5 Strategies for Helping Physicians Cope with Change

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I’ve also worked with a medical staff of more than 1,500 who transitioned through a move from one hospital to our system’s new flagship facility 30 minutes away. And most recently I’ve worked with our physicians in adopting a new electronic health record, replacing a legacy system that had been in place in various forms since the 1970s.

Along the way, I’ve learned many things about how not to manage change — and I’ve discovered some strategies that have helped me with physicians as they deal with major change initiatives.

Here are five of those lessons:

First, communication is absolutely key.

My philosophy is to flood the zone — meaning communicate through many channels. Nothing is more effective than face-to-face communication, but that can be a daunting task when dealing with a large medical staff. In my experience, informal conversations work better than scheduled meetings. I try to catch surgeons in the OR between cases or in the physician lounge. We’re finding some success using mobile apps and texting. And of course we always use the stand-bys of our physician website, newsletters, and emails.

My philosophy is to flood the zone — meaning communicate through many channels. Nothing is more effective than face-to-face communication, but that can be a daunting task when dealing with a large medical staff. In my experience, informal conversations work better than scheduled meetings. I try to catch surgeons in the OR between cases or in the physician lounge. We’re finding some success using mobile apps and texting. And of course we always use the stand-bys of our physician website, newsletters, and emails.

When the message isn’t readily accepted by physicians, I’ve found it’s important to take time and address the “why.” If we can agree on a shared purpose — that we’re ultimately both wanting to do what’s best for our patients — then communication is usually more effective. I encountered this recently when we introduced the idea of Open Notes, which allows patients to review what’s in their charts. A number of our physicians were resistant until we could talk about how this could increase safety by having patients review their information. We’ve seen examples of patients who identified incorrect allergies or missing medications in their charts.

Often one of the “whys” involves economics. Sometimes we need to help physicians understand that it’s in their best interest for the hospital to be economically viable. Cynicism can morph to support when they understand that a financially stable hospital is able to hire and retain the nurses and other staff they need and want and purchase the state-of-the-art technology they depend on.

Second, offering options enhances success.

Physicians, like everyone else, like to feel like they’re in control. Building flexibility into change initiatives is always a positive. One example of this has been scheduling. We’ve worked to give physicians options for scheduling themselves. In one case, we have two female anesthesiologists who share a full-time position, which allows both to meet their family demands. In another case, two other physicians split a full-time position because both are approaching retirement and want to wind down their practices a bit.

Third, simplify processes anytime that’s an option.

With our new electronic health record, we have physicians actually counting the number of clicks it takes to complete a certain task. If we can eliminate one click per procedure, that could mean as many as 50-75 fewer clicks per week for a busy proceduralist. That seems like a small thing, but it’s actually huge for many physicians.

Fourth, foster a team approach.

Many times physicians do things that could better be delegated to other members of the team. We have to make sure teams are organized so work can be shared and all the members of the team trust each other. Of course, we never put staff in the position of working beyond their scope allowed by their licenses and training. Nothing helps build teamwork more than to foster a culture of appreciation. When physicians feel that leaders care about them, morale increases. Again, little things go a long way. For example, a tidy and well-stocked physician lounge, locker rooms, and call rooms send the message that physicians are valued, which helps to mitigate stress.

Fifth, training is often a part of change.

One of the keys to successful training is timing. When we first began implementing our new electronic health record, we trained early, then the project was delayed, so by launch time most of the training had long been forgotten. On the other hand, waiting too close to an initiative’s launch to do training can be detrimental. In our implementation, we found a sweet spot in terms of when to train, which was about six weeks before implementation. We also found that a mix of classroom training and individual coaching worked well for most of our providers.

One of the keys to successful training is timing. When we first began implementing our new electronic health record, we trained early, then the project was delayed, so by launch time most of the training had long been forgotten. On the other hand, waiting too close to an initiative’s launch to do training can be detrimental. In our implementation, we found a sweet spot in terms of when to train, which was about six weeks before implementation. We also found that a mix of classroom training and individual coaching worked well for most of our providers.

As change continues to take place in healthcare, it’s easy to focus on the nature of the change itself and lose sight of the human factor. I’ve found that these five strategies help us focus on our physicians and understand their needs — and they pay big dividends in implementing change successfully.