Posted on Thu, Jan 08, 2015

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by Quint Studer

Copyright 2014 by Studer Group, reprinted with permission.

"People wish to be settled; but only as far as they are unsettled, is there any hope for them." - Ralph Waldo Emerson

Being a leader in healthcare is tough. In fact, when you do it right, it feels kind of like you're climbing up a downward moving escalator. (I've actually tried this and it's not easy!)

Yes, we live and work in an ever-changing, fast-paced environment – both externally and internally. In order to make and sustain the improvements necessary to provide the best possible patient care, we often need to adopt new technologies, tools and processes that require us, and our staff, to change the way we do things.

You've probably noticed that people don't always welcome change with open arms. In fact, they resist it. This is natural. However, as leaders we can help people become more comfortable with that “unsettled” feeling.

The first step is to understand the phases of competency and change. At Studer Group, we often use the following model to illustrate the various stages that individuals will find themselves in at some point in their lives and careers.

Phase one: Unconsciously unskilled (incompetent) – During this phase, we are new to a role, process or skill. We don't know what we don't know because it is still too new.

Phase two: Consciously unskilled (incompetent) – In this phase, we consciously know what we don't know. We've identified a gap between our current skill set and where we need to be to become successful.

Phase three: Consciously skilled (competent) – Here we have the skill set, but we still need reminders or checklists to fully execute. We are likely still unsettled, but we understand the need for change and have embraced it.

Phase four: Unconsciously skilled (competent) – It's in this phase that we can complete tasks without reminders. They have become second nature and we can't imagine doing it any other way.

Anytime change is involved, there will be a level of adjustment for both staff and leaders. Part of our job as a leader is to unsettle people. We like to feel successful in our role, but in order to improve we need to be unsettled from time to time.

Realize that discomfort will be associated with change and that's okay. For example, when you ask a high-performing physician to implement a new process, such as electronic medical records, you will likely receive pushback. It's not because they are trying to be difficult, or even because they don't see the benefit. It's because you are asking them to change when they already feel successful.

When you think about this in terms of the four phases of change, you will see that you are actually requiring that physician to move from being consciously skilled back to being unconsciously unskilled.

You can ease anxiety by explaining how this change will make a difference (and for the better!). Describe what the outcome will be after the change is made. This is the why that makes people willing to be unsettled for a while.

Remember, it takes a lot of frequency to become effective and efficient. The phases of competency and change can be a lengthy process. The first six months are by far the hardest and when resistance is at its highest. The next six months are better but some uncertainty may still be present. But by year two, it no longer feels like we've changed; it's simply the way we do things.

Ultimately, change is necessary to standardize leadership, create consistency, and keep ahead of that downward moving escalator. In turn, we produce better outcomes for our employees and our patients.

Watch accompanying video here.


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