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The Big Story: Driving Organizational Change — Without Abandoning Tradition

“…In business, however, sound logic is no guarantee of success. People have feelings too, especially when change is involved, and left unattended, those feelings can stymie even the most talented leaders and sensible plans.”

“Care must come before change.”

By David Jarrard
3-minute read

It’s the assumptions that always get you.

To you, as a healthcare leader, the need for big change is obvious and as urgent as a clanging fire alarm in a small room.

The disruption required throughout your organization right now is necessary for it to remain viable, competitive and true to its mission. The work ahead will be challenging and not without risk, but the cost of inaction is higher still.

You have many “final straws” to pick from: Will it be AI? The opposing twin spirals taking reimbursements down and costs up? The relentless snipping away of consumers and talent to well-funded competitors?

Team unity on intense, heads-down action is more than warranted. Nothing else makes sense.

But, instead, your calls to action are met with crossed arms. Your decisive, organization-saving strategy is slamming into gooey, sluggish, passive resistance. As if time were on your side. As if the alarm wasn’t ringing at all.

What’s going on?

“The reaction that frustrates leader and stifles innovation…is what organizational scholars call a ‘social defense,’ the Harvard Business Review article maintains. “It’s a collective, often unconscious effort to preserve traditional features of an organization – legacy, structures, strategies or cultures that make leaders feel proud and their followers feel safe.”

Safe? It’s the very lack of safety – the perilous position of your organization – that has ignited the need for transformation.

What’s a change agent to do? Consider two factors:

Don’t assume “everyone knows” the challenges you see.

There is no “common knowledge.” Few see what you see or how you see it as a leader. They’re busy, you know, doing their jobs.

The environmental factors besieging your organization may be clear to you because you are reading the strategic weather forecast every damn day. Storms heading in from the north. Earthquakes in the east. Drought in the southwest.

Together, these elemental forces are characters in a powerful, single story about what is happening today, what feels inevitable, and it shapes how your organization should respond.

But few people share your vantage point. Smart and well-intended as they are, they aren’t reading Becker’s every day, or studying the daily patient census and negotiating the latest reimbursement contract. They see only snippets of the story, so they’re hard pressed to welcome your fix to a problem they can’t see. Simply put: They won’t buy your umbrella unless they feel the rain.

What to do? Level the playing field. Build and run a common knowledge communications campaign. Organizations change when most committed to them agree the current way of working – and being – is untenable, unsustainable.

So, deliberately and methodically, share your perspective. Take the time and invest in the engagement needed to ensure your colleagues – and, especially, your opinion leaders – see what you see.

You know the drill: Use town halls, small group meetings, PowerPoints and websites to set the stage for change. Explain the money. Explain the market strategy. Identify the icebergs that require a change to your compass headings. The bigger the change needed, the more time and energy required.

This critical groundwork will allow you to move faster with a shared vocabulary and common sense of purpose when it’s time to ring the bell.

Don’t assume your organization trusts your good intentions.

Even if you’ve been a leader there, walking the halls, knowing first names of every nurse for 20 years. Don’t presume you have the trust you need.

In a moment of change, deliberately rekindle the organization’s trust in you, so you can leverage it for the change that must take place.

In the pioneering leadership study “Built to Last,” researcher Jim Collins wrote that for  organizations to prosper to thrive they must “stimulate progress” even as they “preserve the core.”

People love “the core” – the traditions, the culture, the comfortable shoes of how things have been and who they have been for so long. They know how to be successful in this world they’ve lived in for a long time, maybe for their entire careers.

Change threatens the core, by definition. Yet the core can also be a powerful force to fuel the very disruption you need.

“Leadership…is an argument with tradition,” says HBR. “You must care about what tradition is trying to accomplish. You can argue with tradition – debating what needs to stay and what has to change – precisely in order to keep the organization’s intent alive.”

What to do? Amidst all the change that must occur – all the reorganization, reassignments, reprioritizations, reallocations – address what is NOT going to change as much as what MUST change.

So often, the list of things that “stay the same” during big change – your mission, your purpose, your calling, your culture – remains rock steady even as these attributes will express themselves differently in the future.

Remind everyone who you personally respect of your organization’s mission, its unique culture and it’s style. Remind them that protecting the spirit of these things is important to you, too, even if some elements may need to evolve because they hinder the achievement of the greater good for which your organization is built.

This requires political elbow grease, time and presence. These words need to be expressed repeatedly prior to, during and after the change work; it’s the background music to all else. Further, it must be said out loud in dialogue, conversations where others can express their connection to your organization’s core elements and know you respect them, too.


In fast-moving, big change moments – when you can feel the tectonic plates shift under your feet and you want to move quickly – this deep-grounding, trust-building work can seem a ponderous distraction. But it’s the opposite, actually.

“Care must come before change,” says HBR.

Yes, and…To express “care” requires much more than Hallmark-card language embedded in a soft-focused, system-wide video before you restructure your org chart.

The expression of care requires your leadership’s time in thoughtful, intentional engagement to overcome assumptions, provide perspective and assurance while being steadily future focused.

This is the muscular, hand-to-hand work of big change management.

When it fails, it’s often because this foundational work was not considered or, worse yet, considered unnecessary.

When big change succeeds, the work always began here. Don’t assume otherwise.

Contributors: David Shifrin, Emme Baxter

Image Credit: Shannon Threadgill

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