ONE BIG DOT
Silos have their place, but healthcare isn't one of them. We can make it easier to do better.
Some leading health systems are working on ‘connecting the dots’ between the traditional silos of experience, quality, safety, and equity.
But Dr. Gregory Makoul suggests that there's a bigger point to consider: “Perhaps more important than connecting the dots is realizing that experience, quality, safety, equity, and even brand are part of One Big Dot – they might be measured separately, but all come down to understanding and addressing what matters for every patient and consumer in a way that is meaningful to those who serve them. In other words, experience is not an extra-added attraction, quality is not the sole purview of the quality team, safety should not be the only focus of a high-reliability mindset and, at root, equity – or the lack thereof – is woven through every decision and discussion. And all of this shapes brand perception.” (2024 Experience Perspective)
To be clear, the One Big Dot approach does not suggest that all of the domains are the same or that the move toward an operating system that drives integration is going to be easy. Rather, the imperative is to transcend silos by aligning domains, goals, and workflows in a manner that improves results, including workforce morale. It requires clearly delineating points of intersection –
prioritizing the overlap between experience, quality, safety, and equity in a coherent effort to elevate all of them. The response to this approach has been overwhelmingly positive in featured sessions at national conferences (Beryl Institute’s Elevate PX, Becker’s 14th Annual Meeting, NRC Health's HUB24, Planetree's Global Forum on Person-Centered Care) as well as within large health systems.
When working with health systems, Dr. Makoul starts by conducting an assessment using structured yet flexible interviews with leaders, managers, and a sample of frontline staff to determine Organizational Readiness for Transformation. This work is summarized in a report and presented along with a high-level roadmap that outlines the path to operationalizing One Big Dot in a manner that accelerates positive change. Dr. Makoul will also facilitate – or conduct, if requested – an inventory of experience, quality, safety, and equity measures with close attention to if and how they are used as well as recommendations for appropriate and effective streamlining.
Dr. Makoul will guide and support this initiative, but success depends on a concerted effort within each organization to be honest about where they are and clear about where they want to be. By engaging stakeholders and leveraging human-centered design principles, this effort will generate a coherent operating system that boosts outcomes and morale because it is:
- Tailored and branded with input from people doing the work.
- Purpose-built to foster both alignment across domains and buy-in across the organization.
- Geared to creating an improved and differentiated experience of care that is more than the sum of its parts.