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6 tips for successful change management in healthcare

Even if Swedish healthcare is ahead in many ways, development possibilities are still good, not least through improving organizations with the help of IT support. At the same time...



change means challenges especially when it is about identifying new ways of working and introducing new technical solutions. To get colleagues on board is key. How can we influence colleagues’ attitudes and give them the best conditions for change, and from there change healthcare for the better?


Important to allow the organization’s needs drive the change


Elisabeth Norén is head of Geriatrics at Praktikertjänst N.Ä.R.A. She is also the driving force behind the STELPA project which has the goal to develop the possibilities of using new technology to improve healthcare.


– To be successful with change management it must first and foremost have clear acceptance in the organization. The STELPA initiative came from the nurses who saw the need and improvement potential in their work. The project stems from the needs of the organization, not a just some idea.

Fredrik Eriksson, CEO at the healthcare center Vårdhuset, also has solid experience of change management and improvement work. Fredrik shares Elisabeth’s experience and means that those times when change projects went wrong, was when the initiative and responsibility was high up in the organization, too far from the daily business.

– For those who want to develop healthcare with the help of IT support, it is very important to begin with the needs in the day to day business. For a new IT solution to be received positively by personnel and patients, how it supports their daily work must be clear. If the change project becomes a pure IT project, there is a huge risk that it will be accepted in the wrong way.


A clear vision shows why change is necessary


One tip to those who want to drive change is to begin with a clear vision that the whole organization shares. First when it clear what the changes will lead to, and why it is important to evolve, then the organization will be prepared to join in.

– To achieve sustainable change it is extremely important to clearly present the purpose of the change.  With STELPA the goal is clear: we want to free up more time with the patient. In that way we will also be able to minimize the frustration that many colleagues feel when they spend too much time in front of the computer. We sell into patient benefit and focus on showing how a changed approach benefits the patient through better, more quality assured care, explains Elisabeth.


Dare to question ingrained habits

Elisabeth and Fredrik agree that healthcare’s hierarchical, profession based organization, with a clear distribution of responsibility and authority, has many advantages. At the same time the staunch integrity between the different professional roles, creates barriers that challenge change management.

– To be able to lift healthcare to the next level we must dare to question ourselves and how we are working today. It is only by daring to break down barriers, and get colleagues to talk about what doesn’t work, that we can change ingrained behaviour and continue to develop. First, when we ask ourselves how well our patients actually are, can we start the journey towards new ways of working and methods that favours our patients, says Fredrik.  Elisabeth gives a concrete example:

– To be able to offer as good as possible healthcare in the home, we chose to work with a multi-professional team. Doctors, nurses, physiotherapists and dietitians work together to take care of our patients in the best possible way. We are taking and chance and expect that nurses and doctors and all others will soon agree on a common medical record template, diagnosis and care plan for the patient. That will bring many advantages to healthcare and the patient, and a new way of thinking and working for our healthcare workers.


Change needs a strong change manager


Fredrik means that the ambition to involve as many as possible in the change management risks ending up in endless discussions about what the next step is.  To avoid getting stuck it is important to appoint a change ambassador with the mandate to drive the work forward and to make decisions when necessary.  In most cases it is more important to make a decision in order to proceed than to involve everyone if a decision is to be taken.

– Appoint a champion who knows the organization, with a clear mandate, that colleagues trust and who is really passionate about the change you want to achieve. The demands placed on a new way of working are often higher than the old ways of working. Those who drive the change project will be questioned by others. Therefore it is important that the person who will drive the change is confident in his or her role and organization.


Start over by creating a new team


If despite a clear vision and communicated change mandate, the change feels slow in the current organization, where personnel have an established ways or working together, it can be beneficial to start over. Elisabeth explains how they chose to drive the work through STELPA:

– The goal of the eHealth project is to take advantage of, and develop possibilities by using new technology to improve healthcare. To test our ideas we wanted to form a team in the organization who are in the forefront technically than what is generally common in healthcare. To get things to happen we put together a whole new group of individuals who really want to be involved and think in a new way.

Also Fredrik means that is it often easier to start with small scale changes. It is better to work with a group of individuals who are really passionate about development and win acceptance.  When changes give results in a smaller group it is easier to expand to others.


Evaluate to show success

– To be able to demonstrate the success of a new way of working or a new type of IT solution, means improvements should be measured. Both soft and hard values, describes Elisabeth.

According to Fredrik this often involves a challenge in itself, where the Swedish healthcare is generally bad at measuring and talking about actual results.

– But evaluating, connecting results with behaviour and comparing the different organizations with each other is the basis for being able to change and develop. Those who manage to establish a culture where evaluating and looking at things in the right way, will have the power to drive change!