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How to manage change in healthcare organisations

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The training time is the right time for change managers to intervene and emphasise the change, writes Vinay Mehta, CEO, PoleVault Healthcare.

 

The story of change is a common story, especially in any healthcare system. A healthcare system is a witness to change taking place every moment. It is, therefore, very pertinent that change managers occupy an important place in hospitals.

Change is important, more so, when you a part of the team implementing a new EHR or HIS in any hospital. The technology is one part of the change, the other part of the change is people’s mindset to use and exploit the features of the new system to deliver results!

Motivation or Management?

More often, I have seen the management dictates that goad the staff to accept and work on the system. But this brings a slow change in the system and everyone, more so the patient and his attendants bear the brunt using this approach. Change managers are therefore not welcomed by the staff! How do you convince the staff to change without major interventions of the management — this is the question we are going to address in this article.

As per my experience, we need to apply a simple methodology. We know all of us are individually governed by logic and emotion, rather a combination of both in different measures. If you are an emotional person, you will get convinced with the emotional aspect of change, but if you are more governed by rationale, you will get convinced by the logic or the perceived benefit of change. If you can do this in a balanced manner, you can achieve results with people.

Let us approach both the sides of Change one by one.

The training time is the right time for change managers to intervene and emphasise the change. I remember, in a big hospital with over 2,000 beds in southern India we were implementing a HIS and it involved training a staff of more than 800. The old system being COBOL based was very efficient with the keyboard, but new system used mouse clicks, as also the tabs.

Emotional Appeal

How did we handle training such a large number of people accustomed to a DOS look and feel like system for past 10 years? We had to set up a pre-HIS training workshop that would change the minds of people and get them hooked to few specific games. For this we used examples from Windows and smart phones extensively.

Their user interface is very intuitive and friendly. This changed their mindset to accept a UI that facilitates ease of working. Then the training took lesser time to make them understand various features and processes in the application. In this case, we appealed to their emotional self first and then trained them on technology.

The implementation team shouldn’t think that motivating people or making people accept the new system this is not their job. Gustavo Razzetti puts very nicely in his book “Stretch for Change”: For a change maker, everything is his job. So whatever it takes for people to change and accept your system, doing that is our job.

But there are places where people are intellectual and do not accept the system as it is. There a different strategy has to be adopted to succeed. One case, I remember, of a hospital in Mumbai where there were two political groups, and one group was very opposed to the implementation of the system, not because they did not want automation, but because the decision was taken by the other group to go for automation. As we attended the meetings, we could clearly make out the rift between the two groups, and members aligned to each group.

Intellectual Appeal

This was a precarious situation wherein every task we did to complete the project was seen as a favour to the first group. We changed our strategy to complete the project. We sat with the people from the second group and asked them clearly what and how they wanted the system to operate. We noted down all their requirements, prepared comprehensive tables wherein requirements and features were discussed in detail and the process to get the results in approximate timelines was documented. We presented our facts and figures to them to satisfy their queries.

Once they understood that we stood our ground and we will do everything to get this going, their resistance to change dropped, although not diminished. Slowly we tackled individual departments separately and satisfied their workforce and got the workforce to say good things about our system to their respective heads. This helped us gain ground and get through the project. Here we appealed to their rationale.

Dan and Chip Heath have very beautifully put it across in their book ‘Switch – how to change things when change is hard’. They say, “If you want people to change, you must provide a crystal clear direction.” What looks like resistance is often a lack of clarity. So, wherever you are facing resistance, it means you need to work out more to bring more clarity.

 

*(The views and opinions expressed in this article are those of the authors and do not necessarily reflect the official policy or position of Elets Technomedia Private Limited.)

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