By Rick Vanasse - April 9th, 2015

Healthcare reform is driving the largest industry transformation in US history.  Over 5000 hospitals and health systems, nearly 1 million physicians, and thousands of home health agencies, nursing homes, and ambulatory facilities are making the shift from a volume driven to a value driven business model. The shift to value requires the formation of integrated health systems focused on the health of entire populations while at the same time lowering costs and improving clinical quality to individual patients.

In the fall of 2012, a major health system provider in the Eastern US  launched an enterprise-wide strategic organization design process to address the emerging challenges and opportunities facing the healthcare industry. This provider is a multi-billion dollar integrated health system with acute care and psychiatric hospitals, nursing care facilities, assisted living residences, hospice and home care. The system has primary and specialty care physician practices employing hundreds of physicians

A cross-sectional Design Team of sixteen leaders participated in four Design Sessions between November 2012 and June 2013 producing a new, long-term, ideal organizational design. The matrix strucuture consisted of vertical markets based on geographical regions and functional horizontals built around system-wide shared services. The new organization was presented to and accepted by the Board of Directors mid-year in 2013.

In December 2013, one of the regional market CEOs were asked to pilot a vertical market redesign which would model what it meant to be a value-based, patient-centric, market-focused organization. The vertical design process would serve as a prototype and learning opportunity within the company for creating and implementing a new organizational model consistent with the enterprise-wide design and addressing the transformations occurring in the healthcare industry.

The regional system consisted of an acute care hospital, physician practices, imaging centers, home health services, and a wellness center. In January 2014, the regional market CEO brought together physicians and leaders from across the system to begin the vertical design.

Early in the process the Design Team realized the challenges of leading and operating a well established and successful existing organization (core business) while at the same time designing and implementing a fundamentally new organization and business model (innovating unit). The team turned to other industries with greater depth and experience in start-ups. They chose an ambidextrous organization design framework. 



The vertical market design process was sanctioned and supported by a Sponsor Team consisting of five corporate executives and two local leaders who had the authority to sanction the process and approve the design recommendations and implementation plans. SPRING Network worked with the Sponsor Team to develop the design process, facilitate the design sessions, and coach leaders on the implementation.  

Spring’s approach is to co-create with clients a collaborative problem solving experience that creates high-quality, tangible products (results) better and faster than be can accomplished through traditional optimization processes and tools. This collaborative experience mobilizes a collective group (Design Team) in a Decision Accelerator (DA) event to design a solution and initial implementation plan. In the course of collaboratively defining a solution, the DA builds high commitment and a critical mass network of people who can be involved in the downstream implementation.

The local vertical system held six design sessions over a 12 month period with Adaptive Work Teams continuing the work of the Design Team between sessions. The combination of rapid design sessions followed by iterative work teams not only produces an innovative product but introduces the organization to an Adaptive Work System.

This design is still underway and continues to serve as a prototype for an Adaptive Ambidextrous Organization.

Rick Vanasse is a partner at SPRING Network driving large scale organization design change in Health care companies.  To schedule a meeting, please send an email to Rick Vanasse <rick.vanasse@spring-network.biz>