Don’t pick the outcome, pick the outcomes framework

When an organization picks a specific outcome, it will do whatever it needs to get that outcome.

In the world according to Simon Sinek, this is a finite mindset. 

A finite mindset can ruin a business. In healthcare — and especially addiction care — it can destroy lives.

Addiction treatment would be better if it adopted an infinite mindset. 

An infinite mindset is one that is fixated on bettering itself, not beating or competing with others.

An infinite mindset “understands that the goals and the metrics are waypoints, they help us understand speed and distance, but they are not the purpose of the game.” 

Outcomes. Outcomes. Outcomes. 

This is the conversation in addiction, recovery, and behavioral healthcare right now. 

“We need outcomes.”

“What are your outcomes?”

“We’ll get nowhere until we have standardized outcomes.”

Of course, outcomes are critical if the field wants to move from getting paid to do tasks to getting for for achieving results (i.e., value-based care). 

We need clinical measures. We need process measures. But we also need social measures. 

We need them all. Not, one over the other. All of them working together and (hopefully) harmoniously. 

You can start to see how this becomes an outcomes framework. It’s an encompassing approach to success. Sure, within each of those three buckets — clinical, process, social — there are specific metrics, but hitting specific targets isn’t the game. Those targets are arbitrary anyway — they’re just made up.

That doesn’t make the targets invaluable. Our brains are wired for certainty.

Here’s what doesn’t work … 

You choose sobriety for the rest of your life. Whoa. On the surface, that’s infinite thinking and very good. But how does that even happen, especially if you’ve been mired in addiction for a decade? 

Instead, you set aside the lifetime goal and make the task more doable. You choose to be sober for the next 30 days. Great, now you can look at a calendar, go day by day toward that goal. 

What happens if you drink on day 29 and you miss your goal?

NOTHING. 

Nothing happens. You simply fell 1 day short of your arbitrary prediction. But, for those 28 days before, you started training yourself to do all the things necessary to get to where you got. And you don’t stop doing those things, you just keep going. 

[see Sinek, “There’s No WINNING in an Infinite Game”]

Same with process or clinical measures in a treatment program. Your clinical measures may be targets for risk or symptoms. Your processes measures may be admission conversions, discharges, or readmits. All fine, but the game isn’t to just reach those targets and say you won. 

You refine and adjust and repeat the cycle. 

You repeat the cycle to better yourself.

This is why we like recovery capital as a social measure. It leans into an infinite mindset. 

It is inherently an outcomes framework, not a specific outcome. It can be quantified, which means you can set specific targets within specific areas of the measure.

But that’s not the focus. 

The focus is to use the measure to build the muscles for a good, well-rounded, and thriving life. 

You have to have meaningful work with your basic needs met, strong family and social relationships, a commitment of values, and a sense that you are part of something bigger than yourself.

All of these things are not going to be perfect all the time. They go up and down because that’s life. But what we want is a trend toward growth. 

Same goes for addiction, recovery, and behavioral healthcare businesses. 

If you have to be good across the board. You need competent providers, good marketing, quality facilities, sound leadership, solid discharge process. 

Your competition is you. 

You want to be a quality provider. And as a purpose-driven organization, you must take on an outcomes framework with a quality lifestyle.

This infinite mindset permeates everything and everyone in your organization — including your clients or patients. 

You and your clients will focus on the trend data. 

“Progress not perfection” becomes part of your DNA.  

This will improve your business, change the lives of those you serve, and transform the communities your work in.