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Why is this Healthcare vision statement wrong?

This is one anonymous Health System’s vision for healthcare quality:

“Our health system is world-leading in delivering the best outcomes across all six dimensions of quality. 

Our healthcare system is just, 

engages patients and families, 

and is relentlessly committed to improvement.”

Yes, it’s the use of the present tense to describe a desired future reality.

So many vision statements do this – express a ‘wish’ as an ‘is’. 

What that does to people working within that system is embed the ‘is’ as … an ‘is’ !! It becomes, in a subconscious sense, their current reality.

It’s Martin Seligman’s positive thinking in all its unrefined, undeveloped ideal form:

Imagine the reality you want. Picture and describe and talk about it as real. Then move your existing reality to become that. 

The problem is that more recent research into how to create a desired future state shows that once you talk about it as if it exists, you fool your brain and the brain of everyone else who works within that system into thinking the desired state DOES exist. 

Healthcare Leadership

Like you, I’m sure, I’ve worked in large organisations with smart people who can’t see the improvement needs in their own practices because of this sense of the vision and values that have been ‘socialised’ in the organisation. 

Any voice of criticism that suggests you aren’t living them is seen as disloyal. Hence the ‘whistleblower’ problem across all healthcare systems across the world. 

This Health System’s report on its vision (from 2015) goes on as follows

Having set out the vision and principles underlying a quality system, the committee working on this project then delved more deeply into how to implement such a system in our health system.

Released in April, this report acknowledges that our province still does not have a high quality healthcare system for everybody, with the health system working well only for some people, with some conditions, treated some of the time. 

The report sets out a number of recommendations for organizations in how to better understand quality healthcare, and how to deliver that care and foster a culture of quality.

Talking about quality across all six dimensions has to involve all stakeholders in the system – from governments, to hospitals and health authorities, to health care providers, patients and caregivers.

These conversations are essential if we are to move forward and make quality care a reality for everybody in the province.

Great. All true. But all totally undermined by the use of the present tense in that vision statement. Which sabotages the thinking of all involved right from the start. 

Healthcare Leadership

That’s just one example of how leadership and quality improvement in healthcare and other systems needs to keep up with advances in the psychology of work and not get stuck in old ‘vision’ thinking that is no longer fit for purpose. 

Leadership Conversations

The ‘leadership conversations’ talked about above have to be honest and reflect reality – ‘brutally confront existing reality’ (Collins, Bossidy etc) while creating and sustaining a sense of realistic optimism that “we can do this” by sharing small-scale real examples of changes happening at all levels. 

That’s what the online communities (that my team builds) do: enable real conversations that “prevent a BS culture of management speak from being the dominant and only acceptable mode of conversation” (in the words of one of the leaders in one of our communities run for one of the largest companies in the world). 


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