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Innovative thinking for the improvement of medical systems

Anticipating How the Improvement Process Affects Staff

An improvement process often requires significant changes in people’s attitudes and behaviors, often requiring staff to give up their old standards and practices and adopt new ones. As a result, you can expect pushback from some staff as you introduce new processes and habits.

Many staff will “get it” early and pitch in enthusiastically. But introducing and reinforcing changes in behavior that “stick” in the form of sustainable practices will take some work and time to succeed. Over time, as less enthusiastic staff see positive progress, they too will become more engaged and supportive.

When you succeed, the payoff is significant, with benefits not only for patients but also for clinicians and staff. Many organizations have found that job satisfaction for their staff rises with improved patient experiences because the new, better practices usually reduce frustrating inefficiencies in the system that created extra work for staff.

As part of its work, the team will need to take a hard look at the psychological, physical, and procedural barriers it has to address in order to accomplish its aim. Barriers to improvement come in many guises. Psychological barriers such as fear of change, fear of failure, grief over loss of familiar processes, or fear of loss of control or power can be significant impediments to overcome. Other common barriers include the following:

  • Lack of basic management expertise.
  • Lack of training in customer service, quality improvement methods, or clinical areas such as doctor-patient communication.
  • Inadequate staffing levels.
  • Poor information technology systems.
  • Outdated or misguided organizational policies. For example, many organizations are so concerned about violating HIPAA regulations that they do not want to give information to a patient about their own care for fear of violating patient confidentiality.

Despite the serious nature of some of these barriers, few are large enough to bring a project to a halt. Typically, they are cited as excuses for two of the fundamental barriers to change: the fear of new ways of doing things and the fear of failure