Staffing: Conquering the Change Conundrum

You likely have a natural skill for spotting areas of needed improvement and identifying the changes your facility needs to make. Of course, identifying those areas is the easy part. Making change happen seamlessly is what separates the great leaders from the so-so ones.

While the inclination of leaders, especially those who are new to the position, is to move quickly when implementing policies or practices, that is often the wrong approach. Not everyone welcomes change — particularly OR staff who have become quite comfortable with “the way things have always been done.” Pushing through your ideas without allowing for healthy discussion can alienate your staff — and other leaders. When it comes to implementing a new way of doing things, use the five C’s of change to do it effectively:

• Connect. If you’ve come up through the ranks, you may know your team members well as peers, but leadership changes the dynamic of your relationships. Find out what they expect from you in your new role. If you’re new to the facility, it’s crucial to put in the effort to find out what makes the team tick, what’s important to them and how they think. I’ve seen facilities use a “Spotlight On” series where they highlight one or more staff members by asking questions such as, “What’s your favorite food?” or “How do you like to spend your downtime?” It’s an easy, pressure-free way to connect that often reveals some important insights. Remember to ask about where new staff worked previously. I’ve learned that nurses who have only worked in one facility aren’t always up to speed on current best practices and might think their processes are correct because that’s the only experience they’ve ever had.

• Coordinate. One of the most effective ways to make change happen is by coordinating the process with your staff. For instance, while I was working as an interim director at a hospital, the staff and I quickly identified that the processes surrounding our bone-bank freezer needed to be updated. We formed a team of staff members who were interested in solving the issue, and I supplied them with literature and resources on the correct procedure for storing human tissue. Then, I handed over the reins to them. The team put together a new policy and provided education to the staff. Together, with them taking the lead, we were able to identify an issue and implement improved practices.

• Collaborate. Collaboration is a crucial component of successful change, but it’s not always easy to get staff to share their honest feedback. Recently, I encouraged collaboration by meeting with members of the perioperative team, ensuring anonymity and asking them for their unfiltered answers to two simple questions: What are we doing well? What can we do to better support you in your work?

The staff mostly agreed on what the facility was doing well, and their answers fit on a single page. On the other hand, the list of what they felt could be done better to support them was pages long. Their concerns focused on how we could improve patient care, processes and, of course, salaries. To help organize the issues, we divided the laundry list into categories and brought them to the C-suite. During my conversations with the staff, I made it clear there were certain things I simply couldn’t change, but also assured them I would do everything I could on my end to facilitate the fixes that were feasible.

• Communicate constructively. There will always be messages you don’t want to deliver to your team — that’s part of being a leader — but being upfront with your staff while also showing empathy can make an enormous difference in how any message is perceived. Leaders sometimes take pride in being brutally honest and saying exactly what’s on their mind. There’s a fine line between being blunt and just being brutal. It’s almost always better to color difficult or harsh messages with at least a tinge of kindness and empathy. Some people call this being politically correct. I call it empathy in action.

• Choose your battles. I once saw an anesthesia provider leave the OR while their patient was sedated, an unsafe practice I immediately questioned the staff about. I was told anesthesia had “always done it this way” and “everyone does that.” The practice was deeply embedded in the culture of the entire health system. To stop it from happening, the chief medical officer had to meet with the team of anesthesia providers to establish an immediate intervention. This wasn’t an easy change for me to facilitate, but it was a necessary one.

However, some battles for change aren’t worth the effort they entail. The strongest leaders can decide what needs to be changed immediately for the sake of patient safety, what needs to be done eventually and what changes would be “nice” to make but aren’t necessarily crucial to improving patient care or the overall success of the organization. Prioritization will help you take a step back, involve your team and ultimately get to where you need to be. By taking the time to get your staff involved and maintaining a focus on what must be done, you and your team will be more successful.

Every leader sets out to build a cohesive team while simultaneously improving processes and providing better patient care, but making changes too quickly — and with too little buy-in — can have the opposite effect on the morale of your staff and ultimately cause an entirely new set of headaches and problems. Try using these five C’s the next time you’re called upon to make changes at your facility. Hopefully, the typical struggles associated with introducing and implementing new practices will be avoided if you integrate the strategies into your leadership style. OSM