Jo-Louise Huq, Ph.D, MBA, CCMP
November 6, 2019
When I talk to senior leaders and managers about change and improvement, they ask variants of the following questions:
“How can I get my people to pay attention to and participate in the change project,” and, “ How can I reduce resistance to change in my staff?”
With a bit of probing, I often then find out that the staff are people who are professionals and occupational experts.
Today, many organizational change initiatives require that professionals and occupational experts change their established ways of working. For example, initiatives might ask professionals to work:
- More collaboratively with each other and with clients,
- With a greater focus on efficiency or quality improvement, or
- With attention to new frameworks or evidence-informed practices.
If I ask leaders and managers to describe how they involve professionals and experts in change, I hear that they have focused on communicating the need for change. Sometimes I hear that Human Resources has updated policies and job descriptions in line with desired changes and that new job expectations have been communicated. Occasionally, I hear that departments or functional units have been asked to ask staff to identify goals and objectives in support of the desired change.
Rarely do I hear that professional and expert staff have been encouraged and supported to get fully engaged in the change initiative and to deeply explore what the desired change or improvement means for their work.
Recently, a co-author and I published an article that investigated a successful healthcare quality improvement (QI) initiative.  Healthcare is a highly professionalized environment and an environment where change and improvement are an ongoing concern.
In the paper, we identified how the QI team engaged professionals in the initiative through activities that disrupted professionals’ established ways of thinking and working. The QI team incorporated activities that shifted professionals’ established understanding of the (clinical) problem and their belief in the adequacy of their existing treatment (or more generally, problem-solving) approaches. These activities include, but were not limited to, ones that:
- Created urgency around the problem that was the focus of the quality improvement effort,
- Drew professionals away from regular work activities and gave them dedicated time to focus on the initiative, and
- Encouraged professionals to reflect on and question their established ways of working individually and together.
Although we are cautious about suggesting our findings are broadly generalizable, we do think the activities could be considered when planning and delivering organizational change initiatives in a variety of professionalized organizations.
Our findings suggest that change and quality improvement leaders and practitioners need to go beyond general stakeholder engagement, communication, and policy and job-description change when change and improvement initiaives are set-in motion in professionalized organizations.
In my change work with organizations, I encourage leaders, managers, and change practitioners to meaningfully design opportunities that involve professionals and that allow professionals themselves to explore and identify what change or improvement means for their work. Of course, professionals’ efforts need to align with the organizational direction for change or improvement, but this can be accomplished through careful facilitation and guidance.
I hope I have convinced you to explore ways to more meaningfully engage professionals and occupational experts in change and improvement initiatives. If you would like to explore these ideas in greater depth, write to me!
#qualityimprovement #professionals #organizationalchange #changemanagement #engagement
1. Huq J-L, Woiceshyn J. Disrupting activities in quality improvement initiatives: A qualitative case study of the QuICR Door-To-Needle initiative. BMJ Quality & Safety, 2019: bmjqs-2018-008898. doi:10.1136/bmjqs-2018-008898