Change Management in Health Care: Navigating the Human Side of Successful Transitions
Employees are a healthcare organization’s most valuable asset. Strategic approaches can help an organization nurture this asset during potentially turbulent change.
Change is occurring at a rapid pace in the healthcare industry: Hospitals are merging, large medical groups are forming, and clinically integrated networks and integrated delivery networks are acquiring hospitals and physicians. As a result, leaders are involved in due diligence and transitional processes that address corporate structures, employee benefits, insurance policies, financials, hard assets, and facilities, just to name a few. But these processes often miss a key area.
These business transactions also have a direct effect on the most valuable asset any healthcare organization has: its employees. Although the human side of these transactions is seldom talked about, failing to address employee issues can be expensive in both cost and reputation.
Average turnover costs range from $37,700 to $58,400 for a nurse and $274,000 to $498,000 per physician, for example—and that doesn’t account for the toll that low morale, decreased productivity, and workplace drama can take on an organization. Leaders should consider the human side during the transition process and develop a plan to anticipate and address this period of change. A quote often attributed to Charles Darwin states, “It is not the strongest of the species that survives, nor the most intelligent, but the one most responsive to change.”
The Human Side of Change
Most people ask themselves three main questions when experiencing a transition at work:
- Am I going to have a job?
- What is changing that will affect my position?
- What’s in it for me?
Leaders must place themselves in their employees’ shoes and be prepared to answer these questions in an open, honest, and direct manner. Britt Andreatta, PhD, author of Wired to Resist: The Brain Science of Why Change Fails and a New Model for Driving Success , writes that about 50 percent to 70 percent of change initiatives fail because we are biologically wired to resist change. As a result, organizations have lost billions of dollars. Furthermore, she notes, a change journey is different for each person and can elicit a variety of emotions and reactions.
Unlike some changes, employees typically would not choose to experience the kind of workplace transition that occurs during a merger; hence the change journey causes disruption and can be peppered with resistance. Employers must anticipate this journey and take steps to address the emotions of fear, confusion, frustration, and resignation that may arise and to help employees understand and ultimately accept the “new normal.”
For example, when word of a potential merger leaks, your employees may have one of three reactions:
- They’re excited about the news and the possibilities associated with change.
- They’re indifferent and keep plugging along.
- They’re anxious and have many questions.
The majority of your employees will be in the third category because they may instinctively feel their safety is being threatened, and as a result, they will act out what are referred to in a change management context as “derailing” behaviors. These may include looking for new positions, exhibiting a decline in productivity, gossiping about sensitive office issues, and—most concerning—contributing to a compromised patient experience and plummeting patient satisfaction scores.
These behaviors in turn lead to increased stress levels in the workplace, which can affect morale and even employees’ health and well-being. Even with the most positive of intentions, one mention of the word “change” can send employees running for the exits, turning your upcoming transition into an expensive nightmare—or even a failure.
Steps to a Successful Transition
The focus of any change management plan should be on maintaining a healthy employee culture that produces an unparalleled patient experience. Organizations can take four steps to promote such a culture during times of significant change.
Identify and build your transition team. Identifying change champions is vital. Candidates for change champions are employees who have handled department moves or absorbed new roles successfully. They should be people of integrity whom others respect. But there should also be room on the transition team for naysayers, or individuals who are resistant to change. The naysayers may end up being your best change supporters.
A retreat meeting is a good forum for change champions to thoroughly learn about and understand the transition. At the retreat, focus on the “why” of the upcoming merger and how it will benefit the wider community. A retreat of this sort should never be a one-way conversation; encourage your change champions to openly express their fears about the upcoming transaction.
Back in the office, your team of change champions will be in the trenches with their colleagues, meaning they will experience any workplace drama firsthand. Therefore, at the retreat, these employees should develop a transition roadmap, which should include training on people skills and change management. Give your core team incentives—whether financial or other—to continuously engage in any adjustments and find ways to overcome the challenges that change can bring.
Clearly and honestly communicate the news. People naturally think about themselves and what matters most to them in a scenario involving a merger or acquisition. We have seen janitors fretting over pay differentials, physicians worrying about on-call schedules, and nurses who are fearful of a change in scrub colors. These issues may seem trivial, but they matter deeply to your staff. One way to honor your staff is to inform them and keep them updated throughout the process.
Create a simple system for your staff to submit questions and concerns. A quick weekly meeting to share upcoming transition activities and address questions will alleviate unnecessary anxiety. Other elements that should be incorporated into weekly meetings include:
- Milestones and information related to staff
- Change management activities that employees are participating in
- Anticipated changes and processes that will stay the same
Compile meeting minutes for those who are not able to participate in the weekly updates and send them to your team in a timely fashion.
In addition, with multiple generations comprising the healthcare workforce, it is necessary to relay information via multiple platforms. For example, leaders can send out short vlogs as a way of staying in touch with their teams. Be innovative and make the process exciting.
Train leaders to communicate clearly and collaboratively. Receiving information about a major upcoming change can be overwhelming. Sharing data about a forthcoming transaction needs to happen in a clear, succinct, and empathic way. Therefore, training your change management team in communication skills is a must.
Along with conveying a clear vision of a compelling future, the most critical part of communicating with employees is providing them with a consistent message. Your team will immediately pick up on any inconsistencies in your messaging, and that will only create additional uncertainty and fear. People tend to fill in gaps in communication with their own stories, so be sure to keep rumors at bay by dispensing clear and thorough information. Do your best to map out a schedule of communications, and adjust it as needed.
Just important as clear communication is the need for leaders to be accessible. Adding a hotline that employees can call for information may be one useful way to provide updates. In addition, training leaders on topics such as listening, mindfulness, and empathy, along with giving them tools to decrease stress, helps them to manage their own anxiety and that of their employees. Together, leaders and employees can weather the storm, accept the change, and engage positively in anticipation of the future.
Ensure all systems and processes are in order. A situation in which your staff cannot do their jobs because of system or process changes is to be avoided at all costs. Prepare well in advance for employee orientations that will educate staff about such changes. While planning these orientations, give yourself and your team much longer than you expect—even twice as long as you estimate an implementation might take.
Finally, design a “problem solving” group that can seek out glitches or anything that’s not running smoothly and create solutions. This step can increase employee engagement while also solving small problems before they become big problems.
Throughout the change management process, remember that your employees are your most valuable asset, and you should treat them as such. Clear, empathetic communication coupled with consistent messaging will go a long way toward leading your team through the challenges that change management can present.
Lucy Zielinski is managing partner, Lumina Health Partners.
Molly Rodriguez is CEO, Empower Yourself Coaching.