Tami Michele D O FACOOG Ann Forster Page MS APRN CNM Principles of Implementing Change How do we respond to change Our limbic brain responds very quickly Multisite Systems Change Example ID: 482963
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Slide1
Building a Culture of Change
Tami Michele, D. O. FACOOG
Ann Forster Page, MS, APRN, CNMSlide2
Principles of Implementing ChangeSlide3Slide4
How do we respond to change?Slide5
Our limbic brain responds very quicklySlide6Slide7
Multi-site Systems Change Example
Hospital Association OB Keystone Project
Plan to implement change
Team had clear rationale and evidence for practice change. Core team was formed.Slide8
Recruitment, Find Champions
Most opposed
providers and nurses
Older leaders
Younger
leaders
Kick-off
meeting
to create a sense of focus and
teamwork, include team building activities
Partner with senior executive leaders
Gathering
Data for Quality Improvement
Opportunity to be a leader in practice for other hospitals to follow
Use existing quality improvement committeesSlide9
Existing QI Committees
Projects are easily acceptable when placed in the context of “quality improvement”
Reducing interventions → Reduced patient risk → Reduced
provider
risk
When patients feel they are receiving individualized care, and part of shared decision making, their perception of quality care goes up, and hospital scores increase. Slide10
Individual Work Styles of OB Unit
Example:
DiSC
Understanding personal characteristics can help overcome
barriers
4 basic individual work styles
Dominance (direct, results-oriented, strong-willed, forceful)
Influence (outgoing, enthusiastic, high-spirited, lively)
Steadiness (even-tempered, accommodating, patient, humble, tactful)
Conscientiousness (analytical, reserved, precise, private, systematic)Slide11
Individual Motivators and Fears
Dominance:
Likes Competition, Winning, Action, Results
Fears Loss of Control, Vulnerability
Influence:
Likes Recognition, Enthusiasm, Collaboration
Fears Rejection, Disapproval
Steadiness:
Likes Stability, Cooperation, opportunities to help
Fears Change, Loss of Harmony, Offending others
Conscientiousness:
Likes using Expertise and Knowledge, Quality
Fears Criticism, being Wrong, DisorganizationSlide12
Evidence
Providers and nurses
are more willing to change current practice when shown
evidence and when they are emotionally engaged in the importance of the practice change
Use hospital success stories
Provide packet of information on project with supportive articles
Journal Club to review & discussSlide13
Barriers
Find common ground
Define the areas of
concern
Plan regular meetings, inform & update at every opportunity
If the system is overwhelmed by too many changes, present the project in
stages, go for the low hanging fruit.
Reduces
resistance
Easier to get Buy-InSlide14
Unless you perceive there is a really good reason to change, you won't. Change goes against what is familiar, stable and routine