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Enacting Communication Change

Enacting Communication Change

Do changes in your practice stall because of negativism, distractions, disinterest, or active resistance? Is a culture of complacency and inertia suffocating new ideas? Investigating what it takes to overcome the status quo and implement change is worthwhile because stagnation can jeopardize your practice’s future. Changeability is critical to the success of any organization, and it has never been more important than in today’s changing oncology practice environment.
Visit: The Fundamental Underpinnings of Change

For change to take hold in an organization, certain elements must be in place: an agreed-upon direction for the practice, a functional and effective leadership structure, and a culture that promotes and rewards change.

Visionary Collaboration
Any suggestion for change should be consistent with the practice’s overall direction. Start there if your practice still needs to engage in strategic planning, which includes developing a vision statement. (For more information, see “Strategic Planning: Why It Matters and How to Do It,” an earlier article in the Strategies for Career Success series.) 1 The process of developing a vision and strategic direction for the practice encourages input from all practice decision-makers. It allows divergent perspectives to be heard and addressed to reach a consensus. The resulting vision should be communicated to everyone in the practice and reinforced on a regular basis to foster a culture that is ready to make the necessary changes to move toward the vision.

Leadership that works
Effective leadership, in addition to a shared vision, is required for change to be successful. “The key to transformational or any change is to have leadership that can understand, support, explain, and moves the organization to commit to it. “That is 95% of the success of any change,” says Nick A. Fabrizio, Ph.D., a Medical Group Management Association practice management consultant (Englewood, CO).
Enacting Communication Change
Radiation oncologist David Fryefield, MD, medical director at Willamette Valley Cancer Institute (Eugene, OR), agrees, describing a leader as “someone who is willing to say ‘yes, I’m going to do what is necessary to lead,’ which includes knowing how to build consensus, what to communicate, and what decisions to make independently. It’s a difficult task.”

The requirement for followers is the inverse of the requirement for a leader. “Among physicians, the term “follower” connotes a certain weakness, but this is not the case, according to Fryefield. “If everyone tries to be a leader, the organization will stagnate. The role of a follower is one of strength, involving elements of trust and letting go of some control.” Transformative change requires an appropriate leadership structure, which includes a leader and physicians who are committed to the vision and willing to support it. All physicians in practice must be team players, which includes accepting responsibility for the entire practice and being willing to recognize the leader’s authority.

Change-Supporting Organizational Culture
Although busy schedules, distracting events, fear of change, and apathy are all obstacles to change, complacency is the true enemy of change. “The willingness to change is critical,” says consultant Fabrizio. “Do [the practice leaders] have the determination to see change through? Otherwise, stop right there.”

Even groups seeking change may need to be more active and willing to follow through. That was the situation confronted by Joyce Mills, a practice administrator hired to “fix problems” in an eight-physician oncology practice in the Midwest. She stated that “the single most significant impediment to change in the practice was that both the physicians and the staff were content with not changing.” A practice that is ready for change has a culture that encourages and supports ways to improve quality, patient care, and efficiency.

Developing a Willingness to Change
The “fire in the belly” required to bring about change must begin at the top when shifting from a culture that is satisfied with the status quo to one that is ready to change. The doctors are crucial. They set the tone for the practice, so it will be ready to change once they are.

If the doctors in your practice appear to be stuck in their ways, providing the information is one way to increase the group’s desire to change. “Data is extremely powerful, especially for physicians,” Fryefield says. “Measure anything and everything you can think of, and use that data to help drive change.”

When Mills was brought in as a change agent, she discovered that the physicians “believed that all of the necessary changes were at the staff level.” One of the areas in which she provided information to cultivate a readiness to change was the practice’s referral base. She gathered information about oncologists from the practice’s referring doctors. In the absence of data, physicians in her practice assumed that their referral base sent patients exclusively to their practice. However, the facts proved otherwise. According to Mills, after seeing the data on their referring doctors, the oncologists realized they needed to do some face-to-face marketing.

“Asking your patients and referring physicians what they think of you can also help you identify needed changes,” says Fryefield. “That defines what you need to change pretty clearly—sometimes painfully clearly.” You can collect data by inviting patients to focus groups and conducting ongoing surveys. Fryefield recommends monthly patient surveys rather than one-time ones.

Benchmarking data, which compares your practice’s performance on key practice indicators to other oncology practices, also provides information that can encourage change readiness.


Visit: Dealing With Resistants
When you propose a change, identify those who support and oppose it. “Determine who will be on board and support the initiative, who will be skeptics, and who will say they support it but will actually undermine it,” says Fabrizio. Mills agrees and suggests approaching them right away.

According to Ana-Elena Jensen, Ph.D., a practice enhancement facilitator with TransforMED (Leawood, KS), an American Academy of Family Physicians subsidiary, resistance to change is normal and should be expected. “Fear of what will happen to me in my world, how will my relationships with my colleagues change, or how will our practice and our patients be affected,” she explains.

According to Fairfield, fear of change is often at the root of resistance. “You have to be extremely sensitive to the effects of change on the people who will be affected,” he says. “People are skilled at their jobs and understand what to expect. If you put them in a situation where they don’t know what to expect, they will become afraid, but they will not express it. Instead, they say it’s not a good idea or that we won’t be able to do it.”

In some cases, the critics may not be forthcoming. “You have to listen actively,” Mills says. “You may hear them say yes, but their body language says otherwise.” If you suspect someone is a resister, Jensen recommends sitting down with them to discuss their concerns rather than allowing their opposition to being a hidden distraction. “Find out why they’re resisting and what they’d suggest,” she says. “They may have very valid reasons that can lead to practice innovations.”

To alleviate fears, show individuals how the change will help them do their jobs more effectively or support the practice’s direction. Another strategy is to start the change on a trial basis. Inform everyone that the pros and cons of the change will be evaluated after a set period, such as three months.

However, some people may continue to resist change despite efforts to persuade them. Their pessimism and low morale can be toxic to the changes that are being implemented. 4 “It’s bad if people who aren’t on the bus are kept,” says Fabrizio. “Those who are going to undermine the program must be removed.”

Go to: Change Implementation
Because there is so much going on during change, frequent and effective communication is especially important. Jensen recommends communicating at the strategic, operational, and individual levels.

Jensen recommends creating a plan for who needs to know what, when they need to know it, and how they need to know it. “Communicate the who, what, where, why, and how of the change. Begin with a high-level overview of the strategic reasons for the change. Communicate the vision for what will occur, how individuals will be involved, what is expected of them and their team, and why it is important to the practice and the patients. In the absence of communication, people will fill the void with inaccurate information and will frequently start talking to each other and making false assumptions.”

Jensen emphasizes the importance of allowing staff members to express themselves. “At staff meetings, ask for concerns, questions, clarifications, and suggestions. Take them into consideration.”

Use every medium available to inform people about the change. Meet with people individually as well as in groups. Use e-mail, the practice intranet, and bulletin boards in the break room. “You can’t say something once and expect everyone to understand it,” Fairfield says. “If you’ve already said it 15 times, say it again.”

Create a Team Culture
The participation of those who must change is critical in managing a change process. Develop a team culture where everyone works together to achieve a common goal. The practice’s vision and the goals of specific changes should be clearly articulated. Creating and nurturing a team culture is an ongoing process based on trust and mutual respect.

Establish clear expectations. Individuals should understand what is expected of them, as well as the roles of others, and have a sense of shared accountability. Allow people to work toward the goal in their jobs while contributing ideas for the team. Invite team members to identify areas where they would like to take the lead. “They need to see the future vision and what they can contribute,” Jensen says.

Determine and Empower Champions
All changes require visible champions who are dedicated to the cause and can inspire others. “The practice leaders may be aware of individuals with natural leadership skills among the staff, people who will do an excellent job persuading their peers,” Jensen says. She recommends forming a change team centered on a specific process and having individuals lead their peers in that effort. “Support them and provide them with the tools and resources they need to do the job.”

Give Positive Reinforcement and Feedback
Individuals want to know how they are doing and if their efforts are having an impact. Just as you initially used data to foster change readiness, you should continue to use it to document progress and reinforce new behaviors. Some change activities may necessitate daily or weekly results reports, whereas others, such as a report on the number of medical records converted to a new system or average patient waiting times, may necessitate a monthly report.

External data also provide credible feedback that aids in the maintenance of change. Determine what your patients and referring physicians think about the changes you’re implementing and share that information with physicians and staff.

Take the lead in encouraging others and praising those who succeed. Recognize people’s efforts in the change process and thank individuals for contributing to the practice’s success. Celebrate achievements and milestones to build team cohesion and sustain change efforts. According to Fryefield, “successful change occurs when everyone believes the change is their idea.”
Required Resources
Read/review the following resources for this activity:

Textbook: Review all chapters and use as needed
Link (Word doc): Week 3 CCC Template Links to an external site.(Use this template to complete the assignment.)
Introduction: Communication Change Challenge (CCC)
This is your week to put into action what you have been learning regarding the communication challenge that you would like to change. You have put a plan in place, and now you will be implementing that plan. The goal is successful change.

Project Timeline
The following is a breakdown of what will be covered in each part of the project:



Week 1

Selecting a communication goal and conducting research

Week 2

Describing communication pattern, analyzing goal, and developing a plan

Week 3

Implementation of the plan and evaluation of your progress

Part 1: Beginning of the Week (1 paragraph)
For this CCC, you should have chosen a person with whom you share regular communication. So, you should have a few occasions this week to apply your plan. Under this heading for your submission, write down what you project will be your opportunities to implement your plan. You need to be on the look-out for when you will be putting your plan into place.

Part 2: Middle of the Week (1-2 paragraphs)
In this section, you will describe the setting and people involved in your exchange that was your implementation of your CCC plan. Include enough details so that the process of the exchange is understood.

Part 3: End of the Week
Under this heading, you will have the opportunity to reflect on the process that you went through for your Communication Change Challenge. Use the following sub-section headings for your responses (see template). You will evaluate the impact of the project as it relates to interpersonal communication and the course objectives (COs). It is important here that you clearly demonstrate your understanding of the course concepts through application to your course project.

Remember that your patterns for communicating interpersonally have been developed over many years. Therefore, you should be neither surprised nor discouraged to find that changing your interpersonal communication behavior takes time. In order for you to take this project to its fullest potential, you may need to continue to modify, implement, and reinforce these new behaviors for far longer than the duration of the project. It is possible, however, to modify the way you communicate because the payoff is improvement to our communication and relationship outcomes. Changing interpersonal communication for the better is worth the effort.

3A. Topic Selection Reflection (1 paragraph)
What course material did you use to help guide your particular communication change? Cite the information you found helpful as you write your paragraph summary of texts used.

3B. Implementation Analysis: Satisfaction (1 paragraph)
Consider the implementation of your new approach to communication and share which of your communication changes particularly pleased you?

3C. Implementation Analysis: Dissatisfaction (1 paragraph)
Consider the implementation of your new approach to communication and share which of your communication changes particularly displeased you.

3D. Implementation Analysis: Additional Changes (1 paragraph)
Consider the implementation of your new approach to communication and share which of your communication changes you still want to work on.

Note: For each section, be detailed and specific. You need to use several course materials from different chapters, course outcomes, videos, assessments, articles, etc. Your course project evaluation will be graded for comprehensive content, analysis evaluation, application of the course material, organization, and so forth. Please consider its weight when you place value on its importance to your final course grade.

Writing Requirements (APA format)

Length: 2-3 pages (not including title page or references page)
1-inch margins
Double spaced
12-point Times New Roman font
Title page
References page (minimum of 2 citations from course materials)
Example Citation for Lesson

Online Lesson In-Text Citation
Chamberlain University (2020) stated . . .
Conclude your paraphrase with (Chamberlain University, 2020).

Online Lesson Reference

Chamberlain University. (2020). SPCH277. Week 3: Effective communication [Online lesson]. Downers Grove, IL: Adtalem.

This activity will be graded based on W3 CCC Grading Rubric.

Course Outcomes (CO): 5, 8

Due Date: By 11:59 p.m. MT on Sunday


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