Ch-ch-ch-changes: managing change in your practice

The practice environment can be mired in a sea of change – governmental, organisational, as well as an ever-changing body of patients and staff. This doesn’t make strategic, operational change easy. Philip Cox-Hynd, change implementation specialist and author of Mindfulness and the Art of Change by Choice, looks at some common pitfalls when implementing change and offers some choice words of wisdom

‘Change’ is one of those words that has been used a great deal in recent years. It is often encompassed within platitudes and soundbites such as, ‘The only consistent thing in life is change’, or, ‘It’s always better to embrace change than resist it’, and ‘Better to choose change than to be a victim of it’.

These phrases are easy to say, and yet, often end up being problematic when they are dished out by those in charge of the change to the unsuspecting mortals who are expected to do the embracing! This is the first big common mistake.

An open conclusion

Another mistake when implementing change is to assume that, just because the leadership team have come to the conclusion that certain processes or systems need to be improved or done differently, everyone else involved will suddenly jump to the same conclusion. It takes time for people to work through a thought process and conclude that change is beneficial. Engaging with people in a thorough, two-way conversation can help avoid the mistake of change coming across as a fait accomplis, or imposition, rather than experiencing some degree of choice within the change.

Dot your ‘i’s: involvement and implementation

One of the biggest mistakes is to forget one of the fundamental paradoxes of being human; on the one hand, we human beings are the most flexible and adaptable species on the planet, incredibly evolved to live and thrive with changes in climate, changes in food and the ways we live and interact. However, we can also be the most resistant ‘so-and-so’s’, especially when change is thrust upon us without adequate explanation. So, engaging with people whom you wish to do things differently, and for them to embrace change, is critical if you are to reduce the feeling of change by imposition.

However, even if people are engaged in the thought process leading up to the need for change, another mistake can be to cease the engagement at that point and not involve them in the design of the new. Put another way, if you can strike up a conversation with your staff such that they realise some of the processes, for example, that they follow are out-of-date or not fit-for-purpose, that could be a good step forward. The mistake would be not to go beyond this step and fail to involve them in the co-creation of the new processes. Instead, it would be better to get representative groups of those who will need to use the new processes in a room and, for as many sessions as it takes over a period of time, to co-create what the new processes might look like.

Once the new process has been co-created it will be even more powerful to help members of this group implement them too; this would continue the sense of engagement and also involvement in bringing about a change that they have helped identify and deliver. Colleagues working amongst colleagues in this way, with ‘light guidance’ from management, can help the ‘change’ be embraced through a sense of choice.

Driving change home

All these common mistakes can, in many ways, fall under one single common error – that of not setting a big enough or broad enough context. In any form of communication it is often too easy to explain the features of something without exploring the benefits, or to describe the ‘what’ without exploring the reasons. In many ways the depth and breadth of context should be determined by the level of engagement created. in other words, if people are driving the change from the bottom up, only then can you assume enough engagement has been created.

The mistake often made in creating engagement is that it’s another ‘management speak’ word that’s trotted out without being fully understood. It can be useful to take a sideways look at the word in a different context. Have you, or close friends of yours, ever been engaged to get married? If so, how was this done? Via a PowerPoint presentation? Or, perhaps, a few emails? Or, a bit of an away day? The answer is probably, ‘Of course not!’ Getting engaged to be married is a decision arrived at by thorough, two-way conversation at best, and engagement for change needs to be just as thorough if the change is to be real and sustained.



Philip Cox-Hynd is a change implementation specialist and

author of Mindfulness and the Art of Change by Choice



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