Changing Behaviors

Within healthcare, organizational change management is something that is frequently discussed and often utilized. Disrupters in the industry that force changes can originate from the creation and modification of healthcare laws, compliance requirement updates, and even internal initiatives to improve company services. This frequent transformation does not necessarily make changes within healthcare any easier. Augustsson et al. (2019) describes that “the complexity of the healthcare system and the challenge of implementing new evidence and improving care practices calls for multifaceted, flexible approaches to facilitate change that take these complexities into consideration” (p. 4).

Vital Behaviors

While these external requirements force changes that need to be adopted, A company needs to identify what changes need to take place to improve culture or patient care. To assist in identifying the vital behaviors to change within a company, the behaviors need to be evaluated. Grenny et al. (2013) suggest four search strategies to “avoid spending time and effort on the wrong behaviors” (p. 47). These identified vital behaviors will give the organization a focus not only on some areas to spend this effort, but also will provide some clear reasons on how the behaviors were vetted.

Notice the obvious

This first search strategy encourages the organization to notice the obvious things that could be improved. In healthcare, the obvious lies in simple things such as the patient experience and recognition. Rowson and McSherry (2018) describe in their study that “care must be holistic and person-centred and individuals should be recognized for their contribution” (p. 23). While the idea of putting the patient first and recognizing those that achieve success may seem obvious to an organization, it may take a back seat to larger company initiatives. The focus on getting these organizational behaviors correct makes a big impact on the culture of the company.

Look for crucial moments

The second strategy is to look for crucial moments. Crucial measurements in healthcare that are already being reported and scrutinized today include the dispensing and abuse of opioids. This is one such behavior that is crucial in the industry and has been approached using multiple change management theories. Sokol et al. (2020) stated that “deliberate use of change management theory to support both safe opioid prescribing and treating patients with OUD [opioid use disorder] over the past 5 years resulted in changes to the practices, people, skills, and infrastructure within our clinic” (p. 129).

Learn positive deviants

Additionally, positive deviants can create new methods within an organization that break from the normal practices. While deviants can often be looked at as a negative within an organization, many process improvements can be discovered when deviating from the idea that things have always been done one way. Deviations can breed innovation in an organization from the people that live in the process on an everyday basis. Xaio et al (2018) discuss this as the idea of “uncovering ‘positive deviants’ (better than average practices in any given cohort), and assess the extent to which specific practices or innovations are likely to be of relevance, or reproducible, in other jurisdictions and therefore worth propagating” (p. 2)

Spot culture busters

The fourth search strategy provided is to spot culture busters in the organization. These are behaviors that can fester within a company and create a culture that doesn’t align with the mission or outcome of the business. At AdventHealth, a recent rebranding addressed the consistency of the services they provide. To do this, all employees underwent a multi-hour training titled The Whole Care Experience. This not only addressed how the company would provide care, but also defined the service standards each employee should represent every day. The four service standards included “love me”, “make it easy”, “own it”, and “keep me safe”. Without addressing individual behaviors, these standards were set as an expectation to the employees and patients.

Other Search Methods

This author would suggest a new search method to be included in the list provided by Grenny et al. (2013). With the clear disruption that has occurred from the effects of COVID-19 on all businesses, a method to search for potential changes is becoming more necessary. Anticipating how a company will need to respond to certain disasters, organizational shifts, or customer desires will potentially be a new focus in many industries. This can be referred to as the “what if” search method and used to prepare the culture of an organization on what is expected in response to certain scenarios.

References

Augustsson, H., Churruca, K., & Braithwaite, J. (2019). Mapping the use of soft systems methodology for change management in healthcare: A scoping review protocol. BMJ Open, 9(4) https://dx.doi.org.ezproxy.liberty.edu/10.1136/bmjopen-2018-026028

Grenny, J., Patterson, K., Maxfield, D., McMillan, R., & Switzler, A. (2013). Influencer the new science of leading change (2nd Edition). McGraw-Hill Education,

Rowson, T., & McSherry, W. (2018). Using the care excellence framework to benchmark and improve patient care. Nursing Management, 25(3), 22-28. https://doi.org/10.7748/nm.2018.e1710

Sokol, R., Schuman-Olivier, Z., Batalden, M., Sullivan, L., & Shaughnessy, A. F. (2020). A change management case study for safe opioid prescribing and opioid use disorder treatment. Journal of the American Board of Family Medicine, 33(1), 129-137. https://doi.org/10.3122/jabfm.2020.01.190223

Xiao, Y., Husain, L., & Bloom, G. (2018). Evaluation and learning in complex, rapidly changing health systems: China’s management of health sector reform. Globalization and Health, 14(1), 112-11. https://doi.org/10.1186/s12992-018-0429-7