How to unlock velocity across the entire healthcare system
Building a faster, smarter and more resilient organization by simplifying the complex, building engagement and innovating.
Healthcare is gaining momentum, and that progress is real. Even so, the world around us continues to accelerate even faster. To lead rather than follow, we have a unique opportunity to elevate operations by sharpening decision-making, streamlining governance and embracing innovation as a true accelerator of performance.
When we commit to these shifts, transformation becomes something we deliver every day, rather than just a distant ideal to which we aspire.
Having spent my career in healthcare operations, I have witnessed both the brilliance and persistent friction within our systems. While we are advancing with innovation that was unimaginable only a few years ago, progress in isolated pockets is not enough. Real progress occurs only when every part of healthcare moves forward simultaneously.
Achieving true velocity
Speed in a few areas is encouraging, but true velocity requires the entire system, from the patient encounter to operations, to work in harmony. By integrating these elements, we ensure our momentum builds a cohesive, future-ready model of care.
Healthcare is a multifaceted ecosystem. It is the physician encounter, the patient experience, the customer connection, the operational engine and the financial stewardship required to deliver both quality and access. When we look across all these components, we see that meaningful transformation is not defined by a single element. It shows up everywhere, across every touchpoint, as the entire system evolves in unison.
So, the question is simply this – what would it take for healthcare to always be nimble by design? Not nimble by heroics, not nimble only in a crisis, but nimble as a forever default operating model. This shift requires us to rethink the very foundations of how we organize our work and empower people to meet the demands of a rapidly changing environment.
Simplifying the complex
The path forward begins with the ability to simplify the complex. We have long emphasized vision, communication and alignment, and these factors remain essential. However, in this new era, accelerated by artificial intelligence and digital transformation, the highest impact will come from leaders who can take an environment full of ambiguity and distill it into clarity that teams can execute against.
Healthcare systems are doing this well today, but the opportunity ahead is to do it even more intentionally. One of the most important lessons in leading a system is clarity in decision-making that is the ultimate catalyst for progress. When ownership is well-defined, teams can move forward with confidence rather than caution.
In complex, matrixed organizations, roles and authority naturally become diffused. Leaders often invest significant time in building alignment, but they remain uncertain about who ultimately holds the decision. While inclusivity must remain a core principle that strengthens both outcome and culture, it works best when paired with disciplined decision pathways. When too many voices occupy the decision seat, momentum inevitably stalls.
Building broad engagement
There’s a prime opportunity to maintain broad engagement that defines our culture while reinforcing clear ownership. When these elements move in harmony, teams feel both heard and empowered, and systems move forward with purpose accelerating progress across the entire organization.
Imagine an operating model in which communication, roles and decision rights are transparent. Stakeholders are engaged early to evaluate risks, while a designated leader is empowered to make the final call.
This isn't about consolidating authority; it’s about accountable leadership that honors diverse voices while creating conditions for timely, confident decisions. When we draw clearer lines, we strengthen alignment and provide teams with what they need most: the clarity to execute without hesitation. By prioritizing this structure, we ensure system-wide velocity.
Trust is the foundation of this speed. It grows when we lead with transparency, sharing data, inputs and tradeoffs behind each decision, all while consistency reinforces that trust over time. A practical truth remains – speed depends on clear permission to execute. When decision rights are well understood, leaders move with the velocity that patients need to thrive.
The importance of innovation
This is why innovation must be embraced as a true performance accelerator, not a disruption. It is the engine that expands access, elevates quality and reduces administrative burden. While safety is non-negotiable, governance must keep pace with the market. Being safe and being fast are not opposites; they must coexist to lead effectively.
There’s growing evidence that an agile, sustainable future is already taking shape.
For example, bringing acute care home isn't just a program; it’s a new operating system. These models scale effectively, delivering vital outcomes for patients, physicians and operators, as seen in How 4 Providers Successfully Launched Hospital-at-Home Programs | AHA. This transformation redefines staffing and hospital capacity.
To adopt AI responsibly, we need practical governance and clear frameworks that streamline processes, ensuring innovation is both safe and operationalized across systems, such as how 4 health systems adopt AI contract intelligence platform.
Closer to home, we are also seeing critical care models evolve. At Penn State Health, virtual ICU services supplement bedside teams and extend specialist support. Virtual models do not remove the human element; in fact, they create another layer of safety and responsiveness.
When organizations deploy ambient AI, the goal isn't to replace clinicians, but to restore presence and eliminate "pajama time." Such innovations prove that the industry can move swiftly; the real challenge isn't the technology, but our ability to scale with confidence.
So, what should we do? Start by asking where your organization loses time. Is it in approvals, handoffs, ambiguity or fear? Then, ask what must be redesigned to execute faster without compromising safety.
My approach includes three commitments – simplify decision rights by separating stakeholder and decision lanes; build governance that enables movement; and treat innovation as core to operations.
If something improves outcomes, it belongs in the operating model. By delivering consistently, we won’t just outpace the past, we’ll build a resilient, future-ready healthcare system that strengthens our ability to serve our teams, patients and communities.
Mona Miliner, MHA, NHA, FACHE, FACMPE, FHFMA, FACHCA, FACHDM is vice president of operations at Penn State Health Milton S. Hershey Medical Center.