Accelerating systemness through shared vision and culture

As health systems across the United States consolidate, tremendous potential exists to expand and optimise their breadth and depth by integrating services so that patient care is coordinated, supportive and equitable. The financial pressures and workforce crisis resulting from the COVID-19 pandemic have further exacerbated the need for fiscal discipline and operational efficiencies that can come from effective, system-wide integration. Yet many health systems continue to fall short of achieving the promise of post-merger integration and the value it can create for the diverse communities they serve. This paper explores one health system’s journey from ‘operational synergies’ to full ‘systemness’ enabled by a shared vision laser focused on a commitment to frictionless, patient-centred care through enabling care teams to do their best work, accelerating integrated operations and building an inclusive culture. It will explore the journey of a system in name only (Wellforce) to a unified team with a single brand (Tufts Medicine) and a shared commitment to the future with a mission to empower people to live their best lives. This case study will describe how the system evolved, starting from the development of a transformational Strategic Vision, through the shared trials of the COVID-19 pandemic and its effect on patients and providers. Having a shared vision is an essential first step to building systemness. Bringing that vision to life requires significant discipline and culture change. It requires a systemic approach and unwavering leadership, rooted in a shared philosophy, deep commitment and aligned behaviour. The case study will continue with an exploration of the path system and entity leaders took to identify shared priorities, adapt organisational and governance structures, and engage more than 14,000 clinical and administrative staff and physicians in building an inclusive culture with a clear and actionable commitment to anti-racism. It is a story about moving from words and ideas to action and removing the barriers that impeded progress.