I was the opening act for Gen. Stan McChrystal during last week’s American Health Care Association/National Center for Assisted Living convention in San Antonio. Well, sort of – I conducted a breakout session prior to his general keynote. But we had a lot in common.
I spoke of the case for the Chief Experience Officer (CXO) in long-term care. One role of the CXO is chief cultural officer. While the CEO must be the head cheerleader for improving experiences, the CXO operationally executes the vision. Working with the CEO, it is the CXO’s role to get everyone singing from the same song sheet through consistent communication and effective messaging. It is this role that can rise above the silos and unite the organization. It is this role that can best achieve a shared culture or what McChrystal called a “shard consciousness.”
The general said having teams is not enough. You need a team of teams. You need a conversation across the command. Armed forces work in silos too. He mentioned that the country had all the information needed to stop 9/11 but silos, lack of communication and common culture all hindered the ability to coordinate. Pride of the branch often leads to animosity toward other branches.
I talked in my session about some of the things that hinder effective experience management. Rules and regulations sometimes cloud our ability to focus on the person. We map experiences and artificially script people. We sometimes don’t understand our ultimate role as healers. We pride ourselves on efficiency and lose the nimbleness to be adaptable in the moment on the spot.
There is no doubt military operations operate with the utmost efficiency and by their standards with the utmost quality. But McChrystal said that they are so efficient as to become inflexible.
Toby Cosgrove, president of the Cleveland Clinic, once said that the real measures of experience come from the heart. We need to sometimes step back, take a breath, use intuition and simplify. And that is when it is so important to build contextual understanding in order to empower decentralized execution. Front line workers must feel that they can act from the heart in the best interests of the patient without repercussions if their actions do not quite fit into the efficiency model but do support the organizational culture.
McChrystal made this point by looking at how terrorists operate. Different groups exist and individuals in the groups seldom know the chain of command but they all share a common culture. They work from the same playbook. Their ability to execute quickly, deadly and effectively comes from sharing a common vision but being empowered locally to execute in ways they see fit. They are adaptable. And adaptability trumps efficiency.
Maybe the ultimate conclusion is that we need to balance efficiency with adaptability. And we need to find ways to transcend organization silos in order to more effectively create a common culture that empowers decision-making and adaptability on the front lines. And new roles in the organization like a CXO could help.
After all, working in healthcare is terrifying enough.
Anthony Cirillo, FACHE, ABC, is president of The Aging Experience.
