Happy Monday, Healthcare Leaders!
Welcome to this week’s edition of The Healthcare Leader, where we’ll explore why the best leaders don’t always rush to act, how hospitals are improving early-day discharges without adding staff, and one crucial skill required to succeed in a career as a healthcare executive.
Let’s dive in.
In Today's Issue
🧠 Leadership: Don’t Do Something, Just Stand There
The title of Frank Cohen’s book Don’t Do Something, Just Stand There feels almost offensive in healthcare.
We operate in environments where action is rewarded, urgency is expected, and decisiveness is seen as strength.
But there’s a deeply relevant message here: action without evidence is not leadership.
In complex systems like hospitals, the instinct to “fix it now” often creates downstream problems.
A staffing change increases overtime. A policy update adds documentation burden. A workflow tweak shifts bottlenecks instead of removing them.
Leaders feel productive by “doing” a lot — but outcomes don’t improve.
Evidence-based management asks leaders to pause long enough to ask:
What problem are we actually solving?
What data do we already have?
What has worked elsewhere — and under what conditions?
This doesn’t mean paralysis. It means disciplined thinking before decisive action.
High-performing leaders create space for hypothesis testing, small pilots, and measurement.
They treat operational decisions more like clinical decisions — informed by evidence, not instinct alone.
In healthcare, where every change touches patients and staff, sometimes the most courageous move is to stand still long enough to think clearly.
Discussion & Reflection
When was the last time a “quick fix” created downstream work for another team? How could the idea have been vetted better?
What’s a decision you need to make soon? What does it look like to use evidence-based management in this situation?
⚙️ Operations: Micro-Discharge Planning and Early-Day Flow
Many hospitals face the same frustrating paradox: beds appear “available” on paper, yet emergency departments remain congested and elective cases are delayed.
The problem often isn’t capacity — it’s timing.
Discharges tend to cluster late in the afternoon, long after demand for beds has already peaked — a pattern widely documented in patient flow research.
Rather than launching sweeping throughput initiatives, many health systems have focused on a narrower, more controllable lever: discharge timing.
Both operational case studies and peer-reviewed research show that shifting even a portion of discharges earlier in the day can materially improve hospital flow.
The work doesn’t feel revolutionary, but it can save lives.
Practices commonly highlighted in the literature include:
Identify likely next-day discharges during afternoon rounds.
Complete discharge orders, prescriptions, and care coordination the day before discharge.
Prioritize early-morning workflows for case management and pharmacy.
Set unit-level expectations for early discharges rather than broad hospital mandates.
Peer-reviewed studies have linked higher “discharge before noon” rates with earlier admissions and reduced peak emergency department congestion — without adding beds or staff.
Sources & Further Reading on discharges: NEJM Catalyst (patient flow & care coordination) • Joint Commission Journal (discharge-before-noon initiatives) • PubMed (peer-reviewed discharge timing studies) • IHI (flow improvement toolkits)
While anyone in healthcare leadership should understand the basics of discharge planning, the broader lesson here isn’t about discharges. It’s about evidence based management.
Small changes, applied consistently and measured thoughtfully, often outperform sweeping transformations.
Discussion & Reflection
Think of a metric you are currently trying to improve. What process change — not resource increase — might most influence it?
Are the outcomes you’re pursuing supported by the right metrics, ownership, and timing — or are you measuring the right thing too late to act?
🚀 Career: One Crucial Skill to Succeed in Healthcare Leadership
What does it take to survive and thrive as a leader in healthcare?
I’ve heard many great (and true) answers to this question. The diversity of responses demonstrates the complexity of the work.
One of the best responses I’ve heard to this question was shared during the ACHE San Diego 2026 Annual Conference.
Brett Tande, Corporate Executive VP and CFO of Scripps Health, quoted what a CEO told him early in his healthcare leadership career:
Your success in this business will be directly correlated to your ability to withstand ambiguity.
Sure, healthcare executives and senior leaders are expected to maintain what’s already working. But this isn’t the challenging part of the job.
The real challenge is facing the complexity of the unknown. Leading your community through pandemics, deciding what service lines to open or close, identifying where to focus your time and resources — and recognizing that your career path will look different than the next person’s.
Change is the only consistent in healthcare, and being okay making decisions and leading based on your current knowledge isn’t just a nice to have in healthcare, it’s a necessity.
Discussion & Reflection
How do you handle ambiguity? What could you do to be better prepared to manage it?
What’s one part of your job that’s currently ambiguous? How could you bring a little more structure to that work?
If this issue sparked a new way of thinking, consider forwarding it to a colleague or mentor who’d enjoy it too.
Until next time, stay inspired!
Rob Erich, MBA, FACHE
P.S. We all know your importance is measured by the number of letters after your name… The longest single credential I’ve found is for graduates of the Royal College of Surgeons in Ireland, who get to place “MB BCh BAO, LRCPI, LRCSI” after their name. They must be really important! 😉