Healthcare is a pillar of every society. It is universally hoped that the existing healthcare system works optimally in that community. Everyone shares these ideals.

However, many of the strengths of embedded healthcare systems can hinder progress in the face of changed circumstances and new challenges. It appears that we are in the midst of this situation currently. Our system still works in terms of clinical outcomes, but the ongoing demands including shortage of resources can make us feel that we are in a leaky boat and baling out water as fast as we can. Will we go under?

In the entrenched and relatively static environment that is healthcare, systems change, and respond to change, very slowly. This is due to the culture being long-standing, hierarchical, conservative, and expert-based.

These are not negatives – these features provide advantages in consistency and reliability. They allow known work practices and learning platforms, and facilitate patient care outcomes that are desirable and comparable across all of a nation’s healthcare system. However, they do slow the recognition of challenges requiring bold thinking.

While we in Australia, and much of the world, are still achieving excellent clinical outcomes our organisations and workers within them are struggling. Our people are disengaged and leaving. It seems that in the face of these increasing challenges it is becoming more urgent to re-examine ourselves. Even with our inherent resistance, we must address a need for change.

What do we make of this? Do we have the courage and ability to re-imagine our systems?

Is it possible to continue to achieve excellent clinical results while also improving organisational systems to a place where they actually benefit those working within them? Surely this goal would be worth pursuing?

It seems that while we have overarching all-of-healthcare processes that are important in clinical care (and which each organisation shares in some way), the solution to plummeting worker wellbeing and poor culture must occur at the level of each individual organisation. Each workplace can produce its own organisational style and bureacratic processes that will be part of the change required to address these challenges.

Organisations should not be carbon-copies of each other and can identify and enact the processes required for their workers, in their context. More of the same will not suffice. Hoping for organisational culture improvement in exactly the same setting, without new ways, will not occur. What got us here will not be sufficient to get us where we want to go.

This is the time for attention to these issues – while we are still afloat. I believe we have an amazing opportunity to reinvent ourselves. We can continue to provide excellent patient care while also altering organisational structures in a way that cares for our own people.