Embrace change by avoiding these mistakes

Dear medical staff leader:

A few months ago, I wrote a column about change. Few columns I've written elicited such a variety of responses. 

Most of the feedback I received was positive, but some people were clearly struggling with changes in their organization.

In this column, I'm going to share with you some examples of individuals involved with medical staff organizations who have refused to change. I personally observed these situations in hospitals around the country in 2007. All of these refusals of change have negatively affected the medical staff organization or on the careers of individuals who refused to make changes.

I hope you won't recognize your organization or yourself in any of the examples below, but if you see an example that is uncomfortably close to your situation, you should examine why you haven't embraced change.

Example #1: The bylaws committee chair who personally wrote the medical staff bylaws 20 years ago and does not believe any changes are necessary. Rather than replacing the chair with someone willing to consider committee input and who is educated about modern bylaws, the medical executive committee (MEC) lives with outdated documents and counts the days until the current chair retires.

Example #2: The medical staff professional (MSP) who refuses to use new credentialing software that was installed eight months ago. The MSP still uses manual checklists and rolodexes to manage the credentialing process and data needs for over 500 practitioners.  (This example is a career-limiting choice for the MSP.)

Example #3: The MSP who refuses to participate in the organization plan to convert to electronic patient records and eliminate paper credentials files.  When I worked in this organization, the MSP's office was so crowded with paper that there was literally almost no floor space to bring in a chair. All surfaces were piled high with paper.  Again--a career limiting move for this MSP.  The organization is determined to move in a new direction with individuals who are enthusiastically forwarding the hospital's mission and plans.

Example #4: The hospital where some members of the medical staff organization have effectively stonewalled implementation of criteria-based privilege delineation forms for the past five years. Instead, they are using outdated laundry lists without criteria.  Every time a department or specialty meets to consider adoption of new forms, the show up to defeat any attempts to introduce more contemporary approaches to delineating privileges. (These same physicians are also opposed to the use of profiles/meaningful data to evaluate practitioner performance).  Why does the MEC allow this to continue?  Probably because it is easier to acquiesce to the demands of the few, rather than to move forward to implement a system that creates more practitioner accountability.

These are just a few examples. To be fair, I've also been privileged to work with organizations that have achieved excellent credentialing, privileging, efficiency, and effectiveness in management of medical staff organization functions by embracing change. 

As we all know, change is a constant in healthcare. Some organizations and people are pioneers (early adapters) embracing change and paving the way for others to follow.

Others are more conservative, waiting to see how early adapters fare before venturing out. These types of organizations get the advantage of learning from the early adapters. 

The third group includes those who actively resist change. 

My advice to you is to constantly seek to improve what you do and how you do it. That doesn't mean change simply for the sake of change. It does mean looking for solutions and sometimes being among the pioneers.

Until next time,

Vicki L. Searcy, CPMSM
Practice Director, Credentialing & Privileging
The Greeley Company
vsearcy@greeley.com
www.greeley.com