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Leading Operational Changes Within your Medical Imaging
Department
Laurie Schachtner MBA, CRA, FACHE, RT(R)(M)
Change hasChange hasConsiderable psychological impact on the human mind.
To the fearful, it is threatening because it means that things may get worse.
To the hopeful, it is encouraging because things may get better.
To the confident, it is inspiring because the challenge exists to make things better. King Whitney Jr.
Change - why is it so important?
Change - why is it so important?
Change is here to stay, and with constant demands from the marketplace to deliver more with less, one will have to change in order to accomplish success.
One’s ability to lead change is becoming a key factor in determining job success.
ObjectivesObjectivesHow to lead change with five steps.
How people respond to change both positively and negatively
Define the change variables: adaptability and resilience.
How to adapt when performing a RIF (reduction-in-force) in Medical Imaging.
Why change requires us to involve others:
Why change requires us to involve others:
Participation builds commitment
Change leaders must be masters at involving others for momentum (Sales/Marketing skills)
Use effective questions to solicit input from those who will be affected by the change.
Skilled change leaders
Skilled change leaders
Need to be comfortable facilitating a wide range of group interaction
Use impromptu brainstorming
Use well structured problem-solving sessions
Must be flexible for various levels of involvement for maximum participation
The key is to provide many varied opportunities for others to shape the change
The key is to provide many varied opportunities for others to shape the change
These processes will translate abstract change goals into concrete ways that can alter their behavior on the job
This builds ownership
Leading the change participation processLeading the change participation process
Be able to let others express fears and/or negative feelings toward the change.
Have some “thick skin.” Don’t take others’ rejection of the change personally or be worn down by their resistance.
Think of a project you are planning for change you
are planning for
Think of a project you are planning for change you
are planning for
Implementing voice recognition
Installing FFDM
Installing PACS
Working on a RFP for new radiologists
20 % 60 % 20 %
Dimensions of leading changeDimensions of leading change
MODELING the change
COMMUNICATING about the change
INVOLVING others in the change
HELPING others break from the past
CREATING a supportive learning environment
MODEL the ChangeMODEL the Change
To lead change, one must be able to show others what it means to change.
Douglas Smith (1996) calls it “the courage to live the change” and perceptively point out that leaders, by the very nature of their role, must be the ones to go first.
Communicating about the changeCommunicating
about the changeTo lead change, you must reach everyone who will be affected by it.
Written communications, one-on-one conversations, and/or group discussions.
Put yourself in others’ shoes.
You need to be comfortable communicating the change even when you are not sure what is going to happen.
Things do not change; we
change Henry thoreau
Things do not change; we
change Henry thoreau
INVOLVING others in the change
INVOLVING others in the change
Be prepared to facilitate impromptu brainstorming to structured problem-solving sessions.
Flexibility is paramount because every aspect of the change may require a different level of involvement (written, group, one-on-one).
This involves personal involvement.
Balance - one must be sensitive enough to empathize with those who have fears with the change. As well as be prepared for others’ rejection of the change itself - and do not be worn down by their resistance. (ex. Rads with VR)
INVOLVING others in the change
INVOLVING others in the change
Leaders for the change need to be masters at involving others in the process.
Have a mindset that change is something everyone helps bring, rather than something that is “done” to others.
Use effective questions to solicit input from those who will be affected by the change.
To actively listen once people start opening up (take notes).
Helping others break from the past
Helping others break from the past
Greatest challenge in leading change is to help others break free from the present way of doing things
1. Help others adopt a questioning stance in their daily routine.
2. Encourage others to approach the future with a clean mental slate. Goal is to generate innovative ideas for achieving the ideas. Foster their insight.
We did not change as we grew older; we just
became more clearly ourselves. Lynn Hall
We did not change as we grew older; we just
became more clearly ourselves. Lynn Hall
Helping others break from the past
Helping others break from the past
As the change leader, you will need to help others understand that the most rewarding profitable future may not necessarily look like an extension of the present. You will need to be the guardian of possibilities, encouraging others to ask both “why” and “why not?”
Creating a supportive learning environmentCreating a supportive learning environment
For change to happen, large numbers of people will need to do things differently, as well as attempt things they have never done before.
This learning process for some can be frightening and frustrating. Try to minimize the stress by creating an open and accepting environment.
Creating a supportive learning environmentCreating a supportive learning environment
This means finding ways for people to try new behaviors with minimal risk.
It also means focusing on the correction of errors rather than punishing those who made them.
Have some fun with it!
Now, I am going to walk you through a
change
Now, I am going to walk you through a
change
• With a RIF I implemented in Medical Imaging
• a couple of months ago.
RIF in Medical Imaging
RIF in Medical Imaging
Consultants came to all 6 hospitals to access staffing and enhance revenue.
Productivity within each Imaging modality was evaluated. All FTEs, hours of staffing etc. were investigated.
Imaging support was told to cut 2 (1 position person and the rest registry) FTES.
Our HR policy was last in- first out, unless an employee was in documented disciplinary action.
RIF in Medical Imaging
RIF in Medical ImagingI worked with HR as what to say and how
to say it. I explained that this was not a personal decision, that this was a business decision.
Once I communicated that her position was eliminated, I brought her to HR for detailed information regarding severance etc.
Around 11:00AM that morning, I went back to the department- set up a 5 minute stand up meeting with everyone I could gather and informed them of this position elimination.
RIF in Medical Imaging
RIF in Medical Imaging
At 3PM I held a second 5 minute stand up meeting informing them of this position elimination. I also opened these mini-sessions up for questions after the communication.
It is important as a leader NOT to blame administration or someone else - that you support the decisions as actions.
What do you think their questions were?
William Bridges points out that as individuals experience change, there are three phases of transition that take place, often marked by changes in behavior.
There are two (2) different ways for others to respond
to change
There are two (2) different ways for others to respond
to change
Negative response to change
Negative response to change
ODR 1989
Stability
Immobilization
Denial
Anger
Bargaining
Depression
Testing
Time
ActiveActive
PassivePassive
EMOTIONAL
RESPONSE
EMOTIONAL
RESPONSE
Informed anguish
Blissful ignorance
Coming to terms
Realistic support
Overtchecking
out
Covertchecking
out
1. UninformedOptimism
(Certainty)
2. InformedPessimism
(Doubt)
3. HopefulRealism(Hope)
4. InformedOptimism
(Confidence)
Resistant
Time
Supportive
Positive response to change
Positive response to change
1. UniformedOptimism - Certainty
1. UniformedOptimism - Certainty
4. Informed Optimism- Confidence
4. Informed Optimism- Confidence
the speed of changethe speed of changeWe each have a unique pace at which we adapt to changes around us.
Proceeding beneath that pace is boring and unchallenging.
Proceeding beyond that pace causes fatigue, emotional burnout and inefficiency.
They always say time changes things, but you actually have to change
them yourself. Andy Warhol (1928-1987)
They always say time changes things, but you actually have to change
them yourself. Andy Warhol (1928-1987)
Change usually involves three aspects
Change usually involves three aspects
Work with theWork with the
Adapt theAdapt the
to suit the changeto suit the changeTeamwork with strong effective leadership
Teamwork with strong effective leadership
Change is happening around us all the timeChange is happening around us all the time
Like the pendulum of a clock, movement is constant.
Trying to manage change is like trying to manage other constants like the weather- nearly impossible.
As leaders, we must initiate change when the need is identified.
What can we influence?
What can we influence?
Our adaptability - is what we do in response to change. It can be proactive, when we prepare in advance for changes, or it can be reactive, making adjustments for changes that have already taken place. As leaders, we can help our staff work through the process of adaptation.
What can we influence?
What can we influence?
Our resilience - is how easily we, our staff, and or our organizations adapt to the changes taking place. There are many characteristics and factors that can either contribute to, or inhibit our resilience. As leaders, we can create an environment that encourages the trust and confidence necessary to develop a resilient team.
Every one minute you spend in planning will save you at least three minutes in execution. Crawford Greenwald
Change- Build your plan (the HOW)Change- Build your plan (the HOW)
Define the specific outcomes and expectations
Provide detailed list of action steps (with the timelines)
List of needed resources
Communication plan
KNOWING + FEELING = DOINGKNOWING + FEELING = DOING
People are more resistant to change if they feel uninformed
The more they understand the WHY and the HOW about a change initiative, the greater opportunity for them to accept the change.
KNOWING + FEELING = DOINGKNOWING + FEELING = DOING
Acknowledging an employee’s feelings of uncertainty, frustration, anxiety is important in the adaptation process. A little empathy goes a long way.
ReferencesReferencesKatzenbach, Jon. (2995) Real Change Leaders: How You Can Create Growth and High Performance at Your Company. New York Times: Times Business.
Kofman, Fred & Senge, Peter. (1993). Communities of commitment. The heart of learning organizations. Organizational Dynamics, 22(2), 5-23.
Kotter, John. (1995). Leading change: Why transformation efforts fail. Harvard Business Review, 73(2), 59-67.
Larkin, T.J. & Larking, Sandar. (1994). Communicating Change: Winning Employee Support for New Business goals. New York: McGraw-Hill.
O’Toole, James. (1995). Lading Change: Overcoming the Ideology of Comfort and the Tyranny of Custom. San Francisco, CA: Jossey-Bass.
Smith, Douglas. (1996). Taking Charge of Change: 10 Principles for Managing People and Performance. Reading, MA: Addison-Wesley.
• Managing People and Performance. Reading, MA: Addison-Wesley.
Marshal Goldsmith Forbes- executive coach
Marshal Goldsmith Forbes- executive coach
Have to be mentally tougher than in the past even though we know things will improve.
You have to reapply for your job every day - The boss is in the driver’s eat - pay attention to his/her “hot buttons”
Focus on what you are giving, not what you are getting. Bring your “A” game.
Time to shine - notice what others are doing-
• others drag you hustle;
• others moan you smile.
Be stronger and more determined.
Keep positive,
stay focused and
do your best!