Dr. Gary Kaplan on the recent Warwick Business School NHS partnership evaluation

A new way of working within the healthcare system is possible

Our industry grapples with extraordinary challenges today. We see and feel them every day as we struggle to sustain quality, safety and patient experience along with a worldwide healthcare staffing crisis marked by high burnout and resignation rates. The COVID-19 pandemic can take credit for intensifying these challenges but not for causing them. To address the true causes, we must consider fundamental aspects of how we do our work.

The U.K.’s National Health Service (NHS) answered that call by partnering with Virginia Mason Institute in 2015. The five-year partnership with five NHS hospital trusts focused on building sustainable and continuous improvement capability by implementing localized versions of our management system. In many ways, this partnership builds on the transformational work we started with the NHS in 2007.

The Warwick Business School’s careful and illuminating report reveals the successes, challenges and lessons learned from this effort to lead change across a healthcare system. It shines a light on the pathway forward, not only for these trusts, but for the NHS, and healthcare systems worldwide.

One of the critical findings is that culture is a make-or-break factor in successful transformation. I couldn’t agree more. Creating an environment of respect and empowerment that spans the organization — from the front-line to the C-suite — is vital to build sustainable capability. To achieve that culture change, leadership needs to be committed, present and consistent. Changing CEOs every few years can be crippling to culture, as the report shows.

The challenge is that many leaders have cut their teeth on traditional top-down leadership and the perpetuation of hierarchy. To move forward, leaders must lead differently, shifting their role from problem-solver to problem-framer. As elucidated in this report, when we come to the table willing to learn and transform — beginning with ourselves — the result is powerful. Personally, I’ve also found this approach to be much more enjoyable and rewarding, and I was pleased to see executives echoing that sentiment throughout the report.

The report also shows us how various parties in healthcare in the U.S. and U.K. — from deliverers of care to regulators and payers — can overcome the conflict that so often colors our relationships and holds back progress. The partnership achieved this via the Transformation Guiding Board, a monthly meeting that brought the five trust CEOs together with NHS regulators at the same table to work toward a shared vision. The Board facilitated a rare environment of trust and transparency that broke down barriers and accelerated momentum toward long-lasting improvement. Before long, all five CEOs considered this meeting the “best working day of the month,” and I’m excited that the Board continues to meet today of their own volition.

I hope you’ll make time to read the report. It expertly outlines lessons about culture, leadership behaviors and cross-organizational collaboration — exactly the lessons we must take to heart in order to reverse the trends holding us back today.

Most importantly, the report shows that a new way of working is possible. A way of focusing on quality every day and supporting each other in that effort. To some, that may sound like too much. But if there’s a better way to fulfill our promise to patients, while making our jobs more rewarding and enjoyable, I’ve yet to see it.

With Continued Optimism,

Gary Kaplan, MD
Senior Vice President, CommonSpirit Health
Immediate Past CEO, Virginia Mason Franciscan Health