Season One in Review: The Elements of Change

Truth is, you are in control of your role within today’s change in healthcare.

Are you defining it or being defined by it?  Are you pushing for change or being pulled along? Are you telling the story, or allowing a story to be told for you? Are you building trust, leading and thriving – or are you hunkering down, defending and risking slowly fading away?

We at Jarrard Inc. are convinced that those questions are not hyperbolic. Our goal is to help ensure that healthcare leaders can answer in the affirmative to the first option in each pairing. Because our communities need healthy, efficient, agile and sustainable provider systems that they can trust for their care.

Yet, increasingly, the relationship between community and provider is showing cracks. Regaining trust will require healthcare leaders to make hard, necessary changes AND communicate more effectively to internal and external stakeholders about why they are doing so.

Throughout this first season of Art of Change, we’ve sought to lay the groundwork for change in healthcare: Why and how change happens, setting a vision for change, the role of authentic leadership in change, and the importance of communicating through listening and storytelling to advancing change initiatives.

In this exploration, we found several common threads across the 26 articles that make up the five volumes of the Art of Change series. These common threads are practical and, we believe, necessary for any change initiative to succeed. They emerged from the comments we heard in conversations with our many sources: academic medical center chiefs, regional hospital heads, healthcare disruptors, hospice leaders, communications consultants, national health system CEOs, bankers, lawyers, psychologists, a mindfulness expert – and absolutely zero politicians. These elements are universal yet adaptable. They are, in other words, powerful.

Above all, we’ve learned from the acclaimed healthcare influencers we interviewed that the discussion is not linear.  Everything is interconnected, making the ideas discussed a network, not an outline. Prescribing a process for change, while useful, isn’t quite what we want to do here. (Listed at the end of this article are a few outstanding books that might help you with that.)

Instead, Art of Change intends to provide you with a framework for how to think about change. Below, we’ve compiled our thoughts on this first season, including the common threads, a few resources for change agents and what comes next.

Scroll through the whole thing or use the navigation below to check out the bits that interest you:

  1. The Elements of Change
  2. Resources for Change Agents
  3. What’s Next

The Elements of Change

If you don’t, someone else will

Maybe the most important – and galling – note across this entire series:

  • If you don’t change your organization, another organization will – and they’ll take the lead.
  • If you don’t communicate clearly with your staff, they will make assumptions and act accordingly – and those assumptions could be wrong.
  • If you don’t make change personal and exciting, another hospital will – and they’ll poach your physicians and nurses who want to be part of the excitement…or, at least, the security.

The list goes on. A leader must lead, and there cannot be a vacuum. Don’t let the void be filled by things that could sabotage the important work.

Look from a different angle

From creating mini tempests within an organization to communicating through an unorthodox medium, finding ways to shake things up can be a powerful driver of creative change.
In one of the first articles in this series, Jarrard Inc. Chief Innovation Officer Molly Cate wrote, “One of the best definitions of art I’ve ever heard is this: to take something that’s familiar and make it unfamiliar – to see or experience something we know in a new way.”

There’s a beauty to seeing an object or idea from a new angle. It’s also practical. When you take a different (e.g., uncomfortable or non-natural) approach to a question, you’re forced to slow down and process the situation more carefully.

Similarly, it helps other people process what you’re trying to do. In Volume V., Dr. David Pate explained that, when confronted by two groups of executives who had seemingly reached an impasse, he had them write out what they had been trying to say verbally, then compare notes. Turned out, the areas of disagreement were far fewer than expected; it was an issue of merely talking past each other rather than substantive controversy.

Looking for another way to think about this (see what we did there)? Check out Bowie, Jazz and the Unplayable Piano from the Cautionary Tales podcast.

Identify and use differentiators

The hard truth is that healthcare is becoming commoditized. The significant (and necessary) energy spent by hospitals and regulators on quality metrics and the wide variation in pricing between facilities can obscure the fact that many services provided are generally comparable. All due respect to those performing the procedures, but joint replacement or cardiac stent are table stakes. Therefore, you should focus change initiatives on areas where your organization offers something that can’t be or isn’t being replicated elsewhere.

Differentiators could be clinical – a renowned medical center touting their specialty in treating a particular type of cancer. However, when looking at strategic change, a healthcare organization’s differentiator is just as likely to be cultural. For example, a unique interdisciplinary approach to care teams, or a set of behaviors that the nursing staff takes with each patient.

Focusing on these characteristics provides an anchor point for other changes. Highlighting positive differentiators helps create buy-in from staff as you say, “This is who we already are. Therefore, we’re going to use that to do [x] and become even better.”

Trust your gut

Information is critical. Too much of it can paralyze. As a leader, you’re in your position because you have an appropriate level of experience for the issues you’ll face. Hopefully, that experience also comes with a healthy, humble confidence. Multiple executives we spoke with highlighted the importance of collecting information – and, critically, using it – but making a decision sooner than later. Overthinking can reduce confidence in your ability. It can create delays that lead to further problems and, similarly, reduce the amount of time available to make a correction if the original decision wasn’t quite right.

Change is necessary and will not become less so by trying to wait it out. External change is happening, and forces are acting on organizations and individuals regardless of their actions. Better to use the information and expertise available to make the best possible decision and move. And again, the confidence that a calm, decisive leader will generate among staff will help them feel comfortable joining the project.

Don’t rely on technical details to drive change

People make decisions based on emotional factors, not rational ones. People need to feel in order to change. Why are people who have a workout partner more likely to accomplish their fitness goals? Because of peer pressure. A person working out on her own has the exact same data about the health benefits as someone doing group fitness. The difference is not wanting to disappoint others, to avoid feeling like they’ve let down a friend.*

You must connect the emotional and empirical dots to get full buy-in from the people involved in change. That means not just running through the numbers, but also putting them in context of what they mean for the organization, the community and the individuals involved. And the story must be about the long-term. People will see the pain of immediate change and resist it if they don’t see how the inconvenience now will lead to payoffs later.

*A word of caution here. You must be careful not to use emotional appeals to manipulate. Saying “We need your help,” and “You don’t want to let your colleagues down, do you?” is passive aggressive and likely harmful. (Away Luggage offering a prime recent example.) Instead, build, sustain and rely on a strong positive culture so that people naturally feel an affinity towards helping their team.

Be (responsibly) transparent, even about the negative

When was the last time you made a change in the absence of any pressure to do so? Even if that pressure was mere restlessness, we do not change without some kind of discomfort. The people around you know that, too, and they’re feeling discomfort. As a result, you can build enormous trust and buy-in by being vulnerable: Vulnerable about the need for change. Vulnerable about previous efforts to change. Vulnerable about the tension felt about the unknown and potential ramifications. Vulnerable about the weight of responsibility as a leader.

Sunshine and roses are not helpful in any situation, but especially not when communicating with frontline staff. They are, by definition, the first people to see and feel many of the problems that face a healthcare organization. And, the issues they may not be privy to directly still trickle down and affect them. Better to get in front of those issues and explain why something is happening than leave them to make assumptions.

Collect information from everywhere/one

While on the surface this sounds counter to it, “Collect information from everywhere” actually goes hand in hand with “Trust your gut.”

There are two reasons to gather as much information as possible – and as necessary. It gives people an opportunity to be involved in the process, which will increase their buy-in for any resulting initiatives. It also, obviously, helps you understand the context in which the decision will be made and, possibly alter what they ultimately decide to do.

Though out Art of Change, our sources talked about the importance of giving people within their organizations and communities opportunities to offer feedback. As noted above, people must see themselves in a story, and they must have an emotional connection to it. The best way to do that is to ask them what they think. Plus, good ideas are everywhere. A key bit of insight can change the course of an organization. Here at Jarrard Inc., we know of a health system that recognized the need to delay the rollout of a major strategic initiative based on employee feedback. The change was necessary, but more groundwork was needed to ensure it was successful. That’s information leadership would have missed had they not provided opportunities for feedback.

So, listening tours, online surveys, lunch with staff in the cafeteria, townhall meetings… whatever the modality, you should be willing to hear from the people around them. And then, when you’ve collected enough information, shut it down and make a decision.

Follow up, speak back

People need to have an opportunity to provide input. However, if they don’t see their input reflected in the final outcome, they’ll quickly lose faith. Our sources spoke to the importance of returning to their stakeholders and communicating back. First, communicating back what they heard during the collection process. Second, communicating back the final decision and how it incorporated that feedback.

Interestingly, we also heard that communicating back can build trust and buy-in even if the final decision isn’t what a person or people said they wanted. Rather, people need to know that their insight has been heard and considered. Getting their way might be nice but not necessary. (And if it is necessary, they may not be the right fit for the organization.) So, better to come back with hard news than no news at all.

Resources for change agents

Looking for more reading on change – both personal and professional? Here are a few of our favorites:

What’s next

The response to our first season of Art of Change has exceeded our expectations and, frankly, has been a lot of fun to produce.

We believe that it fills an important role in the rapidly evolving healthcare landscape, giving leaders of all stripes a framework to drive change at their organization – and to share their successes with us.

So, stay tuned for Season 2 of Art of Change, which will debut this Spring. Spoiler alert: The working title is Anatomy of a Leader. In it, we’ll be looking more closely at case studies from healthcare organizations and their leadership to better understand the ways in which they have changed – and responded to external change. Moreover, we’ll look at the components of change set up throughout Season 1 to see how they’re used in practice, as well as areas that we might have missed.

Questions, comments, insights? Let us know what you think. We’ll be listening – and just might report back what we hear.

If you work at an organization that you think would make for an interesting case study on the art of change, ping Jarrard Inc. Editorial Manager David Shifrin for a chat.

About the Author /

dshifrin@jarrardinc.com

As Editorial Manager for Jarrard Inc., David Shifrin is responsible for coordinating and executing the firm’s content programs, working closely with the Creative and Business Development teams. Shifrin specializes in curating ideas and making technical concepts accessible to broad audiences, helping thought leaders move past jargon to present core messages in a meaningful way. He received his PhD in Cell and Developmental Biology from Vanderbilt University.