The conventional wisdom
Service rationalization—defined as service closure or consolidation—can support growth, boost quality, and improve financial sustainability by directing resources to where they will be most valuable. But even when rationalization supports those goals, it may also disrupt care patient care, change provider practice, or lead to community distrust.
Because of those risks, system executives, site leaders, and board members all need to support or at least understand the need for closure. To achieve consensus, leaders usually pitch the need for service rationalization with analysis to back up the decision. We identified two missteps in that approach:
- Leading with the decision to rationalize, which stifles meaningful debate about alternatives and puts skeptical leaders on the defensive.
- Overwhelming with data, which diverts the discussion into defending the methodology rather than discussing the core insights that show the need for change.
The result is that leaders often miss opportunities to make decisions. This leads to tabled discussions that delay corrective actions necessary to improve quality and growth.