Podcast #44 - Incorporating Change in a Slow Changing Environment

​Medicine is slow to change, and using #FOAMed can be a challenge at times if you feel stuck and unable to speed up the process.  Today, we talk about some tips that could help you better move things along in your department and among colleagues.

When you want to make a change in practice, the first step is to make a plan on how to introduce that change.  Before you make your “pitch” to others, you need to know what you are going for.  Questions that need answered in this stage include who is your audience and what is your goal?  Is this something that is only involving part of your department or does this require cooperation from multiple outside departments?  If this is a more complex change, more assistance will be needed and potentially more planning.

Change is not just about presenting data.  In fact, this is only a small part.  Your colleagues are knowledgeable and will have their own barriers to practice.  Data will help support change, but you as the person introducing the change need to bring other aspects to the table.  It is vital to plan for potential complications and barriers.  By knowing these and preparing on how to address them prior to introducing the plan, it is easier for people to buy-in to the change.  Once you know how to address these issues, you can start to find others that will help support your plan.

You have identified your audience and have the information you need to present the change, but now you need to share it with others.  For most of us, this requires getting someone more senior to buy in to the idea.  Having multiple people who will help you in suggesting the change is essential.  As they say on FOAMcast, “Don’t FOAM it alone.”  In this case, you want a champion at least by your side.  A champion is someone who believes in the change.  It is best to have someone who is well respected and can further push the change possibly beyond what you are capable of alone.  Champions are necessary to help with the buy-in that comes next.

Early buy-in is crucial.  There is almost guaranteed resistance and this should be expected.  However, champions will help support you.  It is good to approach those who are skeptical early, as they can be some of your biggest allies.  John Hinds believed this and talked about it in his SMACC talk “Crack the Chest, Get Crucified.”  As John put it, there will also be #ResusWANKER types and there is not much you can do about those, except get others to support your decision.  As with every step, you have to be patient, but that does not mean giving up.

Once your change is accepted and it is being introduced, you cannot stop.  Make sure that people are getting the information they need to be successful.  If it is a new protocol, do not just tell them once and expect it to stick.  Spaced repetition in helpful in reminding people of what you want and to get them to do it long-term.  If this was your idea, you and your champions can help manage the change.  Especially for those who were more hesitant to change in the first place, they will sometimes require the most management.  Do not abandon them as they may ruin what you worked so hard for in the first place.

Thank you for listening to the podcast and reading the blog.  Two of the resources used to help make the basic idea from the podcast were from two very difference places.  One came from the business world with Forbes and the other is more from the medical world having come from Physicians Practice.  Please let us know what you think by giving us feedback here in the comments section or contacting us on Twitter or Facebook.  Remember to look us up on Libsyn and on iTunes.  If you have any questions you can also comment below, email at thetotalem@gmail.com, or send a message from the page.  We hope to talk to everyone again soon.  ​Until then, continue to provide total care everywhere.

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