Making change stick

A team of healthcare workers having a discussion

Transformational change doesn’t happen by a single act alone. Not just from giving a speech, not just by sending a memo to all staff, and not by hanging a plaque on the wall listing a new set of organizational values. So why do so many organizations think this is all it takes?

The sentiment around, “we really have to improve”, is probably universal. But when asked what that improvement looks like, or how it will be achieved – there’s real difficulty articulating the plan and the desired outcomes.

Achieving Lasting Change

Based on our experience, the foundation for achieving lasting change within a team entails several components, one of which is the support of executive leaders. Without this support, change may be possible, but it will not be sustainable. The leadership team sets the values, which in turn, drive the behavior of the team members, and this behavior ultimately drives performance.

The teams that are most successful in achieving sustainable change are those where leaders actively engage in the process and model the behaviors, they wish to see from their team members. However, without genuine support and engagement from the frontline team members, change cannot be sustained.

While having an accessible executive team is critical to success, a top-down approach is not enough to engage the frontline team members. All members of the team, from nurses, physicians, and midwives to unit clerks and environmental services staff, must feel a sense of ownership in the process and outcomes. If not, team members may comply with the new changes superficially, but it will not create a deep and sustainable culture change.

Creating change in an organization involves all levels of the team working together.

Here are 7 elements that may be useful in helping to guide and support change:

  1. Ensure the goals of the patient-facing team and the overall organization are in complete alignment.
  2. Look for the opportunity to leverage the organizational strategy to support the clinical work, rather than the other way around.
  3. Identify agents of change at every level of the facility.
  4. Identify quick wins and showcase and communicate them early and regularly.
  5. Ensure the patient-facing team is fully supported throughout the implementation process required for change.
  6. Create clarity and understanding. When people are resistant to change, often it’s because they fear what’s happening is going to negatively affect them. Employees need to trust and respect their direct manager, trust and respect the organization and trust and respect the leadership team in order for change to stick.
  7. Establish a safe place where employees can try new processes and break deeply embedded patterns — without the fear of reprisal or embarrassment. It takes hard work to get through the difficult steps that a shift in culture requires. At every stage, it’s important to remember that lasting change doesn’t happen overnight. It takes consistency, persistence, and visible leadership at all levels to make change possible on every shift and in every unit.

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