Most crises weren't sudden. They were visible for months beforehand. You just had to know where to look.
Randy Polito has learned that in healthcare, a small workflow problem compounds into a patient safety issue, and a patient safety issue becomes a regulatory nightmare. The organizations that navigate complexity best aren't reacting to crises—they're seeing them coming.
He's worked with healthcare systems scaling rapid change: new software, new workflows, new partnerships, new regulations. The difference between the ones that land smoothly and the ones that explode is rarely about intellect or resources. It's about anticipation.
Here's how to see what's coming:
Listen to frontline staff. They see friction first. A nurse manager notices the new system adds 15 minutes to discharge workflow. An addiction counselor realizes the digital engagement tool doesn't match how patients actually check in. A data coordinator sees three different systems tracking the same metric differently. These aren't complaints—these are early warnings. Most leadership dismisses them. Don't.
Question your own assumptions. Most healthcare leaders are smart and well-intentioned, operating on premises that felt true six months ago. If your assumption was "this software will reduce charting time by 30%," and the data shows it added time instead, believe the data. Adjust fast. The cost of being wrong compounds every day you wait.
Create psychological safety for bad news. Healthcare hierarchy makes this hard. But if your team can't tell you "this won't work" without fear, you won't see problems until they're disasters. The best leaders Randy Polito has worked with explicitly ask: "What am I not seeing? What are we getting wrong?"
Map dependencies. Every healthcare change touches other systems. New software affects workflows, which affects staffing, which affects patient experience, which affects outcomes, which affects reputation, which affects recruitment, which affects culture. If you only look at one link, you miss the reverberations.
Plan the unplanning. Most projects have a go-live plan. Few have a "if this assumption breaks, here's what we do instead" plan. The ones that do rarely need it because they're watching for failure signals and adjusting before crisis hits.
The organizations Randy Polito has seen pull off ambitious change—scaling recovery services across a state, launching new digital engagement platforms in complex health systems—they all did this. They didn't just implement. They saw around the corner.
— Randy Polito