Getting Everyone on the Same Page: The 5 Principles of Successful Change in Your Healthcare Organization

Change is hard. No matter whether it occurs for positive or negative reasons, making the leap to something new does not come easy to the vast majority of us. In healthcare historically we know that change has been difficult. Many executives and physician leaders have put great effort into driving and managing quality, process improvement, or patient safety initiatives, only to see them resisted, lose steam under the stress of the daily grind of their practice, or not “stick”. Great frustration can come from the knowledge that the change is a good one based in clear data, that it has been successfully implemented elsewhere, or that colleagues and staff agree that the change is needed and will be beneficial. And still the initiative - innovation, process improvement, mandate, whatever you want to call it - fails. It begs the question, why?

To understand successful change in the healthcare world is to understand that “cookie-cutter” approaches to managing change don’t work well. Change in healthcare is a dynamic, moving target, both due to high volatility within the industry, as well as individual differences between groups and practices where there are high levels of autonomy. What works well in one system is not a “given” to work well elsewhere. Even within health systems things such as differences in governance, organizational structure, chosen processes and the collections of individuals who make up those systems, create a complexity that makes successful change more difficult.

What we do know however, is that even with the high degree of variability in healthcare, people’s responses to change in an organization, practice or team tend to follow a fairly typical pattern. The introduction of anything new is commonly met with a certain level of resistance and an initial drop in individual performance – what is often called in change management circles as the “valley of despair” during a transition. This valley has been seen across industries, sizes of groups, and differently structured organizations, and it can bring with it all kinds of difficulties – rumors and miscommunications, employee dissatisfaction, subtle “sabotage” of the new changes, in-fighting and/or blame between staff for errors, and a direct impact to an organization’s bottom-line. Depending on how you manage change with your group determines how deep your people will dip into the valley of despair and how long they will stay there.

Figure 1: Typical impact of change on productivity and morale

To combat this natural dip in the process of change, you must focus on those things which will:

1. help move your people from a place of resistance / challenge

2. facilitate their adjustment to the change you are implementing

3. ensure a successful change outcome that allows for continuous improvement within your group

In order to do this there are a number of key considerations that you must understand and implement. I call these considerations the “5 Principles of Successful Change in Healthcare Organizations”, and they are critical to the success of any endeavor.

Next time:

Principle #1: Understand the core characteristics of change in complex environments