Change happening in your workplace?
Want to feel like you have change management covered?
Want your team to succeed with change?
This post was originally published on August 12 2019. It is being republished as a 2019 popular post, over the holiday season.
One of the common topics I get asked to train and present on for healthcare workers is change. In 10 years of running a training business, I’d say about half of the work I do is on change – helping healthcare organisations plan for, and implement change. And I’m often asked in when they have tried to introduce change and it’s not exactly worked.
In the last few years, a number of our clients and training attendees have been implementing the Patient Centred Medical Home (PCMH) concepts in their practices. This has brought about change for the business strategy, staff operations and patient experience. So there have been huge impacts to consider. With this as an example, I see change resistance being the major hurdle practices have to overcome – with their staff, their patients, suppliers, and sometimes even with their own mindsets!
If you are interested in where change resistance comes from initially (and it’s important to understand, so you can effectively deal with it), we have:
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- Our Members Community with more in depth training on healthcare change.
Leading change is one of the biggest challenges in healthcare today.
Leading change in healthcare is challenging, one of the biggest challenges facing healthcare leaders today. And it’s relentless – whether through government policy, technology, medico-legal issues or business development needs, it seems to be a constant part of our healthcare management lives.
If it’s so prevalent and relentless, then to succeed as healthcare managers, it’s critical to be developing our change leadership skills.
How to deal with change resistance?
So let’s take a look at overcoming change resistance. This is when we find that the team are not complying or implementing what we’ve told them to do to get the change underway. It seems so obvious to us – so important – and yet they linger, they hesitate, and sometimes blatantly refuse to do as we ask.
Below are 5 areas we can start to improve for better change leadership.
Five change management and leadership strategies for healthcare
- Start right, plan right
- Get the team onboard EARLY
- Communicate, Coach, Communicate (and repeat)
- Create a safe environment
- Actively use milestones and measures
- Start right, plan right
Planning is important. It’s like having a disease management plan, a treatment protocol, or a business plan. It makes the pathway clearer, assigns responsibilities, and predicts challenges. It guides us.
There are lots of templates, resources, and models to help you plan change. At engageyourhealthcareleadership.com, we use the Change Quadrant as a starting guide, and build our plans around that. Key things we want to be planning are:
- Vision for success. What does it look like when we have implemented the change? What are the end benefits or outcomes? Even if the change has been brought on by a higher power, we still need this or we will fail.
- Pathway to success. How we are going to achieve our vision? What are the steps involved, the resources needed, the staff training required? What’s our communication plan? What are our timeframes? What roles and responsibilities are involved? What’s our feedback loop?
- Assess ourselves and plan accordingly. I always recommend teams do a SWOT analysis before major change. A SWOT analysis is looking at your Strengths, Weaknesses, Opportunities and Threats. Strengths and Weaknesses tend to be internal and current. Opportunities and Threats tend to be external forces and usually are future related. Once you’ve done the analysis, you must discuss how you will leverage strengths, minimise weaknesses, capitalise on opportunities and eliminate threats. What actions will you take? This will also help inform your Pathway to success.
- Get the team onboard EARLY
Often with change, the managers discuss it for a while, mull it over, hopefully plan and then bam, hit the team with it. It’s all sorted, ready to go. Now implement! Well, this rarely works. Especially if we’ve had a lot of time to plan or think about the change as managers, we sometimes assume that because we understand it, and have a great strategy, that the team will instantly ‘get it’ and get on board. People as a whole are geared to resist change. It takes time to process the change and it’s not going to happen just because we say so. And it certainly won’t happen by just telling people what to do, and telling them once.
We need to allow people time to process information. And, as much as we can we need to INVOLVE, not dictate.
Real change is influence, not force.
We influence by connecting, communicating, coaching, involving.
- Pre-empt that change is coming. (if appropriate). Try not to get people worried – be calm, paint a positive picture, assure them that they will be involved along the way, encourage them to come to you if they have questions.
- Ask for the team’s input as much as you can. Once people start to input ideas, they feel like they have a say in what’s going on, that they have some choice, and that they are in some way taking ownership. People need to start to OWN the change. They start to own it when they start to talk about it – in a solutions focused way. Encourage input – “What do you think we need to keep in mind as we plan for this?” “Who needs to be involved in our planning team?” “What challenges do you think we need to cater for?” If you can’t include all their ideas, that’s fine, explain that from the start. (Check out our podcast for more information on how to do this).
- Have regular team meetings and ask for their thoughts, ask how they are feeling. Discuss progress – celebrate success, plan for challenges and identify solutions where issues occur.
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- Communicate, coach, communicate (and repeat!)
We cannot understate the role communication will play in the success or failure of your change initiatives.
If people are fearful of change, or overwhelmed at work, they won’t hear about all of what you explain about the change. There is interference – from their own thoughts “I hate change” “Change is bad”, “Management are stupid.”, “I don’t have time for this.” Also interference from the way you deliver the message and how they like to receive information (written, verbal, visual, demonstration).
- Have a communications plan. What will we communicate, when, to whom, and through which method? When will we repeat it and how?
- Make your messages clear and concise. Balance your need to give lots of information, with their ability to process. Often, less is more.
- Deliver messages through varied mediums, and try to include visuals. Mediums include presentation, workshop, posters, meetings, videos…
- Repeat your messages.
The other part to this is coaching.
For change to work in healthcare, you MUST be coaching.
At the core of successful coaching are great questions. So get curious! “What do you think we should do?” What is the first step you will take here?” How do you think we can address this issue?” “Who do we need to get involved in this?” “What are the issues from a patient’s perspective?” “What haven’t we covered?” “How do you feel this change is progressing?” And so on. Please coach.
- Create a safe environment.
Change often induces fear – whether people consciously recognise this or not. It feels uncertain, so it feels unsafe. Safety in healthcare is a normal thing to discuss. Yet we often don’t think about it for our team’s emotional safety. We often don’t realise that we in so many ways can make them feel unsafe – by talking harshly, by not sharing important information, by not thanking them for a job well done, by not assuring them we are in this change together, by telling them what to do without giving them some choice.
- Encourage an environment that is open and honest.
- Show empathy for how people might be feeling.
- Support without judgement.
- Celebrate progress, even before you see results.
- Actively use milestones and measures
We need to have milestones and measures planned from the start. Milestones are the key points during the change process (remember most changes take time). So it’s the steps needed or the critical timeframes that must be achieved. So it might be that we have to inform patients as one big step, we might have to write a policy, we might have to train staff.
- Map milestones out from the start, communicate what they are to your team and provide timeframes.
- Identify how you will measure success, the targets required and consequences of not achieving results.
- Measure the things that are important for change success, not trivial things.
- Track and communicate regularly, even f things aren’t going well! Involve the team in finding solutions to challenges.
These 5 change strategies for healthcare won’t solve every issue you have, yet they are a good starting point in supporting the team. Remember, you need your team to get on board and your role as manager and leader is to help them do so.
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