Health care is one of the last major worldwide industries to be fundamentally disrupted. The "gig" economy has already revolutionized industries that have survived for hundreds, even thousands of years. Rideshare apps have virtually eliminated taxis; home sharing has forced massive changes in lodging; online retail has removed the need for shopping malls and stores; and social networks have changed the way people consume and interpret the news. And then there is health care ...
In spite of the revolutionary change around us, the health care industry has avoided similar fundamental transformations. It is the one industrial era model that has not radically changed at its core. However, the signposts, patterns, and evidence of imminent disruption are starting to emerge. As a result of unsustainable costs, mediocre outcomes, and conflict between providers, payors, and the public, space is opening up to allow new entrants to challenge existing structures and organizations.
While the industry as a whole has not experienced a full disruption, there is evidence of revolution underway. Unfortunately, our nurse leaders are not fully prepared for an approaching era that may make our current structures monoliths of the past. Symptoms of the lack of change readiness are illustrated by poor adoption of evidence-based practice, a wide lack of technology competency, antiquated hiring and staffing processes, and an absence of urgency to challenge our own profession to lead into the unknown.
This may sound negative and depressing, but we are framing the landscape this way in order to build a fire in the belly of our nursing leaders. There are very few moments in a lifetime that allow an entire profession to reinvent itself, its leadership, and its practices while also being catalyzed through the dramatic energy of industry change. The good news is that we still have an opportunity to build the future rather than react to a changing tide. This is a call to action to be bold; to challenge the current way we do everything, and design the nursing practice of the future.
This Nursing Administration Quarterly edition is part of a 2-edition series on the topic of disruption. These articles give insights into the building momentum of change that leaders must understand in order to make informed and future-focused decisions. Through a complex systems lens, leaders understand that small disruptions can lead to massive disruption over time. For example, author Todd Griner discusses how policy around how we receive broadband internet could lead to massive shifts in how hospitals deliver care. As a nurse leader, is this how your hospital receives internet on your radar? Have you thought about how societal, cultural, and technical changes will affect your organization eve if those changes don't, on the surface, appear to be about health care? On another subject, have you considered how emerging evidence in span of control and its link to staff productivity and engagement calls for action from leaders?
Change is occurring in pockets that might not be on our hospital-centric radar. We need to see the patterns of disruption and seize the moment to place the nursing profession into the future, or risk being left behind. Let us embrace the innovation, build an amazing future, and step up and lead the revolution of an entire industry.
-Dan Weberg, PhD, MHI, BSN, RN
Senior Director, Innovation and Leadership, National Nursing Strategy, Kaiser Permanente, Oakland, California
-Franklin A. Shaffer, EdD, RN, FAAN, FFNMRCSI
President and Chief Executive Officer, CGFNS International, Inc, Philadelphia, Pennsylvania