3 Ways Workforces Resist Change
Posted on: August 10th, 2009
Tricks for resisting change
We’ve all seen them in action: the tri-fecta of change resistance, the dreaded resistance triplets:
- Digging our feet in
- Outlasting you and your program
- Active and open sabotage
It seems that every time a healthcare leader wants to create a change for his or her organization, these 3 ugly sisters show up and ruin the party. It doesn’t matter if the entire organization voted unanimously for the change in question, once implementation begins you can be sure that these party crashers will show up with it! You can always tell when the triplets have arrived by the noise they make and the wreckage they leave as they wend their way through your carefully crafted initiatives, dismantling this, overturning that and throwing out the other! So where did they come from and how on earth can you get them to leave . . .?
It turns out, strangely enough, that the culture of healthcare is actually a culture carefully crafted and maintained by the providers of care that lend the industry its name. The doctors, nurses, techs, assistants and other sundry and assorted providers all agree on one clear thing: CHANGE = DEATH! It appears that our educational systems (both formal and informal) actually work! We train our clinical staff to the highest levels in detailed focused assessment skills and it is this very wiring that inevitably forces the invitation of the triplets. Let me explain.
Have you ever met a nurse so acutely attuned to the condition of a patient that she (or he) could tell something was wrong before the monitors did!??? If you haven’t, I suggest you spend some time at the bedside where you will see it aplenty. The bi-product of this amazing skill is two-fold:
- The better the assessment skills of the clinician, the more likely they will be promoted into leadership creating a cycle that reinforces greater and greater assessment skills
- The better the assessment skills of the clinician, the more likely they will be hyper sensitive to change and over time come to view change as an almost universally a “bad” thing!
What would you call a culture that over time, promoted its most change sensitive people, and championed change sensitivity as not only an asset, but the holy grail of competencies . . .? Might it be called, “Change Sensitive”?
There is a second issue that hastens the invitation. It can best be described as “Progress”. Over the years, healthcare as an industry has been the guinea pig of hundreds if not thousands of ideas about effectiveness and efficiency that inevitably are later discovered to be “in-effective” and “Inefficient”.
Many of them, at the time of their implementation, created significant increases in work burden for the very people they were designed to assist. Each and every time, they were “sold” as the great solution and great helper that most never actually became.
As time has worn on, the typical healthcare staffer has been conditioned to believe that “Progress” is just another word for, “something done to me rather than with me” and it usually connotes a heightened short-term work burden followed by an inevitable decline in utilization ending with the program’s ultimate abandonment months or even years later.
The third and final inviter of the triplets is the significant and under managed burden created by healthcare’s notorious “initiative overload”. The average hospital visited is mid-implementation of no less than 60 parallel initiatives! This number is so vast that even 12 months in, the average employee has grown numb from trying to keep track of them all and views the resistance sisters as their only hope of salvation from a world gone mad. In short, it is your own workforce that is inviting resistance and in many cases inviting would not be strong enough – begging would be more appropriate!
If any of this sounds familiar, then the time may be right to un-invite these “Bells of the ball” with some simple yet profound actions:
- Create a meta initiative map that shows how all your various initiatives ACTUALLY tie to the vision, mission, or strategic priorities of your organization! This allows your workforce to begin to put all the pieces into the context of a larger goal, instead of being overwhelmed by disconnected details.
- DO IT WITH THEM! Make sure that staff aren’t just a part of committees and teams that feed information up, but are actual participants in the decisions that will inevitably affect their jobs and lives.
- Discuss ahead of implementation, how change can be managed in a way that takes into account the change sensitivity of clinical staff and focuses it on the actual dangers the organizations and its patients face rather than on the issue of the moment. It helps to create a communications plan that includes ties to both patient and staff benefit of each and every proposed change. Then allow for time for feedback and opinions to ensure that you are not recreating a previously failed effort or hitting other “hot buttons” guaranteed to initiate the invitation of healthcare’s most un-welcomed party guests!