“Change” is about the only constant in health and aging services these days. Leaders of long-term care organizations are confronted with a tightening fiscal environment, along with savvy customers who want more from the institutions where they may spend their final years. Your survival is likely to hinge on your ability to be a change leader, and to guide your staff toward creating a stronger, more customer service-oriented organization.
But perhaps you’ve noticed that some people respond poorly to change. One of your best nurses never turns in her reports on time, no matter how often you explain the importance of the paperwork. You’ve got a dietary manager who creates fabulous menus but who refuses to give up trays in the dining room.
Why are people so stuck in their ways?
We all have problems with change. Some people like predictability and resist any change; some can manage change only with advanced notice and sufficient explanation; others love change in general, but just not the one you are instructing. The fact is that most of us have something that we feel the need to hold onto, that we just can’t change, or at least not yet.
So, how do we change when we really need to, and how do we get people in our organizations to change when it is imperative that they do so?
The traditional approach
Everyone needs motivation to do things in new ways. The most common forms of motivation are external—we need a push from outside of ourselves to make a change. That push can be a small nudge (“I expect you to do this because it’s part of your job now”) or a big shove (“If you don’t do this, you will be on the way out”).
This familiar approach can work, but more often than not, compliance that comes with this approach is short-lived. The person who was asked to “comply” still doesn’t understand or accept the need to change, and resistance is likely to manifest down the way.
Key to change: Listening
PHI has worked with dozens of nursing home leaders to enhance their ability to manage change. These leaders have turned “resisters”—for example, a director of nursing wedded to traditional models of care—into champions for change, using a skill that we all can learn and practice. That skill is active listening; that is, paying close attention to what is going on for the person who is stuck in his or her patterns of behavior. By discovering the background story that underlies staff resistance, administrators, department heads and supervisors have been able to address root problems, rather than symptoms, and thereby make change stick.
For example, a CEO discovered that a manager who was resisting becoming more collaborative knew only top-down models of management. Listening to his story, the CEO realized this manager interpreted the efforts to get him to change as attempts to undermine his authority. With assurance from his CEO that she wanted him to succeed, the manager became interested in how he could engage his direct reports. With ongoing coaching support, his skill improved, he became a better manager and he now leads the interdisciplinary leadership team that is rolling out a more collaborative management style throughout his organization.
He made an active choice to change his approach to leadership and management, and both he and his organization have benefited immeasurably.