Navigating Healthcare's Bureaucracy System: Clearing the Path for Better Patient Care

This text is based on the article Bureaucracy Is Keeping Health Care from Getting Better, published in Harvard Business Review on 13 October 2017

In a recent article by Gary Hamel and Michele Zanini, the negative impact of growing bureaucracy in healthcare is laid bare. This bureaucracy is causing delays in solving problems, hindering innovation, and wasting valuable time on internal politics. For those involved in cancer care, it means frontline staff are dealing with more and more directives from above, leading them to find workarounds to tackle inefficient problem-solving systems. The article stresses the need for a strategic approach to dismantle bureaucratic obstacles, with key lessons that can benefit the cancer community.

In this regard, the article 'Bureaucracy Is Keeping Health Care from Getting Better' suggests that successful organisations, in various fields, are effectively combating bureaucracy by restructuring leadership systems to connect everyone in the organization to frontline issues. This approach involves clearly defining the roles of each leadership layer to actively support quick problem-solving and empower frontline workers. For the cancer community, this translates to fostering an environment where clinicians and healthcare professionals have the authority to address issues promptly, ensuring a streamlined and patient-focused approach.

Two key components of this anti-bureaucracy approach are lean daily management systems and real-time safety learning. These systems, inspired by industry leaders like Toyota and Honda, ensure that every leader is actively involved in understanding frontline problems and improvement opportunities every day. In cancer care, these systems can enhance the efficiency of treatment protocols and ensure that leaders are aligned with strategies that directly impact patient outcomes.

Real-time safety learning, as practiced by companies like Alcoa and DuPont, offers a practical lesson for the cancer community. The approach involves promptly reporting and investigating any injury, sharing solutions within 48 hours, and disseminating this information across the organisation. For cancer care providers, this means establishing a transparent system that addresses incidents swiftly, fostering a continuous learning environment, and improving overall patient care.

Several healthcare organisations are already leading the way in implementing these anti-bureaucracy strategies. ThedaCare, for example, has successfully used lean daily management to innovate care models and reduce the cost of care by 30%. The University of Virginia Health System's daily huddle, led by the CEO, focuses on reviewing unexpected deaths and injuries, showcasing a commitment to rapid problem-solving and learning. The merger of Fairview and HealthEast health systems in Minneapolis-St. Paul, with a shared commitment to lean management, indicates a growing recognition of the importance of these strategies.

The fight against bureaucracy in healthcare provides valuable insights for the cancer community. By actively embracing lean daily management systems, real-time safety learning, and a commitment to frontline empowerment, healthcare organizations can revolutionise cancer care, ensuring efficient problem-solving, continuous learning, and improved patient outcomes.

This text is part of the European Cancer Organisation (ECO) repository of best practices and innovations to address the cancer workforce crisis in Europe. You can find more examples of best practices here.