Madonna has been an icon in her industry for over 4 decades.
Her music career started in 1979, and today in 2021 she is still actively creating and contributing in this space. She has reinvented herself countless times in her career and has managed to stay relevant in a world that prioritises the fresh and new. Are our hospitals as durable as Madonna? If Madonna was a hospital, what would she look like?
Madonna has undergone multiple musical transformations in her career. In the 80s she was a material girl, in the 90s, she became Evita, in the 21st century, she experimented with a free spirit style and more recently she has developed a new style in Madame X. She recognises that challenges we will face will change over time, and that we need to grow and evolve to remain current and functional.
When we build hospitals, we try to project what the future will hold based on what is happening now. I have had the experience of working in new departments that were well designed and set up with room for expansion and growth, and those who were outdated by the time they were built. How can we design hospitals and health systems where we can remodel and change easily to accommodate the expanding needs of our community? There is a long held belief in many hierarchical industries that we should ‘find a winning formula and stick to it’. But winning formulas cannot stay current in a fluid world. What worked yesterday may not work tomorrow. We need to acknowledge that although hospital walls are hard they are not immovable objects, and that although there are current process and systems they are not unstoppable forces. Willingness to anticipate the need to change as well providing the resources to do so should be part of our original organisational plan
Madonna has had outstanding success in many areas, along with public and, (I assume private), failures. In her first band, she played the drums and the guitar which, while valuable skills for a musician she abandoned when they no longer served her overall purpose.. Madonna has demonstrated the ability to quit things that are not working to achieve her aims and adapt and try something else. The important distinction between quitting totally if something is not working or forging ahead despite the immediate lack of reward depends on the contribution the current actions have towards the final goal. Smart decisions to achieve an objective when there are limited resources may require abandoning the current approach if it becomes apparent we will not get to our target.
In hospitals, we want to be agile and responsive to the needs of our communities. However, when we invest in a service, a role or a project- we have a vested interest in seeing it succeed. There is a form of bias called ‘sunk cost bias’ that influences us to believe that if we have paid for something it must be good. We don’t want to be wasting funds on ineffective or inefficient services. Also, individuals in roles who enjoy their jobs may be reticent to acknowledge that the money for their service/ role/ project could be better spent elsewhere, even when they know this is true. Madonna may have overvalued her time spent on learning the drums and never taken the leap to becoming the lead singer or even a solo artist if she had this style of thinking. Luckily, she recognised those skills were helpful for her early career and she was now free to stop investing in them and focus in a different direction.
When Madonna took a risk and branched out into the world of film, at best she received mixed reviews. Receiving negative feedback like this could have easily been seen as a sign that she should “stick to what she knew best”. Madonna did not interpret the feedback this way and decided to continue to apply herself to the challenge despites some early stumbles. Although music was always her main passion, she continued to apply herself to various film roles, ultimately rising to critical acclaim in Evita. Hospitals could use a similar approach when considering branching out from their core business, to support new activities that support their overall goals. One way to do this would be microtrials.
Microtrials are a great way to sample the potential for a service, a role or a new product. When conducting a microtrial, we need to: be specific in what we are looking for (what does success look like and are we measuring it correctly? What does failure look like? How would we know if it needed a tweak or cancellation?) and how we will assess its ongoing relevance in the future. It was 1900 when the first social workers were trialled in hospitals, and now many of us can’t imagine a hospital without them. Madonna used microtrials when commissioning her first documentary- she was the executive producer , and oversaw the project as it was compiled to determine if it should be released. The producer advised that he was surprised ‘she didn’t want anything removed- just more left in’. Micro trials allow us to fail (or succeed) small and fast, tweak or cancel and then move on. Micro trials allow us the option to try something new without a big cost, and with little consequence if it does not work. Micro trials allow us flexibility and the opportunity to increase skill, while teaching others in the hospital that we are open to improvement.
Many people know that Madonna has written most of her own music, but have you also considered her widespread collaboration with other artists? She has performed with countless other musicians, but also cowritten and collaborated with them musically in other ways. One thing that is incredible about Madonna is her focus on adding value. Some artists may see other artists as threats. Madonna sees them as allies. This has helped her career, and careers of others in many ways. ‘Like a Prayer’ was cowritten by Prince. Madonna has also performed on stage with other women significantly younger than her (not worrying about age as a factor that defines her or detracts from her value). Collaboration can leverage the success of others to enhance our performance.
If Madonna was a hospital, how would this approach be demonstrated? She would collaborate widely and with those perceived to be competition for better outcomes for her patients. In a Madonna-like hospital, public and private services would collaborate well and for mutual benefit. Primary care, community care and hospital care would be seen as equally important, and funded in a way that valued them in equitable ways. If a hospital was able to add value to another organsisation (like primary care), even if there was no immediate reward for the hospital they would still help them as their overall goals are aligned. Not only would she collaborate with known and existing organisations, but she would be open to collaborate with other industries for the benefit of her patients as well. Uber (for example) has partnered with some hospitals in taking patients to and from their outpatient appointments. This has resulted in much lower absentee rates for appointments, allowing the hospital to be more effective. This collaboration is the type of collaboration Madonna would embrace (if she were a hospital).
For a minute let’s forget about the distant past (yes cone bras I’m talking about you). The Madonna we know today is a classy elegant woman who takes care of her body to stay functional and look good. If Madonna was a hospital, she would be clean, bright and classy. Madonna as a hospital would recognise that the environment surrounding people impacts their health. If Madonna was a hospital, I believe she would have a lot of windows, indoor plants to help improve air quality and promote healing (there are many studies that show people who can see plants/ flowers get better faster), and less of the unnecessary clutter.
And because Madonna does have an interest in sound, perhaps the inpatient rooms would have options available for people to play music they enjoy? I can’t imagine a Madonna hospital being silent.
When we think about what health could be, there are many aspects to consider. But one thing is clear. The systems we have in place now become dysfunctional quickly. As technology improves, so will our health system- but is the current system compatible with this pace of change?
I am interested to hear your views. If there are other things about Madonna that could be incorporated into hospitals, let me know!
Tracy Churchill is a Nurse Manager and LinkedIn Top Voice 2020. She shares her insight and expertise as a nursing leader during a time of tremendous upheaval for frontline health care workers. Her articles cover topics such as the loneliness facing COVID-19 patients as they isolate from their loved ones; the small acts of kindness that nurses provide to their patients; and how hospitals are managing nurse burnout, such as with four-day workweeks. She also writes about leadership and management from a nursing perspective.