Early Adopters: How to Implement Change
Early Adopters: How to Successfully Implement Change
To stay ahead of the curve, consider these suggestions for implementing change.
By Bruce Maller
It is increasingly clear that the delivery of and payment for health care services will undergo significant changes in the coming years. The combination of changing demographics, legislative forces, market-based initiatives, and higher consumer expectations are converging to create significant future challenges for ophthalmology practices.
However, even in the face of these developments, many practices have not yet reached their “pain point” and may be reticent or unwilling to change patient care processes. Yet, as is the case with the introduction of any new technology, there will be early adopters who embrace these changes as an opportunity to improve practice efficiency and optimize the patient’s experience. Others will wait until it is absolutely necessary to change, or will choose to ignore these outside forces and continue to operate in the same manner, often to the detriment of their own practice.
For ophthalmology practices that want to be “ahead of the change curve,” consider these six suggestions to make the implementation process easier.
1 Engage Your Team
The first step is to convince others to embrace the need for change. Educate the team on market trends and make the case for why change is important. At the same time, the physician owners and management team need to create a clear picture of how change can (and will) be a good thing. For example:
“By reducing patient wait time, we will improve not only our efficiency, but increase patient satisfaction.”
When engaging others, it is also important to anticipate team member needs and possible concerns. Just the thought of change can create a wide range of emotion. Awareness and anticipation of this range of emotion will help management respond appropriately to these concerns.
When initiating a change-management process, it is best to start small and build consensus from the ground up. Practice leaders should carefully select a small, targeted group of staff members to help build the proper foundation. Individuals considered for selection should:
■ Be open to change
■ Have a positive attitude
■ Have the respect of their peers
■ Possess the ability to influence others
These individuals do not necessarily need to be managers or department supervisors. Some of the best ideas come from staff members who work in the trenches and are acutely tuned into the pulse of the practice.
Generally, effective engagement of any team starts with reaching consensus on vision and goals. The initial planning team should begin by addressing several important questions:
■ What is the main issue or concern requiring a more in-depth assessment?
■ What data would be helpful to accurately diagnose the situation?
■ Are the owners committed to addressing the issues being evaluated?
■ What potential obstacles might the team encounter?
■ What resources might be necessary to complete the assessment?
■ What will be the most effective manner to present the team’s findings?
■ Who will provide leadership for the project?
■ What are the primary goals the team hopes to accomplish?
■ How will success be measured?
■ Should there be some type of incentive offered, assuming team goals are accomplished?
2 Develop a Plan
Teams need structure, order, discipline, and clear performance guidelines. A plan of action with specific activities, timelines, and responsible parties is recommended. However, the plan must be flexible so the team can adapt accordingly as circumstances change. (See the table “Sample Action Plan for Reducing Patient Wait Time.”)
The team should designate one person to “own” the plan. This individual should be in a position of authority and be accountable for achievement of the plan goals. Although effective leadership is essential, it is important to recognize that real and enduring change comes from the workers in the trenches who ultimately will execute the various elements of the plan.
3 Celebrate Small Wins
The plan should include specific and measurable objectives or milestones. Celebrate when the team achieves success, even if the accomplishment represents only a small win. This will provide motivation and impetus for the team to tackle additional challenges. Rewards do not need to be in the form of a financial bonus. In fact, team members often appreciate the opportunity to simply get together and enjoy a celebratory meal or team activity. Be creative and make sure activities are fun and enjoyable.
4 Effectively Align Incentives
It is unwise to expect others to work harder or support a plan without effective alignment of incentives. Too frequently, leaders expect others to get fully engaged in the change process without considering how team members will win when goals are achieved. It is always important to address the what’s-in-it-for-me (WIIFM) factor when embarking on implementing change.
Incentive plans can be an effective motivator if the team feels it can exercise control over the outcome. Additionally, team leaders must be transparent in sharing information relevant to meeting plan goals. This serves to build trust in the process and in team leaders. Although practice owners may be reluctant to share details of financial performance, it is relatively easy to come up with several key performance indicators that are closely linked to goal achievement but do not compromise the sharing of confidential information.
By way of example, patient survey scores and patient wait time measures generally provide an objective and meaningful set of measures that can be integrated into the overall practice goals. The key is to establish a baseline of historical performance upon which the practice can easily compare.
Sample Action Plan for Reducing Patient Wait Time
Start morning session on time.
|Develop written protocols defining the time technicians must be ready to start seeing patients; require techs to arrive at work 15 min. before the official patient start time.
||Lead Tech and Practice Administrator
||Draft protocols are complete; being reviewed by management team.
Reduce patient wait time from arrival to start of exam to comply with recommended wait time of 15 minutes.
||Assess scheduling patterns and determine if too many long exams are grouped together. If so, balance schedule with a mix of brief, intermediate and long exams
||Front Desk Supervisor
||Once assessment is complete, meet with lead tech and practice administrator to discuss recommended changes.
|Reduce nonclinical time the doctor spends with patients.
||Limit personal conversations, interruptions, and discontinue the habit of escorting patients to the checkout area.
||Lead Tech and Physician Owner
||Discuss recommendations during upcoming doctor meeting.
5 Model the Right Behavior
It is normal to assume that teams take on the personality of their leader(s). Additionally, team members are likely to take their cue from the boss. If a physician habitually shows up late for clinic, soon others may demonstrate a similar disrespect for the schedule. On the other hand, if leaders show respect for others (both employees and patients), staff will tend to demonstrate similar behavior. By modeling appropriate behavior, leaders build trust with the team and will be in a position to ask for (and expect) support when the need arises.
Leaders in practices and organizations who are successful in implementing change enjoy strong “currency” with their teams. This currency is earned in part because the leaders have effectively created an environment built on a foundation of trust and mutual respect. These core values become the rudder that serves to keep the practice going in the right direction, even when there are challenges.
6 Make Effective Use of Data
It is easier to gain team support when there is hard data that clearly illustrates the issue or problem at hand. For example, a clinic with wait time issues is much better able to address the problem if it has patient survey results, documented patient feedback, and time and motion study results. These data give the team a baseline from which to measure progress. Successful teams learn to manage out the drama by focusing on tangible results. This is not to suggest that a subjective assessment is not important. It is. In the end, however, teams must be able to marry the objective and subjective components in order to complete an effective diagnosis of the situation and bring forward a clear and concise plan of action.
Meeting Future Challenges
An uncertain future mandates that practices plan for the unexpected. While it is impossible to anticipate exactly what the future will look like, implementing change to meet new challenges certainly will be easier if leaders are proactive and have a plan that includes a team of insightful, energetic, and talented staff members. OP
Mr. Maller is the president and founder of BSM Consulting, which offers a full range of healthcare consulting and practice management services. Contact Mr. Maller at firstname.lastname@example.org.
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