Accelerating Innovation: Impediment to Care or Essential to Survival?
Sunday, June 3, 2018 at 08:56AM
George Handzo

Recently, Rick Pollack, the President and CEO of the American Hospital Association started off his message to his membership in AHA Today with the following:

 

"If your only defense against invading armies is a moat, you will not last long. What matters is the pace of innovation. That is the fundamental determinant of competitiveness." That's a recent quote from Tesla co-founder Elon Musk referring to an economic theory that promotes buffers, or "moats," around a company to help them maintain a competitive edge.

  While it's true that many companies have succeeded and continue to succeed by building such moats, as Warren Buffet pointed out to Musk, it's also true that technology is helping many companies seeking to disrupt the status quo figure out ways to get past those moats. And perhaps no field seems as ripe for these types of disruptions as health care."

 

Pollack goes on to point out what all of us know- that there are a lot of new companies, like Amazon and Walmart, getting into the health care business which is a sure sign that these companies agree with Pollack that there are opportunities in health care for innovation that will cross some long-existing moats. 

What struck me, in part, about Musk's message was that accelerating the pace of innovation was not only necessary to gain a competitive edge but, at least by implication, it is necessary for survival.  Maintaining the status quo and even evolving over time may no longer be enough to maintain one's place in a given business space. Musk, and I think Pollack, are suggesting that what will be increasingly called for is not tweaking the current situation or developing a variant on current practice, but imagining and developing fundamentally new ways of delivering a service or a product.  

Now, to be clear, I understand that health care chaplaincy is not like the for-profit businesses that Musk is talking about or even the largely non-profit health providers that Pollack is talking about. We are not concerned about metrics like operating margins or market share. However, I do hope that we as chaplains could agree that (a) those who are sick and suffering want and benefit from attention to their spiritual and religious needs and (b) attention to those needs also benefits health systems and (c) those needs and desires are best attended to by trained, professional health care chaplains.  

Over most of my 40 year or so career in health care chaplaincy, we have been ignored which has also had the benefit of being not challenged to innovate. What is changing I think is that more and more people in health care leadership including payers and policy makers are coming to agree that (a) is true but, more importantly, that (b) is true. Whether we like it this way or not, they are coming to understand that there is money to be made, or at least money to be saved by providing good spiritual care. What they do not see any evidence of particularly is that (c) is true. That gap opens the door for other ways besides hiring chaplains to take advantage of (a) and (b). Pollack points out that health care institutional leaders are the best positioned to drive innovation in health care implying, I think, that if those leaders do not assume this role, others (like Amazon and Walmart) will. I would suggest that if professional health care chaplains do not assume leadership on innovation in spiritual care, others will and they won't do it nearly as well as we will. 

Granted there are a lot of difficulties here.  Innovation especially fast paced, disruptive innovation is often not fun- at least for me. There never seems to be a clear way forward and that produces anxiety and conflict, even within the group doing the innovating. To do innovation well I think you have to be prepared to fail. Not every project will "work". There are ways to minimize those risks of course that a lot of people ignore but, even then, very public failure often happens and innovators have to be prepared to admit to that failure quickly and move on. So being risk-averse is not a desirable attribute for innovators. Finally, innovation is messy. I for one don't like mess. 

So whether we are individual chaplains, chaplaincy departments or chaplaincy associations, it is easy to sit behind our moats and continue to believe that no one will really go to the effort of trying to bridge our moats and it they try, all we have to do is raise the draw bridges and hunker down until the attack passes. 

Among other things, what this strategy ignores is that some of the fundamental facts of the health care system on which chaplaincy justified its existence have changed. When a majority of what constituted spiritual care was religious ritual and attention to the belief of patients who practiced some variant of Christianity was the most obvious priority, then of course the provider needed to be theologically trained and recognized as a representative of a Christian faith tradition. No longer true. When health care's most sacred metric was volume of care delivered (i.e. number of visits), the cheap labor provided by chaplaincy students were easy to sell. In a health care economy in which the metric is value demonstrated by the outcomes of care best delivered by fully trained practitioners, justifying students is increasingly difficult. The increased sophistication of psychosocial measurement has made the mantra, "you can't measure what chaplains do" increasingly give the impression that we simply want to avoid accountability. In short, some of the most basic realities that strengthened our moats are no longer there. 

We need innovation and we need it quickly or else spiritual care may vanish or, at best, be provided by those less qualified to do it.  And there are bright spots. We are getting over one of the basic tenets of chaplaincy training- that CPE must be done face-to-face. But we still have many barriers. Competition is likely good in the auto industry. It is not good in health care chaplaincy. We need to be fully transparent to our own memberships and to each other. We don't need to agree with one another- in fact more innovation will happen if we don't agree- but we need to talk to one another respectfully. I am well aware that tradition is sacred to us in faith communities but so is continuing revelation. We should be respectfully critiquing any innovation. We should not be dismissing it out of hand without testing, evidence and thoughtful discussion. We should be questioning every standard and assumption of how we practice and how we are trained. This questioning will be painful and anxiety producing because we will likely find that some of what is sacred to us will have to be put aside. This finding won't mean we have been doing it wrong all these years. It does mean that the world around us has, and continues to change at an increasingly pace and unless we change with it patients and their caregivers will not receive the best spiritual care. 

 

 

 

 

Article originally appeared on handzoconsulting (http://www.handzoconsulting.com/).
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