This is a problem that a lot of organizations are struggling with. When we begun the deployment of our EHR we were given a statistic that stated that there was about an 8 week period before the clinicians went back to full productivity. 8 years later, I don’t believe that is anywhere near accurate. Clinicians are challenged by the extra amount of work that is now required to work through the EHR. Some of that has to do with poor design, many implementations duplicated paper workflow, and it just doesn’t translate in terms of technology. An option is to look at workflow redesign where possible. Other options are to provide supporting mechanisms such as scribes, to lessen the load on the clinicians. Ultimately, after an organization has matured enough in their us of the EHR, the data amassed as a result is invaluable and can help to demonstrate the value. But that will take time. And to other’s point, data is only as good as what the clinicians provide so it can be a potential pitfall. Finding quick wins can certainly help but I really think it’s important to understand where the day to day challenges are and work with the clinicians to determine if there are opportunities to make their day to day work less challenging.
I agree with a lot of the comments. The division director needs to be given a clear set of goals and expectations. Additionally, at that level most organizations would also expect this leader to take on initiative and set goals and expectations for his/her division to thrive. Assuming that at this point, leadership has had conversations with the director, then one needs to consider the root cause of why this person is struggling. Is it lack of skill? Lack of interest and accountability? Is the culture fostering his ability to under perform and in some way undermining the potential for someone to step in and lead successfully? I would not recommend going around him but making sure that the problem is faced head on. Have an honest conversation with the individual around expectations. Set clear goals and explore what barriers may pose challenges to the director’s success so that you can work together to remove them. If those barriers are actually imposed by the director, then that can be a conversation around how to change his behavior. Ultimately, organizations need to make difficult decisions on whether leaders and/or team members that are not contributing to overall goals need to move on. To allow an under-performer to remain in their role sends a dangerous message to the rest of the team. I recommend making a genuine attempt at working with the director to help them be successful. If that is not working, then making the decision to move on from the individual.
Organizational change is hard. I have seen many attempts fail. At the core of those failures was a lack of understanding and commitment from leadership that it really must start at the top. If there is no demonstrated commitment from executive leadership, the rest of the workforce will see it as a gimmick and will continue to behave as business as usual simply for the fact that they don’t really expect anything to change. If initiatives are pushed from the top the workforce will think that leadership is disconnected and doesn’t really understand the issues. Building change management initiatives with core input from the front lines, where their voices are truly heard and represented can have better success. It is still a very heavy lift but achievable. Additionally, if change is really to take hold, every single individual (including influential leaders and money making physicians) have to be held to the same standard. The smallest sense from the workforce that there are some that are held to a different standard, will bring the whole house of cards crashing.