Recently, I spent a day on the care management unit at a community health system — one of dozens of Gemba walks I run each year across Aidin’s partner hospitals nationwide. I wasn’t there to run a report or lead a training. I was there to watch.
Gemba walks with Aidin customers
In process-improvement circles, this is called a Gemba walk — going to the place where the work actually happens and observing it in real time. Some teams prefer to call it rounding, or simply “observe and coach.” Whatever the name, the idea is the same: I come to you, in your world, in the middle of your day. I’m not interrupting the workflow; I’m watching it unfold on live referrals, as it really happens.
I spent 16 years leading care management teams before joining Aidin, and I learned something dashboards never taught me. A dashboard can tell you what happened. A support queue can tell you what broke. A check-in call may get you a polite ‘it’s fine.’ None of them tell you what it’s actually like to do the work — which is why we’ve started doing gemba walks.
Things on the floor tell you the truth — the workaround someone invented, the old habit quietly creeping back, the post-acute provider who isn’t responding so the case manager just picks up the phone. You can only see those things, and help with them in the moment, when you’re standing there.
What one onsite visit taught me
One onsite hospital visit sticks with me, not because of the technology, but because of the leaders.
The director and manager didn’t treat my visit as a vendor stop. They gave me one-on-one time with every staff member and a seat in their staff meeting to reinforce what we’d been hearing. That kind of access signals something important: these leaders were personally invested in the change, and their teams could feel it. Engagement at the top had a visible downstream effect on the floor.
The staff told me so themselves. One social worker said the new system was “a lifesaver.” A case manager who had just returned from several weeks away — coming back to a workflow she’d barely touched — told me, “Even though it’s still new to me, I love it.”
That second comment is the one I keep coming back to. Coming back from leave to a brand-new system is usually a recipe for a rough week. What made her re-entry smooth wasn’t tribal knowledge or a seasoned colleague walking her through it. It was clarity: the workflow itself showed her where each transition stood, who owned the next step, and what needed to happen next. When the system carries that knowledge, no one has to write it down on a sticky note or hope the right person is at the desk.
What engaged leaders do differently
As we help health systems nationwide roll out an upgraded care transitions intelligence platform, the most engaged leaders start well before go-live. They work with their teams to get specific about what the future-state workflow looks like and also which old processes need to stop.
They learn the system themselves and work with it on real patients at go-live, so they see what’s working and what’s frustrating firsthand rather than hearing about it secondhand.
Standout leaders also stay close afterward: staff meetings, one-on-ones, and small recognition rituals. One team we work with gives out an award for great work in the new workflow. It’s simple, and it makes an impact because habits are sustained by reinforcement, not training decks.
The 80/20 rule applies here, too. About 80% of referrals follow a consistent workflow; the other 20% are the outliers for care teams — out-of-state placements, complex cases, situations no two days will repeat. Engaged leaders make the 80% automatic so their teams have the time and headspace for the 20% that truly needs their expertise.
If your go-live is 90 days out
Here are three things I’d put on your calendar today:
- Align on workflow first. Define the future state with your team and name what stops. Consistency and buy-in start here, not at training.
- Use your data early. Soon after go-live, sit down with your staff and the numbers to spot opportunities together.
- Do your own walking. Observe firsthand. Are people using workarounds? Reverting to old habits? You won’t find that in a report.
Why we keep showing up
A new platform launch isn’t the only time case management teams need support. Walking the floor builds trust, keeps us honest about how the work really happens, and lets us advocate for what frontline teams need, partnering closely with their leaders to support the entire organization.
Across over 200 hospitals, our team at Aidin has seen what clarity in care transitions makes possible — including an average length-of-stay reduction of 0.86 days in the first year. But those numbers start on the floor, with engaged leaders and teams who trust the process in front of them.
Technology doesn’t transform a care management team. Leaders do. By showing up, setting clear expectations, and walking the floor alongside the people doing the work.
About the author
Shara Ragan, LMSW, Client Executive at Aidin
Shara Ragan is a Client Executive at Aidin, partnering with hospital and health system leaders to strengthen discharge processes and post-acute placement, aligning clinical needs with the right providers. She spent 16 years at AdventHealth Kansas City, beginning as a floor social worker and rising to Director of Care Management, where she led a 40+ person team and helped launch the Post-Acute Care Collaborative and General Inpatient Hospice program. With over a decade of progressive leadership in care management, she has a proven track record of designing care coordination strategies that shorten length of stay, reduce readmissions, and improve patient transitions — all while keeping team morale high.
