News & Insights

Structured reflections, early signals, and real-world insights from the field.

Field Notes

This is the outward expression of our internal practice — a disciplined record of what we are learning as we work to strengthen the foundations of healthcare delivery.

Each month, we share precise, field-informed perspectives on the structural forces shaping institutional performance and system design. Drawn from our advisory work, research synthesis, and network dialogue, these pieces are meant to inform and advance the practice of serious improvement.

What You’ll Find Here

  • Focused reflections that translate foundational theory into operational relevance — e.g., “What Mintzberg taught us this month — and what it implies for organizational redesign.”

  • Early indicators of emerging challenges or overlooked leverage points — from persistent performance blind spots to quiet patterns of change.

  • Brief, de-identified observations from active engagements. Where systems are struggling. Where progress is breaking through. What we’re seeing behind the metrics.

  • Select pieces of research or writing that warrant your attention — shared with clear context and commentary on their practical implications.

  • Themes, questions, and reading pairings from our Monthly Forum — a space where leaders and learners reflect seriously on the systems we live and work in.

Topics

  • An evidence-based view of patient safety outcomes, drawing on CDC data — revealing a more urgent and underacknowledged picture.

  • While delivery models evolve, the underlying systems enabling care remain overlooked. This structural blind spot represents both a risk and a profound opportunity.

  • A review of Grand Rounds lectures reveals a striking imbalance: while thousands focus on clinical or subspecialty topics, virtually none address healthcare management, organizational performance, or system design.

  • Lack of standardization in clinical FTE (cFTE) definitions and measurement undermines both benchmarking and performance management. Inclusion criteria matter — and without precision, data mislead.

  • Emerging data show that some of the highest contributors are also at risk — yet they continue to carry the system.

  • Tensions between legacy norms and emerging expectations aren’t just interpersonal — they reflect deeper structural misalignments. We explore how these gaps can be transformed into opportunities.

  • Tools like Interpretative Phenomenological Analysis and Narrative Inquiry — common tools in academic research — when applied in practice can uncover misalignments in engagement, performance, and experience.

  • Baumol’s cost disease offers a different frame: costs may rise, but that won’t necessarily make healthcare unaffordable in the future.

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