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Eight Steps for Health Care Change Management Success
By Zaida Aronovsky

Change is happening faster than ever before in health care. Consider the recent rise of an array of digital transformations, such as artificial intelligence–enabled medical devices and blockchain EHRs. Or on the clinical side with the major shift from inpatient to outpatient care.

Despite the inherent operational, clinical, and financial benefits of such changes, many health care employees are resistant to them, for a variety of reasons. What’s behind employees’ hesitancy toward inevitable changes in health care? How can leaders help their employees understand and sustain such changes? By understanding the most common reasons people object to changes and proactively taking steps up front to address such resistance, health care leaders will more likely and consistently achieve change management success.

Common Change Objections
Fear of the unknown typically tops the list of reasons for change resistance; we are neurologically hardwired to resist unfamiliar things. Staying out of a spooky dark cave decreases our likelihood of encountering a slumbering bear or bat by nearly 100%!

Workplace changes—even the good kind—are fraught with unknowns. Providing employees with additional information and rationale about changes can decrease change anxiety.

Reasons for employees’ reluctance to change include the following:

• The change isn’t really necessary.
• The change is potentially going to make their jobs more difficult.
• The change is going to be difficult to personally implement.
• The change’s perceived risks appear to outweigh its benefits.
• The change process is being improperly handled.
• The change is destined to fail.

Employees’ change resistance is readily combatted through leaders’ proactive interventions and communications. Rather than allowing employees’ change anxieties to linger, grow, and affect others, health care leaders are better served building a workplace culture of trust, transparency, and engagement in which employees feel empowered to discuss the changes they’re asked to accept. Think of it as change management through employee collaboration.

Eight Steps for Change
There are eight principal steps to change management success. Steps one through three deal with creating a climate for change. Steps four through six are about engaging and enabling the organization. Steps seven and eight focus on implementing and sustaining the change. Here are the steps, in suggested sequential order:

1. Create a sense of urgency. Immediately address and answer up front the inevitable question: “Why change now?” An appealing way to get this information across is to share it in the form of a story, so that recipients can better understand the rationale and logic of the decision to change. The story typically includes three components: the problem to be addressed, the solution/change that will occur, and the likely outcome of this change. For example: “To reduce our facility’s unacceptably high infection rates and improve our patient health outcomes, we will be implementing new infection control protocols, including …”

2. Build a guiding coalition. Identify up front your “change champions” from among a diverse set of leaders, who will be accountable for implementing and sustaining the desired change. Establish a visible senior leadership team that makes a point of frequently communicating the necessity of the change and their expectations for others to adopt it. Considering that the No. 1 reason that change initiatives fail is a lack of engaged and visible leadership, this step will likely be the most important in your entire effort.

3. Get the vision right. Ensure that all key stakeholders have been consulted about and are in agreement regarding the desired change. Consider the value of getting input from stakeholders indirectly affiliated with the change; you may be surprised how much this “outside” perspective adds greater weight and validity to your desired change. After gaining alignment around the vision, share this success often with all involved.

4. Communicate for buy-in. Focus your communications more on the “why” than on the “what” for your change. Deliver a constant and consistent stream of communications across multiple channels, as you cannot presume that recipients will see or hear your messages from a single source—or understand the rationale for your change in a single sitting. Enlist a team of “change agents” to be responsible for helping get the word out to others.

5. Enable action. Identify up front any barriers to your desired change, remove or amend them, and build a sense of excitement with all stakeholders around the change. Get senior leaders to visibly and vocally support all barrier removals and change support efforts (as noted in step two). You want employees to understand how emphatically their leadership supports this change.

6. Create short-term wins. As work progresses toward achieving your desired change, be sure that people see and know about small wins along the way. The emphasis here should be on how this change is making peoples’ lives better—those of both employees and the people they serve. Celebrate these wins in whichever ways are culturally relevant, eg, through announcements or recognition events.

7. Don’t let up. This is a vital and often overlooked step, as sometimes people think a change is complete when in reality it’s only 80% there. You need to constantly demonstrate and show progress. Use your short-term wins as momentum to encourage employees to persist in implementing and achieving the desired change.

8. Make it stick. Despite the merits of your change, people can and will inevitably revert back to their “old ways” unless you repeatedly reinforce new behaviors and habits in the months following the change. This can be done through follow-up check-ins around your change and refresher trainings.

While you cannot control the world as it changes around you, you can control how you and others respond to it. It’s up to you to develop the right climate and take the sequential steps necessary to help your colleagues adopt your desired change.

— Zaida Aronovsky is a consultant with Freed Associates, a California-based health care management consulting firm.