Change Management and Leadership

by | Aug 8, 2011

Scheduling implementations, by their very nature, bring change. That may seem obvious, as does the logical implication: Bringing change implies a requirement for change management. But not every implementation team truly gets their arms around how much change management is required and how best to carry it out.

Here are some simple facts that I like to take teams through, to help scope the change management effort:

  • Schedulers and employees have strong emotional ties to their existing scheduling process. We can speculate on why this is the case, but regardless of the reasons, it is a consistent fact everywhere I go. If I had to guess, I would say that since scheduling is something that affects the personal life of the employee and because there are so many decisions that a scheduler must make about every individual employee when building a schedule, the status quo process is something that they are all emotionally vested in for their interpersonal relationships.
  • Software implementations require concessions and bring change. This is a two part fact. Part 1 – There is no perfect scheduling system. Part 2 – There is no scheduling system that can completely replicate the existing scheduling process, the one that everyone is emotionally vested in. Together, they imply that no matter what the existing process is or what the theorized perfect process is, there is going to be a process change with scheduling to implement the system and it’s not going to be the absolutely ideal solution. (There will be things about it they won’t like.)
  • Requirements for making concessions and accepting change to processes that are anchored with strong emotional ties is going to result in hate. And that hate will be two-fold: They will hate the system and they will hate you for bringing it to them. Don’t worry—there will be more than enough hate to go around!
  • The natural transition from hate is to rejection. Left unchecked, the hate that naturally results from the disruption to the processes that were anchored with emotional ties will result in a rejection of the change and reverting back to the original state. This can happen quietly with no visibility or loudly with lots of complaining. Both ways are just as devastating.
  • Change management and leadership support can provide the impetus to transition to acceptance instead of rejection. The change management must be proactive, heading off negativity before it boils over, and must provide a path for the users to understand why the hate is natural but the transition needs to be to user acceptance. Leadership support gives the change management authority to hold up against resistance.


It’s this last fact that gives us hope for a successful implementation that ends with user acceptance. But it will not just happen on its own. User acceptance comes through an intentionally designed change management process and leadership support that is constant and firm. Knowing and understanding this progression—change to hate to rejection—in advance is valuable knowledge for the implementation team to plan their change management in context of the hospital culture to mitigate the painful transition process and successfully arrive at a state where the system is being utilized as designed. And that’s a worthwhile future state to strive for, “utilized as designed”, as that’s where the additional ROI’s and improvements that affect patient care can be achieved. Change management itself can take many forms and the execution strategy will vary project to project, but it should always contain strategies for each of these three areas:


  1. Communication
  2. Training
  3. Involvement


It is crucial that leadership must be involved with this change management strategy as well. The support that they provide is necessary to give authority and momentum to an implementation. This support is what the project team will fall back on when the hate reaches a crescendo that cannot be overcome without authority. Good or bad, healthcare culture is such that staff, especially nursing staff, have a lot of clout to push back on things they don’t like. When it comes to the kind of change that is brought about with a scheduling implementation, the push back can be very strong and requires a leadership directive to avoid being derailed. Who knew that “hate” was such a high risk factor in healthcare scheduling implementations?! If you have been through a project like this bringing change to processes anchored in emotional ties, then you know exactly what I’m talking about! As always, if you have experiences to share, email me or post them in the comments below.

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