Don't Be a Dodo: Three Crucial Steps to Evolving Your Healthcare Organization (Part 2 of 3)

David Birdsall , MD

Chief Operations Officer

Published June 07, 2014

In my last post, we discussed the plight of the flightless dodo bird to illustrate the Darwinian imperative to change. We also covered step No. 1 of the change process, which is to create believers.

Now it is time for us to get our wings and take flight.

The change process is like a journey. But as exciting as travel can be, you wouldn't decide to go to the Galapagos one day, then head to the airport the next. Preparations need to be made to ensure you arrive safely at your destination — and survive once you get there.

So it is when you decide to embark on a change project.

Step 2: Prepare for Liftoff

Leading change takes pre-work. My favorite way to prepare for a trip — or a change project — is to talk to those who have gone before. I focus on the path they chose, who went with them, their successes, their failures and their challenges.

Not every project will be the same, and all will have unique problems. However, if I can avoid problems, I would prefer to do so.

We are fortunate at Vituity to have so many folks who are change-oriented and who have worked on many initiatives. If I want to implement provider in triage (PIT), I can tap a number of people who have travelled that path and learn from their experiences. As exciting as it is to be a trailblazer, it is a lot easier to walk in the footsteps of others. Plus you get there faster.

All major change projects require more than one person. In fact, they require quite a few. Thus, you will need to pick your team.

In my experience, it is better to be more inclusive than exclusive. For example, if you are going to implement PIT, you will certainly need the physicians and nurses on board, but others should be involved as well. You will need to inform registration and security about this venture. Lab and x-ray will need to be involved, because orders will be generated in the triage area. Of course, you should make the administration and medical staff aware of this unique project so that they can address any concerns that arise and help to remove any barriers.

Granted, not everyone will be directly involved in the process. But the more who are aware of what you are doing, the more likely that you will be to succeed and the fewer barriers you will face. For example, if registration balks at performing a quick registration at triage, you can leverage hospital leadership, even though they are not directly involved in this project, to overcome this obstacle.

For any major trip, you have to develop a timeline. This involves getting your passport, purchasing supplies and tickets, deciding where you will land, what sights you will see and on what day, packing, etc.

Some things can happen in parallel (you can go get your passport as you shop for travel clothes). Others have to happen in sequence (you can't pack before you have your supplies). And of course, some steps are critical (you have to purchase your ticket before you can get on the plane).

When you plan a change project, you will need to list the steps required to get to your end point. I suggest you map them out on a timeline along with the names of the people responsible for each step (accountability is key).

You should also highlight those steps that are critical. At Vituity, when we started rolling out our new palliative care initiative, we decided it would be crucial to determine each site's current palliative care status and resources before implementing the program. We knew we couldn't move forward without knowing what was already available.

I should also mention that while it is important to set deadlines and stick to them, you will need to be flexible when a significant, unforeseen event occurs (The Joint Commission shows up, a disaster occurs and occupies resources, etc.)

So remember, do your pre-work, pick your team, and develop your timeline.

In the third and final post (whew), we are going to take flight and talk about Quint Studer's five stages of change management.

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