How leading from behind can transform healthcare

Guest post by Thomas Dahlborg, chief financial officer and vice president of strategy for NICHQ (National Institute for Children's Health Quality), where he focuses on improving child health and well-being.

"My preference is to lead from behind."

"You do what?"

I recently had the opportunity to meet with an amazing group of healthcare leaders, each representing a different sector and all coming together to improve the healthcare system locally, regionally and beyond. It was a mosaic of ideas, philosophies and approaches, each intertwined with opportunity, challenge, hope, ideal and complexity.

We discussed the importance of patient and family partnerships in ensuring care plans are aligned with patient preferences and thus lead to improved patient safety, compliance, engagement (of both clinician and patient) and improved health and healthcare outcomes. Further, we focused on the need to engage patients not only at time of care (which again is critical) but also much further upstream to ensure we design care systems which best position patients, families and clinicians to develop relationship and trust, tell and hear whole stories, gain a 360-degree picture of flames to be fanned as well as those barriers to health to be eliminated, and together create care pathways honoring the patient and leveraging this relationship.

We focused on the importance of quality improvement and the need for a collaborative approach to system redesign to better position members of care teams, i.e., physicians, nurses, therapists, administrative staff and others to improve care provision and better position each team member to do what they do best for the betterment of their patients, their teams, their communities and themselves. We paid close attention to the adverse effect the broken system is having on caring, dedicated, compassionate physicians and nurses and how collaborative leadership is needed to fix the brokenness, honor these healers, and better position them to be successful and rediscover joy in healing.

With a variety of opinions offered, health leaders highlighted the need for innovation in healthcare financing aligned with new care model designs. We discussed with great interest and engagement the need for a new vision that would be shared with confidence and implemented effectively.

And then it happened ...

The subject of leadership approaches and styles came up, and I said: "My preference is to lead from behind."

And aside from the visceral reaction of "You do what?" ... the room became silent.

You know the old saying, "the silence was deafening." I have now truly experienced this phenomenon.