The Healthcare Manager's Playbook

Change is a natural part of business growth. Without it, we’d still be charting with pen and paper. Change is needed to stay efficient and relevant, but it can also create anxiety, especially when it is poorly managed. As managers in healthcare, we can help reduce anxiety and resistance by managing change well. Below are 10 key points to consider when leading your next change effort.

1. Understand the change in detail. Take time to learn exactly how the new process will work and why it is being implemented. Understand the reasons behind the change and think through how the new workflow will affect both patients and employees. Test the new process, collect data on process times, and build updated flowcharts or value-stream maps. Your goal is to become an expert on the change. The more thoroughly you understand it, the better prepared you will be able to manage the change effort effectively.

2. Communicate clearly how will things be done after the change. As a leader, you are responsible for communicating the vision. Describe what the change will look like, how it will be implemented, and how the new workflow will function. Write it down. Documenting the change makes it easier to train others on the new way of doing things. It also provides a standard for making, adding, and updating future changes.

3. Create a sense of urgency. Explain why the change is necessary. Without urgency, the motivation to make the change will be low. Outline the consequences of changing. These may include increased fall risk, more missed appointments, or other impacts on patient care. Don’t assume the urgency is obvious to everyone. Not changing should feel more limiting or dangerous than changing.

4. Clearly state the benefits of the change. Be prepared to answer the common question: “What is in it for me?” Be able to clearly state the advantages of the change for the individuals being impacted. Examples include: saving time (less searching for wheelchairs), reducing hassle (fewer applications to manage), reducing confusion (clear posting of appointment times or shifts), etc.

5. Share why you believe in the change. Explain what you like about the change and why it matters. Your team will take cues from you on how to respond. If you are uncertain, they will be uncertain. If you are excited, they will be excited. If you are unsure, continue researching and studying the proposed change until you can speak confidently and authentically about it. A genuine belief in the change builds trust.

6. Identify potential barriers to change. Identify factors that may make the change difficult. Examples include asking if timeline is realistic, whether the tools are adequate, or if more training is needed. When possible, try to implement the change on a small scale first. Take time to test and learn what works well before rolling out the change to the entire team.

7. Avoid common causes of failed change efforts. Many change efforts fail for predictable reasons. These include:

• Lack of communication
• No change champions
• Unrealistic expectations
• Poor execution
• Lack of feedback or follow through
• Lack of accountability
• Insufficient support  

8. Share short-term wins. Highlight early successes from staff who adopt the change quickly. Share these wins through short videos, posts, emails, or updates through Teams (or other messaging platforms). Early success help build momentum and credibility.

9. Watch out for those individuals who strongly resist change. Some people resist change far more than expected. Theses “keepers of the status quo” can slow progress even when change is being managed well. Not changing should not be an option for team members. Have clear process in place for providing feedback and escalating concerns when needed.

10. Leave time for questions and answers. In addition to answering questions in meetings, encourage individuals to stop by your office to ask questions. Hold office hours. Many people resist asking questions in a group setting.

Change can be positive. However, poorly managed change is always tough. Healthcare organizations have long history of rushed, unclear, and weakly supported change efforts. As leaders, we have a responsibility to reverse this trend. By integrating the ten points above, you will be better prepared to lead your team through your next change effort.

About the Author: Shane Haas serves as the National Director of Outpatient Services at Ernest Health, a leading provider of inpatient and outpatient rehabilitation. He enjoys the consistent practice of building, improving, and sharing leadership and management skills. His backgrounds in Physical Therapy (UF ’96) and Industrial Engineering (TTU ’02) provide a balanced heart and head perspective that shapes the Healthcare Managers Playbook.

Additional Materials Related to Change Management:

• Change Management Slide Show
• Horstman, M. (2016, July 25). How to Brief Your Team on a Change. Manager Tools. https://www.manager-tools.com/2016/07/brief-you-change.
• Horstman, M. (2015, June 8). Leading Change – The Ore Cart – Chapter 1 – Hall of Fame Guidance. Manager Tools. https://www.manager-tools.com/2015/06/leading-change-ore-cart-chapter-1-hall-fame-guidance.
• Kotter, J. P. (2012). Leading change. Harvard Business Review Press.
• The First 90 Days, Updated and Expanded by Michael D. Watkins (2013), specifically address change from the perspective a newly promoted or hired manager/leader. Helpful points include, getting to know your team, learning before changing, avoiding land mines, and finding early wins, to name a few.