Saratoga Hospital

Mike VanDerwerken

“Change is the law of life. And those who look only to the past and present are certain to miss the future.” This statement by John F. Kennedy rings as true today as it did the day he voiced those words. Change is one of the few constants in our lives and it has the ability to elicit visceral reactions in those affected. How we personally manage those feelings, and just as importantly, how we manage the thoughts, feelings, and impressions of those within our organization is critical to the success of any project. Some organizations embrace change, while others hold fast to the “if it ain’t broke don’t fix it,” or “that’s the way we’ve always done it” mentality. While I do not advocate for change just for change’s sake, some change is inevitable. Modifications to our way of practice may be imposed on our organization for various reasons, including regulatory compliance, and fiscal concerns.

My experiences with change in the healthcare setting have generally focused on altering and/or enhancing the process of medication delivery and have demonstrated there are essentially three outcomes. Projects either rocket to a successful finish, limp along to an underwhelming conclusion (costing excess time and money in the process), or never even get off the ground. All of these results started with the idea that change is necessary, so how do they end in such different places? The answer from my observations, is that some organizations “embrace the change,” and others fight change at all costs.

Inevitably we will all be presented with change, new processes, new software, or other technology that we are not in favor of. So, how do we “embrace the change?” Once the decision to move forward has been made there should be no looking back, all eyes should be focused ahead on a successful conclusion. It is critical to focus on expected positive outcomes, while at the same time not dismissing concerns and apprehensions being expressed by those around you. Validating those concerns, whether they are valid or not, while providing supporting information as to how you will overcome them is key to garnering support and acceptance. By providing tangible reasons for change instead of anecdotal ones you will find it easier to allay fear and gainacceptance. Dismissing concerns even if they are not valid, does not alter those beliefs, and in many cases “proves” to those around you that their beliefs are in fact true.

"Disruption caused by the initial change is the perfect time to rework and reinvent how we do business and serve our patients"

I have found that engaging your staff/end-user early and often is a commonly overlooked element critical to a successful project implementation. As leaders, we all like to think we know how processes are being handled by our staff; certainly, there is the “correct” way based on our policies and procedures, and then there is the actual way they perform day to day tasks. Why they differ is often due to a functional disconnect that develops as we get farther and farther away from life in the trenches and begin making idealist, instead of realist decisions. The best way to combat this disconnect is to engage end-users to determine how they are performing their tasks. What process improvements would they like to see? Most

importantly, this engagement allows them to have their voices heard and develop a vested interest in the outcome.

Speaking of process improvements, another concept that I like to focus on is “taking advantage of change to make changes.” You may be thinking, “of course we are making changes, that’s what change is,” but I do not necessarily agree. Taking the same antiquated and broken process and forcing it into a new software application is not making changes. Sure, you have changed something, but at the same time changed nothing, and you have also missed the opportunity to truly take progressive steps forward. Do not replicate a bad process in a new system. Take the opportunity to facilitate real change and real process improvements. Disruption caused by the initial change is the perfect time to rework and reinvent how we do business and serve our patients. I believe this not only causes fewer disruptions overall, but in the interest of end-user satisfaction, you get large gains in what otherwise could be a painful process.

Keep in mind, all is well and good when your change only impacts your department. What happens when “your” change impacts multiple departments, affecting those who may not see or experience the benefit. Much of your success in these situations may revolve around relationships you have developed with different leaders within your organization; this is a vital time to engage senior leadership and secure a project champion. The champion can help navigate some of the interdepartmental complexities as well as maintain a global vision as to why this project should move forward. I will caution you, even with a project champion, it is still of the utmost importance to develop relationships with the other leaders in your organization. Engage them just as you would the end-user in your own department to get their input and feedback. Again, taking the time to create that vested interest and have voices be heard goes a long way toward a successful project completion.

I have worked the better part of the last 25 years providing or facilitating the provision of pharmacy services. Throughout that quarter of a century many things have changed, not only clinically, but technologically that have greatly impacted how we deliver medications and care to our patients. One thing that has not changed is change, and that will continue as we move forward. None of us will make it through unscathed, but we can utilize these opportunities to initiate process improvements andtake what could be seen as an inconvenience and turn it into win for everyone involved. By taking a moment to change how you look at change, an entire world of opportunities will present itself to you, your staff, and your organization.