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Three Steps for Engaging Healthcare Providers in Organizational Change

As healthcare organizations feel pressure to cut costs, reduce medical errors and adopt standardized processes and innovations, providers must give up some established and comfortable ways of working. Many view changes as clashing with patient care values. The following are three key ways managers can engage providers and connect innovation efforts to core motivations, passions and values.

Learn why staff think changes do not align with the existing culture and mission.
One medical practice CEO listened as managers explained employees’ concerns regarding quality care versus financial pressures, and the replacement of familiar processes and techniques. The CEO first recommended that the managers listen to doctors and staff to understand the perceived misalignment between the changes and organizational values of the practice. The CEO then took steps, to reframe and strengthen the connection between innovations and the practice’s core values to eliminate the perception of misalignment.

Use data to engage and explain how to address the problem.

Data and metrics can create an awareness of problems, a means to explore them, and a goal post to measure progress. One hospital leader ordered the collection of observational data regarding staff hand hygiene to change existing norms and routines and drive more hand washing. The collated data became an agenda item during the weekly staff dialogue. This not only kept the problem in the forefront, but also engaged employees in diagnosing the barriers and factors outside their control that made change difficult to implement. This combination of data, staff engagement and appealing to the mission of good patient care increased the handwashing rate from 45 percent to 82 percent in one year.

Pay attention to the behaviors you reward and tolerate.

As part of the same hand-washing initiative, the hospital system introduced a campaign empowering staff members, including clinicians, to remind each other—on the spot and regardless of level or status—to wash their hands. The change would not stick if it were exempt from this feedback. An administrator reminded physicians reacting negatively to feedback that the mandate was everyone’s responsibility for patient health. During weekly huddle meetings, the CMO distributed gift cards as positive reinforcement to those who had reminded others of hand washing.

The status quo persists when unwanted behaviors at any level of the organization are tolerated. When leadership understands that ignoring one act of poor behavior can decimate the adoption of innovation, they may be more willing to hold difficult conversations with the highest-status employees in their organizations.

Seeking to understand staff perspectives, using data and holding all employees accountable will help providers understand how change can support, rather than contradict, the values they hold dear.

—Adapted from “3 Steps for Engaging Health Care Providers in Organizational Change,” by Joan F. Brett and Margaret M. Luciano, Harvard Business Review, Oct. 18, 2018.

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