Making process changes at a retina practice can be a huge challenge. At times, the relationship between changemakers and practice stakeholders will feel like a battlefield, where heels are dug in.
Fortunately, just as with any battle, progress can be achieved when strategy governs the interaction. A winning military strategy uses targeted tactics to achieve big-picture goals. Applying the strategy concept to create forward movement at a retina practice requires a tactical plan and solid organization.
Few tasks are more tumultuous than trying to move a group of people in the same direction. Here are several ways to create a strategy that may encourage greater acceptance of process change.
Naming Fears
The uncertainty inherent in change triggers fear and worry for most people. Helping team members to identify their fears and realize they are shared by others can inspire relief, camaraderie, and open-mindedness toward new approaches. Common concerns include:
- I’ll lose control;
- I won’t be able to learn the new process;
- I’ll look or feel foolish;
- It will be more complicated than what I’m doing now; or
- I won’t have a job anymore.
Candidly naming these potential fears may seem too blunt for some managers, but open discussion and sharing helps to communicate that everyone is in the same boat. Once that is clear, people will be more receptive to the message that it is time to start rowing together in the same direction. Few things make good work happen faster than a team willing to lean into its fears and apprehensions for the greater good of the practice.
Shedding Unconscious Biases
In addition to fear, another common blocker to real change is perceptions of what a practice can (or can’t) achieve. Looking for the “perfect” solution can prevent work from starting and slow down progress once the changes are underway. The perfectionist can be just as destructive to real change as the naysayer who believes changes can’t be accomplished.
Although acting on the idiom “throw spaghetti at the wall and see what sticks” isn’t necessarily recommended, getting started and tweaking the processes as time goes on is more important than perfection. During the nitty-gritty activity of making the desired changes, managers must be willing to acknowledge that the “right” solution may differ from the original concept. If (or when) this occurs, it is time to pivot. It’s important to remain flexible as situations evolve.
Suppose a practice gets stuck trying to select the “correct” path forward due to the number of potential solutions. The team may benefit from agreeing on what change is critical to improving the process and creating a solution to the fundamental issue. Baby steps are the most straightforward route to accomplishing these goals. Additional changes can always be made by adding to or subtracting from the process. Continue fine-tuning until the entire process is efficient.
Forgetting the Past
“This is how we have always done it” is a statement that prevents many retina practices from getting where they want to go. Things that are known and familiar feel safe, even when they are inefficient; change is often perceived as threatening or scary. It is likely that some people will behave in ways that sabotage the change — directly or indirectly. When this occurs, remember that fear may be driving the behavior. What is the employee afraid of — looking foolish by being unable to catch on to the technology or process? Having their employment terminated? While the possibilities are endless, there are usually core issues and fears that can be addressed.
Idealized memories of “the way things used to be” or unwarranted satisfaction with the way things work now can be detrimental to positive change. All people feel discomfort when they are required to move out of comfort zones and learn something new. For some, this discomfort can be paralyzing, while others seem to adapt quickly or “lean into” the discomfort. Some personalities are more resistant to change, while others flourish.
One way to gain greater buy-in is by bringing staff members into the discussion at planning meetings. Call on quiet people to add their voices and opinions. This fosters a more inclusive culture and makes the team receptive to fresh ideas. Because some employees may be uncomfortable speaking up in group settings, once the meeting date and time are established, it might help to ask everyone to submit their thoughts in advance. These thoughts can then be shared anonymously as part of the meeting agenda. Reminding the team about the practice goals can help them remain focused on improving the processes.
Aligning With Goals
When trying to improve or revamp a process, goals will be most effective if they align with practice values. For change to occur, physician owners and the administrative team must buy in to the new process for change to occur. Engaging the staff in process change is more manageable if the leaders agree.
When requesting staff input about a process change, provide the end goal, then work backward to the solution. Encourage brainstorming, and don’t dismiss ideas too quickly. There could be a gem in the idea — not as presented, but enough to foster new thoughts about the process issue.
Refining Your Approach
A key to change is flexibility. Communicate and model openness to the team. Relay the message to “fail forward,” learning and adjusting new processes as needed. Express a desire to deal with the “what ifs” and a willingness to play out the change scenarios. Replace “this is how we’ve always done it” with “let’s try it and see what happens,” and other positive phrases.
The more flaws that are worked out before implementation, the better the outcome will be. Ask staff to think about potential unintentional effects of the proposed change, and listen to their input. The plan may need to be adjusted, but the practice will be better off when all angles are considered.
Also, consider whether the change will be implemented in 1 location as a test case before implementing it practice-wide. Sometimes, it is prudent to dip a toe into change instead of plunging in headfirst.
Vision Is Motivational
One way to help teams adjust to changes in a retina practice is to create a picture for them. Help people see where the practice is now and visualize where it could be. Team members are more likely to engage if they understand and accept common goals. Listen to thoughts about the easy changes, possible pitfalls, and challenging areas. Remember that everyday roadblocks to organizational change include fears, ideals, nostalgia, misalignment of objectives, and the approach taken.
Retina can be chaotic, but chances are if you “signed up” for retina, you’re built for chaos. With a few tools for managing pushback in your strategic battle plan, driving change at your retina practice is within reach. NRP
