With so much jargon involved in healthcare IT projects, is there any difference between operational readiness, culture, and change management?
The people side of healthcare IT (HIT) projects ultimately has one goal: to have the users of the technology successfully integrate it as a tool into the work processes needed for either patient care or the business of healthcare.
This sounds easy but the people side of any technology project is often the most expensive and certainly the most difficult to control. Each user is a unique individual, influenced by his or her own knowledge and learning, ability, and adaptability to change, and influences shaping the norms and rules he or she abides by.
Operational readiness, change management, and culture-shaping are three different but interrelated dimensions of the human side of HIT projects.
By the nomenclature, this element refers to the readiness of “operations” (the end users involved in the care and business of healthcare). There are two parts to operational readiness – training and communication. Because layering technology on top of bad processes just speeds up those bad processes, we often abandon previous work processes in favor of newly refined workflows that incorporate the use of the technology being implemented. For this reason, the training of operational end users is of paramount importance. Typically, training should be role based and not just highlighting available functions. The other leg of operational readiness is communications.
Communications can help cement the expectations, allow the leadership to schedule to meet project obligations, and build awareness for the project and its ultimate goals. Once we have those basic elements, the stage is then set for change management.
Change is an individual journey for each end user. Change management is the facilitation of how that individual processes and deals with a change. As seen in the diagram below, a person’s attitude or self-esteem may undergo a rollercoaster of emotions on the journey from awareness of the change to ownership of that change. The goal of change management is to decrease the depth of the disruption state and to decrease the overall time needed to reach rebuilding and ownership phases. The wrong type of message in the operational readiness space can stall the change process. This is where communication matters in change management. An inspirational message espousing the benefits of a new technology can be overwhelming when that individual is still grappling with just the awareness of the change. Managing change is largely giving the right communication at the right time, assisting with self-awareness of the change process, and building a gradual trust in the project or new technology.
Culture is the undercurrent that can either foster support and engagement for a project or it can be the driver for push-back, distrust, and stagnation on the status quo. A culture is defined by what is considered normal and acceptable behavior. If it is normal to be expected to change and accommodate new ideas and systems, then the organization will embrace new projects and technology. If it is acceptable to reject new technologies or to leverage political capital to stop a project, then failure will be the inevitable fate. Culture is largely shaped by how leaders act, react in a crisis, and by the stories they share – good and bad. In healthcare as a whole and in healthcare IT, a culture based on trust, learning, and being proactive is the most desirable.
Through managing all three human aspects of a new project or technology, one can almost ensure success in the adoption and eventual ownership of both the workflows and technology involved. Without addressing all three components, any one of them can destabilize the project and inject unnecessary risk.