Navigating Business Change - Lessons from the Operating Room

Businesses today face an environment of nearly constant change, whether planned or unexpected. This mirrors the situations surgeons face in the operating room - the contrast between an elective surgery already carefully mapped out versus traumatic emergencies requiring quick thinking and iterations.

In an elective procedure like a knee replacement surgery, the surgeon has time to carefully examine the patient and perform and review imaging, optimize the patient's health, and prepare the necessary tools and devices. The team walks through the standardized steps together, executed as designed many times before. If the surgeon encounters an unexpected complication, they have capacity to pause and reevaluate the approach before proceeding. The prognosis following the procedure is relatively defined, with a typical recovery process to get the patient back on their feet.

Contrast this to the trauma surgeon, who must spring into action when a patient with life-threatening bleeding arrives at the emergency department. There is no time for preparation as the surgeon works to stop the immediate threat. Procedures are performed in quick succession to first stabilize, then address internal damage found along the way. The patient may return to the OR multiple times as complications arise. The road to recovery is unpredictable, written hour by hour, and ultimately dictated by the ABCDE paradigm of the Advanced Trauma Life Support (ATLS) system of trauma care - airway, breathing, circulation, disability, and exposure.

Businesses today often feel they are operating in the trauma surgery environment even for changes supposedly "elective" in nature. Hyper-competitive threats, rapid technology shifts, economic fluctuations, and other external forces conspire to disrupt the best laid plans. Iteration becomes essential, whether modifying a product, pivoting a strategy, or reconfiguring teams and organizations.

Leaders must adapt a situational view when managing change, tailoring their approach to match the circumstances. In planned change, they can methodically set the vision and march down a defined path toward execution in an almost linear and mathematical fashion. But with emergent change, they must provide clear guiding principles for the team while demonstrating agility. Like the trauma surgeon stabilizing a bleeding trauma patient, leaders must instill focus and trust amidst the uncertainty.

Like the trauma surgeon also, the business leader may follow the ABCDE paradigm when navigating complex and rapidly oscillating business environments.

A - Awareness (Situational)

The business leader should stay alert and attuned to external and internal signals that may require a change in course by monitor leading indicators constantly.

B - Balance

The business leader should maintain organizational balance between implementing immediate stabilization actions and adhering to long-term strategic priorities. Furthermore, the business leader should avoid extreme trade-offs if at all possible.

C - Communication

The business leader should communicate early and with transparency to all key stakeholders. They should strive to keep leadership aligned, motivate employees, and explain changes to customers.

D - Decisiveness

The business leader ought to make tough calls quickly when needed, even with imperfect and unverified information. Inaction can be the riskiest path. The leader should also concurrently empower teams to handle required iterations.

E - Exploration

The business leader and their team should explore options collaboratively, but should not get paralyzed by analysis (analysis paralysis). Once organizational damage control has been achieved, the organizational leaders should run controlled experiments to guide the next phase of the organizational change process in response to the trigger. This would involve continually expanding and adjusting the organizational context and perspectives.

Following this ABCDE paradigm, much like the trauma surgeon, organizations can hope to maintain a steady hand in times of change crisis, stabilizing operations while working towards recovery and the next normal. Awareness, balance, communication, decisiveness and exploration allow for disciplined progress.

By learning from extremes in the operating room, businesses can ready themselves both for change on their own terms and unexpected events beyond their control. The ability to toggle approaches can mean the difference between seizing opportunity and losing traction or organizational life. Both elective and trauma surgery have important roles—as do planned change and agility during uncertainty in business.