Organizational Muscle Memory: Does your institution need to hit the gym?
Two recent podcast comments have caused me to reflect on the importance of muscle memory in health systems.
1. The Daily: 'The Mosquitoes are Winning”, mentioned the growing urban malaria problem in Africa and the lack of "malaria muscle memory" to treat these patients in urban clinics.
2. The Healthcare Executive Podcast: "The Foundations of Trust”, shared that 54% of American healthcare professionals who changed jobs last year exited the healthcare field altogether.
Two sentences when taken together that sent a shiver down my spine. Why? Because, muscle memory is critical to patient and staff wellbeing, and yet it is also fragile. If we aren’t intentional about how we protect and relay this knowledge it is to our own detriment. So who are the keepers of this muscle memory?
For our purposes I’ve divided muscle memory into three systems: Collective memory (public health level), Health Human Resources memory (individual staff level), and corporate memory (institutional level). Together these underlying systems keep Canadians healthy and strong.
Collective muscle memory is defined by our government-led public health communications and our health media landscape. For example, as I’m writing this we are preparing for the viral season urging at risk groups to get the Flu and Covid vaccines. I can’t help but reflect on the damage done by covid mis/disinformation campaigns to undermine our collective muscle memory. Work done by Children’s Healthcare Canada points to declining trust in government public health comms, but a high trust in healthcare organizations. We cannot afford erosion in this collective memory system. While governments need to continue providing excellent evidence-led public health guidance, healthcare institutions have a role in developing and communicating this collective health knowledge – and they deserve funding to do so!
HHR muscle memory is so much more than just clinical expertise. It represents knowledge gained from years of hands-on front-line experience. I had a front row seat to nurse leaders planning for St. Patrick's Day and the expected spike in alcohol-related accidents, injuries, and emergency room visits based on past experience. Our frontline healthcare teams were hailed as heroes during the pandemic, but CIHI reported nearly a quarter (21%) of employees in health occupations worked overtime with averages of 8.2 hours per week of paid overtime and 5.8 hours per week of unpaid overtime. That’s a lot. We know workload is a key factor in burnout and experienced staff members are a treasure trove of muscle memory we cannot afford to lose. Their departure risks a drop in care quality and an efficiency loss. New staff are eager sponges - they crave experienced mentors to share their institutional wisdom. We need to design a system that respects and retains experience staff and ensures they have dedicated time to be mentors to entrust tomorrow’s workforce with their HHR muscle memory. These mentors will create the next generation of high performance individuals and teams.
This leads me to institutional muscle memory. High performance individuals and teams are fantastic, but they also pose an issue at the systems and process level. (Bear with me and let me explain!) Across Canada we see spikes of improved health outcomes for different populations due to their regional teams approach/ability to providing XYZ care/treatment. But these outcomes/performance outliers are replicable. High-performing teams showcase practices that, when standardized, can uplift the entire healthcare system. Institutions have to step up and offer training, knowledge sharing programs, and invest meaningfully in staff development. Brian Goldman’s book, The Power of Teamwork: How We Can All Work Better Together identifies some fantastic practices in this regard. Organizations must build systems to ensure teams have adequate resources, simulation, and training to prepare new staff. As our senior staff stables thin out, it falls to the institution to be mentor and guide. Some organizations are already preparing for this with fantastic investments in Organizational Learning departments, but this will increasingly NOT be a strategic differentiator, but an organizational requirement.
So what am I saying here?
Muscle memory is among the most valuable assets our health system has ensuring high-quality care for clients and for staff. But a system built upon individuals is fragile. Due to a million competing pressures we won’t get into now, healthcare staff are burning out and are rethinking their careers - potentially leaving healthcare and taking their muscle memory with them. Simultaneously our governments’ and media’s role in educating our public is coming under attack. Hospitals and other healthcare delivery organizations are trusted voices needed to communicate both outwards to bolster collective muscle memory systems, and inwards to safeguard and foster HHR muscle memory. Organizations must create systems and processes to ensure that muscle memory is captured and built into operations by design to support the next generation of healthcare providers, patients, and their families.
What do you think? Agree, Disagree? Let’s start a conversation!
