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To Break Down Barriers to Change, Leaders Must Let Go

Friday, March 06 2020

Dawn Allbee

Business transformation is a primary focus for health care leaders today, as emerging technologies open the potential to improve patient care, enhance reliability and streamline operations. More often than not, however, challenges in transformation start with those very same leaders. Success begins when leaders learn to let go of ingrained beliefs that impede improvement and empower their team members as ambassadors of effective change.

In my role as executive director of customer engagement for The Joint Commission Center for Transforming Healthcare, I develop, coach and mentor health care leaders, their employees and organizations to manage and facilitate the change that is required to achieve high-reliability cultures. High reliability in health care requires focus on zero harm, a dedicated safety culture and the use of proven standards and methods. More often than not, we work with leaders who are committed to these goals but struggle with execution.

Their challenges often stem from longstanding cultural practices, aka, "it’s always been done this way." Many health care organizations have operated for decades with fairly rigid, top-down cultures. Changes didn’t happen unless they were sponsored and approved from the top. As a result, changes often didn’t happen at all.

This approach won’t work in today’s highly connected, insights-driven environment. Employees at every level of an organization are discovering new applications for technology and potential process improvements every day. Quality must be ensured, of course, but speed is of the essence, and a culture that encourages innovation is needed to make certain that important opportunities aren’t lost in bureaucratic red tape.

Give Managers Authority

To support a shift to high reliability and business transformation, leaders must remove barriers and empower their staff to be agents of change. Mid-level managers are best positioned to see opportunities for process improvements and work with those staff closest to the issues to identify and implement robust solutions. What they need is the authority — even the mandate — to find opportunities for improvement and to pursue them. Too many mid-level managers have a mindset that it’s their job to only ensure current policies and processes are followed. If they aren’t at the core of high reliability efforts, it’s unlikely that transformation will be successful.

This strategic empowerment unlocks the potential for meaningful change and sets the tone that the status quo is no longer expected or acceptable. This tonal shift in and of itself can go a long way toward addressing some of the other common cultural barriers to change such as the perception that leadership isn’t committed to change or the feeling that individual employees don’t have the power to enact meaningful change. By letting go, leaders underscore their commitment to change by being among the first to do so. And the expectation to drive change is shifted to mid-level managers and front-line employees.

Letting go doesn’t mean that senior leaders will have fewer responsibilities. Culture change doesn’t happen automatically, nor does it happen overnight. Leaders must instill openness to learning new skills and supporting new approaches. Managers will be asked to shift a good portion of their focus from keeping the trains running on time to building new trains. Many middle managers embrace this evolution and, in fact, have been seeking it for some time. Others may struggle with a more strategic mindset. Senior leadership needs to keep the individual strengths of their managers in mind as they organize to best tackle change.

Change to a Continuous Improvement Culture

Training is needed to help employees at all levels make the most of their new roles as change agents. Practical training is required to help ensure managers and employees are fully aware of new capabilities. Training should also seek to challenge employees’ existing mindsets on problem solving, encouraging them to engage with staff and other key stakeholders closest to the process when challenges or new opportunities arise. In many instances, managers are accustomed to working only within their own teams. In this new technology-driven environment, broader skills and experience can often lead to better outcomes. Managers should be trained to seek support from staff in areas like IT and human resources to ensure they’re getting a full view of the options at their disposal.

Cultures ultimately must change from a fix-it mindset to a continuous improvement approach, where everyone within the organization has two roles: the role they were hired for and a role in improvement. This means everyone within the organization must be trained in some form of process improvement, including change management methods, relative to their role. Data insights are at the very core of transformation. Used correctly, these insights can help an organization identify trends, predict future challenges and design solutions in advance. This approach requires people and teams to step back and assess a situation, analyze the data, determine what it means and then devise an approach that is best suited to address the issue.

Leaders can promote this mindset among their managers and employees and build realistic staffing structures that enable this approach to play out. Ultimately, the payoff is an organization that is predictive, always one step ahead of patient and business needs.

Light bulbs go on and support skyrockets when employees at all levels understand both the benefits of change and what they can do to help make it a reality. Resistance starts to morph into enthusiasm. Plus, training is recognized by employees as an investment in them, providing concrete evidence of an organization’s and its leaders’ belief in the talent and capabilities of its workforce.

Business transformation isn’t easy, especially in health care. It requires everyone working together effectively in pursuit of common goals. It starts when leaders strategically empower managers and employees to seek process improvement at every turn. It starts when leaders learn to let go… just a little.

Dawn Allbee is executive director of customer engagement for The Joint Commission Center for Transforming Healthcare, Oakbrook Terrace, Ill. (dallbee@