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Why command-and-control doesn’t work in complex healthcare systems — and what to do instead

The assurance meeting is in two days. The team is gathered around a draft slide deck, not to ask what we can learn, change, or adapt, but how to explain the position without being shouted at or appearing weak. When assurance becomes performance, honesty becomes harder. And when honesty becomes harder, complex change becomes slower, more defensive, and less effective. That is not because people do not care or are not capable. It is because of the culture and the approach to change. This is one of the strongest arguments for structured approaches such as Outcomes Key Results and Stages (OKRs). By creating a common spine for stages, outputs, dependencies, intended differences and review, OKRs make delivery, impact, constraints and learning visible in a comparable way.  Read more in our article.