Implementing Change Requires the Right Leadership
Change requires leaders who can keep things on track, help the organization remember why it's shifting, and provide support for staff members who will disrupt long-ingrained habits in favor of better ones. Lab leaders from the nation's top healthcare organizations have steered their staffs through many kinds of changes. Here, they offer strategies that may help their peers.
- Organizational change requires strong management to keep staff on track.
- Look for change agents within the staff.
- Use visual tools to help staff see where change can improve operation.
Contributing Lab Leaders
Children's Hospital of Philadelphia
Chair, Department of Pathology and Laboratory Medicine
Diana L. Kremitske, MHA, MS, MT(ASCP)
VP Laboratory Operations
Identify Your Change Agents
The Children's Hospital of Philadelphia wanted to improve turnaround time on lab testing. "It was a patient safety issue," says Chief of Lab Medicine Michael Bennett. The project was the lab's contribution to a hospital-wide, patient-safety improvement initiative. The lab management identified several leaders among its younger phlebotomist staff who were prepared to do a workflow analysis and then make recommendations. Their work revealed several specific choke points that could be eased by adding more staff, a solution they could simply accomplish by reworking the overall schedule. Now samples are getting to the lab more quickly.
Remember Your Goals
The anatomic pathology lab at the University of Lousiville recently invested in new immunochemistry equipment that allows it to stop batching samples and instead process each one as soon as it's ready. This advance might be old news in clinical laboratories, but it's still novel for the anatomic pathology lab, according to Eyas Hattab, MD, Chair of the Department of Pathology and Laboratory Medicine. Nevertheless, the staff couldn't help itself: Even after being trained on the new equipment, everyone kept batching their samples and the workflow did not improve.
Worried that his organization had made a large capital investment with no payback, Hattab assembled the staff: "I said, Let's take time out here and discuss why we have instituted this change. Why did we switch from a functioning platform to another one? Our focus wasn't just investing in a new technology per se. It was the outcome we were interested in." The meeting didn't magically solve the problem overnight, but it did help the staff remember its objective. In six to nine months—with consistent reminders— technicians had conditioned themselves to load specimens as soon as they were ready and the organization grew more efficient as planned.
Geisinger Health System in Danville, PA, had a clean slate in its brand new laboratory, and Diane Kremitske, Vice President of Laboratory Operations, saw an opportunity to analyze how the staff functioned in the space and create new efficiencies. She used a diagram of the laboratory with sticky dots in different colors to represent staffers wtih different functions. Kremitske and her staff then moved the dots around to analyze who went where, and when, and why. Where there was overlap—say, between the yellow dots representing processors and the blue dots representing techs—they explored whether a given function could be taken over by one group or the other, as long as they had appropriate training. The exercise helped everyone redefine their roles, sometimes in subtle ways, to make the whole operation work better. "Of course there were still bumps in the road," Kremitske notes. "It's up to the supervisor to move the process the way it needs to go. But tools that make people see the reality of it can go a long way."
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