Few aspects of leadership are as challenging as change management. That’s why I spend a lot of time talking with clients about the skills they need to lead teams through adapting to new processes, embracing new ideas, and sometimes totally overhauling how they work.

The upheaval of the past few years means many leaders have been schooled in change management, but perhaps none as dramatically as leaders in health care. So, it was a perfect topic for discussion at the recent ADVANCE PHM 2022 Gender Equity Symposium.

This post is the second in a series capturing the discussion I led at that conference. The first covers the change management context. For this post, let’s get tactical.

Whether you have brought about change yourself or are simply being asked to implement change you had no part in planning, there is a lot to change management. I find it helpful to break it into three themes: Engaging stakeholders, communication, and assessing the landscape. Let’s start with the people, who are your most important asset (or roadblock).

Stakeholder analysis and engagement

Unless your change is minor, it’s likely many people in many different roles will be affected. These are your stakeholders. Start by getting clear on who these people are and what role they play in your change. Consider everyone – from janitorial staff and security all the way to the C-suite. As you think about them, consider a couple of key questions:

What’s in it for them?

What are they afraid of?

If you are working on something like the transition to a new EHR system, the nursing staff will be an important group of stakeholders. What’s in it for them? Hopefully a lot less data entry and clicking in and out of different windows. What are they afraid of? Maybe workflow changes, or that patient care will be affected.

You’ll also want to consider other clinical staff, the IT staff who must implement the technology, maybe external partners whose systems must now integrate with the new EHR. And don’t forget patients, the community you serve, and others who might not be so obvious at first glance.

As you consider these questions, you will also want to examine stakeholders through another lens, driven more by personality and life experience than job title. I’m talking about level of engagement. As you roll out changes, you will have supporters, you will have people who are uncertain, and you will have skeptics. Your challenge is deciding how to manage these groups.

This is my unscientific, yet consistently reliable breakdown for levels of engagement:

• Champions/early adopters: 10-20%
• Wait-and-see types (called the moveable middle in politics): 60-80%
• Naysayers: 10-20%

The champions are important. They will serve as your surrogates, spreading your message, collecting feedback, answering questions and generally smoothing the path forward. These people are worth your time to engage, but fortunately it won’t take much effort. Make sure they understand how things will unfold, then let them go forth and share.

The wait-and-see types typically comprise the largest group, and you will want a good percentage of them on board. You can enlist your champions to help. Make sure people who are uncertain feel heard, and address their concerns if you can. They may have useful insight for how you implement change, and a few of them may become champions themselves.

The naysayers are trickier. I recently read an interesting article about how naysayers can become your best ally. I think that is true – if you convert a naysayer to your way of thinking, they can become the most powerful champion you have. If their input helps you see your blind spots and adjust accordingly, all the better.

However, some people simply won’t see things your way, and that’s OK. Trust yourself to know a lost cause when you see one, and don’t spend a lot of time there.

One more note about naysayers. Occasionally they can become problematic. When that happens, I call them saboteurs. They can undermine what you are trying to do with their words or actions, even if they don’t entirely mean to do so. You’ll need to know who these people are, so you and your champions can mitigate their impact.

Overcommunicate x 2

All that stakeholder talk was critical context for the most important thing you can do as you bring change to your workplace. Communicate, communicate, communicate. It’s the only way you will win anyone over to your way of seeing things. It’s also really important for reassuring those who disagree with the direction you’re headed but who plan to come along anyway. And it’s completely essential to making sure that change happens according to plan, with the least disruption possible.

Communicate that change is coming. Communicate again that it is coming and why. Communicate how it will unfold, when and who is affected. Communicate everything. Over and over. It’s impossible to overdo it. I tell people to determine how much they think they should communicate, and then double it. That is the minimum.

Here’s what’s most important to address or do in your communications about change:

• Why we are doing this
• What’s in it for stakeholders
• Address/mitigate concerns and fears
• Show them how it will work
• Enlist champions to help

Keep one eye on the environment

Whether they are searching for a different job or pursuing a new venture, I urge clients to spend time considering the landscape around them. Doing so yields important context that can help you be more successful (or less harmful).

Change management is no different.

Ideally, the environment should be considered before anyone makes a decision about whether and when to make a change. However, if you’ve been tasked with something like implementing a new workflow, the decision has likely been made, and you may not have a lot of choice about moving forward.

That’s OK. Evaluating the landscape can still help you make a realistic assessment about how smooth your path will be and what roadblocks you should anticipate. Some key questions for your analysis:

• How urgent is this change? It may be …
  • Elective – it can happen anytime, and there’s no harm in waiting if we decide we should do so
  • Urgent – there is some time pressure, but it doesn’t need to be done yesterday
  • Emergent – the team or institution is figuratively on fire, and we need to put it out (lawsuits and compliance issues are examples)
• Is there change fatigue? If you’ve recently implemented a big change, that may be an argument for pressing pause on the next one. Of course, an emergent situation likely can’t be paused. Even so, change fatigue is a consideration for how you move forward, and for how you communicate with everyone about what’s coming
• Does the group at top support this change? What concerns them? And do they care if others are anxious about the change, or do you have to manage that anxiety yourself?
• Do you have the resources you need? And if not, can you get them? Or do you need to rightsize your (and others’) expectations?

If you are making decisions about change, these questions should inform your timing and what you ask of your team. And if you are implementing someone else’s plans for change, they will help you keep your mindset realistic and the tone of your communication thoughtful.

Thriving through change

If you’ve made it this far in this two-part series, congratulations! Hopefully I haven’t scared you off from the idea of taking on the challenge of change management. There’s no question, it is challenging. So don’t forget to take care of yourself. You will need your resilience.

In addition, give yourself grace. You won’t do everything perfectly, but that’s OK. No one ever does. You’ll learn a whole lot that you can lean on next time. Because there’s always a next time!