Managing change

In 35 out of 100 reviews, there were negative views about the management of change.

The reality of healthcare today means that change is a constant. We often review services that are being reorganised, or reconfigured.  A new surgical team is created at short notice due to the merger of previously separate hospitals, or a specialist service centralised through the creation of a new 'hub and spoke' model. 

The quality of change management that occurs within healthcare organisations is highly variable.  While substantial change within hospitals is sometimes managed effectively without disrupting care, we are aware of situations where the opposite holds true.

Problems occur when services lose focus on the experience of a patient in their hospital.  

These are the key points that should be clarified within services undergoing change: 

  • Who is responsible for clinical quality and surgical safety within the service today while the service undergoes change? 
  • Who is leading the programme of change? 
  • How is the success of these leaders being measured and by whom?  
  • How are the individual clinicians ensuring their care is safe as the change takes place?
  • How are the new teams that are being created coming together? 
  • What is the quality of these team members’ interpersonal interactions?
  • How are the individuals within these teams engaging with the change?
  • Are team members accepting the change and working in line with their new working arrangements?
  • What lessons are being learnt as the change is taking place?
  • What immediate actions are being taken to address any safety issues, personnel issues, or service improvement issues that arise as the change occurs?