Evolving Organizational Structure: Learnings From the Iowa Primary Care Association

Evolving Organizational Structure: Learnings From the Iowa Primary Care Association

Jun 14, 2021

By: Kate Shervais

We’ve seen a fundamental shift in the last decade with the rise of technology to a world that is adaptive and evolving in real-time. We’ve also seen the shift to more mission-focused organizations. Are our organizations structured to really deliver what’s needed over the next decade?

We hosted a conversation with Aaron Todd and Kelly Frett of the Iowa Primary Care Association, INConcertCare, and Iowa Health + about how they used change management principles to re-design their organization from the ground up to ensure they could deliver on their vision and the work they foresee needed to improve healthcare over the next decade. While this took place in a healthcare setting, the change principles they used can apply to almost any organization.

To address major changes like value-based care, where payment is tied to the quality of care and not to specific fees for specific services, restructuring an organization may be needed. This shift, along with a change in leadership, a new vision statement, and the desire to build an organization without silos that encourages leadership at all levels, were factors in Todd and Frett’s decision to evolve their organizational structure.

Here’s what they told us that they learned:

Don’t waste a good crisis! The pandemic was challenging. It created opportunity for change and an openness to change that may not have been there before. It also demonstrated the need for more flexible systems and shared leadership.

Change is emotional. Change is not easy. You will have hard days; everyone in the organization will. You will have feelings come up that you didn’t expect. Anticipate that you’ll feel emotional during the process and let it happen!

Culture change happens over time. You can’t just name that you’ll have culture change and put a plaque with your ‘culture’ up on the wall. To actualize a culture shift requires that you continually act in ways that support the culture you want to have, and that supports the people around you in changing as well.

Communication is key and there is never too much. When you think you’ve communicated enough, you probably haven’t, and can do more. Bring your team with you. Don’t assume they understand or know everything you do. Communicate the same messages in different ways repeatedly.

Leaders need change management skills and to practice applying them. Changes like this one don’t happen just by the CEO and COO promoting a change. All leaders in the organization need to model the change and be supported in developing their own skills to do this.

Some people won’t make the transition. This is a hard lesson. Some people won’t be the right fit for the new organization. Whether it’s due to a lack of the right role for them, or their lack of interest in the new way of working, support them in finding something new and be transparent with them.

Perfection is the enemy of progress. It’s unlikely that you are going to get it all exactly right the first time. But you won’t make any change if you wait to have the perfect plan. Be willing to adapt together, to admit when something needs to shift, and to work together to course correct.

Discomfort is where growth happens. This lesson is a common thread that runs through all the others: Change is uncomfortable. Be prepared. Be willing to have hard conversations over and over again. You’ll get better at them, and chances are, you’ll also see the positive impact of having had them.