All industries go through change. In healthcare, specifically perioperative services, there is a noted increasing age and severity of illness of surgical patients, a rising cost of surgical technology, shortages of key personnel and an overall increased demand for surgery.
To embrace changes needed, organizations must determine the priorities that are meaningful and realize that most employees are resistance to change.
- Competing priorities create change fatigue
- Systems, processes and incentives do not support change
- Employees are skeptical due to past change efforts
- Employees do not feel involved in the change process
- Employees do not understand reasons for change
Barriers to change occur for many reasons. Poor team spirit, uninteresting work, high turnover rates, insufficient goal setting and lack of responsibility to name a few.
Successful transformational leaders work to develop teamwork within their department and organization. By coaching and fostering teamwork, new ideas emerge. Employees feel empowered to make changes that will become hardwired and successful.
Some employees do not mean to not embrace change, but psychologically they know if they make certain changes, it will likely affect them personally. As an example, in the OR, why would clinical personnel work quicker or practice parallel processing when turning over a room? If they reduce the minutes to turnover a room, the reward likely will be to take another case. The reward of being successful in improving turnover time does not equate to reasonable logic. Another example in the OR is performing the Daily Huddle to assure patients are optimized for surgery. Many perioperative service departments do feel the time utilized to be proactive prior to the day of surgery is just a waste of time. If first case on time starts (FCOTS) are improved, the reward may be additional case volume at the end of the day in the eyes of OR personnel. The employee is likely not thinking about patient and/or surgeon satisfaction scores or probably not thinking about the added revenue per case performed.
Effective leadership deals with change behavior by identifying the reason employees are skeptical. “We’ve always done it this way” is a classic comment made by many staff members within the operating room suite. “If it’s not broke, don’t fix it” is another familiar comment made by those that think everything is working without issue. What they don’t realize, is it can usually work so much better. Developing key individuals that can champion change is key to moving others forward. Ask the employees what they think is working and what they are having challenges with in their daily routine. List the pros and cons of changing a process, suggest a “pilot” to try something new and then evaluate the result. Individuals that are skeptical will witness the changes and be empowered to offer their opinion.
Change transformation in an OR starts with governance. It takes key stakeholders to be involved including surgeons, anesthesiologists, nurses and administrators. Collaboration is needed to move the OR teams forward. Skepticism by individuals must be acknowledged and monitored to change behavior. Some members of an OR team may take longer than others to board the train while others embrace change and take the opportunity to the next level. Although rapid change may be necessary to make everyone aware, most change transformation involves time and acceptance to hardwire so that the impact is sustainable.
Change is a journey, not a destination. An organization needs to develop a guiding creed such as:
- Exhibit consistency
- Communicate regularly and clearly
- Put measurable systems in place
- Ensure ownership and accountability
- Do not avoid the tough discussions
- Make sure employees feel valued & understand mistakes happen
For more great information on organizational values, visit Trust: The Foundation of any Successful Venture
