SpreadLove In Organizations - Healthcare Leadership

There’s Got to Be a Better Way – Nelson Repenning

Feb 5, 2026
Nelson Repenning, MIT professor and system dynamics expert, explains why smart organizations get stuck in firefighting and short-term fixes. He explores the capability trap and dynamic work design. Topics include the five principles for lasting improvement, regulating flow and prioritizing work, small experiments over top-down rollouts, applying these ideas in healthcare, and practical steps leaders can take.
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INSIGHT

The Capability Trap Explains Firefighting

  • Organizations get trapped in constant firefighting because short-term fixes give immediate feedback while capability building does not.
  • This feedback asymmetry creates a "capability trap" that prevents strategic work and learning.
INSIGHT

Principles Over Copying Practices

  • Principles beat transplanted best practices because contexts differ and practices rarely transfer intact.
  • Learn the underlying principle, then adapt practices to your organization's unique culture.
ANECDOTE

Pull System Shortened ICU Stays

  • A cardiac surgeon used a tailored pull system to cut ICU stay by 0.7 days, saving money and improving patient outcomes.
  • The solution borrowed manufacturing ideas but was adapted to the hospital context.
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