In complex systems, change takes persistence.

Over the years, coworkers have often described me as “the dog with the bone.” Once I become invested in something, I tend not to let it go. That persistence has helped me create meaningful change within health care systems. It has also shown me how much organization, follow-up, patience, and emotional stamina meaningful change often requires.

I have also learned how often the answer is no. Sometimes the “no” is direct. Other times it comes through silence. Some ideas take longer to gain traction within large organizations than people initially expect. Creating change in any environment can be difficult. In health care systems, it can feel especially challenging.

Health care organizations are responsible for large numbers of patients, employees, regulations, budgets, and risks. Decisions that appear simple from the outside often involve layers of oversight, approvals, coordination, and competing priorities that most people never see. Still, understanding those realities does not necessarily make the process less discouraging.

The temptation to give up.

I have experienced this in clinical practice when advocating for patient education initiatives, operational changes, or workflow improvements that initially seemed straightforward. In health care, even small changes can require multiple approvals, coordination across departments, competing priorities, and months […]