Met today with FHA's leadership team, which is composed of the clinicians and manager. Stacey and I have recognized the value of staying in close touch with leadership as the clinic traverses all the changes ahead. Late yesterday afternoon, we got wind that staff were reporting high stress levels at FHA. Stacey and I charted out the projects currently, or soon to be in process for the clinic. This list includes:
Open Access, Planned Care, Idealized Office Design Efficiency, Shared Care Plan, Alternative visits, HF and DM registries, Patient Centeredness, EMR, Millbrook upgrade, transcription changes, recovery from docu-scan and Millbrook implementations, a remodel on the horizon, and HIPAA regulatory remodeling. Phew! No wonder people were getting a little frantic!
This morning, we asked the clinicians what they've noticed as far as staff behavior. Their observations were that staff were expressing increased fragility, frustration, anger, sarcasm, fear, shock and anxiety.
Here's what the clinicians identified that seems to be helping:
Relationship building that is happening in the redesign teams
Quick fixes being addressed and attended to
Cross-function mixing of staff on teams
Adhering to team agreements up front
Role modeling
Everyone together in a room hearing the same thing at the same time (the most recent all-staff meeting)
Acknowledging the situation and the magnitude of the changes, regularly
Expressing gratitude to the staff
We agreed to schedule another all-staff information/sharing meeting in the next few weeks.
What I know from William Bridges excellent work, Managing Transitions, Making the Most of Change is that people benefit from the following in times of change and transition:
- knowing why this is happening -- and the benefits
- understanding the problem with the old way
- focus on the future rather than on the past
- keeping communication lines open
- sharing feelings and plans
- ceremonies to "let go" of the old
- defining what is over and what isn't
- support/caring
- gleaning ideas/ sharing ideas and support
- acknowledgment of the fear and chaos
- understanding that chaos is normal
- focusing on short-term goals
- rewarding small successes
- promoting personal responsibility
- converting complaints to action
- modeling new behaviors
- slowing down and enjoying the newness as much as possible
- mark the arrival of new beginnings with a celebration
- choosing new patterns before routines set in
- noticing the difference.
In addition, I believe this journey is a survivable one if we can just keep our eyes focused on the vision of excellent, patient-centered care and appreciate each other along the way.
