry there’s a danger that you try to do too much, too quickly.”
Organizational culture guru Edgar Schein affirmed the need to gain acceptance from clinicians and staff by emphasizing that, “You can’t impose anything on anyone and expect them to be committed to it.” In the US, Virginia Mason management appreciates the need to get inside the heads of their people, to understand their intrinsic motivations, and ensure that the organizational and personal goals and values are aligned, to maximize commitment.
Patience is as important as persistence. Trying to change too much, too soon can overstretch and disillusion people. Dr. Mark Britnell, Chairman and Partner, KPMG Global Health Practice, argues that a step-by-step approach is preferable. “Although an immediate impact can get people interested, it is more important to sustain an environment committed to transformation. The development of a truly coordinated system, focused on population health, cannot be a single ‘big bang’ change project. Organizations are on a much longer journey to build new skills, new ways of being paid and contracting, and a new dynamic between physicians and patients. This calls for skilled change management, experimentation and development across a wide range of activities over considerable time.”
In just three decades, this health group has become one of India’s biggest providers, with 51 hospitals, 1500 pharmacies, 100 primary care and diagnostic clinics, plus 115 telemedicine units across nine countries.
Director Medical Services, Lt. Gen. Dr. Mandeep Singh, explained how this transformation has been based on three pillars: