Week 6

        The case study for this week emphasized further the need for change management but focused mainly on the strategy element.  A central problem for any organization is keeping the goals of the entire organization in focus over the goals of individuals or specific departments.  In this particular case, the nurses knew that they had a need and viewed that need as more important than anything else going on.  It is possible that this was true but the delay in determining whether it is true is incomprehensible from their standpoint.
        This past summer at UWMC I got to experience some of the changes put forth by management in order to re-design roles and departments for the good of the organization.  When viewed at the 30,000 foot level, all of these role changes made sense.  Some departments were working on projects that really shouldn't have fallen under their jurisdiction and it was best for the organization to arrange things differently.  However, without constant communication it is very hard for the people on the ground to understand what is happening.  It may be helpful to speak to departmental leaders but then you are relying on those leaders to accurately represent the viewpoint to their staff.  Every time the conversation gets a level removed the odds increase that things get lost in translation as if during a game of telephone.  In our case, panic in the department spread until we were able to get the new CAO to give a presentation accurately displaying the viewpoint.  This substantially calmed everyone's nerves and helped them to feel engaged with the process.
        Within the case study it sounds as if this approach is what Larry tried to take.  Including the nurses in the discussion is the proper way to increase buy-in and to allow them to understand the process that you have to go through.  However, it is still difficult for many clinical staff members to engage in any kind of strategy discussion.  Whenever someone is asked to consider the greater good over the things that directly impact their jobs on a day to day basis, there are challenges.  Hiring strong middle management who are able to go between the CIO or CMIO and the nursing staff or the physicians is the surest way to achieve success in these endeavors.  This is easier said than done in the current hiring climate but in that case putting resources into training of change management or leadership skills is likely an investment that will pay off in the long run.