Hey, welcome to the briefing. And what I'm going to cover with you today is this. Navigate obstacles rapidly in healthcare. A hospital can close before the need for the hospital disappears. And I want to start there because that sounds obvious until you actually have to lead through it. A healthcare facility can become unavailable. A clinic can close. A normal pharmacy route can break. A provider can become inaccessible. A communication channel can fail. A wildfire can force people out of an entire area. The route can disappear while the requirement behind that route remains completely intact. The patient still needs care. The medication requirement still exists. Follow-up and communication still have to happen. The work does not disappear simply because the place, person, system, or process that normally carries it is no longer available. That distinction is the entire point of this briefing. In early August, wildfires around Spokane, Washington created exactly that kind of operating problem. Based on what was publicly known through August 8th, large-scale evacuations were underway in the Spokane area. Associated press reporting placed the number of people ordered to evacuate at roughly 60,000, and patients were evacuated from the area's Veterans Affairs Hospital. The Spokane VA reported that patients from Mann Grand Staff VA Medical Center had been safely evacuated and were receiving care at local partner hospitals. Spokane area outpatient clinics and other VA operations were also temporarily closed. At the research cutoff, the VA's operating status information continued to list the Spokane VA Medical Center and several nearby operations as temporarily unavailable. Washington also announced federal approval of a public health emergency for communities affected by the wildfires. According to the state, that created additional flexibility intended to support health care access and critical services, including faster replacement of medications and medical supplies, reduced administrative barriers, and the use of alternative care settings. The state's insurance regulator also issued emergency measures intended to streamline prescription access for people affected by the fires. Those are the facts. Now there are things we do not know, and I want to be very clear about that because this is where people get themselves in trouble when they use a real event to teach a leadership lesson. The public information does not establish the complete patient load absorbed by receiving hospitals, the full capacity effect on those facilities, how every redirected patient experienced the transition or the final restoration timeline for every affected healthcare operation. So I am not going to fill those blanks in just because it would make the story cleaner. The operating pattern is already strong enough. A normal healthcare route became unavailable. The healthcare objective remained. Parts of that objective moved through other paths. That is enough for us to learn from. And uh I want to separate this from emergency management because I am not teaching wildfire response here. I am not teaching evacuation procedures. I am not teaching clinical decision making. I am not telling a healthcare organization how to handle a specific disaster. The wildfire is the proof environment. The operating problem is path dependency. Healthcare organizations are built around routes. A patient goes to a facility, a referral moves into a specialty department, an appointment goes on to a schedule, medication moves through a pharmacy, results, callbacks, questions, documentation, and care transitions each have an expected route. Those routes exist for good reasons. They create consistency, establish ownership, reduce ambiguity, and tell staff and patients where the work is supposed to go. The problem begins when the route becomes so familiar that leadership starts confusing it with the objective. That happens quietly. The clinic becomes patient access, the scheduling queue becomes the appointment, the pharmacy becomes medication access, the provider becomes the entire follow-up path, the physical building becomes the service, then the route becomes unavailable, and the organization reacts as if the objective itself has disappeared. No, let me make that more accurate. The route may have disad um may have become unavailable. The objective did not. Those are different conditions, and they require different thinking. The first instinct under pressure is usually restoration. Get the building reopened, get the clinic and workflow back, reestablish the normal pharmacy route, stabilize the provider schedule, get people back into the process. They already know. I understand that instinct. Actually, I respect that instinct when it is aimed correctly. Leaders should care about restoring stable operations. Established healthcare workflows exist because improvisation carries risk. You want accountability. You want documentation, you want known communication paths, you want people working inside approved processes, so the desire to restore the normal route is not the mistake. The mistake is allowing restoration to become the only strategy you can see, because restoration and continuity are related decisions. They are not always the same decision. If restoration takes longer than the objective can tolerate, leadership has another problem. What still has to move? That question matters, because some obstacles cannot be corrected by the healthcare organization where they sit. You cannot process map a wildfire out of an evacuation zone. You cannot coach a building back into safe operating status. You cannot hold a staff meeting and make a regional fire disappear. Somebody will still schedule one, and I know that sounds ridiculous. But think about how often leaders apply the same logic to smaller problems. They keep pushing at the blocked point because the blocked point is familiar. The clinic is unavailable, so every conversation becomes about the clinic. The provider is unavailable, so every conversation becomes about when that provider returns. The service path is broken, so leadership keeps staring at the blocked point. Pressure narrows attention. Whatever looks broken begins to feel like the whole problem. The actual objective may be sitting behind it. That is what I mean when I say the route is not the mission. The facility, workflow, provider, pharmacy, and communication channel all support the objective. Those things can matter enormously, but they are still supporting structures. Leadership has to understand what those structures are carrying. If you do not know that, you cannot tell the difference between a blocked route and a blocked objective. And those are not interchangeable. In Spokane, the facility became unavailable. The patient care requirement did not. Patients were moved to partner hospitals. Normal health care access was disrupted. The state created additional flexibility for alternative care settings. Normal medication access could also be disrupted, so emergency measures were used to support replacement medications and supplies. Notice the important part the wildfire did not disappear first. The normal facility did not have to reopen first. The healthcare objective moved while the obstacle remained active. That is the operating pattern. That is why obstacle redirection fits this situation so well. Obstacle redirection sits inside deepen, decision execution and problem navigation. At the recognition level, obstacle redirection is useful when an obstacle is actively interfering with the objective. The objective still needs to continue. And direct correction where the obstacle sits is not the best immediate move. I am intentionally staying at the recognition level. I am not going to walk you through the full method or decision sequence. What I want you to understand is the condition. The obstacle is real and active. It is interfering with the normal path. But the organi uh the organization may still have another control route available. That means the obstacle does not automatically get ownership of the objective. Now here is where people can take that idea and mishandle it. They hear, find another route. Fine. Move the work, move the appointments, shift the responsibility. Done. No. That is not what controlled redirection means. Redirection is not dumping work onto another team, moving pressure and pretending it disappeared, or creating a workaround and forgetting who owns it. It is not sending every displaced need into one alternate channel and acting surprised when that channel starts choking on the volume. The moment you move the path, you also move pressure. Pressure keeps excellent forwarding records. Think about an illustrative healthcare operations scenario. This is not a claim about what happened in Spokane. I am giving you a scenario based on the operating conditions, so we can inspect the leadership problem. You oversee healthcare operations across several locations. One location suddenly becomes unavailable. Appointments, staff, patients, medication questions, follow-up work, and documentation are all attached to that location or its normal workflows. The obvious response is to move what can move. Another clinic picks up appointments, another hospital receives patients, another team absorbs part of the workload, and another communication path becomes the temporary route. And that feels responsible because work is moving again. Movement feels good under pressure because it looks like leadership and creates visible progress. But movement is not automatically control. That is where leaders get fooled. Maybe the objective is moving, but the receiving location is carrying more demand. Documentation may be moving through a different sequence. Ownership may be split between teams. One team may think another team is handling follow-up. The alternate location may have different limits, and a 24-hour workaround may have no defined review point. Maybe the new path works beautifully. Maybe it does not. The point is that leadership cannot assume either one. You have to inspect it. Again, those are operating risks. I am not telling you they happened in Spokane. I am showing you what becomes possible any time the route changes. The weak response is not always failure to move. Sometimes the weak response is moving too casually. You solve the visible blockage and create an invisible one somewhere else. The original clinic is unavailable, and now the alternate clinic is overloaded. The original team could not carry the objective, and now three teams own different pieces without a complete picture. The original process had one clear owner. Now the workaround belongs to everybody. And when everybody owns something, um you need to start asking whether anybody actually owns it. Apparently, ownership was routed to voicemail. A workaround without ownership is just tomorrow's obstacle arriving early. That is why the better read starts before the move. What is actually blocked? I know that sounds like a simple question. It is not. There is a massive difference between saying the clinic is blocked and saying patient access is blocked. Those definitions create different decision space. If the clinic is blocked, the leader keeps staring at the clinic. When does it reopen? When can appointments resume? Those may be valid questions. But if the real objective is patient access, then the leadership read widens immediately. The clinic is one route to the objective. Now you can ask whether some parts of the objective have another route. Same thing with medication access. The pharmacy is unavailable and the patient has no medication access path are not the same statement. The provider is unavailable and the patient's follow-up requirement cannot be met, are not automatically the same statement. The portal is down and patient communication has stopped are not automatically the same statement. The words matter because the words define the problem you believe you are solving. And when your problem definition is weak, your options get weak right behind it. So the better question is not, how do I keep every normal healthcare route functioning no matter what? You move from path captivity into objective protection. And I use the word controlled for a reason. If you move the objective without controlling the new path, you have not necessarily solved anything. You may have just moved uncertainty. That is where consequence starts to spread. The first consequence of a blocked healthcare route is usually obvious. Access slows. Location is unavailable. Something cannot happen where it normally happens. The second order effects are harder. Patients may need new information. Staff may inherit work they did not carry yesterday. A receiving location may need visibility on demand that did not originate there. While leadership works, restoration and frontline staff work the alternate route. Now ask yourself, who can see the whole thing? Who knows where the work went, what remains unresolved, whether the new path is temporary, and what happens if that path stops carrying the load? Those questions matter because movement without coherence can look productive for a surprisingly long time. Everyone is busy and trying. Everything looks like it is moving, but nobody can clearly explain where the objective lives now. That is not control. That is activity. And does that make sense? You can have enormous activity and still have weak operating control. Healthcare leaders see versions of this constantly. Take a referral workflow. One specialty pathway normally receives a certain type of referral, and that pathway slows. If leadership defines the objective as getting the referral through that department, attention turns into more messages, escalation, status checks, and pressure. But what is the actual objective? Appropriate access, coordination, clear ownership, and reliable movement through an approved path. Now, that does not mean you just send the referral wherever you want. There may be clinical requirements, authorization requirements, policy requirements, capacity constraints, and other controls. Those still matter. Obstacle redirection is not permission to bypass healthcare controls. The point is that the route and the objective have to be distinguished before leadership decides what is actually possible. That is uh what I want you to hear in this tool. Obstacle redirection is not a clever workaround. It is disciplined recognition that the obstacle and the objective do not always have to remain connected in the same way. I have learned to respect this problem over time because people get incredibly loyal to familiar paths. And I do not mean that as criticism. Familiarity reduces cognitive load. The team knows where work goes, the leader knows who owns it, the patient knows what to expect, and the system is built around that route. When it works, that is a good thing. So when it breaks, the natural response is to fight hard to get it back. There's nothing wrong with that. The problem begins when restoration becomes the only form of success leadership can imagine. Then the obstacle controls you twice. First, it blocks the original route. Second, it blocks your ability to see any other route. That second failure is preventable. The route is not the mission. I keep coming back to that because it is the cleanest way I know to explain the distinction. The building can close, the objective does not. A pharmacy path can become unavailable and the medication requirement remains. A provider can become unavailable and the follow-up requirement may remain. Technology can fail while the communication requirement still exists. The obstacle does not have to disappear before the objective can move, but and this is important, you need a good enough read to know whether moving the objective is responsible. That is where CSA matters before deep in. CSA improves the read. What changed, what still works, what is actually unavailable, who is affected, what objective are we protecting, and what assumptions are pressure pushing us to make. That matters because redirection based on a bad read is just a different way to make a bad decision. If you misunderstand the obstacle, you may move work that never needed to move. If you misunderstand the objective, you may protect the wrong outcome. If you misunderstand capacity, you may redirect demand into a path that cannot carry it. If you misunderstand ownership, you may create the appearance of continuity while actual control falls apart. And so CSA gives Deep and better material. Then Deepen helps the leader determine what kind of response the problem requires. Not every blocked path should be redirected. Sometimes the problem should be stabilized, handled directly, or given to the right person with the right authority or technical capability. Sometimes the organization does not know enough yet. Obstacle redirection is not the universal answer to inconvenience. It fits one type of condition. The obstacle is active, the objective still matters, direct correction is not the strongest immediate move, and another controlled path may exist. Then after the path moves, TMC becomes important because communication and ownership have to move with it. If the patient or appointment moves, who knows and who owns it? If responsibility changes teams, who understands the handoff? If the workaround is temporary, what tells everyone when that condition ends? That is not administrative cleanup. That is part of operational control. A route change that people do not understand can create its own failure. TMC protects direction, ownership, communication method, task clarity, and follow-through once the decision begins moving into execution. Pace can matter too when leaders need primary, alternate, contingency, or emergency routes available as conditions change, but I do not want to turn this into a tour of the direct action system. The main idea is straightforward. Read first, understand what the obstacle is actually doing, determine whether the objective truly has to remain attached to the obstacle. And if the path changes, move ownership and visibility with it. That is the operating discipline. Because if you do not do that, you get something healthcare organizations know well. Everyone is working. Messages are moving, patients and appointments are being redirected, staff are improvising, the operation looks busy, but nobody can clearly explain who owns the objective now. That is motion, not control. A patient transferred, an appointment moved, another team accepted the work. Good. Now ask the harder question. Did control, ownership, and communication move with it? Does the unresolved obstacle still have an owner? That is what leadership has to inspect. Now bring this into your environment. You probably do not have a wildfire outside your office right now, but you almost certainly have at least one operating route that your organization depends on more than it realizes. Maybe it is one provider, referral channel, scheduling queue, portal workflow, service partner, or person who knows how to resolve a specific exception. And if one person's vacation can disable the process, that is not resilience. That is a hostage note with a calendar invite. I am not telling you to build a backup for everything before lunch. I am telling you to notice dependency because dependency has a nasty habit of becoming visible after failure. Good leaders try to see some of it before failure forces the lesson. So ask yourself this. What is the objective? Not the department, software, building, or person. What actual outcome are you responsible for protecting? Then ask what route normally carries that outcome. And then ask one more question. If that route became unavailable tomorrow, would the objective truly have to stop? Or would leadership need to find another controlled path? You do not have to solve the whole scenario. Just notice where your operation has quietly confused a route with an objective. That recognition can improve the next decision before pressure starts doing the thinking for you. There is another thing I want you to watch. Temporary workarounds. Healthcare operations live with temporary workarounds because reality does not stop every time something changes. Sometimes a workaround is exactly what protects the objective. There is nothing inherently wrong with that. The problem is when temporary stops, meaning temporary, and nobody notices. The workaround works, people learn it, pressure drops, the work moves, and everyone turns toward the next problem. A week later, two weeks later, three weeks later, the workaround has become the operating process. Nobody formally decided that. Nobody reviewed whether it was still appropriate or whether the alternate path was actually better. It just happened. By this point, the scene has already written itself. The temporary workaround has its own inbox, a recurring meeting, three color-coded trackers, and a laminated sign nobody remembers approving. The visual is ridiculous. The control failure is not. The workaround just promoted itself to permanent infrastructure without a decision. That is a control failure. The obstacle may be gone. The redirection may still be operating. Now the organization is running through a path that began as a temporary response, but no longer has a clear reason, owner, or returner. Point. That is how temporary decisions become permanent operating conditions by accident. So when I say the objective can move before the obstacle disappears, do not hear, move fast and forget the original issue. That is not what I mean. Obstacle redirection does not eliminate responsibility for the obstacle. If the original path needs restoration, somebody still owns it. If the alternate path is carrying new pressure, somebody needs visibility. If patients need new information or staff responsibilities changed, communication and handoffs still need ownership. If conditions change, the decision may need to change. That is why this is a leadership tool and not just a workaround. The objective is not movement at any cost. The objective is controlled continuation. That is what I want you to take from Spokane. Based on the public record, wildfires made normal healthcare routes unavailable. Patients were moved from the VA Medical Center to partner hospitals, other Spokane area VA operations temporarily closed, and Washington used emergency authorities intended to make alternate care settings, medication access, and supply replacement easier during the disruption. We do not know every downstream effect, capacity consequence, patient experience, or internal decision. We should not pretend we do, but we know enough to see the operating pattern. The wildfire remained. The healthcare requirement remained. The route changed. That is enough to study. And that is what makes this such a useful obstacle redirection example. Leaders often think there are two choices fix the obstacle or stop. Obstacle redirection introduces a third possibility. Change the obstacle's relationship to the objective. Do not pretend the obstacle is gone. Do not ignore the consequences it can still create. Do not dump the burden on another team and call it solved. But do not automatically stop the objective at the obstacle if another responsible path exists. That is a different way to read pressure. And you can apply that recognition to situations much smaller than a regional wildfire. A clinic, provider, cue, or referral route can become unavailable without automatically making the underlying objective unavailable. Those questions are not instructions to bypass controls. Clinical requirements, privacy, authorization, policy, and approved procedures still matter. The organization has to operate inside those boundaries. The leadership lesson comes before that. Do not confuse the process you normally use with the outcome you are responsible for protecting. That is the field level takeaway. Separate the route from the objective. When the normal path becomes unavailable, name the actual objective first. Then determine whether it truly has to wait. If another path becomes available, do not stop thinking just because movement resumed. Ask what pressure moved with it, whether ownership and communication moved to, whether the original obstacle still has an owner, and uh yeah, what would tell you that the route should change again? What would tell you that the original path can safely carry the object the objective again? You do not need the complete obstacle redirection process to start recognizing those conditions. You just need to stop allowing the normal route to define the entire problem. Because once the route becomes the mission and every disruption looks like total failure. It is not always total failure. Sometimes it is a path problem, and path problems are different. The building can close, the objective does not. The system or normal sequence can fail, and the objective can still remain. Leadership starts by identifying what still has to move. Then leadership protects that objective without pretending the obstacle disappeared. And so ah, this is what right looks like to me. Know what the route carries, know what actually stopped, know what still has to happen. Do not attack an obstacle where it sits just because that is the place you are used to working. Do not redirect blindly just because movement feels better than waiting. Move the objective only when another responsible path exists. Move ownership with it. Move the communication with it. Keep the unresolved obstacle visible. Then reassess the path as conditions change. That is operating discipline under pressure. That is why obstacle redirection belongs inside deepen. It gives leaders another way to think about active problems that are already interfering with progress, but do not necessarily need to be solved where they sit before the objective can continue. When you are ready to go deeper with this tool, go to www.direct action dash system.io slash course dash directory. Open the course directory, find the course tied to this tool and module, and start there. That is where the deeper application belongs. Thanks for listening to the briefing.