Helping team members be their best: Implementing change in the hospital (Proceedings)

Helping team members be their best: Implementing change in the hospital (Proceedings)

Aug 01, 2009

An organizational culture consists of the values, beliefs, traditions, attitudes and behavior of the practice and the people that work in it. It's stories about "How we do things around here." It is maintained and carried on by everyone who works in the practice, from the owner to the most part time kennel person. When it comes to making big changes in a practice, the culture of the organization becomes very important. Healthy systems support and encourage changes, along with the growth of individuals on the team, while unhealthy systems prevent it. When you want to implement changes in your practice, for example when you get home from this conference intending to improve your hiring system, how will you be received? Will you be allowed and encouraged to implement what you've learned?

Stephen Covey says that "An organization is made up of individuals who have a relationship and a shared purpose. The highest challenge inside organizations is to set them up and run them in a way that enables each person to inwardly sense his or her innate worth and potential for greatness and to contribute his or her unique talents and passion to accomplish the organization's purpose & highest priorities."

Peter Senge's book "The Fifth Discipline" talks about five stages or levels through which decisions are made and goals are reached. There are many decisions reached in a busy veterinary practice every day, and each will lead to change, whether big or small. Some are simple – which brand of paper toweling should we buy. Others are complex – what should our medical protocol be for hemorrhagic gastroenteritis, or how much money should we budget each year for marketing. Most people don't blink when you change your brand of paper towel. The larger the decision and the more dramatic the change necessary to implement it, the more you will need to manage that change.

Some decisions are made on-the-spot by individuals. Others involve a group of people – the receptionist team, the management team, the marketing committee. Major decisions are usually made with input from at least some of the team. Some goals cannot be developed without a group effort. Regardless of the level of decision needed, it takes practice to make decisions at a higher level. An organization cannot move directly from square one to the fifth and highest level. It must first develop a team through discussion and dialogue.

The Five Stages or Levels Are

Stage I: Telling

In this system, the business or the people working within it do whatever the boss says. Staff members have no opportunity for input. The message is "This is my vision. Be excited about it or choose to work elsewhere." This is the traditional authoritarian method, which is especially prevalent in small businesses with one or two owners/managers. It is also the level that is used in crisis management – "We've got to do this."

Stage II: Selling

At this level, management says "We have the best answer. Let's see if we can get you to buy in." The leader(s) attempts to enroll the staff in the vision. The employees are like the boss's customers and he/she is trying to sell them on a product.

Stage III: Testing

Testing implies the staff will influence the results and the final decision. At this level, management asks "What excites you about this vision? What doesn't? How could we make it better?" We determine how enthusiastically the team will support the vision and what aspects matter most to them. Then the boss reserves the role of judge and final decision maker.

Stage IV: Consulting

Here we might get input from the staff, present two or three scenarios that we have pre-selected and then recognize input from the staff. The question asked is "What vision do team members recommend that we adopt?" We already know that either of the options presented would be OK.