Improv and Health Leadership

Why improv and health leadership? Health experience is unique, of the moment, a journey. A different possible riff every moment.

The patient, client, consumer (let me use the term consumer for now) expects safe, quality, kind, empathetic care and service from professionals and their organizations-it’s a given. Even when safe, quality, and kind are present the health journey can be a very rough road. The challenge for the professional and support staff is to maximize the ability to know and relate to consumers as individuals and respond to the roadblocks, detours, potholes of that journey. 

The compliments my peers hear about health care are not usually about saving a life, successful surgery, hand washing. Rather it’s about the housekeeper who brought coloring books to the child; it’s about the nurse who knew the child’s passion for Ninja Turtles and brought a Ninja Turtle balloon to the bedside or exam room; it’s about the doctor who called the family on her day off; it’s about the registrar who found a private space for a mother to breast feed a non-patient child. These leverage the whole experience positively.

The relationship between professional caregivers and consumers includes constant improv-discretion to customize response and interaction and go off script. Yet the capacity of caregivers to stay up-to-date in their knowledge, compliant with practice and regulation, and productive while still able to improvise approaches superpower.

How can professionals and support staff tap their inner superpower without the intentional complicity of their leaders? Health leaders model and create the conditions that cultivate and learn from this improv. More about those conditions in the next blog.


  • Kate Gleeson says:

    From what I’ve seen in a different field (education), professionals tap their inner superpowers in spite of their leaders. That is, I’ve seen few examples of institutions that support and learn from their employees’ inherent gifts. Instead, employees seem to either navigate without the support of their leaders (and perhaps burn-out), or leave for another institution. I’ll be interested to see what conditions you discuss in the next posting.

  • Mike Brennan says:

    But the economics of healthcare-decreasing resources, increasing demand, payment structures that favor short stays and procedures-militate against moving off the plan to adapt to patient needs. I used to get criticized by colleagues and managers alike for taking too long in ER triage, getting the patients stories: the organizations favored fast triage, even when the fast triage nurses missed important pieces of the story, like AICD’s and allergies.

    • Danny says:

      Yes. I contend however that we can have both: productivity and improvisation and connection. I’m hoping to learn from our Big Apple clowns more about reading the audience, and making those connections quickly and more accurately. I’ll post about that. The metrics are elusive, aren’t they? The cycle time for triage is one thing, avoiding the delay, error, mishap from insufficient information is another. Gauging impact on loyalty of the consumer is a topic for thought too.

  • Mike Brennan says:

    We can teach improvisational music and comedy in a class, so we can probably teach the behavior you identify as going off script. The key might be enriching the interview process to elicit the patient’s story and devising a response to that story that integrates the healthcare experience into that story. The folks at Bassett Healthcare used to gather exemplars as part of the nurse credentialing process, stories from each nurse regarding an occasion of outstanding patient care. These exemplars were published to serve as teaching tools and standards to emulate.

  • Todd says:

    I agree Danny. I think a lot of it comes down to hiring the right people! This isn’t something that we can teach in a class. For example I saw a family in the parking garage this AM who looked bewildered. I saw several employees walk past them. Turns out they parked in the wrong garage and couldn’t figure out where to go.

    • Danny says:

      I agree that hiring the right people is necessary – but it’s not sufficient. We can’t teach nice anyway. Nice people still need superpowers to improvise in health care delivery today. It’s a good thing that superpowers are fun and self-sustaining. I’m still mulling over how we enable these superpowers in our teams. More to come.

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