Health Care: How to engage teams in change decisions
Health professionals are trained by their education and trained to minimize risk, so providing a full spectrum of information about the change effort — from implementation to outcome — is integral to a successful transition.
More than most professional fields, health care is subject to near-constant change, requiring its processes and systems to quickly pivot and shift to adapt. Having the ability to quickly realign processes to adjust to changes is not only critical for patient care but for controlling costs.
The paradox lies in implementing changes, as this is viewed as more difficult in health care than in other industries, Centura Health President and CEO Jeffrey Brickman noted in a 2016 Harvard Business Review article. “Clinical and administrative staff often view their work as a vocation as much as a profession, and they are historically suspicious of senior administrators and resistant to strategic agendas,” Brickman wrote.
The American Association of Physician Leadership echoes this in clearer terms: “When staff members view innovations and changes as clashing with patient-care values, they are less likely to adopt new practices.”
In consulting on change strategies in health care, Boost Midwest finds it helpful to first look into the “why” behind staff reluctance to engage in change. There are six major barriers to change in health care, according to the National Institute of Health:
Magnitude and complexity of the change.
Instability of facility leadership.
At the same time, six “facilitating strategies” were also reported:
Use of administrative authority.
Persistence and oversight on the part of the change “champion.”
Unfolding positive results.
Exploring these barriers and strategies leads to positive ways to engage teams in the implementation of change efforts.
For example, a local cancer clinic needed to adapt its entire processes for a new treatment, from patient intake to billing. To get buy-in from the team members involved, leadership first posed the following questions to its executive team:
Do team members understand why the change is needed? The benefits of the proposed change should be clear from the perspectives of patient care, best practices and cost analysis.
Is there a sense of urgency to change? Administration must agree that the proposed change fits a compelling need. If everyone does not feel the same sense of urgency about the change.
Does senior administration support the change? Support is needed from top administration down to the bedside caregiver for a successful change environment.
Who will take ownership of this initiative? “Successful change projects must have broader support than just one or two champions,” according to the Federal Agency for Healthcare Quality and Research. It recommends pulling people from physicians, specialty nurses, unit supervisors, nutritionists or staff who have a particular interest in the area of change.
What resources are needed? Depending on the size, scope and area of the change, different resources will be needed for successful implementation. Know what these resources are from the start, whether it’s additional staff meetings, leadership time for monitoring and reports, training and education or funding.
Leadership can then engage the organization or team(s) involved with the change effort. Here, Boost Midwest has found that communication is key, these three best practices to bring teams on board:
1. Listen and respond to team members’ concerns about the proposed change from the outset and then check in with them throughout the implementation process.
2. Use data to create a means to explore problems and to measure progress. Many people change ingrained assumptions when presented with cold, hard data.
3. Reward positive behaviors towards the change effort equally across team members regardless of their status.
Health professionals are trained by their education and training to minimize risk, so providing a full spectrum of information about the change effort — from implementation to outcome — is integral to a successful transition. Equally important is soliciting feedback from team members. Both will help positively engage health care teams in the change process.