Cultural Change in the Transforming Health Care Industry
Looking to develop a strategy to support our employees through a time of rapid change
We are an inner-city safety net hospital that is constantly adapting and changing to the health Care Industry changes. We are restructuring some of the services we offer to focus on optimal patient care and through put as we continue to navigate through the healthcare transformation. The restructuring of different groups within our medical center has created a lot of change for our employees. We have a significant amount of employees who have been with the organization for many years. We also are starting to hire a lot of new employees and millennials who are coming in with a lot of ideas for change. There is a natural tension between “How we always have done things” and “this can be done so much better if we changed…”. Our leaders are constantly working through these issues and we have created a few company wide programs and team performance improvement programs but its seems like we are just putting out small fires as opposed to strategically developing a plan to truly help our employees find a common ground to navigate the changes we are experiencing.
Change is hard in most circumstance. Its probably harder in the situation you describe. Culture ( established way of doing thing) change is difficult and requires a very methodical approach. When established ways of doing things are challenged perhaps the first response is always to defend ( this is how we have always done it).
I am sure you are aware, John Kotter has written much on this subject from a very elementary who moved my cheese to a more methodical Accelerate. I found his books and article to be very informative on change management.
I had to go into two turn around situations and when planning a big change, I always thought of his methods to guide the change. I failed few times in implementing some changes and I went back and found the explanation.
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.
Few suggestions from past experience:
The reason behind the change and its positive impact on processes, people and the organisation have to be well presented by highly acceptable and respected staff in a logical and easy to understand way and frequently.
You need champions everywhere to keep momentum and prevent u-turns, they need to work hand in hand, set an example and celebrate the success and prove the effectiveness of the change.
Since you are hiring new blood, it’s a chance to incorporate the ability and openness to change as an essential element of new hires, there are tools and probing questions that help you identify your targets.
And finally the way I see it: “convince me and I will go with you”
I think you answered your own question in your last sentence – “we are just putting out small fires as opposed to strategically developing a plan to truly help our employees find a common ground to navigate the changes we are experiencing.” If you are just making small changes in multiple departments with no overarching strategy it will always feel like you are chasing your tail. You need the big vision of what you want first – then go after the small wins to build to it.
Here is what I started with, even though it is on digital transformation I would say the theme is consistent where it starts with culture.
http://www.cio.com/article/3193039/leadership-management/foundation-of-digital-transformation.html
We partner and intergate with many different types of health care organizations and cultural alignment is the number 1 issue we encounter in every situation. In order to successful, even if you are just focusing on internal cultural alignment is ensuring that everyone is aligned toward the same vision and goals.
You indicated your strategy has changed. How have you communicated and planned with the team to align them with that strategy? Do they understand why the strategy is changing and the value behind the change? Do they understand what will happen if you don’t change? Do they understand their role in the change?
Once this is done you may need to identify your thought leaders at every level and begin the process of having the same level of conversation system wide using them as leaders and facilitators – pushing the vision and goals to every level of the organization and getting feedback about what is working and what is not and what the change will mean for them.
Ultimately, the team’s participation and understanding of the change is key to your success. this will also show you who isn’t aligned and who likely won’t align going forward and these may be changes you need to make.
i recently used the teaming model to facilitate hard discussions with my team and it was very useful. Happy to share.
In agreement with several of the comments above, particularly with the environment you described; seems like any large organizational change may be only successful with a real shift in culture. More like a controlled burn then putting out small fires. We have had some success with recruiting the established employees to serve as champions of change while making it clear to them that change was coming. This may help to incentivize the more established folks to go along with the changes rather than resist them.
Context is defining. What about changing their context by having them work in new teams or send them for one week to your dream organisation?
I’m sure the organization realizes that the more you have a cross-section of employees involved in the process of change, the better it will be. Another reminder is to be mindful of the differences in the generations at work, because each generation will see certain issues differently and could actually have a negative influence on the outcome. So, communicate, communicate, and then communicate some more.
Should employees and managers in a company start feeling that they are only fire fighting and not creating value, the root cause is either a lack of a clear vision or poor cascading of the vision down the line.
The next indication is that company lacks a clear strategy to overcome its issues on a sustainable basis, or that it has a strategy but that has not been communicated clearly down the line.
Around the Company Vision and Growth strategy are a series of sub-strategies what help deliver the boarder vision and strategy.
For instance the HR department in turn would develop its own strategy to help deliver the broader company strategy – which includes recruitment, comp and ben strategy, training and development, organization alignment plans/ change management where needed, to cater to the changes/growth plans.
Healthcare can easily learn from what happens in other industries like Hospitality and FMCG and adopt some of their models of Company Growth strategies and tweak them to healthcare industry needs.
We all know cultural change is hard but not adapting to the transformation is even harder. You can make everyone happy by using the new ideas and adding the old experience flavor to it. Make a team of old and new employees that can get along and come up with strategies to make the change as painless as possible. The faster the change, the sooner people adapt (or leave)! Go for the big fire.
Cultural change is difficult but it is possible with the right level of employee engagement and empowerment. it also needs to start at top (lead by example) and spread through your organization.
Changing organizational culture is difficult because it involves looking at the tedious process of performance reviews, and most importantly the principles that the organization will adapt. Similarly, it is not an individual decision but everybody in the organization has to embrace it and translate it to a daily habit.
In leading organizational culture shift, leadership plays a significant role. It is also important to identify the change makers; the most influential group of people in the organization to lead the change on the other hand, the stumbling blocks “the other group of people who are resistant to change”. These category of people should be given roles in the subject and be actively involved in the process because most often they influence others to resist.
Leaders on the other hand have to commit to changing their own behaviors and to lead by example. The process requires a fundamental change in the thinking process and consistency to produce the same results every time.
Set clear goals of what change you have to bring and most importantly the rationale for the change. For example, rather than telling everyone that they have to use the new tools, It is important for them to understand the implication of evidence-based practice and standardization of care in improving patient outcomes. Similarly, involving your team in the change process and having a feedback mechanism to see the gaps or to learn why it is not working is equally a significant step to take.