“The secret of change is to focus all of your energy,
not on fighting the old, but on building the new.”
Way of the Peaceful Warrior: A Book That Changes Lives
We spend a lot of time agonizing about how existing systems function, complaining about inefficiencies or about tedious work. We can affect improvement and real change in our workplaces and lives by focusing on building the new.
Creating change in the workplace can be challenging. You may not be in a position to influence others or enforce change, you may lack the know-how to implement procedures outside your bubble of knowledge, or you simply may not know where to begin. But we all know that change is inevitable and that we must adapt, especially in the ever-changing O&P profession. It is imperative that each of us embraces change and learns to adapt to keep up with (and in some cases, stay ahead of) the curve for continued success.
How can you successfully implement lasting change in your workplace? To begin, you need to decide whether the idea/procedure/thing you would like to modify offers value. If you want your company to use orange paperclips instead of standard paperclips because you like orange, you are not offering value. If your idea has genuine value to a department and/or the company (i.e., you discover that orange paperclips cost one-tenth that of standard ones and will save the company $1,000 a year), it is time to think about how you can implement that idea. Will this be something the company is willing to spend its time on?
Your first step is to pitch the idea to your supervisor and have some information about the value of the change. When you can demonstrate the value of your proposed change, you are more likely to get buy-in. It will be challenging as an employee to affect meaningful change without the backing of a superior. Even the most brilliant idea explained poorly or lacking buy-in from management will likely fail. Also consider that in some cases, your actions may be perceived as overstepping your role and authority. Once you have the support of a superior who has the power to influence and enforce change, you need to think about the effect it will have on other departments.
Many O&P companies are small, close-knit teams that rely heavily on one another to move services through the workflow and provide patient care. Changing a procedure may positively impact one department but negatively affect workflow in another department if the ripple effects are not taken into consideration. It is important to avoid upsetting the flow of other departments or procedures in your zeal to create change. It is also crucial to understand how your colleagues and coworkers react to change. In Diffusion of Innovations, Everett Rogers identifies five categories of people as they receive change: innovators, early adopters, early majority, late majority, and laggards (Figure 1).
Innovators embrace change, while early adopters are open to change but proceed more cautiously. The early majority may ask more questions before adopting the practice. The late majority will be even slower to adopt new ideas, often giving in to peer pressure or enforcement of rules. Laggards are the slowest to adopt change, the most cautious of new ideas, and keener to cling to tradition.
Identifying which employees or departments generally fall into these categories can help you strategize how to present your idea and consider the value you are offering to these different groups.
Once you have thought carefully about how this change could affect other departments, craft a written procedure. Having one for reference will minimize confusion and establishing standards can help streamline problem-solving when things do not go according to plan. Consider the example of requiring new documentation before a patient is seen at the clinic. While it may be an annoyance to those who need to do more work upfront, the result is that services are moved through more quickly and less time is spent chasing paperwork. Reminding others of the value, especially long-term, can help facilitate acceptance of change. Procedures can also help during on-boarding of new employees by providing answers quickly. Depending on the topic, you may be able to write the procedure before your supervisors review it. In some circumstances, it may be more helpful to create the procedure in conjunction with your supervisor.
Once you have a well-written procedure, it is wise to communicate with the other department heads (via your supervisor) to ensure that potential issues were not missed. This step will also encourage buy-in from other departments because you demonstrated a consideration for others’ work and a desire to improve the company. It will also allow them to better explain the changes to their subordinates.
The next step is implementation. Think about the best way to communicate the change to employees. Who needs to know about the change? If practitioners change casting methods, it does not need to be communicated to the front office. However, it is important to communicate with the purchasing department if new materials are being used. What is the best way to communicate information to the people affected? Depending on your office, an email may suffice. Perhaps an in-person meeting is necessary or distributing printed procedures. Think about what method will be effective for communicating the information. Who is the best person to communicate this change? Remember that just because it was your idea does not mean that you will announce it to the company, or that you will even get credit for it. Depending on the idea, how big the change is, or how many people it affects, the announcement may come from your supervisor or even higher up the chain.
Consider whether your idea calls for implementation in stages and the types of change adopters who will be impacted as you craft your strategy. You may want to target your innovators and early adopters to get the ball rolling. However, do not simply ignore laggards because they do not agree with you. Consider their concerns and whether you need to adjust your plan.
Once your change has been implemented, things are better, right? Maybe. A certain level of enforcement and auditing needs to happen to ensure the changes have been made and will last. Part of enforcement is tracking what happens after change is implemented. If you can show that since your change was made, for example, that prostheses are being delivered two days earlier, that idea is a winner. Sharing results of the change can help encourage others to see the value of the new processes and improve acceptance. In a study about implementation of new emergency department procedures in hospital networks, the authors wrote, “It is important for leaders to be transparent with performance improvement data and encourage continuing, two-way communication. At one hospital, staff support for the improvement strategy lagged because management did not share up-to-date data with staff.” (To read the study, visit https://bit.ly/2O8Ctel.) Communication is key: Employees should not feel that they are blindly following orders. Their buy-in and understanding can improve acceptance and help job satisfaction.
By now you are probably thinking of all the things that can go wrong. You will likely be met by resistance. It takes a lot of effort to create change, and you will need to prove the value of the required effort. Some coworkers will be frustrated that they need to change their daily routines. Some may resist the change because it is easier to not alter what they are doing, and the value is unclear. Even well-intended changes are not sustainable if they require more time or energy than employees have available within their workflows. Having said this, it is still invaluable to push change and improve what you can in your circle.
Build on your change. Use one success as a catalyst for implementing other ideas. The more you encourage change, the more you shift the culture of your company. You can help a company that is resistant to change become one that wants to continually re-evaluate and improve its processes.
For more information and case examples about implementing change in a healthcare setting, see the Canadian Institutes of Health Research’s document “Moving into action: We know what practices we want to change, now what? An implementation guide for health care practitioners” at https://bit.ly/2O4e2OR.
Nina Bondre, CPO, practices at Dankmeyer Prosthetics & Orthotics in Linthicum, Maryland. She can be reached at [email protected].