6 Strategies for Courageous Change in Post-Acute Care

Most of us have a love-hate relationship with change. We hate monotony. We become bored with the same old rote way of doing things. Many of us love the excitement of something fresh. Yet change is scary and uncomfortable. In post-acute care, regulations and expectations continue to shift. Keeping up with healthcare regulations and evidence-based practices requires continued education, a professional growth mind-set, and the courage to change.

Shifting Landscape

Expectations are surely shifting in post-acute care. Home health agencies are adapting to the Patient Driven Groupings Model (PDGM). Skilled nursing facilities are adjusting to the Patient Driven Payment Model (PDPM) and Phase 3 of the Requirements of Participation (ROP). And hospice organizations are facing increased scrutiny on care and billing.

The recent PDPM, ROP, and PDGM regulatory updates mean changes in procedures, billing, staff and clinician teams, patient acuity levels, and clinician skills—all of which can all add up to a culture shift.

In an industry forecast, 2019 Global Health Care Outlook, the management consulting firm Deloitte notes that this year’s challenges have included ensuring regulatory compliance; recruiting, developing, and retaining talented clinicians; and maintaining financial strength amid an uncertain health economy.

As shifting expectations continue in 2020, leaders and clinicians alike will need courage to break out of familiar patterns and view these changes in a positive light. They will need to work collaboratively to succeed in meeting evolving client needs, reduce risk, and remain competitive.

Choosing Your Response

You don’t have a choice about adapting to new regulatory requirements. You must conform.

But you do have a choice about how you view those new expectations and what you do in response. Instead of staying as close as you can to your professional comfort zone, you can choose to transform by tapping into your courage to change.

In her Netflix documentary, “The Call to Courage,” Brené Brown talked about the challenge of choosing courage over comfort when faced with difficult situations. In a blog post adapted from her book, Dare to Lead, she explained: “Courage and fear are not mutually exclusive. Most of us feel brave and afraid at the exact same time.”

Culture shifts in post-acute care organizations can inspire the same feelings. Often, we know that some good is coming from the changes and that we need to be brave as we face up to them. But it’s not easy.

As Brown observed, it’s human nature to pull back into self-protection mode when faced with challenging situations. Instead, she advocates staying curious, keeping an open mind, and seeking understanding.

If you view the change as something being done to you, you’re more likely to resist and complain. That’s self-protection; that’s opting for comfort.

Instead, get curious about how these new expectations will help you grow as a professional and provide better care. Try focusing on the good that will come from this change — for you, your patients or clients, and your organization. Find a way to truly transform.

An Optimistic Viewpoint

In “The Power of Positivity,” Nina M. Flanagan, a professor and geriatric nurse practitioner, noted that recent healthcare industry developments are giving rise to negative emotions.

“The outside influences — changes in ownership, reimbursement, and regulations — have been profound and continue to rapidly shift. Our workplace environment feels unstable, and instability can invoke fear and anxiety,” she said.

In this environment, cultivating a positive outlook can create powerful ripples. “Being positive and reframing these situations can help to decrease some of the fear and anxiety,” Flanagan asserted.

It starts at the top, with leadership setting the tone. “Positive energy attracts,” she said, and the multiplying energy will create productivity.

When you approach a change as something you’re empowered to do to make your life and your patients’ lives better, you’ll feel excited. Think about ways you can encourage your team members to embrace courageous change as well.

That’s the high-level way of looking at change. But you still need to map out practical steps to achieve a successful transformation.

Strategies for Courageous Change

In order to shape the required changes into desired goals, you’ll need to focus on six key steps:

1. Sharing the change vision.
2. Planning for implementation.
3. Communicating plans and progress.
4. Connecting to meaningful outcomes.
5. Nurturing a positive culture.
6. Celebrating successes.

How do you execute on each of these six steps? Let’s take a deeper dive and find out.

1. Sharing the Vision

At the start, you’ll need to craft a clear vision for your courageous change.

• Identify what the end result will be and what success will look like.
• When introducing the change, share the Ws—why you’re making the change, what initiated it, and where it will lead your organization.

2. Planning for Implementation

You need a detailed and coherent plan for implementing the change.

• Break it down into task assignments.
• Appoint task owners and implementation teams.
• Set deadlines and reinforce them.
• Schedule stakeholder meetings to report on progress.

3. Communicating Plans and Progress

Communication should reinforce leadership and organizational commitment to the change.

• Meet in large and small groups, by teams and by job roles to support a shared vision.
• In meetings and one on one, discuss potential pitfalls and solicit solutions.
• Note accomplishments at each step along the way.
• Keep emphasizing what the team is doing right.

4. Connecting to Meaningful Outcomes

To enhance buy-in, connect the vision to values and purpose at the individual level.

• Explain how the change will help staff members do their jobs better.
• Share authentic anecdotes of similar challenges, achievements, and insights.
• Emphasize how the shift will improve patient and client outcomes.

5. Nurturing a Positive Culture

Amid the shifting landscape, you will encounter peaks and valleys. Engage all levels of the organization to nurture a culture with the courage to change.

• Model and emphasize kindness amid uncertainty and stress.
• Coach employees through the low points, emphasizing what they’re reaching for.
• Keep an eye on workloads and adjust as necessary.
• Help alleviate change anxiety through staff-initiated social activities.
• Reiterate your confidence in the team to achieve the goals.

6. Celebrating Successes

Along the way, find public and private ways to recognize individual contributions and team progress.

• Share success stories and encourage colleagues to congratulate one another.
• Regularly express appreciation to individuals for the extra effort involved in implementing new practices.
• Provide regular updates on progress, using data and positive client feedback.
• Applaud the accomplishment of milestones with authentic praise and team rewards for courageous change.