How to engage your staff when introducing a new model of care

Effective change management when introducing new models of service delivery is always going to be a challenge.  We asked some of the speakers from our Developing a 7 Day Health Service conference about strategies for creating awareness of change, increasing staff satisfaction, battling with ingrained culture and improving training and education when their organisations moved to a 7 day health service.

“This was certainly a big challenge for us, with some involved staff having worked in the same role unchanged for over 15 years. Some of our key strategies involved:

• Early engagement of senior staff in design of the service, these staff became our ‘champions’
• Regular, open communication with all involved staff with the key focus on the outcome being on improved patient care
• Involvement of staff in the selection and design of rostering models
• Creation of key positions to accommodate all staff involved in service provision in this area
• Anticipating (where possible) and listening to concerns and addressing these or assuring people that these would be evaluated
• Leaving some flexibility in the model to adapt to issues not initially anticipated
• Resilience in the leadership group, continually referring to the goal of improved patient care.”

 Geraldine Millar, Associate Director Allied Health –Physiotherapy (Acting), Eastern Health

“Firstly on the Gold Coast right now there is massive change management, with the new hospital opening in 3 weeks. This has created a position of opportunity where change is accepted a little more readily. We have utilised this environment to develop and reassess models of care moving forward to the opening of Gold Coast University Hospital.

The main focus of this change has come from directly involving the staff in the decision-making process. Much like the Fish philosophy that was developed in the Magnet hospitals in the USA, if staff members help designing the model they will drive the implementation and sustain the model. This creates increased satisfaction and helps to change the cultures from the ground up. “

 Brett Sellars, Clinical Nurse Consultant, Business Practice Improvement Officer (BPIO), Gold Coast Hospital

“Conceiving a new weekend service model is very much the first step.  Wide consultation with staff and the many other stakeholders impacted on by the change proposal is critical because there will be a range of interests and agendas at play that need to be taken into account in order to get buy-in and momentum. Information gathered during the consultation phase, especially valid implementation concerns, is really valuable for informing and reshaping the proposal so it is more robust and acceptable to stakeholders. The consultation phase will also determine if the timing is right for the proposed change. Experience has shown that adopting an incremental approach to change whenever possible, combined with an agreed trial period for evaluation, does help to allay concerns by making it more manageable, increasing staff acceptance, involvement and ultimate satisfaction.”

Peter Nuttman, Imaging Operations Manager, Melbourne Health

“Effective change management is all about the right types of information, positive and realistic change leaders and forming strong trusting relationships. Great ideas of improved services often fail due to these “basics of human nature” are not followed.  I always consider 2 things related to engendering change: capturing both hearts and minds.” 

Darren Clark, Nursing Director Medicine & Emergency Department Logan Hospital, Metro South Hospital and Health Service

 “Communication strategies require careful consideration and planning when implementing service model changes. A number of workshops were facilitated within days of the project commencing to assist in gaining engagement. This enabled all levels of staff (including unions) to understand the rationale and timelines associated with the service change. However, most importantly staff were able to influence the development of the new model. Staff were encouraged to participate in a range of working groups which enabled them to develop structure and processes around key components of the new model. Staff were concerned that they did not have the requisite competencies for the new intervention types. Therefore the service created a working group exploring clinical skill and competency gaps and developing strategies for meeting these gaps. Using best practice principles all disciplines were involved in developing and defining care journeys for each of the intervention types. Most importantly they were involved in the development of the service profile for the new service including the development of service aims and objectives, inclusion and exclusion criteria, referral types, priority framework and key performance indicators.”

Kim Fraser, Nursing Director Post Acute Care Service, Metro North Hospital and Health Service

 “Communication, communication, communication. It is undoubtedly the key to implementing any successful change. In order to ensure that communication occurs with all key stakeholders, develop a key role map and have it displayed publicly for all to comment on, there is nearly always someone or a group of people that can be missed by only having ‘one set of eyes’ look.

Listen to the feedback and concerns of staff, and don’t take criticism personally. People don’t traditionally like to change and will often lash out and ‘shoot the messenger’. Going through change is like the 5 stages of grief and you have to support staff as they move through them.

Understanding each person’s frame of reference and the ‘what’s in it for me’ of each of the staff required to change. Clinicians are generally driven by what will improve patient care and not in meeting any targets from Local, State or Federal bodies. Phrase all changes in light of how it will affect the patient.

Build a case for change with a ‘burning platform’ that staff can relate to.

Most importantly, maintain a sense of humour!”

 Sherylle Sheehy,  Clinical Nurse Consultant Acute Surgical Unit, Wagga Wagga Health Service

Visit the Developing a 7 Day Health Service conference website to view the full conference agenda and to register.