Too bad we can’t surgically make the changes we want to see in our organization. Although some might argue that slashing headcount could be an extreme change management tactic.
Here, at CARA, our organization experienced a surgical change, to a degree. Well, it was me actually. I underwent two knee replacement surgeries this year. What does knee replacement surgery have to do with change management, you ask?
Change management is really about helping individuals travel the emotional distance between the initial anxiety and shock, through ambivalence, to acceptance and then making the new change a routine.
Using patient care as a metaphor for the company/employee relationship through an organizational change, I thought I would compare my two experiences with knee replacement surgery. My goal is to illustrate how the impact of clarifying the vision, broadening the stakeholders, organizing a support team, etc. helped manage my change experience to a more positive outcome in the second situation.
Left knee replacement
No Change Management
Right knee replacement
|Determine a Clear Vision of the Future State||My left knee hurt and was so unstable I stopped doing yoga. I wanted to get better so I could continue a more active lifestyle.Complaining to a friend, she recommended an orthopedic surgeon who had worked on her husband’s sports injury. After 45 minutes of completing intake paperwork, I had X-rays taken and finally met with the surgeon.
The surgeon diagnosed me as a candidate for knee replacement and sent in his assistant (PA) to get the process rolling.
I was a little unclear of what to expect.
|My right knee began to fail almost immediately upon recovery from the first surgery.I was determined to find an alternative solution to my first knee replacement experience that would be less invasive, shorten my recovery time, and help me return to a healthier, active lifestyle – quicker.I began my research, weighing pros and cons between procedures. Another friend sent me an article about an orthopedic practice that performs “minimally invasive” knee replacements where the patient walks out of the hospital the same day.
I made an appointment with a new orthopedic surgeon to learn more about the procedure and determine if it was the right solution to help me achieve the goal I intended.
|Provide Support and Coaching||The Physician’s Assistant came in to discuss the procedure in depth, answer any questions, and verbally tell me to call the hospital to register for a 3 hour class, and then schedule a number of pre-op tests with my general practitioner to clear me for surgery.I was worried about the time off of work. Who was going to take care of my dog? What about my family? Who could drive me to the hospital, and who could take care of me throughout the process? There were a lot more stakeholders involved than I had initially considered, and I had to figure it all out myself.Then, at 9:00 p.m., the night before surgery, the hospital finally called to confirm the arrangements for my surgery the next day.
I felt frustrated and overwhelmed.
|In advance of my appointment, I was emailed the new patient paperwork, directions and a map to the office.When it was confirmed that I was again a candidate for knee replacement, surgeon’s team met with me and scheduled for me a full day of pre-op work at the hospital:
They also provided an indexed booklet that referenced what I needed to know about the procedure—from medications to what do I do if something unforeseen occurs.
Finally, my post-op follow-up appointment was already scheduled for me in advance of surgery, and every appointment was documented and slid inside the pocket of the booklet. Low-tech, but user-friendly!
They called me prior to my surgery date to ask if I had any questions and to confirm any last minute details.
I was told a family member could to stay over with me in the hospital. My concerns were anticipated and expectations managed even with suggestions on how to handle my dog for the first week I was at home.
I felt encouraged and optimistic from the early onset of coaching and support I received.
|Allow Leaders to Contribute New Ideas||In the traditional knee replacement procedure, the surface of the femur and shin bones, and the damaged cartilage is replaced with new joint surfaces. In this procedure, the surgeon cut through the tendons and ligaments to get to these surfaces.||Because I sought out new ideas, in this procedure specialized instruments, designed by the surgeon, allowed him to perform a minimally invasive procedure without cutting any muscle, tendon or ligament. He also designed the gender-specific implant that fits better.|
|Communicate, Communicate, Communicate||In my unfortunate case, the tip of the femur was broken during surgery. Four pins were used to hold the bone in place resulting in additional trauma during the procedure.The surgeon told my family member about the break while I was in recovery. My family member shared the information with me as I awoke from anesthesia. And, while the broken bone was documented in the surgical notes, no one in the hospital—the head nurse or the physical therapist—was informed until I mentioned it.I felt angry and afraid about my expected ability to recover.||As an example of good communication, the booklet provided by the surgeon’s office included cell and home phone numbers for each member of the team, including the surgeon.I was encouraged to call them with any questions or concerns.|
|Create a change support team||Seeking reassurance, and only after 3 days of demanding to see the surgeon, did he come to the hospital to explain what happened.||The doctor’s office proactively called me every other day the first week I was home to check in with me.|
|Continue Reinforcement to Ensure the Change Sticks||I had a physical therapy routine, and three follow-up appointments scheduled. Each appointment was rescheduled due to the surgeon’s lack of availability.Reinforcement came from the physical therapist with no obvious collaboration from the surgeon.||I had a physical therapy routine and there seemed to be more collaboration between the surgeon’s office and my therapist, even once sharing a photo of my knee for examination.After each visit to my surgeon’s office, I received a survey asking me about my experience with the staff, the wait time, the service and the doctor.|
|Measure Success of the Change||
Estimating healthcare expenditures merely from the hospital and rehabilitation stays, it’s obvious this second experience was less of a financial burden.
What made me trust that the outcome with my second surgery would be successful than my first experience? Some might say it was the drugs, but I assert that is was good change management practices employed by the second surgeon and his team. They were inclusive. They anticipated my needs as the primary stakeholder, listened, managed expectations, communicated and supported me throughout the initiative to successful acceptance and implementation of the change.
Now, within the organization, change occurs only through the sustained, combined actions of the employees. This suggests monitoring ongoing results, leadership modeling and continued communication. Sort of like my physical therapy sessions right now.