Operational leaders—from department-level management to senior management—are the heartbeat of organizational stability and the key to unlocking meaningful, lasting digital transformation. They are asked to maintain high-performing departments while adapting to ever-changing systems, workflows, and technology.
Yet too often, transformation efforts are designed around them, not with them—creating resistance, distrust, and ultimately poor adoption of enhanced healthcare technologies. And yet, despite their critical role, they are often brought into technical transformation efforts too late—or in name only.
When operational leaders aren't authentically engaged, transformation stalls. Fear of disruption, loss of control, and uncertainty about impact can override even the most well-intentioned initiatives. But when operational leaders are empowered as co-owners of change, digital transformation moves from abstract ambition to tangible results.
In this blog post, we explore three proven strategies to make operational leadership true partners in transformation. These recommendations are drawn from real-world experience and highlight a successful patient access transformation that not only improved care, but continues to keep the doors open for a large community health center.
1. Establish Shared Governance with Embedded Operational Authority
Governance is more than a project plan checkpoint. It's the structural backbone of transformation—and a powerful lever for engagement. Too often, governance bodies skew heavily toward IT or administrative oversight, with operational leaders acting as passive advisers. This leads to misalignment, siloed decisions, and resentment when processes break down in real-world settings.
What works:
- Create a formal governance body that includes operations, clinical leadership, IT, and transformation leaders. Ensure each member is bought in and has decision-making authoritywithin their area—not just the ability to escalate.
- Major decisions will require a quorum (e.g., four out of five) with consensus preferred; however, if consensus cannot be reached, the chairperson of the governance body (typically the chief operating officer in larger organizations and the chief executive officer in smaller organizations, especially when decisions cross clinical, operational, and IT boundaries) will have ultimate authority.
- Establish clear rules for standardized design concepts in the EHR architecture, while being flexible with exceptions. Not every request can be accommodated, but when exceptions are necessary, operational leaders and technology partners both must be involved in determining feasibility and impact.
- Map out a joint transformation timeline that includes governance checkpoints aligned with project phases—discovery, pilot design, build, rollout, and stabilization. This balances technical progress with operational capacity and real-world timing.
2. Empower through Co-Design, Not Just Communication
Operational leaders don't want to be "kept in the loop." They want to be hands-on contributors. In successful transformations, co-design is not a one-time workshop—it’s a discipline. When operational leaders help shape workflows, data structures, and end user experiences, they see their fingerprints on the outcome—and take ownership of the result.
What works:
- Conduct multidisciplinary design sessions with frontline managers, IT analysts, scheduling leads, and clinical SMEs to shape the solution together.
- Identify and elevate transformation champions—influential operational team members who can provide real-time feedback, advocate for peers, and bridge communication gaps.
- Use design to uncover and address deep-rooted pain points, such as lack of scheduling transparency, template inconsistencies, or workarounds that hide bigger system flaws.
3. Align Metrics and Timelines with Operational Priorities
Metrics matter—but only if they're meaningful. Too often, success is defined by system go-live dates or feature delivery, while operational leaders care about volume, efficiency, staffing stability, and patient outcomes. For true engagement, transformation must be measured against what operational leaders value—not just what IT can track.
What works:
- Define shared success metrics early in the process. These could include improved patient access, reduced appointment types, fewer errors, or increased capacity for preventive care.
- Link those metrics to grant performance, quality measures, or compliance thresholds—so the "why" is as clear as the "how."
- Use the transformation timeline to coordinate stakeholder input and manage competing priorities across IT, clinical teams, and operational leadership.
Case Study: Transforming Patient Access in a Healthcare Safety Net Organization
A large public health system in Southern California serves under-resourced populations, and their leadership faced a crisis: fragmented scheduling workflows, exorbitant amount of appointment types, and a chaotic EHR build designed over a decade before were threatening patient access—and future funding.
Working collaboratively with operational leaders across access, clinics, and IT, our team:
- Reduced active provider templates by over 80% through co-designed scheduling standards.
- Consolidated appointment types to a core, high-utility set that reflected real patient needs.
- Reestablished scheduling workflows to adapt to modern access to care challenges.
- Streamlined scheduling database build rows by over 30%, dramatically reducing build errors and maintenance overhead by IT.
This wasn't just a technical cleanup—it was an operational breakthrough.
Operational leaders co-led every design session and owned the governance process, allowing them to make informed exceptions when needed while holding the line on standards elsewhere. Their input ensured that changes reflected actual clinic needs, and timelines were adjusted to account for high-volume months like flu season.
The results:
- Protected the integrity of the EHR by aligning design with operational simplicity
- Increased preventive care visit volumes by over 40% in key cohorts
- Achieved maximum grant funding eligibility, securing the organization's financial future and ensuring continued access for thousands of patients
This transformation only succeeded because operational leaders were treated as partners, not gatekeepers.
Co-Ownership Is the Future of Transformation
Engaging operational leaders isn't a soft skill—it's a strategic requirement. When governance, design, and metrics are built with operations, not around them, organizations move from resistance to results. If you're facing challenges with digital or technical transformation in a complex environment, ask yourself: Are your operational leaders truly part of the ownership team—or just another stakeholder?
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Published May 16, 2025