One of the lessons I’ve learned from leading large-scale change is that the problem you see is often not the problem you need to solve.
Years ago, I worked with the American Nurses Association on Healthy Nurse, Healthy Nation, an initiative to measurably improve the health of America’s nurses. One issue we encountered was surprisingly mundane: food.
Nurses working overnight shifts often had few healthy choices. Hospitals understandably viewed keeping cafeterias open at night as an expense, so nurses might find themselves working a demanding 12-hour shift with vending-machine food as their primary option.
But look at the system rather than the cafeteria.
A poorly nourished, exhausted nurse is more likely to make mistakes. Those mistakes can affect patient care, readmissions, interactions with families, and even hospital liability. Suddenly, access to decent food at 2 a.m. isn’t a cafeteria issue. It’s a patient-safety and organizational-performance issue.
And the solution didn’t necessarily require keeping an entire cafeteria staffed all night. Sometimes it could be as simple as providing refrigerated vending machines stocked with real meals.
That’s an important discipline for anyone leading change: follow the consequences.
When you encounter an apparently isolated problem, ask: What larger system is producing this—and what else does it affect? The leverage point may be somewhere very different from where the problem first appears.
