Make sure you tie your carrot to a stick

Changes in external incentives and in internal management are powerfully complementary. Giving managers incentives without also giving them the skills, authority, and resources they need to respond to those incentives is likely to be quite ineffectual. The same is true in reverse. Increased managerial authority is not likely to lead to improved care if managers have no incentive to do so. This is why various writers on organizational reform in health care have seen a need for “consistent” change (Harding and Preker 2002). It is not aesthetics that lies behind their observations, but rather the need to combine reasons to do better with this capacity to do better–in the same reform package.

Getting Health Reform Right, p. 215

I’m still finishing up Getting Health Reform Right, so a review is a week or so off. But in the meantime, I came across this passage on the plane last night and thought it held wonderful insight into leadership generally.

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