HOW CAN A LEADER FACILITATE TRANSFORMATION?
In today’s uncertain environment, many health care organizations are looking for solutions to their most pressing issues by implementing large-scale changes in their cultures and launching new processes. Transformation is a series of vision-related changes driving to a much more long-lasting effect. Leading any change is scary for most leaders, and many organizations. While there are several things an individual can do to prepare to lead transformation, in the end, being properly equipped is both a skill and a mindset.
Successful transformation management is reliant upon the attitudes and perspectives of leadership. If leaders see change as an opportunity, not as a burden, and choose to think about it differently, they can lead others in their health care organization by creating a culture of improvement osmosis.
Transformation is rooted in a leader’s intention and, in order to obtain support, that intention needs to be an honorable one, demonstrated first and foremost by leaders themselves. Good leaders will actively immerse themselves in the process of transformation, not just the goal. The gradual pace of implementing substantial changes can be particularly challenging for professionals in health care, where there is a sense of urgency and a tendency for providers and management to focus on the goals, anticipating results rather than being active participants in the process.
As Frances Hesselbein said, “Culture does not change because we desire to change it. Culture changes when the organization is transformed; the culture reflects the realities of people working together every day.”1
WHOM SHOULD A LEADER LOOK TO FOR INPUT?
Leadership is often a lonely place to be, especially when implementing change—resistance and barriers to success surely await. Leaders should engage a trusted team of advisors and stakeholders who will be willing to provide honest feedback or call ideas into question. Wise leaders also seek others who have accomplished the changes they want to achieve, and learn from their experience. Why reinvent the wheel?
Once an intention has been set, a leader can begin to break long-term goals down to a beginning, middle, and end, establishing a path forward. During the initial stages of implementation, engaging others in the strategic planning process will result in a better long-term vision. Without this engagement, managing transformation is very difficult.
Focusing on one or two metrics—related to the value stream—to measure throughout the transformation process, and measuring them the same way every time, is essential. This will help to ensure that the improvement work stays aligned with long-term goals.
HOW CAN LEADERS CREATE BUY-IN?
A leader’s willingness to collaboratively engage others in achieving the desired outcome is also critical. Proactively engaging staff in strategic planning sessions will help to achieve and align the “end in mind,” and help gain buy-in from the organization and staff.
Another way to create buy-in is to create a compelling story. Many people need data to substantiate reasoning, and data is a puzzle that, once completed, can tell a compelling story. When choosing a value stream to focus on, first listen to what the data is saying. Numbers are a great source of truthful information that should drive the scope and magnitude of the changes being implemented. What story are the data telling? Substantiate quantitative data with qualitative data, and be willing to look at things not normally considered. Consider what opportunities present. What is the cost of not changing? Data modeling tools, such as waterfall charts, are helpful here. Be willing to assemble the story one picture at a time, like a puzzle, and reassess when something doesn’t fit.
HOW DO LEADERS GET DETRACTORS AND FENCE-SITTERS ON BOARD?
Engaging skeptics and detractors on the front end of a change can turn them into powerful advocates in the long run. Leaders should focus on educating others about the benefits the change will create, to encourage buy-in. Most importantly, they must show a willingness to listen to concerns. This is also a great way to solicit some creative solutions for the planning process from an alternate perspective. If you include these reluctant participants early on, everything else opens up. Even late adopters can be some of your greatest champions. Your supporters will give you energy and momentum. This bottom-up approach will create a well-prepared team with a shared vision.
HOW CAN LEADERS BEST ENGAGE THEIR TEAMS?
Self-reflection is essential to leadership. It is important to look at where your strengths are and how to grow, both as a leader and as an organization. Ask your staff, “How can we all grow?” One of the core qualities of a strong leader is the willingness to be in a state of continuous learning and constant improvement.
Know your team’s strengths. Tap into their skills as key resources in implementing transformation initiatives. Also, be willing to invest in the tools or resources that will make growth and transformation possible. If it is a new Electronic Health Record platform, be sure to customize this tool so that it will alleviate the burden of work, reduce errors, and allow your staff to perform more high-level tasks.
Listen to your team—the people who will be experiencing the changes. Demonstrating a willingness to listen is one of the most important things a leader can do to prepare their collaborators for transformation. Even further, it’s important to demonstrate a willingness to engage all members of staff in finding and creating solutions. Outside the critical, immutable decisions for which a leader may be solely responsible—such as safety or crisis management—most issues are opportunities to solicit input from the individuals who work every day in the environment in question.
Continue to engage others to find solutions. Your staff are often the people best equipped to identify where the obstacles to improvement are, whether these are people or processes. Most often the obstacles are processes that prevent people from maximizing their strengths, so leading transformation also means leading the change of process elements.
Be realistic about resources when planning transformation initiatives. Short-term change is necessary at times to get things started or propel them forward. Do the next right thing today. Small steps made frequently keep the organization agile and in motion. As for a runner in a marathon, each step is important—and though some steps may not seem significant, as a whole, even these small steps will deliver you further toward the goal. Small adjustments continuously applied provide the opportunity for the leader to be a visible, active participant in change and make changing an iterative process over time. Keep in mind: everything that your organization does now was at one point someone else’s transformation.
Debra Wiggs is a board-certified fellow in the American College of Medical Practice Executives and a past board chair of the national Medical Group Management Association. Deb can be reached through V2V Management Solutions at dwiggs@v2vms.com.
Resources
1 Frances Hesselbein, “The Key to Cultural Transformation,” Leader to Leader, 1999.