Health Systems Strengthening and Leadership

In healthcare, innovation isn’t just about shiny apps or breakthrough devices. The most impactful innovations can involve rethinking how an entire system works—while still keeping it running. That’s the challenging truth facing large US health systems like Advocate Health and Sutter Health. With mounting pressures—rising costs, staff shortages, and digital-first competitors—these organizations are finding that focusing only on incremental change won’t cut it. They’re building enterprise-wide innovation ecosystems designed to unlock creativity at scale. I explore what they’re doing in a new article for Forbes (a link is in the Comments below). At Advocate Health, for example, this means going beyond pilot projects or siloed innovation labs. Their approach includes: - Strategic partnerships with startups and accelerators - Internal investment funds and innovation districts - Tech transfer capabilities to bring discoveries to market - Leadership development programs built around tools like Jobs to Be Done, human-centered design, and the business model canvas It’s a significant shift—embedding innovation not just in strategy decks, but in the day-to-day work of solving persistent pain points. Teams aren’t just testing new tech. They’re tackling the real “struggling moments” for patients, clinicians, and administrators alike—from vendor inefficiencies to emergency room backlogs—and redesigning care delivery around those needs. One key lesson? Change happens when innovation teams forge close ties with operational leaders and treat them as co-creators, not gatekeepers. That approach opens the door for adoption and scale—critical in a sector that can be both risk-averse and in dire need of reinvention. In a future where innovation methods are as standard as EHRs and MRIs, standalone “innovation departments” may become obsolete. But, until then, health systems that build these capabilities now will be better equipped to navigate uncertainty—and lead the industry transformation already underway. The takeaway for innovators everywhere: When facing entrenched systems and high stakes, don’t just think different—build systems that work differently.

A few years ago, I worked with a hospital that was struggling with high turnover rates and low morale. People simply didn't feel valued or heard. Our strategy was aimed at reshaping organizational culture, and we believed the key to this transformation was leadership development. We coached leaders on conducting regular one-on-one check-ins with team members, which provide opportunities to discuss progress, address concerns, and invite feedback. We stressed the need for leaders to recognize people for their efforts and the pivotal role they play in the organization. We guided leaders on fostering psychological safety, ensuring an inclusive environment where everyone feels comfortable sharing ideas and asking questions. Over time, things started to change. People not only felt recognized, but they also began to communicate more openly, bring forward ideas, express concerns, and collaborate. Morale rose, turnover decreased, and quality improved. This transformation aligns with what neuroscience teaches us. Our brains naturally thrive in environments that foster trust, respect, and positivity. Leaders who tap into this understanding not only create better work environments but also elevate overall team performance. I encourage healthcare leaders to focus on the culture they are building. See the difference it makes in your teams and the care your patients receive. Strong teams and strong cultures lead to outstanding results, which means a healthier healthcare system for all. Have you experienced a similar transformation in your organization? What have you found effective in boosting culture? Share below! #Healthcare #Leadership #teamwork #Leadershipdevelopment

Why Healthcare Leadership in West Africa Needs a Different Playbook I’ve planned to start sharing these insights for a long time, but I wanted to first settle properly into my new role leading a quaternary care hospital in Abuja. Now feels like the right time. In Nigeria, healthcare management is not just about running hospitals — it’s about navigating financing gaps, cultural resistance, and fragmented systems. When I transitioned from founding Doctoora to leading a hospital, one thing became clear: Western management models don’t transplant neatly into African healthcare. Here’s what I’ve seen firsthand: 1. Culture eats strategy for breakfast. We once rolled out a learning platform to upskill staff — adoption was below 30% until we aligned policy and culture. 2. Procurement is risk management. I’ve seen patients delay life-saving surgery because implants were priced out of reach. Strategic partnerships cut those costs by 60%. 3. Financing is as critical as clinical quality. Universal Health Coverage in Africa won’t be built on clinical skill alone, but on access and affordability. Healthcare leadership here requires a different playbook — one that blends strategy, innovation, and cultural intelligence. 👉 Over the coming weeks, I’ll share real-world case studies from my experience in Nigeria: 1. How procurement restructuring reduced stockouts. 2. How implant price negotiations made surgeries more accessible. 3. How governance and culture shape hospital strategy. My goal is to spark honest conversations on what it really takes to build sustainable healthcare systems in our region. What do you see as the biggest leadership challenge in African healthcare today?

After leading hundreds of healthcare workers across 5+ orgs, I can predict team failure from the first meeting. The warning signs are subtle but consistent. At the companies we've built, I learned to spot dysfunctional team dynamics before they destroyed patient care. Here's what I watch for and how I intervene: Red Flag #1: The "That's Not My Job" Culture Early sign: Staff won't cover basic tasks outside their role Impact: Patients suffer during transitions and emergencies My intervention: Cross-train everyone on core functions, rotate responsibilities monthly Red Flag #2: Heroic Individual Contributors Early sign: One person handling all complex cases alone Impact: Single points of failure, team skill stagnation My intervention: Mandate case collaboration, no solo complex decisions Red Flag #3: Meeting Fatigue Without Action Early sign: Same problems discussed repeatedly without resolution Impact: Decision paralysis, staff disengagement My intervention: 48-hour action requirement for all meeting decisions Red Flag #4: Upward Problem Delegation Early sign: Staff bringing problems without proposed solutions Impact: Leadership bottlenecks, reduced team autonomy My intervention: "No problem without three potential solutions" rule Red Flag #5: Patient Complaints Treated as Anomalies Early sign: Dismissing feedback as "difficult patients" Impact: Systemic quality issues go unaddressed My intervention: Monthly patient feedback review with action plans The Intervention Framework That Works: Week 1: Individual skill assessment and gap identification Week 2: Clear role definition with overlap responsibilities Week 3: Decision-making authority documentation Week 4: Patient feedback integration into workflow Results: Staff turnover dropped Patient satisfaction scores increased to over 98% Clinical quality metrics improved across all measures Time to resolution for patient concerns decreased 70% The difference between high-performing and failing healthcare teams isn't talent. It's systems that either amplify individual strengths or expose team weaknesses. Many healthcare leaders try to fix people. I fix the systems that shape behavior. ⁉️ Healthcare leaders: What early warning signs have you seen in struggling teams? How did you address them? ♻️ Repost if you believe healthcare team dysfunction is preventable 👉 Follow me (Reza Hosseini Ghomi, MD, MSE) for proven healthcare leadership strategies

The gap between policy and impact is often vast. A well-intentioned policy can falter not in its conception, but in its execution, where leaders must make critical decisions under pressure with imperfect information. The central challenge is not merely crafting policy, but designing systems that enable optimal decision-making at every level. The consequences of unclear or inefficient decision-making are severe. The OECD (2023) notes that operational inefficiencies and coordination failures; often due to ambiguous policy guidance can waste over 10% of total health expenditure in advanced systems. During crises, such ambiguity erodes public trust and compromises response effectiveness. Bridging this gap requires a disciplined approach centered on three principles: Data-Informed Foresight Policy must be grounded in predictive modeling and real-time analytics, shifting from reactive posturing to proactive scenario planning. This allows systems to anticipate effects before they disrupt care. Clarity with Delegated Authority Effective policy provides clear goals while empowering frontline leaders; clinical directors, operational managers to make situation-specific decisions. This balances strategic alignment with tactical agility. Resilience as a Core Metric Policies should be evaluated by the resilience they create. Do they enable systems to absorb shocks and maintain continuity? Decision-making must be measured against this standard. Health policy is not an abstract exercise. It is the architecture within which daily decisions determine the quality, equity, and sustainability of care. Leadership must ensure this architecture enables clarity, speed, and wisdom when it matters most. We specialize in making policy actionable at Rickshaw Health, ensuring strategies support both resilience and impact. We welcome thoughtful discussions with leaders pursuing the same goal. #HealthPolicy #DecisionMaking #HealthLeadership #HealthSystems #PublicHealth #StrategicPlanning #OperationalExcellence

Leadership is a practice, not a position. That simple but powerful truth from Marshall Ganz, a Harvard professor, civil rights organizer, and architect of transformative social movements, resonated with me.   In global health and development, we too often equate leadership with job titles or academic credentials. A brilliant PhD biochemist suddenly finds herself responsible for managing a team of 20. A skilled physician, trained to make split-second, life-saving decisions, is now expected to lead a diverse coalition of mothers, community leaders, and frontline workers to improve breastfeeding outcomes. These experts and many like them were equipped with the knowledge and tools needed for their field of science and medicine but not for the demands of leadership. Leadership is not technical expertise.   Technical mastery equips you to solve problems. Leadership practice equips you to align people, navigate complexity, foster trust, resolve conflict, and inspire collective action — especially in times of uncertainty.   As health challenges become increasingly complex, compounded by pandemics, climate crises, and fragile health systems, adaptive, inclusive, and intentional leadership becomes more important than ever. Yet while we invest billions in vaccines, health technologies, and program delivery, we often leave leadership development to chance.   That’s why the work of WomenLift Health matters so deeply.   We invest in the leadership capacity of talented health experts at pivotal moments in their careers, equipping them with the tools, networks, and confidence to drive transformational change in health and beyond.   As we tackle health challenges, we must treat leadership development with the same rigor, innovation and investment that we bring to the tools and interventions of public health. Leadership isn’t a luxury. It’s a skill, a discipline, and a practice. And it is essential to global impact. #LeadershipIsAPractice #GlobalHealth #HealthEquity #WomenLiftHealth #LeadershipDevelopment #GenderEquality #HealthSystems #PurposeDrivenLeadership  

Change management is a vital but often misunderstood discipline in the context of implementing complex organizational change—especially within health system strengthening efforts at a time of significant fiscal constraints and rapid digital adoption across LMICs and other settings. Change management matters in health systems. Effective change management enables organizations to: - Navigate fiscal limitations and economic pressures by prioritizing and executing change initiatives efficiently. - Align staff, leadership, and stakeholders with revised processes, new technologies, and updated ways of working. - Support digital adoption and integration, ensuring that new tools are embraced and used to their full potential. - Mitigate risks of project failure, financial waste, and staff disengagement—factors that can undermine both immediate reforms and long-term system resilience. Without structured change management, health systems face increased risk of: - Failed projects and initiatives with limited benefit realization and escalating costs due to poor execution and financial overruns. - Lack of stakeholder support, leading to stalled or derailed transformation efforts. - Reduced quality of care, patient safety incidents, and disrupted services caused by communication gaps and poor planning during change. - Workforce resistance, diminished morale, and higher turnover as changes are imposed rather than collaboratively implemented. - Regulatory breaches, particularly when changes are rushed or compliance needs are overlooked. - Data security and privacy issues, especially in digital health projects, if stakeholders are not adequately prepared or trained. - Lost productivity and efficiency due to process disruptions and unclear workflows. - Eroded stakeholder trust and reputational harm stemming from unaddressed concerns and insufficient engagement. Understanding the value of comprehensive change management is essential. A well-applied change management program aligns people, processes, and technology, contributing to: - Smoother transitions with fewer errors and disruptions. - Sustained improvement in patient and workforce outcomes. - Increased capacity for innovation and future reform. - Greater return on investment, safeguarding financial and human resources. In summary, effective change management is essential for health system strengthening. It can protect investments, building organizational capability, and ensure health system reforms deliver real, lasting benefits for patients, staff, and stakeholders—while its absence poses significant risks at every level.

The best healthcare leaders aren't necessarily the smartest. They're the most compassionate. This is because healthcare is about people, not just processes or profits. Let me share some examples from Africa that illustrate this perfectly. _________________ Dr. Agnes Binagwaho: Former Minister of Health of Rwanda. - She led the charge to rebuild Rwanda’s healthcare system post-genocide. - Focused on equity and accessibility, she expanded health insurance to over 90% of the population. - Her work isn't just about policies; it's about ensuring every Rwandan has access to care. ___________________ Strive Masiyiwa Founder of Econet Wireless and Higherlife Foundation. - Not a medical professional, but his impact on healthcare is profound. - His foundation provides scholarships to orphaned and vulnerable children. - He funds health initiatives from HIV/AIDS programs to rural healthcare facilities. ____________________ Dr. Amina Abubakar: Co-founder of the Centre for Public Health and Development in Kenya. - Her focus is on maternal and child health. - She created the innovative 'Kangaroo Mother Care' program to reduce infant mortality. - Her compassion drives her to ensure no mother or child is left behind. ___________________ These leaders aren’t just visionary; they deeply empathise with the people they serve. They understand that healthcare is a human right. They listen to their communities and adapt solutions to meet their needs. They lead with their hearts, not just their heads. ____________________ What other compassionate healthcare leaders inspire you? Follow me, Ikechukwu Okoh, for more insights on leadership, public health and business strategy. Have a great weekend!

Some health systems are ditching traditional leadership structures to reimagine a more effective way to lead their organizations. This is good news for everyone in healthcare. The rapid introduction of digital technology and the need for timely decisions are forcing hospitals to change with the times. “Paul Coyne, DNP, senior vice president and chief nursing executive for HSS | Hospital for Special Surgery in New York City, sees a similar shift in healthcare executive structure. He said frontline clinical leadership "must become more human centric and less administrative." "People who seek a career in healthcare are not looking for their management to facilitate their projects or enter their timecards," Dr. Coyne said. "They are looking to be cared about, to be mentored and to be given an environment in which they can truly flourish, not only as professionals, but as human beings." So, what are leaders running toward if they break down hierarchical structures? Their jobs will be to break down silos, improve collaboration within their organizations, encourage interdisciplinary work among teams, and empower more leaders to make decisions. "Leadership within rigid, compartmentalized structures will become less important [in the next two years]," said Edward Kim, MD, vice physician-in-chief at Duarte, Calf.-based City of Hope and physician-in-chief at City of Hope Orange County. "Moving forward, the focus will shift away from hierarchies and toward collaborative, cross-functional team dynamics, creating a more integrated and effective approach to care and innovation." This could not come any sooner. Paul Coyne, David Dibble, Ed Kim #nursesonlinkedin #nurseleaders #healthcareleaders #nurseeducators #nursing