The Great Transition

“In a world flooded with irrelevant information, clarity is power. In theory, anyone can join the debate about the future of humanity, but it is difficult to maintain a clear view”.  Yuval Noah Harari

For two decades, international accreditation standards have been preaching that health institutions should be understood as an organic system, with socioeconomic responsibility, part of an adaptive and complex system.

In this system model, problems are not limited, and solutions do not occur within stable parameters. These problems, called complex, are difficult to define and solve. The dynamics of a complex system have a lot of connectivity and interdependence.

Despite an entire context that led us to analyze a world of interconnected relationships, which provoked us to develop a holistic view, health services continued to work with Cartesian tools. Instead of understanding the customer as a society, they focused on those who used or could use the services. All problems were analyzed within the hospital walls. Health production was restricted to the treatment of diseases, technological solutions were developed to detect critical signs of health problems and few tools were developed to analyze the vulnerability of the Brazilian population.

All indicators, even the so-called quality indicators, measure the production of errors and complications of patients. When starting the discussion of value, they were concerned solely and exclusively with receiving the services provided. The value of health promotion and prevention has never been part of these discussions.

They sought to measure the customer experience using retail tools without understanding the user’s journey and the service’s response to the expectations of each individual. They tried to convince with marketing actions that the services were safe and quality.

We had references, theories and guidelines that worked like a cake recipe, of course, with some deviations, but they always took something away.

In health, we have always had great gurus who preached the best recipe for success, always clinging to successful examples of a stable scenario. These gurus were blind to the transformations of the world, after all they never needed to innovate.

Now, organizations will need speed to transform what does not create value for society. Organizations will have to convince their employees that this crisis is a learning problem and no longer an execution problem. We will no longer be able to focus only on existing solutions; we will need to explore new strategies and dive into the digital world.

The reality is that due to incompetence combined with the bad faith of some managers, health has become a questionable delivery business. Naturally, new leaders will emerge and early to say who they will be.

Currently, most leaders, whether in senior management positions in companies or in government, have never planned for such a dire scenario. This clearly shows that the leaderships that brought us here will not be the same ones that will take us in another direction.

Some leaders are still inert and have not accepted what is happening. Others have understood and started to look inside themselves, in order to become better leaders in totally different environments than they operated in recent years.

 You Must Start

Comece a olhar o mundo a partir da perspectiva e demanda dos usuários. Deixe as noções preconcebidas de lado. O comportamento  avesso aos riscos de empresas estabelecidas não pode mais permanecer. É preciso  coragem para apostar no novo, na empresa, em um novo produto ou serviço que transforme a estrutura do negócio da saúde.

Start looking at the world from the perspective and demand of users. Leave preconceived notions aside. The risk-averse behavior of established companies can no longer remain. It takes courage to bet on the new, on the company, on a new product or service that transforms the structure of the health business.

Faced with the unpredictability of changes, often uncontrollable and rapid, organizations need to have the necessary flexibility to reinvent themselves, always maintaining the clarity of their purpose, in an ethical and collaborative way.

The planning cost exceeds the experimentation cost.

 The key to success comes from planning, agility, accurate data and a willingness to collect good ideas at all levels of the company. Many companies spent the first weeks of the crisis reviewing continuity plans, establishing crisis command centers and ensuring the safety of their workers. Now, the focus is on preserving the business value by planning the operational scenario.

Our advice is to start designing strategies and actions to make your company emerge from this crisis transformed for the better.

Rebuilding Culture

We believe that companies should align their strategy with the operational model in building culture. Too often, organizations focus only on strategy and the operational model, after all they are easier to change. However, for anything to be done, people need to act, culture being the major determinant, much more than the models of strategy or operation.

From now on, health service users will buy and consume only what is important, necessary and relevant. We are living in an extreme scenario, and therefore the needs are acute. Beliefs rooted in the culture that nothing new was to come crashed down. It is easier to identify opportunities and solve problems now than before, when they were masked by the veil of stability.

The great challenge is to make the “culture” go off the record and become action, attitude, decision making. On paper we have everything very perfect: Codes of Ethical Conduct, Compliance, Bioethics Policies, Quality and Safety, People, etc. but they do not work, they are not practiced. Culture is not imposed; it is not trained. Culture is built, cultivated. And it starts with the posture and attitude of Governance. The example comes from above and will only be accomplished when seen, when witnessed, when experienced.

At this point, you may be asking yourself: where do we want to go? And how to do that?

“It is impossible to predict exactly what will happen. The future is not a prediction, but a series of possibilities. We need to speculate possibilities to make the ones we want more likely, because they are our preferable futures.” Juliana Proserpio, Chief Design Officer, Fundadora Echos

We not always get it right at first, but we must learn from what happened and come out better and stronger for the others. In the face of crisis situations, it will not always be possible to understand them in their entirety.

There is no time to understand or to express emotions, it is necessary to act and change.

Processos Prioritários – Apoio a Segunda Vítima
SAITG – Sociedade de Anestesia e Inaloterapia de Taguatinga – DF

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