How to Create Meaningful Transformational Change in Your Organization
By Bob Gleason-Moore, RN, MN
Having worked in hospitals for many years, it has become obvious to me that making real transformational change is extremely difficult. Hospitals are large, complex organizations consisting of hundreds of departments utilizing thousands of processes and procedures to get their work done each day. It’s no wonder that making real, meaningful change is a challenge. Some leaders think of the work and time to make change in a hospital similar to “turning a battleship”…. a slow and lumbering effort.
I think most if not all, hospital leaders would agree that the way hospitals render care and do business needs to be changed and improved upon to remain viable in today’s healthcare service delivery market.
In a recent discussion with a leader of care management for a regional health system, she said they had a very traditional approach to care management. She believed they had tools in place to cause change to their bottom line, length of stay, and case mix index, yet year over year they had not seen these performance measures change. She said, “We cannot do the same thing over and over again and expect different results”. Some say this is the definition of insanity. For her, making a significant change in structure and process in her organization was necessary.
Making real, sustainable change that causes measurable improvement is not easy, and most hospitals are not equipped to undertake large change initiatives by themselves. There is a field of change management, which is the expert word on making change. I've outlined Prosci’s Seven Concepts of Change and how they can impact change management in healthcare.
Senders and Receivers
A leader (sender) explaining change and the need for change is often not “received” accurately by the receivers who are being expected to change.
Resistance
When people hear that change is coming, they have fear, anxiety, and the concern that long-standing routines are being disrupted.
Authority for Change
Having a senior leader assigned as a sponsor for a change effort does not guarantee the organization will support the change; having the right sponsor with the right authority is crucial for effective change.
Value Systems
The underlying values of the hospital/health system directly influence the way change will be perceived and how much work will ultimately be required to ensure successful outcomes during a change.
Incremental vs. Radical Change
The right approach and amount of change management required by a given project or initiative is unique and specific to that change and the approach must be adjusted based on how the change uniquely affects each group of impacted employees.
The Right Answer is Not Enough
Just providing the solution in the organization is not enough to cause improved operations and achieve results. The solution without effective change management will not address these necessary elements: must create buy-in, create commitment, mitigate resistance, eliminate fear, and ensure compliance.
Change is a Process
Organizational change does not happen instantaneously just because there was an announcement, kickoff meeting, or even go-live date. Real change occurs when we move in time to a new way of behaving and doing our job.
Moving the traditionally-based care management team we discussed earlier to a new way of thinking and a new approach to daily work and communications takes the inclusion of these concepts to assure success; success of each employee as they leverage their professional experience in the context of the newly change system/process, as well as the support of the organization to sustain these improved measures.
In my experience at Care Logistics, the change we cause in an organization is often significant and leads to improved measurable operational performance. I have personally experienced how we incorporate these change management concepts to lead the organization to a successful and sustainable change.