There may be no industry undergoing more significant and rapid change than healthcare. Transformational changes abound, whether it is in healthcare delivery (clinical redesign and transformation) or on the support side with changes created by electronic medical records or ICD 10.
Historically, healthcare organizations are culturally risk-averse. While there is good reason why this cultural pattern exists, it does get in the way of transformational change. It's important to recognize this cultural pattern, and its implications, and to put strategies and tactics in place that will support the implementation of desired changes (technology, process, and people-related.)
In our change management consulting work, we have identified 5 specific organizational capabilities to leading healthcare transformational changes:
1. Align on the change and define it in terms of human behaviors. Organizational leaders must define the desired future state in terms of new behaviors, and achieve consensus on those behaviors so that physicians, nurses, administrators, and supporting staff can understand and follow through on behaviors that will change the status quo.
2. Turn individual stakeholders into active Sponsors. Key individuals with strong organizational influence must communicate the new expectations, demonstrate their personal commitment to the changes, and reinforce the new behaviors with their direct reports. This demonstrated commitment must be visible and durable at all points in time in order for the new behaviors to be adopted on a sustained basis.
3. Develop a Change Agent network across all the areas of the organization that are impacted by the change. A critical mass of experts, working in concert with Sponsors, must drive the implementation of new processes, policies and behaviors locally within multiple functional and geographic locations of the organization. You need to have Change Agents in every area that is impacted by the change, and the selected individuals must have trust and credibility with both the Sponsors and with the Targets.
4. Develop rewards and recognition that will be meaningful to those impacted by the change. No change in behaviors will be sustained for the long-term unless leaders recognize and reinforce performance (or non-performance) with their direct reports. Motivation for changed behaviors must be identified and applied.
5. Manage the resistance. Resistance to change is inevitable, and left unchecked will slow down or even prevent the change. Resistance must be pro-actively managed through Sponsorship, effective communication tactics, and use of involvement strategies.
Note that there are some unique challenges in healthcare. The key stakeholders for many changes, particularly those in clinical delivery, are physicians. These individuals invested significant time and money obtaining the knowledge and credentials to practice medicine, rather than lead and drive a market-oriented organizational mission. However, in our current system of healthcare delivery one can't exist without the other.
These physicians (and also nurses) are indispensable Sponsors, and specific strategies must be put in place to ensure they have the skills, knowledge, and motivation to fulfill the role. In our change management consulting, for example, we have found that the most successful Change Agents for supporting physicians are other physicians.
There is little doubt that the old models for healthcare delivery can no longer deliver high quality outcomes while managing consumer satisfaction and profitability. Healthcare organizations must become more proficient and effective in leading and managing change.
Additionally, successful healthcare organizations will need a structured and repeatable process like the Accelerating Implementation Methodology (AIM) to ensure that all impacted areas attend to the ongoing risks.