When it comes to organizational change, whether to value-based models of care, implementing Imaging 3.0 initiatives or following Meaningful Use Stage 2 objectives, CEOs and radiology leaders might feel as though the majority of their staff resists.
“What tends to happen when we get complicated, complex change, and we’ve got some moving parts, is that people don’t know … what their work is going to look like,” says Daniel Lock, a consultant about organizational change, in an online interview. “All this ambiguity and uncertainty causes people to resist and it’s one of the major reasons people resist.”
In order to have successful change, CEOs and radiology leaders need physician buy-in. Although it sounds simple, obtaining buy-in from a radiology team can be daunting. According to researchers, there are three ways that managers can obtain physician buy-in: through strong communication, proving that changes work as intended and by fostering a positive team culture within the radiology department.
1. Communicate Effectively About Upcoming Changes
From the start, radiology leaders should begin discussing changes that will affect their team. CEOs should emphasize that changes are not a criticism of how staff members perform, and they are not just to cut costs. For example, if a radiology department is implementing a program that aims to reduce MRIs and CT tests as part of a value-based care initiative, the communication needs to begin with the “why.” Americans receive twice as many MRIs and CT tests (100 and 265 each year respectively for every 1,000 people) than the average in peer countries. Unnecessary testing can subject patients to unnecessary radiation exposure and cause undue stress from false positives. Then leaders can explain the “how,” which may include a clinical decision support (CDS) tool implemented into physicians’ workflow.
An essential piece of obtaining physician buy-in is sharing how the change has benefited other organizations. Radiologists have an extensive science-based education, and they expect to see evidence-based facts proving the value of organizational change. Radiology leaders should provide information about peer facilities that followed the same program and saw a reduction in unnecessary MRIs and CT tests, for example.
2. Prove That Changes are Working
Once healthcare organizational change is in place, radiology leaders should show their team data about results in order to obtain physician buy-in. Look at statistics that compare a month or quarter before change was implemented to the same time frame afterwards. Evidence-based mindsets won’t just take someone’s word for it but need to see data that proves results. For example, if MRIs for headache or lumbar spine were reduced by 15 percent, that may prove the new CDS tool is working.
Once results are visible, find team members internally who support the change and will influence others to do likewise. Internal champions don’t have to be the best radiologist; what’s most important is that they are effective communicators, understand the radiology team, have clinical credibility and both understand and believe in the big picture. Radiology leaders can identify internal champions who can act as both internal advocates for the CDS change and can be called upon to address challenges that might result during implementation, such as if CT scans for cervical spine injury are not showing reductions as anticipated.
3. Create a Team Environment
From planning through implementation, radiology leaders will see improved physician buy-in if their radiology team members feel like they are part of a supported team environment. Creating a team environment involves a number of actions on leaders’ parts:
- Seek and Respect Input. As your organization implements change, radiology managers should foster open communication. Their goal should be that their radiologists feel able to give suggestions, criticism and ideas without any negative consequences.
- Meet with Skeptics. Most radiology teams will have skeptics in the crowd. Managers should have individual meetings with skeptics and coach them on the new procedures, identifying what challenges the skeptic is facing and seeking strategies to overcome them. When a skeptic begins adopting the CDS tool and using it, leaders should positively reinforce that behavior with a face-to-face “thank you,” maybe even alongside a morning cup of coffee.
- Tweak as Needed. As organizational changes are implemented, radiology leaders may have to step back regularly to see how the change affects staff needs. For example, if a radiologist is part of a multi-disciplinary team initiative, that new role may be more time-consuming than expected. His or her hours may have to be tweaked, with fewer hours assigned to reading scans and more hours dedicated to the team. Healthcare leaders will need to access resources and support team members through the change initiative.
Organizational changes in radiology are challenging, for both the leaders overseeing change and the radiologists implementing new tasks. With effective communication, proving the positive outcomes that result and fostering a team environment, radiology leaders can make the change as painless as possible with improved physician buy-in.
What strategies are you employing to promote physician buy-in and improve communication?