“With this bureaucracy, including the judges on the bench, we can have … laws written by angels and they cannot lift us from the swamp. With bad laws and good civil servants (judges) one can still govern, (but) with bad civil servants, the best laws cannot help.” — Otto Von Bismarck (in a letter to Hermann Wagener, June 1850) “Bismarck: A Life” Steinberg 2011
Must like a chicken-or-egg debate, the question has been bouncing around my head for some time: Which is the paramount factor for attaining organizational success — the people or the process (think governance)? For awhile, I’d been convinced it was the latter; that good people get chewed up and spit out by Byzantine governance that leaves them ineffectual and frustrated — think “culture eats strategy for breakfast.” But Bismarck and Former Secretary of Defense Donald Rumsfeld both noted it’s the people that ultimately determine the outcome.
I live, (I read or listen), I learn.
Still, I think most of us would agree that effectiveness largely depends on both, with a healthy dose of leadership laid on top. That’s where you come in — the CIOs. Your job, more than anything else, is to effect change, change on both the process and people levels.
Let’s take process first. Process can be described as including both bureaucracy (established systems of getting things done) and governance (both the standard org chart and committee-based decision making processes). When we think of bureaucracy, many see a hydra that must be slain, which is why they often fail, for bureaucracy is necessary, even essential, for any organization to function; it’s the standardization we all need to achieve repeatable, and thus improvable, processes. So rather than rage against it, why not co-opt its power for good by infusing change initiation and management into your bureaucracy’s DNA? Why not make the devil do your bidding and make process review part of “business as usual”? Why not make the act of questioning the way everything’s always been done part of the way things are always done?
Now to the part Bismarck, Rumsfeld and Jim Collins (Good to Great) say is the most important — the people. A common attribute in the people I’ve read about (Former Vice President Dick Cheney also comes to mind) is a seeming lack of emotion or personal struggle around making people moves. Attributing this seeming nonchalance to heartlessness is to miss a valuable lesson. In my past column, I talked about how these individuals stood out for their appropriate, but often extended, deliberation on important matters, and how that extended deliberation gave rise to confident and easily defended decisions. It’s clear therein lies the source of the calm resolution often mistaken for a cold heart. However unpleasant, these individuals were simply doing what had to be done — why would anyone excessively lament about that?
What does this mean for you? First off, to fix a troubled department, you must have a green light from your boss (CEO, CFO or COO) to initiate a review of both the people and processes of your department. You must then get the necessary resources (perhaps external consultants) to assist with this review. Tell the investigating team or internal task force that you do not want one proposed solution, but rather a range of two, three or more well thought-out options to pick from. (Cheney and Rumsfeld, both of whom served as Secretary of Defense — Rumsfeld twice — wrote of being frustrated with the military brass for not providing them with enough robust options to share with the president.) Who should stay and why? Who must go and why? How must your department’s organizational chart and decision-making methodology change to fix problems almost everyone knows exist?
After you’ve got good choices on both levels, deliberate extensively. After that, act with no regrets, with no anguish. It will be much easier than you anticipate.
But don’t stop there. Solving departmental problems, especially in IT, will only get you so far. The larger problems in your organizational effectiveness likely lay in its relation with the overall enterprise. While you probably cannot effect personnel changes in other areas of the health system, you can weigh in on governance issues that result in your department left to execute the poorly informed, perhaps impractical or even impossible, decisions of others.
Leadership is the art of effecting change, and change is hard because it’s uncomfortable. Thus, as a leader, you are often the bearer of unpleasant news. Decisions that are informed by homework and deliberation are delivered with confidence and, therefore, easier to both communicate and absorb. Nowhere can you effect greater change than by addressing shortcomings in both processes and high-level people. As Harry Truman, a man who perhaps made more momentous decisions than any president in history, said on a number of occasions, the president’s job was to decide and, right or wrong, that’s what he was going to do. Review, analyze, deliberate, then act decisively. It’s as good a recipe today as it was in 1945.