The New Year's Resolution for Innovation: Rituals as the 2026 Compass
- Dr Gillie Gabay
- 2 days ago
- 5 min read
As we step into 2026, most health systems find themselves in a familiar cycle of drafting ambitious strategic resolutions, usually setting aggressive targets such as digital health integration, cost reduction, or excellent patient satisfaction scores. However, data suggests that while 85% of healthcare executives believe innovation is a top priority, only 20% report that their organization is successful at innovation. The disconnect lies in a fundamental misunderstanding of organizational dynamics.
In healthcare, strategy is often treated as a set of static goals, while culture is the dynamic set of habits that determine whether those goals are ever met. When strategic goals clash with a deeply ingrained cultural habit (e.g., risk-aversion, extreme hierarchy), the habit wins every single time. Psychologically, the New Year provides a temporal landmark allowing leadership to leave behind their negative experiences from 2025 and its hurdles and think creatively. In this last paper of 2025, I will stress rituals for values-led innovation. My most important message for leaders is to move from typical New Year's resolutions to practical rituals. Why?
For a health system to become innovative, it must stop trying to innovate and start being an organization that encourages curiosity, safety, and agility. A resolution is a statement of intent. But traditional New Year's resolutions in an organizational context typically fail. When management asks providers to be more innovative, on top of their 12-hour shifts, it creates resentment, not innovations. Also, innovation requires mental energy, and currently, providers have no bandwidth to think creatively. In addition, a lack of psychological safety, the #1 predictor of clinical errors, impedes innovations. Last, if an executive's resolution is "innovation," but the incentive for middle managers is tied to productivity at all costs, providers and frontline employees will choose productivity to survive.
In contrast to resolutions, rituals form an identity while enhancing retention and reducing burnout. Rituals are comprised of repeated, predictable behaviors that signal what an organization truly values. Since in clinical settings a ritual like the surgical timeout has successfully transformed safety, it is possible to apply rituals to innovation, replacing the failing New Year's resolution. Before adopting rituals for implementing innovation, the organization must be aligned with the values that the rituals are meant to protect.
Innovative behavior is driven by primary values of psychological safety and learning. Psychological safety exists when an error or speaking differently than the hegemonic norm is not punished. The value of safety must extend beyond the physical safety of the patient to the intellectual safety of providers and staff. In an innovative health system, the most dangerous phenomenon occurs when one feels unsafe, sees a flaw, and stays silent. If leadership hosts a "Failure Forum" once a quarter, where successful executives share a story of an innovative project that failed, and discuss new learning from the failure, it will create a safe learning environment. Innovation may be blocked by the lack of listening to providers, who experience the organization day in and day out. Providers may have better ideas for changes and innovations to improve the patient's journey or efficiency than consultants and board members. While a lack of listening to providers and staff may result in foregoing important learning opportunities, listening promotes agility.
For agility, leadership should move from the "What" to the "How." While most departments will be setting "What" goals (e.g., "Reduce readmission by 5%"), a value-driven reset focuses on the "How" (e.g., "We will dedicate the first 5 minutes of every Monday huddle to a 'safety' story). To promote innovative behaviors, leadership should adopt five core rituals that translate values into daily clinical and administrative practice.
First, cope with over-regulation that may drain the cognitive energy required for innovation. One way of coping is to ask each department to identify and retire one redundant administrative task or reporting requirement. The leadership can empower department heads to eliminate one process that no longer serves patient safety or efficiency. Second, to voice providers, leaders can initiate a preemptive innovation by incorporating a 2-minute Innovation Moment into daily shift changes. The leadership can also shift from "Provider of the Month" to "Problem Finder of the Quarter," rewarding those who identified a systemic friction point and proposed a value-aligned solution. In addition, the leadership can ask all employees to come up with one thing that they do in their role simply because that's how they have always done it, and instead ask for suggestions on how to execute it more efficiently.
Third, to enhance experimentation and emphasize that innovation is not a binary process (success or failure), leading to risk aversion, leadership will present innovation as based on quarterly pitch days, where employees present small-scale pilots for innovations in work methods. If a pilot fails to show value in 30 days, it is celebrated for the data it provided and then retired. Fourth, leadership can measure how many innovative ideas are submitted to an innovation think tank or innovation council. Fifth, since we only manage what we measure, leaders may add managerial KPIs for innovation, for example, how many activities are conducted to encourage employees to suggest process improvements. To prevent middle managers from becoming bottlenecks, they will be the custodians of the modified culture. These rituals can be metrics for cultural shifts. For these rituals to take root, the leadership must pivot from monitoring results to modeling vulnerability. When a high-level strategic initiative fails, leaders should host a learning Hyde Park event discussing the data gathered and the pivot required. This will signal that the organization values the efforts that they invested in the process. Health systems have a natural "immune system" designed to protect the status quo. Therefore, to ensure these rituals take root, leadership must address two processes: incentives and performance appraisal. Traditionally, health systems reward zero errors. While logical for safety, this creates a culture of zero risk that inhibits innovation.
Figure 1 presents the rituals replacing resolutions, and Figure 2 presents the 2026 Compass of Three Questions.
To conclude, in 2026, leadership must adjust performance appraisals to reward proactive problem identification. If a provider identifies a systemic flaw and proposes a solution, that should be weighted as heavily as clinical productivity. The challenges of 2026, staffing shortages, inflationary pressures, and the rapid evolution of artificial intelligence, cannot be solved with the mindset of 2020. Health leadership must move beyond the "Resolution" of being an innovative system and commit to the "Rituals" that make it innovative. By grounding the innovation strategy in values and protecting those values through consistent rituals, the leadership will both improve the bottom line and restore the sense of agency and purpose to providers and staff. As we enter 2026, let us provide employees with the cultural infrastructure to achieve desired results. By embedding Innovation rituals into the workflow, leadership will transform the healthcare system and move from a culture of compliance to a culture of curiosity and excellence.
Additional Reading
Bier R. THE POWER OF RITUALS IN BUILDING A HIGH‐PERFORMANCE, SCALABLE ORGANIZATION. Leader to Leader. 2025 Jan;2025(115):71-6.
Spagnoletti P, Kazemargi N, Prencipe A. Agile practices and organizational agility in software ecosystems. IEEE Transactions on Engineering Management. 2021 Sep 24;69(6):3604-17.
Vaszkun B, Sziráki É. Unlocking the key dimensions of organizational agility: A systematic literature review on leadership, structural, and cultural antecedents. Society and Economy. 2023 Nov 7;45(4):393-410.
