Do you always brush your teeth by holding your toothbrush in the same hand? Have you ever pulled into your driveway without clearly recalling how you got home? How often do you have what feels like the exact same conversation at work, meeting after meeting?
We all have habits. The dictionary tells us that a habit is a pattern of behavior that has become almost completely involuntary. We pick up our toothbrush with the same hand. We follow the same series of turns from the grocery store to our home. We can even fall into unintentional habits at work. Often habits are harmless and can even help us get through our days more efficiently. The challenge comes when we try to break a habit. Anyone who has ever sprained their dominant wrist can attest to the difficulty of brushing their teeth with the opposite hand. It’s no less challenging to break a habit, and become accustomed to something new, at work.
As we look to make changes in our work environments or to adjust to new workflows, we need to be aware that everyone who is impacted by the change has habits that may interfere with the success of the change. It is highly unlikely that anyone will make a habit of the change immediately after it is introduced. As leaders, we can help our teams to adjust by making intentional choices about how to identify current habits, how to communicate what will be changing, and how to help our teams adapt to the change. Intentional decision-making in these areas is a powerful way to manage our practices and lead our teams through an often-changing healthcare environment.
Intentional Recognition of Habits
Before introducing change or making improvements, it is helpful to become aware of our current state. Often, we follow workflows in our practices simply because that’s the way we have always done it. When a pattern of behavior has become so ingrained in our everyday lives that we are not even aware of carrying out those actions, it becomes difficult to change. Sometimes that difficulty comes from being so used to one set of actions that we revert to them even when we’re trying to make a change. Other times, the change itself feels threatening to the security of our ingrained patterns.
What is important to recognize as leaders is that neither of these scenarios means that the employee is acting defiantly on purpose. Generally speaking, the basal ganglia are responsible for our habitual movements and behaviors. The basal ganglia sit deep within the brain, near the brainstem, and are responsible for coordinating movement. This part of our brain is incredibly sensitive to reward learning, which is why a full habit is not defined just as the behavior itself but also as the cue that comes before the behavior and the reward that comes after. As we focus on changing the behavior, or routine, we should pay attention to the cues that activate the habitual routine as well as the reasons we feel good about completing it. If we focus only on the routine, we are going to have less success with change.
Take time to work with the whole staff or a representative group of staff to identify the current state. Guide them through naming the cue, the routine, and the reward. A cue could be a patient’s arrival, a ringing phone, or an upset coworker. It is simply anything that precedes the action in question. The reward, likewise, could vary widely from a completed activity, a happy patient, or a calmer sense of well-being.
Intentional Communication of Change
When change has to be communicated, leaders generally start with the change itself: what is changing, but starting with why instead of what can make the conversation flow more smoothly. Begin with the rationale for the change, and rather than simply stating facts or logical arguments, use stories and examples that will connect the employees to the result. Humans love a good story; it becomes both memorable and motivational.
Next communicate what the team can expect. Describe the change and include timelines, resources, and goals. Tell the team what you expect of them as the change rolls out and what they can expect from you and the organization. Details could include the type of training they will receive, when they will be expected to be fully able to perform the new workflows, or how they will get updates from you.
Remember to frame both the why and the what from the perspective of the employee being impacted. While the organization may receive significant cost-savings or another department’s workload may be substantially decreased from the change, neither of these details may matter to the employee. If an employee is going to embrace something new, they need to see “what’s in it for me” (often known by its acronym: WIIFM).
Intentional Support for Adaptation
Finally, leaders can support changes by realizing that change is a process. Adaptation requires both a change (also known as a mutation) and selection. It involves a healthy tension between maintaining consistency for stabilization purposes and innovating change to advance the boundaries of what is possible for our workplaces. Can we see more patients? Can we use less effort? Advancing a boundary does not always involve more, and support can be demonstrated in several ways.
Creating and fostering psychological safety means that everyone on the team feels safe to have an opinion and to participate in the conversation. Inviting employees to question the change and advance their concerns is a healthy and important part of supporting the practice. Every individual must know and feel that their opinion matters and will not be mocked or ridiculed, neither in public nor behind closed doors.
Having intellectual humility indicates that as leaders we understand that we cannot know everything and we welcome the insights of others. The more we are willing to see the experiences and opinions of others as valid, and the more they see us communicating and interacting in a way that consistently demonstrates our openness, the more psychologically safe the environment becomes. We can use phrases like “I could be wrong, but I see the issue as ____” and “I hear you saying _____, and the story that I’m telling myself when I hear that is _____.”
Ultimately, it is our willingness to revise our own viewpoints that will help us lead our teams to the best of our abilities. If I share what is true for me in a nonthreatening way and communicate my willingness to be curious and to adjust when appropriate, it is likely that people will share where I am wrong, what I am missing, or facts I have overlooked.
When we become intentional with our awareness of our current habits as an organization, make intentional choices as we communicate change, and demonstrate intentional support for our team members, the changes we introduce become selected and eventually hard-wired by the group. That’s not just adaptation, that’s powerful practice management!
Ms Lawrence is Principal Consultant, Willow Strategy Group, Greenville, SC. Willow Strategy Group equips individual leaders and organizations of all sizes with skills, tools, and coaching to enhance culture, leadership, and operational outcomes.