Organizational excellence has been the topic of countless business texts. However, even some of the organizations profiled in these books have stumbled, with some recovering and others ultimately failing. Did the leaders of those organizations recognize the telltale signs of decline? What should they have been looking for?
Clearly, decline is a state that all organizations want to avoid. And while there has been very little research on the topic of organizational decline, there are some valuable lessons to be learned from studying organizational decline in healthcare.
Healthcare organizations that are in a state of decline tend to share four key symptoms:
- A decline in human resources health indicators. These indicators include lower levels of staff engagement, low morale, increased sick days, overtime and lower engagement scores.
- Organizational malaise. As the HR health of the organization starts to wane, the focus on improvement and innovation deteriorates. This can be particularly dangerous, as organizations that fail to recognize the need to innovate as their environments and patient needs evolve are setting themselves up for failure.
- Poor quality of care indicators. These include decreased patient satisfaction, increased readmission rates, longer stays, higher costs, longer wait times and increased care variation. Poor quality of care indicators can be masked in the short term. Organizations can also contribute to these behaviors be creating metrics based on misaligned priorities.
- Poor communication and lack of trust. Negative changes in employee behavior are often accompanied by communication breakdowns and trust issues. Groups and individuals are less inclined to communicate, share information, collaborate or socialize together.
Paying attention to these early warning signs is vital, since the changes that can destabilize organizations are happening with greater speed.