Peter Drucker, Empowering Caregivers, and Adaptation vs. Disruption in Top Performing Hospitals


Management and Marketing Mastermind Peter Drucker

The headline from Becker’s got our attention: “Peter Drucker’s brilliant 47-year-old idea could transform healthcare.”

We are big fans of Drucker. His ideas about leadership, focus and efficiency have guided success and productivity in many industries. Healthcare stands to gain from his wisdom as well.

The article cites this quote from Drucker about empowering leaders at all levels to make key decisions:

“On the other hand, we are going to open up a new problem of development at the middle-management level. It isn’t difficult for us to get people into middle management today. But it is going to be, because we shall need thinking people in the middle, not just at the top. The point at which we teach people to think will have to be moved further and further down the line.

This reinforces the first point made by author Lindsey Dunn in the article: “The front-line employees are the ones with the real power to transform an organization, leadership just guides them.”

We see this firsthand all the time in top performing hospitals. Here are a couple of specific examples of how hospitals are arming the folks on the front lines of care to make the best care decisions swiftly and confidently:

SNAP Huddles: SNAP in this case stands for “Status Now, Action Planning.” Care coordinators, nurses and doctors convene for 15-30 minutes each morning to review plans and activities of care for all patients. With a live, accurate view of all patient care activity and services provided by logistics software, those caregivers can identify and overcome any obstacles to their patients’ care plans that day. The discipline, supported by the real-time information, has proven extremely effective for many hospitals. Here’s a look at the SNAP huddle in action at St. Peter’s Hospital in Albany, N.Y.:

Weekly Executive Rounding: In addition to the daily cadence of empowering SNAP huddles, high-performing and high-reliability hospitals keep leadership informed and engaged with weekly executive rounding. And for hospitals we partner with, executives commit active regular participation in  rounding. The rounding also employs the A3 problem-solving process familiar to Lean thinking and production systems. The continuous cycle of “Plan, Do, Check, Act” empowers frontline caregivers to own their areas of service, with the information and hands-on support they need from hospital executives to ensure that patient needs are met and processes for care continuously improve.

These examples reflect another focus of the article: Adaptation vs. disruption in healthcare. While hospitals must make bold changes to make the transition to fee-for-value, we argue that providers still will not chart a “disruptive” path to success. Fundamentally, the hospitals’ missions of taking the best care of the most patients won’t change. (Although certainly we’ll see changes in how and where those patients will receive that care.)

But we consider the work we do with hospitals to be adaptive. Applying a logistics-based production model to care delivery simply acknowledges that true patient-centered care requires the right roles, processes, tools and information. People and departments must work in efficient harmony at all times to ensure that time and attention focuses foremost on the care of all patients. We’re not changing what the hospital does; we’re just helping them do it in the best way possible.

Which brings us to another favorite quote by Drucker: “Efficiency is doing better what is already being done.” Nowhere does this apply more aptly than to hospital inpatient care. Clearly every hospital delivers care to its patients. But until they coordinate that care with the continuous focus on more efficiently moving forward productive care activities and milestones, they can never predict or rely on throughput performance and outcomes.

Posted by Doug Walker


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