The Problem
An implementation of an Electronic Health Record (EHR), including the Intensive Care Units (ICUs) as part of the rest of the hospital, had a problem. The implementation team thought they considered the ICUs’ unique needs. When it came time for training, ICU nurses had a higher no-show rate in the training when compared to other units in the hospital. Anecdotally, EHR trainers reported more negative behavior among ICU nurses, like vocalizing disparaging comments about EHR usability.
One implementation team member referred to the ICU nurses as nitpickers and whiners, stressed out from their work, who take it out on everyone else. To hold these people in disdain assumes we know so much about their situation, intentions, and actions that we can demean their character without fear of misjudgment. Why do we avoid or discredit such individuals with a negative response?
When people push back against change, we often ignore them or tell them why they’re wrong.
The Solution
There are reasons why people, like the ICU nurses, push back against change. They’re protecting themselves against an unknown or threat to their point of view. Resisters dispute the claim of others, like the ICU nurses, who openly expressed their opposition to change caused by the EHR. Unfortunately, the ICU nurses who complained could be the tip of an iceberg. There could be a larger silent group, like the ICU nurses who were trainee no-shows.
When someone does not go along with change, it’s because they’re resisting. This is a cue to stop and listen with an open mind to the resister. Outspoken resisters have the courage to come forward with their arguments or negative behaviors about the change. You owe them respect, no matter how hostile their opposition, to listen first and then ask more questions, because in many instances they’re right.
For example, after considering why the ICU nurses opposed the EHR project plan, the implementation team had to adapt the EHR to accommodate the greater amount of patient documentation required in critical care cases. The team had to adjust their EHR implementation plans based on considering insights from an opposing point of view.
Going forward, the EHR implementation team learned to figure out why people object to change instead of dismissing or criticizing them. The team stopped resisting resisters. Instead, they found that exploring why people fail to comply to change is the path of least resistance.
Source
Coplan, Scott and David Masuda, Project Management for Healthcare Information Technology, McGraw-Hill, Inc., New York, NY, 2011.
