Why Healthcare Change is Hard

4 minutes read

The Barrier
Collaboration can feel threatening to clinicians and healthcare managers. Both groups can become territorial and defensive, creating a barrier to change.

The Breakthrough
By conducting a threat assessment to ensure clinicians and healthcare managers feel confident that their skills, knowledge, and experience are fully recognised and valued, leaders can break down the ‘us and them’ mentality and generate effective collaboration and positive change.

Cross-group collaboration is central to organisational success. It lies at the heart of innovation and problem-solving. However, despite the clear benefits, it is not always easy to achieve. When one or both of the groups involved in a new project feel threatened, they can quickly close ranks. This leads to problems such as unilateral decision-making, lack of data sharing, excluding the other group from discussions and meetings, or creating huge volumes of unnecessary work to overwhelm the other group. All of which leads to frustration, a lack of trust, and, in many cases, the failure of the initiative.

So why does this happen?
Processes and outcomes are the natural focus of collaborative initiatives. However, by placing the focus exclusively on these areas, leaders overlook the importance of each group’s individual identity. When groups are asked to share their work, autonomy, resources, information, and responsibilities, this can feel extremely threatening. This threat may be in relation to their identity, their reputation, their status, their resources or their role within the organisation. These concerns lead to a lack of cooperation. This can impact not only the current initiative but also any future initiatives, as others within the organisation may come to view the groups involved as difficult to work with and unable to achieve results.

Identity Crisis
When clinicians are asked to collaborate with healthcare managers, there can be concerns about what is being asked of them. Clinicians know what they do and why they do it. The ability for this group to act autonomously and to have control over their decision-making is vital to the success of their work. This need for autonomy can become a huge barrier to change, leading to the dismissal of the opinions, views, and roles of healthcare managers, and the exclusion from meetings, discussions, and work that needs to be undertaken in order to move the project forward.

To avoid these pitfalls, leaders can focus on a few key areas:

  • Understand how clinicians and healthcare managers self-identify. This enables leaders to ensure the two groups have greater ownership over the areas of a project that are most closely associated with their identity.
  • Understand the specific value that clinicians and healthcare managers bring to the organisation. This enables leaders to ensure the initiative the two groups are being asked to collaborate on aligns with their respective roles within the organisation.
  • Acknowledge the importance of clinicians and healthcare workers within the organisation. By repeating and reaffirming this message throughout the collaboration, leaders ensure that the individual identities of the groups stay in focus. The aim of all these points is to reinforce the ownership that both groups have over the initiative in relation to their identities. By ensuring each group feels comfortable about what it, and the other group, is responsible for, any remaining potential areas of threat are far more easily identified and can, therefore, be far more easily addressed, leading to successful collaboration and positive change.

Further reading:

  • Harvard Business Review – Collaboration Challenges, Chapter 8
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