There is a need for a new leadership in healthcare

Before the Symposium on Leadership that I will participate in at WCPT Congress next week, I publish here the English version of the article of debate that I wrote together with Cecilia Winberg, Vice President. It was published in the Swedish newspaper Dagens Medicin on April 4. You can follow the Leadership Symposium on the web on livestream May 11th 4 pm CEST.

”The Swedish healthcare system needs to overcome the challenge of a future population increase, which includes a growing ratio of children and the elderly. All this together with the increase of noncommunicable diseases (NCDs). There is a need of change in leadership – at all levels. Healthcare is the occupational sector with the highest level of sick leave and we cannot continue to do as we always have done if we want to see improvement.  Therefore, a new leadership is needed that demands, follows up and creates conditions for new working methods, but also a new health-promoting leadership.

Sweden has signed the UN’s global goals and Agenda 2030, where goal number three stipulates to ensure healthy living and promote well-being for everyone, which is absolutely a beautiful sentence in its right, but to realize this we need to make the change.  An increasing proportion of employees in the health care sector feel that they are unable to see and meet the patients and their family’s needsethical stress is a well-known concept. Competition for personnel is increasing due to lack of health care employees and a considerable innovative approach will be required to be an attractive employer.

Last year, the Swedish Agency for Health and Care Analysis presented the report From recipients to co-creators, a knowledge base for a more person-centred healthcare. The report describes the need for a more person-centred approach, not only in meetings with patients and their families, but throughout the hole organization.  The organizational culture within healthcare is characterized by a hierarchical approach and has been for decades.

We believe that we must create a culture in which employees work for patients and their families, not for the management.  This can only be reality when politicians, stake holders and senior management as well as the business-related management themselves have the person-centred working method, demand, follow up and use this as conditions for their leadership.

The culture and leadership that characterize the healthcare organisations also permeates in meeting with patients and their families. One cannot give to others what one does not have, therefore leaders should ask the question to their employees: ”What matters to you?”.  In the broader perspective, this is about creating the conditions for sustainable health and working life.  For this to become a reality, four changes are needed in leadership.

1. Clearer person-centred and sustainable managementOrganizations must be organized on basis of the people you are there for and not on basis of a certain profession.  If we want to see results, we must encourage, ask for and follow up results.  This applies to both clinical treatment results and to sustainable health for employees.  Otherwise, we can’t expect any improvement.  The leaders need to take precedence in the sustainability work and live by its own device, otherwise no one else follows.

2. Use the possibilities of digitalization. Through digitalization people can be given the opportunity for treatments and information through completely new tools and applications. The health care must take on the challenge and be a part of the development in the way that the patients demand.  Organisations must have well equipped digital systems and software, which are user friendly to both personnel and patients.

3. Focus on competence supply in organisations. Employees ability to develop competence is a matter and guarantee for patient safety. Today many health care organisations are failing in their responsibility to secure competence. In Sweden this responsibility is given to the first line manager, but in a stressful everyday life it is not easy for competence development to be prioritized.  In 2019, according to a political four-party agreement, the new government will introduce a national coordination with assignment to long-term planning of personnel and competence supply in healthcare.  

4. Together. In a person-centred healthcare, all patients are entitled to the right competence. It is necessary to cooperate between employees within different professions and employers.  

Barriers to collaboration must be removed, between both systems and in the remuneration systems that regulate large parts of the private healthcare system.  

It can never be the patient’s responsibility to coordinate what healthcare to get from different professions. The caregiver is a guest in the patient’s life, not the other way around.

For several years, we have been talking about the importance of the participation of patients and their families.  Now there is a need to move from words into action. Managers and leaders must take their responsibility and always work towards a person-centred health care, for the benefit of patients and their families”.