Change and the challenge of healthcare process improvement

By Bill Schell | Montana State University – Industrial and Management Systems Engineering — In a recent post, Chinweike asks why people are so resistant to change, using an example of Electronic Medical Record (EMR) Adoption in healthcare.  He then takes time for introspective reflection on what we, as people focused on process improvement, can do differently to overcome resistance.

While failure to successfully implement change is a common occurrence, the need for organizations to be effective at change and increase their organizational agility continues to grow.  Perhaps nowhere are the stakes higher in these change efforts, than in healthcare – where a recent report found that medical errors continue to cause an astounding number of deaths.  Given the high stakes, why do change efforts, such as EMR implementation, continue to fail?  A key reason is leadership.  A review of the healthcare related literature by a recent Masters graduate of our program found the following disturbing points:

  • 60% of major organizational change efforts fall short of expectations and 40% of these cases can be attributed to inadequate leadership – estimated by hospital CEOs (McDeavitt et al. 2012).
  • Leadership behavior and organizational skill are associated with better staff morale, engagement, employee behavior and success of change management initiatives – Study on nurse leaders in Canada identified (Macphee and Suryaprakash, 2012).
  • Only 38 out of 67 organization wide quality improvement programs in Huddinge University Hospital in Sweden were deemed successful. A primary reason was identified as inconsistency of leadership during several changes (Thor et al. 2010)

This information begs the question –> What do we do about it?  Part of the solution is what Chinweike discussed with regard to how we design the changes.  Perhaps a bigger part is how we look at leadership and what behaviors we need from our leaders during times of change.  Something I’ll come back to again in a future blog.

1 Comment so far

  1. Garry Coleman

    I believe leaders tend to overvalue an appealing design or purchased solution for making a change, yet underappreciate the tenacity and attention to detail required to successfully implement and deploy the change. If giving an approval and providing the funds were all that was required to implement change, we wouldn’t have as much unused exercise equipment and untouched DIY improvement project materials in our homes. Implementing change requires continual infusions of energy, from leaders and those living the change.

    Good topic Bill.

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