Healthcare News & Insights

Implement new hospital protcols with the least amount of resistance

Nowadays, there are a lot of changes and new protocols being implemented at hospitals all around the country. Reason: The healthcare industry is in a state of flux with the Affordable Care Act. And let’s face it, very few people like change. So how can you create a change at your facility with as little pain and as much adherence as possible?

139547018First off, managers and supervisors need to realize that most people are afraid of change. And the bigger the change, the higher people’s emotions will run and the more they will resist it.

One way to nip it in the bud: Allow providers to have some control and say in their destiny. When people are involved in the change effort, they’re more likely to join in, rather than resist. That’s why it’s a must to get employees at all levels involved in the planning and implementation of a new protocol or patient safety program.

Just getting their input will make them happy, because they think – and know – they’re an important part of the facility. Plus it creates opportunities for others to get involved with the planning and implementation of the change process. This in turn, can lighten a supervisor’s load by spreading the workload, and gives those involved a sense of ownership.

Honest communication

It’s of vital importance that hospital execs and supervisors share all of the information they can about the change, and are honest about it. Letting providers know what’s really going on is key.

If things aren’t going well, be honest about it. It’s better that providers know to expect some bumps in the road. Make sure your direct reports and their direct reports know management will be there with them through those times.

Or if supervisors don’t know something, they should answer honestly with “I don’t know, but I will do my best to find out and let you know.” This is a legit and acceptable answer – just follow through.

People value transparency, and it’ll help build their loyalty and commitment to the change, their manager and the facility.

Remember, it’s impossible to over-communicate.

Share urgency

Learning new ways of doing things and developing new habits can be intimidating. Especially for nurses, who have been doing something a certain way for a very long time and are constantly on the go, learning a new treatment protocol isn’t something they are dying to do. So managers need to give them a compelling reason to make the changes, and positive support during the adjustment period.

Giving people the big picture of what the change will do and the expected outcomes helps. Employees need to see that despite the fact the changes may not be easy, there is a positive outcome down the road.

But one word of warning: Don’t try to scare people. Scare tactics don’t work. They only create resentful, untrusting employees who are unmotivated.

A successful change

One push most hospitals, including BJC HealthCare,  in St. Louis, are making is to cut hospital acquired infections, like urinary tract infections from catheters.

BJC HealthCare,  implemented a new nursing protocol for reducing urinary tract infection from catheters in a three-step process with little resistance and a lot of success, reported The Advisory Board Company.

Here’s how they did it:

  • First they thought like marketers. How could they make this change easy for nurses to remember? Answer: Make the name of the new protocol an acronym. So the name of BJC’s new foley catheter removal protocol is “HOUDINI.” Each letter stands for a condition for which a foley catheter remains in. If the patient doesn’t have one of those conditions, the catheter … disappears.
  • Second, the nurse leaders anticipated concerns and objections they thought their nurses would have, such as “we didn’t know we could remove a catheter without a doctor’s order” and “great, more work for us.” So since nurses are caregivers, the leaders appealed to that side of them and framed the protocol in terms of patient safety. They also reassured their staff that catheter removal was well within their scope of practice.
  • Finally, the nurse leaders set a goal — remove one to two catheters per day. When the nurses met their goal they would put their initials on the unit white board. If they weren’t able to meet the goal, they had to document why.

That’s all it took for BJC Healthcare nurse leaders to reduce the number of catheter days on their unit by 18% in a year.


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