Monday, 2 January 2017

The soul of healthcare institutions

Professional groups, just like any other groups, have a soul or, as they now like to say, values. But whenever they try to write down these values, every group finds it difficult to find the words that express what unites them, what makes them say: "This woman/man will succeed, she/he’s ours." When professionals are immersed in a stimulating project or when they work in a team, it takes only a few words to understand each other, most people know this feeling especially when contrasting it with the feeling they get when they perform a job that doesn’t interest them so they end up literally counting the hours until the end.

"The Sprit of the Clinic"

There are few health institutions that have put effort into preserving their soul, being aware of how values are prone to oblivion and of how little the excellence of a unit lasts when effort goes unrewarded with the arrival of a new boss who sees things differently from how they are. For this reason, I have always admired the consistency of Mayo Clinic governance. It’s an institution created in 1892 by the Mayo brothers that has successfully overcome two major challenges: generational change and the entry of foreign capital (for more details see post of June 23, 2014). We must mention that, in recognition of the Mayo Clinic, most comparable projects have not overcome the challenges posed to the survival of values in the US or anywhere else. And how did the Mayo clinic do it? The answer is as simple as it is complex: "The Spirit of the Clinic" determines professional careers and the professionals’ progress; on the other hand, there’s nothing too different to how the great religions have survived over millennia.

"The for-impact culture code"

In a recent post, "People's Health Beyond Service Integration," I was talking about an NGO, "Possible", which has been active in Nepal since 2001, and I did so because I was interested in the internal process they had carried out in order to develop a strategy that would allow them to offer a transformative and sustainable model for 20 dollars per capita, per year. "Possible" has written its "spirit" in an impressive document, "Our for-impact culture code" (if you have a few minutes you must read it as it’s one of the best presentations I've seen so far), where they explain what is the soul of the organization in the same way as the Mayo brothers did, with the difference that "Possible" aims to bring the best services to the poorest people on earth. And how do they do it? Well, by investing a lot of effort in creating a group culture, because they know that if they don’t reflect the values of their mission, the services they offer can be misguided or even bring more harm than good.

Achieving cross-cutting values (equity, accessibility, homogeneity, wage equalization, etc.) has been a great social triumph. Now, however, just like the Mayo brothers, or like "Possible", we should know how to breathe spirit into public institutions so that these at their turn can instil professional pride for employees, capture talent and offer services adjusted to the real needs of the population and all this can only be achieved by devoting time to fostering a collective way of looking at reality.

Jordi Varela

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