Turn and Face the Strange, Changes

by Barry P Chaiken, MD

(Download a PDF of this article)

Implementing change in a healthcare setting is a complex endeavor, with the challenges varying significantly between staff who provide direct patient care and those who do not. For those providing direct patient care, changes in processes and workflows can directly impact patients, raising the stakes of the change. Any change can lead to increased resistance, especially if staff believe the change could negatively affect patient care. Conversely, staff not working directly with patients might focus more on how the change impacts their roles or the organization.

The Challenge of Change

Changing processes and workflows in a healthcare provider organization can be challenging due to various potential obstacles.

Clinicians often face significant time constraints due to high patient loads and demanding schedules, making adjusting to new processes difficult. Staff not directly involved in patient care may have more flexibility to adapt to changes. 

Emotional factors also play a role, with healthcare providers often having strong emotional connections to their work and patients. Changes perceived to interfere with the patient-provider relationship or the quality of care will meet strong resistance. Staff not directly involved with patients might focus more on practical considerations, such as how the change affects their workload or job responsibilities.

Regulatory and compliance considerations are another factor. Changes involving direct patient care often have to comply with strict regulations and standards to ensure patient safety and privacy, which can slow down and complicate the implementation of change. For staff not working directly with patients, these considerations may be less of a concern, allowing for more flexibility and speed in implementing change.

Changing processes and workflows impacting patient care requires coordination among teams of professionals from different disciplines across different roles. This need for interdisciplinary collaboration may be less pronounced for staff who do not work directly with patients.

Obstacles to Change

Changing processes and workflows in a healthcare provider organization can indeed be a challenging task due to a variety of potential obstacles. People often feel comfortable with their current ways of working and may resist changes, especially if they don’t understand the reasons for the change or perceive it as threatening their job security or status.

Adequate training is required to effect change. If staff members are not properly trained on the new processes and workflows, they may be unable to adapt to the changes, leading to errors, inefficiencies, and frustration. 

Poor communication can also pose a challenge. Suppose the reasons for the changes are not clearly communicated. In that case, staff may need help understanding the need for the change or how it will benefit them or the organization, leading to resistance or lack of engagement with the new processes.

Healthcare staff often work under high pressure and tight schedules, and implementing new processes and workflows can be seen as an additional burden, especially if it’s perceived to increase workload or decrease efficiency. This can also lead to resistance. 

Changes often require added resources, such as new software or equipment, additional staff, or an increased budget. If these resources are unavailable, it can hinder the implementation of new processes and workflows.

The organization’s culture can also significantly affect how change is received. If the culture does not support change or innovation, staff may be less likely to embrace new ways of working. Similarly, leaders need to support the changes or model the new behaviors so that staff may be more likely to adopt the new processes and workflows.

Steps to Foster Change

Effecting change in a healthcare organization, especially among clinical staff, requires careful planning, communication, and follow-through. Here are some best practices a healthcare manager should follow:

  1. Clear Communication: Communicate the reasons for the change, its benefits, and how it will be implemented. Inform everyone early and often, using multiple channels of communication.
  2. Involve staff in the Process: Involve clinical staff in the planning and implementation process. This increases buy-in, reduces resistance, and provides valuable insights to improve the change process.
  3. Provide Adequate Training and Support: Ensure staff have the training and resources needed to adapt to the new processes or workflows. This includes formal training sessions, written guidelines, or one-on-one support.
  4. Lead by Example: Leaders should model the new behaviors and attitudes they want to see in their staff. This behavior reinforces the change and shows that it is supported at the highest levels of the organization.
  5. Address Concerns and Objections: Be open to feedback and ready to address concerns or objections. This helps to alleviate fears, clears up misunderstandings, and builds trust.
  6. Monitor and Adjust: After implementing change, monitor its impact and be ready to make adjustments as needed. This helps ensure that the change is effective and minimizes any negative consequences.
  7. Celebrate Successes: Recognize and celebrate successes along the way. This builds momentum, reinforces the change, and boosts morale.
  8. Patient-Centered Approach: Always keep the focus on improving patient care. This keeps everyone motivated and aligned with the organization’s mission.

Remember, change is a process, not an event. It takes time for people to adjust to new ways of doing things, and there may be setbacks along the way. Patience, persistence, and a positive attitude can go a long way in effecting successful change. 

Author Note: I wrote this article using ChatGPT (4.0). By requesting several “regenerations” of the responses, I constructed a more in-formative article from pieces of each version. This is the finished document.

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