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Leading your team through change

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Leading your team through change in a time of increasing demands and diminishing resources

 

Being a healthcare leader today poses many challenges with competing priorities. It can be easy to fall into a routine that consists of constant reaction to one urgent need after the other, never focusing on true process improvement. Too often, this leads to stagnant outcomes and complacent staff, where everyone is working as hard as possible but never making true progress. In the demanding environment of healthcare, how can leaders motivate a team to plan, support, and implement change to reach goals, especially goals they may have had little influence creating? Great news! It can be done, and the process is reliably repeatable. Many articles have been written on how to achieve this. In this instance however, you will find a simple and easy-to-remember three-step approach to achieve superior outcomes. 

While this strategy may feel overwhelming at first glance, it is essential to ensure successful implementation of sustainable process improvement. In the long-term, using these three simple steps can decrease your workload and reduce stress.”

Randy Loveless

Consultant

One example of success using this method was demonstrated in a Level II Trauma Center in California serving 80,000 patients per year. The tactics and recommendations below were implemented, with the help of a Philips consultant, to address challenges and to find confidence in achieving positive, long-term results. At this facility, time to initial RN assessment was improved by 97%, wait time to see a provider was decreased by 43%, patients leaving before being seen by a provider decreased by 37%, and patient experience ranking improved by 48%.

Workgroup

 

Legendary football coach, Bill Belichick, sums up the first element of successful change implementation with his quote, “On a team, it’s not the strength of the individual players, but it is the strength of the unit and how they all function together.” No matter how extraordinary your individual skills may be, you cannot enact change and reach new goals in a vacuum. Change takes teamwork. Philips refers to these teams as ‘workgroups’, since they are truly groups that work in close consultation to realize dramatic outcomes. The most effective workgroups include stakeholders from all levels within the organization – frontline staff, department leaders, decision makers (from potentially impacted departments), and an executive sponsor. While this seems an elementary concept, it is surprising to discover how many projects fail due to a lack of frontline staff inclusion at the outset. When forming your team, consider the ripple effect as well. Who will be impacted? On the flipside, refrain from including too many in the brainstorming sessions, as leading a large group to an agreed upon action plan can be difficult. Strike this balance well and you are on your way to a winning strategy!

 

You may also consider talking to individuals who are most likely to be a barrier to reaching the target. Speak to them privately, review the objective, get their thoughts on the goal, and express to them the importance of achieving that goal. This will help you gain their support and positively influence their understanding of the goal, the direction of the workgroup, and the part they play in a positive outcome. 

 

The success of the initial meeting depends on the method of facilitation. It is important to listen more than speak and to guide the conversation more than lead. It is also vital that the workgroup have a clear understanding of the goal and current problem areas affecting the desired outcome. Guide the group to envision the ideal state from the patient perspective, drawing on available resources. Allocate time to determine action tasks, create sub-workgroups responsible for action follow-up, define deadlines, and agree to rapid cycle tests or go-live dates. Each workgroup member must understand the plan and their associated responsibilities. Ensure that someone is tasked to create an informational plan (and educational plan if necessary), targeting staff who will be impacted by the new process to generate enthusiasm around the upcoming changes.

Operationalize

 

When go-live time finally comes, remember that it is natural for people to be concerned that the new process will fail or cause additional work. Be aware – the path of least resistance is easier, and some may gravitate back to the way it has always been done. Do not let this deter you. As the leader, you MUST be there in person to assist in the rollout, ensuring proper implementation. Be ready and available for questions, concerns, or suggestions. High performers from the workgroup should also be present to assist. Full implementation does not end until every shift has been observed and all have had a chance to take the new process for a ‘test drive’. Feedback forms should be available and every suggestion and concern considered when the workgroup reconvenes.

Watch the process in action

 

This is where it gets difficult and many leaders fall short. After the initial implementation phase, which may last a week or more, validation must be completed for every person utilizing the new process. This means that anyone performing the new process must be watched to ensure satisfactory achievement. This can be time consuming for the leader(s), but the end justifies the means. Validation is different from education. It includes direct observation of the individual in real time, with immediate feedback on performance. Consider creating a workflow, checklist, and role descriptions for each step of the new process. This will help increase consistency when using several team leaders for the validation process. Proper validation requires more than one observation and feedback loop. Repeat it as many times as it takes to get the process correct. Then, revisit the staff member to re-validate at a later date. 

 

A tracking form may prove useful to validate processes. Validation should not be punitive. If a staff member refuses to adhere to the process after proper coaching, your accountability cascade should be invoked. 

 

Celebrate successes and recognize outstanding performance. This will act as a catalyst to help solidify the new process long-term. Acknowledgment is also a way to communicate progress toward goals. Once the new process is successfully implemented, develop a follow-up plan and revisit it every one to three months. If you are not following up, there is a strong chance that the process will revert to the way it was, even if the new way is an improvement. 

Leveraging these steps for success

 

While this strategy may feel overwhelming at first glance, it is essential to ensure successful implementation of sustainable process improvement. In the long-term, using these three simple steps can decrease your workload and reduce stress. This method of change implementation has been successful in countless settings and situations. Keep it close at hand, methodically follow the steps, and you will achieve success..

 

Discover how we’ve helped others by implementing this method of staff leadership and change management with our Interim Leadership Consulting or contact me directly via LinkedIn.

About the author

Randy Loveless

Randy Loveless, MBA, BSM, BSN, RN, NE-BC, LNC, LSS-GB

Consultant

Randy has over 20 years’ experience in nursing, nurse management, and healthcare consulting. He has led teams in increasing process efficiency across the healthcare continuum. His work has resulted in the engagement of multidisciplinary teams to improve efficiency, enhance the patient experience, and increase staff safety in the workplace.