- Traditional Change Models
- Disparate Change Groups
- Uncontained Change
- No Standard Change Approach
- Tools Focus
- Reliance on Benchmarking
- Changes Are Not Based On Data, Good Data, Or The Right Data
- Changes Made Based On Symptoms, Not Causes
- Systems Versus Processes
- Focus On People, Not On Process
- Lack of Context for Solutions
- Adding Versus Subtracting (Patching)
- Poor Implementation
- No Emphasis On Control
- Management Versus Leadership
The majority of people making changes in hospitals have never been formally trained in any improvement methods beyond rudimentary techniques. Complex change management requires something more than a flowchart or a quick team decision to resolve.
The ad hoc use of simple tools in projects is clearly better than using no tools at all. However, the approach misses two critical aspects of performance improvement. First, using tools independently without a systematic roadmap fails to illuminate the linkage between tools so that they build upon one another and advance critical thinking. Second, it fails to recognize the importance of an organizational infrastructure necessary at a program level to prioritize, align, and appropriately resource change.
By hiding behind the tools, change agents revert to the cubicle change model mentioned earlier. There is an unwillingness and inability to challenge the more difficult issues, which are often the more important ones in the organization. When the infrastructure elements are not considered, change groups are disconnected from the strategic direction of the organization, and there is no real understanding of what’s really motivating leadership.
With this low-level thinking, change managers are not considered in a professional role. Projects are handed to untrained, inexperienced project leaders who, with no data-driven, systematic approaches available to them, in effect do little more than “wing it.”
Even when more advanced infrastructure-based change methodologies, such as Lean Sigma, come along, the thinking is more about just adding a few more tools to the toolkit versus truly embracing a more advanced, higher-performing model; the effect is essentially to neuter the methodology in the process.