A case-study in Systemic Transformation

  • 2min.

Nationwide Children Hospital in Ohio had a clear responsibility: people must leave healthier than when they entered. Simple.

But serving one of the poorest and most run-down neighbourhoods of Detroit meant that people were not staying health for long. To quote director of the Centre for innovations in Paediatric Practice, Kelly Kelleher, “As a clinician, a paediatrician, it’s very frustrating to give a kid antibiotics for their ear infection or cortisone cream for their rash and then send them back into a war zone.”

The hospital was doing what it was designed to do – people were coming in sick and leaving healthier. But it was not sustainable. It was treating the symptoms but not fixing the problem.

I work with organisations who are going through various transformations. A lot of the time the emphasis is on fixing the problems: trust, better way of working, creating a purpose, reducing costs. Perfectly acceptable but if you fail to take a systemic you may create short term change but you’re unlikely to create meaningful and long-term transformation. Certainly not the type of transformation that many of these organisations are looking for.

A systemic approach looks at the whole organisations, the team, the leadership, the natural and corporate hierarchies, the balance in what people give and what they receive,  the unseen dynamics at work. The solutions tackle the root cause of the symptoms, creates balance in the system and delivers sustainable transformation throughout the system.

Your chiropractor does not treat your headache, she treats your lower back and knee that is causing the headache.

Nationwide Children Hospital realised that they could spend a life-time making people better, providing treatments for the headache. Or they could take a more systemic approach and look at what was causing the symptoms. The impact of that decision has seen the hospital renovate older house, build new houses, and given home improvement grants to hundred of familiar. And the impact on the neighbourhood have been huge: high school graduation is up, murder rates down and A&E visits are down. Results on specific sicknesses like asthma have yet to be measured but the overall trend is clear.

A systemic approach has an impact way beyond the initial complaint and in the case of Nationwide Children’s Hospital – is seeing a year on year increase in the satisfaction of living in the neighbourhood.

We are programmed to think in terms of problem and solution, very rarely do we pause to look at the broader system and dare to wonder what impact we could have if we stopped fixing the problems and started fixing the system itself,


For a more in-depth look at the Nationwide Children Hospital: tap here.