The words coronavirus and healthcare are inextricably intertwined. However, one needs to only listen for a moment, and invariably, a third word emerges: change. It is time for the healthcare industry to begin a crucial conversation about change.
As a board member and the CEO of a major integrated healthcare system, respectively, we have been immersed in transformational change even before the pandemic. From experience, we know any crucial conversation about change must begin with several immutable realities:
There is nothing inherently good about change. Change simply means making something different. Positive change means making something better. As quality guru W. Edwards Deming observed, 95% of all changes made by management make no difference. Healthcare does not need transformational change. Instead, we seek transformational advantage, or Kaizen—change for the better.
Stasis frequently triumphs. There is often a visceral desire to maintain the status quo. Further, it may be impossible to convince stakeholders to change when they believe their job security, job satisfaction, and livelihood depend on not changing. This is a status quo trap in which maintaining the current situation is believed to involve the least professional and psychological risk. Leaders must consider how they bring everyone along as they initiate change.
Change invariably ends with regression to the mean. In healthcare it is common for any change pendulum to revert to the status quo. Think annual abandonment of New Year’s resolutions on a organizationalwide scale.
With change, there are winners and losers. The resisters and cheerleaders draw battle lines believing one group’s gain is another’s loss. Experience has shown it is easier to sabotage a change initiative than to implement it. Moreover, those opposed are often more passionate in their opposition than those who offer support.
Change is scary. Leaders who have lived through a major transformation will be familiar with the following scenario: You introduce a change initiative to your team and before you even finish your presentation, some will try to shut it down, saying it may be a good idea elsewhere—but not here. Over two millennia ago the Buddha spoke of the “suffering of change.” The Buddha attributed this suffering to one primary reason—fear. He went on to suggest that fear was present even when the change was perceived as something positive. It is a natural human evolutionary tendency to resist change in an effort to feel in control—the survival instinct.
Hesitancy is to be expected, accepted and respected. With any quantum change, the unit of measurement is the people. If you can’t change people, you can’t change anything.
You can never forcefully change anyone. In order to assist change resisters, you need to get inside their heads. Showing empathy for their concerns builds trust. We find that trust is a primary enabler to increasing people’s tolerance for uncertainty.
If the healthcare delivery sector is going to make change happen and stick, we must tackle the greatest obstacle to innovation: fear of change. We must address the process of moving our colleagues from change resisters to change insisters. Many executives ignore or push back against those who challenge them, even opting for a punitive approach to move their plans forward. Resistance is a natural response to change and can be destructive; but it can also be constructive and improve change initiatives. Further, if leaders employ a punitive approach to resistance, they will drive it underground.
We are in the midst of a defining moment for leaders and their organizations. With anxiety, depression and stress abounding in this pandemic, leaders must have crucial conversations focused on the pain points surrounding change initiatives. If they don’t, they will continue to find better odds of winning by rolling the dice in Las Vegas, than of having their change initiatives become and remain successful.
