Nurses! – Our Best Hope For The Much Needed Transformation of Healthcare

Changes and even transformation to the US healthcare system are so needed. Past efforts to change the system, well-intentioned as they may have been, have proven a dismal failure. The proof is in the pudding with our current system remaining bloated, inefficient, overpriced, dangerous, and

Nurses – Transforming Healthcare from the Bottom Up

low-rated in quality of care compared to other modern systems. Our healthcare is more than twice as expensive as the average of advanced nations worldwide. Twice! Yet, the US is rated number 37 in the world in quality of care, just behind of Costa Rica and just ahead of Slovenia. Obviously, whatever we have been doing to change healthcare for the better is not working.

It appears that a big factor in our inability to change and improve is related to the fact that most improvement efforts are driven top/down in the form of a never-ending parade of “programs”. Most of these programs significantly under-perform or outright fail in their promise of major improvement, much less real transformation. Leadership’s response to this fact is to do more of what is not working or bring in a shiny new program. Note that little of this addresses improving the existing systems in place for delivery of healthcare, especially on the front lines where care is actually delivered. Here we get to the core issue.

Fact: Approximately 94% of the results we experience in healthcare, both good and bad, are a function of the systems and processes in which people work, not the efforts of people. How many leaders and managers in healthcare know this? Not many. If we want better results, including better outcomes for patients, front-line care providers and the bottom line, we have to fix legacy healthcare systems/processes, especially where care is delivered. Because they are on the front-lines, nurses and nursing, for the most part, must take the lead in creating the much-needed transformation of healthcare.

Nobel Prize Winning Science at Work in Healthcare

Nobel Prize winning science shows us that stresses in systems that resist change in a changing environment (think healthcare) are passed on to those who have to work in those systems. Now we have stressed systems, stressed people, high costs and poor outcomes, both for patients and care providers. Let’s look at how we might use these stresses to speed change for the benefit of patients, care providers and the organization.

In order to create better outcomes in healthcare, it becomes clear we must upgrade the systems to produce the desired results. This requires that leaders and managers grow and expand their skill sets to include systems thinking and regular use of system optimization tools in their roles as leaders or managers. Also, we must begin to work where care is actually delivered. This means the strategy for creating the transformation we so desperately want and need will be more bottom up than top down and become more of a way of being than a program to be done. Lastly, nurses and nursing must take the lead in this systems-based transformational model and allow their successes to spread organically across and up through the organization.

Here are a few of the outcomes created primarily by nurses and front-line care providers optimizing their systems of care delivery. Notice how the improvement on the front-lines has positively effected all aspects of the organization:

To learn more about this new model for healthcare and business transformation, pick up a copy of my book, The New Agreements for Leaders – The 4 New Agreements and 7 Simple Tools that Develop Emerging Leaders and Managers and Grow Great Organizations. It’s free at Also, ask us for a flyer describing the New Agreements Online Tools Training, which is at the heart of these improvements at: