Navigating the minefield of change

Implementing change in the workplace can be like crossing a minefield to reach safety. You don’t know what lies immediately ahead, where the pitfalls and explosives may be located, but you must get to the other side and keep moving forward. The challenge is how tactfully and strategically you can navigate your way there. How many people will be lost along the way? Hopefully, none. But know that there will be moments when everything collides and then finally comes into focus, whether good or bad. Learning to implement and navigate change is a constant challenge.

One of the most significant changes (and, therefore, challenges) I faced centered around the increased use of automation and software capabilities. Everyone should want to do this, right? It should be a “no-brainer.” Well, not exactly. So, let me set the stage.

The reluctance of management and staff to be open to implementing new automation and software capabilities may be somewhat surprising at first glance. After all, automation, software usage, and technology upgrades occur frequently in everyone’s personal lives. However, staff may have failed to notice or didn’t equate the changes they saw in their personal life with those that might happen in their professional life. For example, barcode reading at the checkout line at the grocery store had long ago replaced the manual entry of prices into the cash register. This is a use of automation and software that everyone takes for granted now, but at some point, the cashiers had their jobs massively affected by this change.

It's funny how it was fine for someone else’s job to be affected by upgraded technology. The adoption of technology and computer advancements reaching a “technical” or “professional” position struck a chord of apprehension or, worse yet, outright rejection.

The supervisors and staff at the laboratory I managed were facing this. The new automation and computer software that the staff were asked to consider could accomplish tasks faster, more consistently, and with a 99.9% error-free rate. Patient laboratory results would be available to physicians in less than 6 hours, compared to the current 18-24 hours. These facts alone created a fear among supervisors and employees that their jobs would soon be taken over by software and robotics, and they would no longer be needed or valued. Open-mindedness and acceptance were not in the cards for these technical and professional employees.

To complicate things a bit further, the manufacturers of the products were struggling to position and market them to the end user in a positive way, so as not to add fuel to the simmering fire of reluctance. They didn’t want to offend the professionals or diminish their importance, but at the same time, their goal was to sell their automation and software, and in doing so, they had to justify the cost of acquiring it. Their justification of the cost was frequently centered on savings that could be realized by reducing the time to complete a task. That, in turn, could mean a reduction of staff needed to complete a given task. The sales promotion line “implementation of this automation system and associated software will save you money” was predicated on one thing: time savings.

Translation: Time Savings = Reduction in staff. Possible job loss. This was clearly what the managers, supervisors, and staff saw and heard in every presentation. This was unwelcome news for the professionals expected to accept and use this new platform.

In the meantime, the administration was imploring management to look at their current processes and figure out how to “Do More With Less.” “Do More With Less” is a common directive given to management to critically examine what was being done and determine how a task, assignment, or product could be performed or produced using fewer resources than you currently have or fewer resources than it currently consumes.“ Do More With Less” sounds harsh and not very encouraging, and people find it uncomfortable, even threatening. Does the “less” mean fewer people? Am I losing my job? Everyone in the company, not just management, was aware of this directive.

So here was the intersection: Implementing the new automation and software would be the logical and perfect solution, right?

Not so fast….

The people expected to implement and use the platform and its capabilities were the same individuals who viewed themselves as at risk of losing their jobs if the new systems were utilized. If that wasn’t bad enough, now the administrative directive compounded the situation, instilling more fear of change.

I was responsible for following the administrative directive and delivering results for my departments. I was also responsible for implementing the new automation and software.

This is “change management” at its most challenging moment. What was I to do, and how could I successfully get through this

minefield? It was clear that the department needed to “get to the other side and keep moving forward,” but I needed the team to go with me, and I didn’t want any casualties along the way. The vision for what this should look like and how it should work could not be a one-man show. I was willing to lead the group and share a vision, but I needed their involvement and an operational atmosphere based on mutual support and commitment.

Three key strategies were used:

Address the fear.
Involve the staff.
Assure flexibility.

1. Address the Fear

Fear is frequently cited as the most significant factor to address when managing change. It is epitomized in the question, “What if?”…. followed by a myriad of everything that could possibly go wrong. What are they going to lose?

The elephant in the room that day needed to be tackled first. The staff were fearing the uncertainty of their employment more than anything else. The first statement made when we gathered for a meeting was this, and it was the most impactful thing said: “I understand that you are worried about the new platform implementation. It is not being brought in as a staff reduction program. It is a stress reduction program. You will not lose your job if we implement this new system. Once that idea sank in, we discussed the project and how it might be possible to use the advances in computer software and automation capabilities to eliminate steps in the daily workflow that are manually performed. If time were saved by eliminating manual steps, what would the staff do with that extra time? This question brought apprehension, as again, the staff feared job elimination. Who wouldn’t? They were reminded again that the project was meant to reduce stress, and their jobs were safe.

The second source of their fear was the administration's directive to “Do More with Less.” The staff had all heard the statement, which they found threatening. I decided to provide a new statement that caught the staff's attention. I offered the following option to the staff: “Instead of concentrating on Do More with Less, let’s use the software to figure out how to ‘Do Less, Accomplish More’.”

I have been told that my statement makes no sense or is impossible. The same might be said for “Do More with Less.” My statement shifted the staff's focus to something more positive and offered a challenge in a positive tone.

The statement offered two concepts that staff didn’t object to:

1. “Do Less” was not negative or threatening like “With less.” It posed no veiled threat of losing their job. These people were already working hard. The idea of being able to “do less” was attractive.

2. “Accomplish More” – who doesn’t want to do that? Completing more tasks during a shift would naturally help alleviate the workload and improve the workflow for everyone. Were these two ideas in contrast? It seemed so, but when combined with the discussion that day about exploring options and opportunities the new automation and software might offer, maybe these two conflicting statements could co-exist and make sense.

2. Involve the staff in the change discussion and direction from the start. Give them ownership

We started a discussion based on a vision of what could be. Once the discussion gained momentum and the fear factor was reduced (although not entirely eliminated), the staff was willing to explore the possibilities of something new and different. The conversation was full of ideas about what steps they could and /or would like to change or eliminate, where pain points existed, and whether there was an operational or software solution for addressing the issue. What did the staff want to see changed?

We had all worked as techs in this lab and were familiar with the workflow processes. This background knowledge was helpful, allowing the conversation to concentrate on the processes that were not “technical” but were required to complete a task. We discussed various processes and alerts that would help manage the workflow and sought software options. The staff took ownership of the process.

We talked about their time and how valuable it was. If time could be freed up to better attend to procedures that require professional experience and expertise, what would the impact be? The staff was full of ideas.

It’s important to remember that managers and supervisors don’t have all the answers simply because they were promoted or hold a title. The staff on all shifts can share a wealth of information and ideas, and we ensured they understood that there were no “bad suggestions.” Most importantly, the discussion was not limited to the “technical” staff. The phlebotomists, processors, and lab assistants were solicited for ideas and involved in the conversations and project ownership.

This was not a “top-down” implementation but a team effort involving staff on many levels. Being heard, asked, and valued can never be overrated when implementing change. Getting views and ideas from all angles is imperative.

3. Assure Flexibility

“Nothing is set in stone. We will adjust until we get it right.” I can’t remember how many times those lines were repeated. The mere admission that things would not instantly be perfect helped reduce the anxiety. The relief of knowing that changes made could be reversed or adjusted as needed provided a level of comfort and reassurance for the staff. This made the staff more inclined to give the changes a try. Nothing is worse than a bad change being permanent just because we “thought” it would work, or because pride or ownership by someone gets in the way of correcting the problem. This mindset also allowed room for patience and understanding.

What happened? Change happened.

The dreaded new automation and software that everyone initially feared would replace their job was implemented. The entire system was able to automate manual steps that the technologists had previously done.

With the use of this new platform, the technologist’s time was freed up to perform other technical procedures. Staff consistently started to get to break and lunch on time, their stress levels were reduced, and they were completing more tasks on each shift. No one lost their job. Morale improved. Pride in accomplishments was shared all around.

Procedures and settings that didn’t work well or as expected were reversed, adjusted, or optimized. We met regularly to check in, especially where there were issues with the changes made. This process was ongoing and fruitful, keeping staff engaged and giving them a sense of ownership.

We found that the open communication between technical and non-technical staff, which started as part of this project, continued naturally and benefited all operations. This was an unexpected bonus. Due to the more effective use of time and the system’s capabilities, new assays were added to the testing menu. This was something that was hoped for but not guaranteed, and it was a welcome added benefit.

Do Less, Accomplish More … initially sounded illogical … until you consider the use of automation and software and what it was able to do. By allowing the system to fully handle specific procedures automatically, the techs could physically “Do less.” They were performing fewer manual steps. As a result of the time freed up, they could complete procedures by the end of their shift, something that they had been unable to do a year earlier. They accomplished more, performed new assays, and completed more work during their shift.

Do More With Less …The directive from the administration. That was accomplished as well. As a result of being able to perform more tests without increasing staff and adding more assays to the testing menu, the department's statistics indicated that more testing was being done without additional staff. The cost of producing the end product, a test result, decreased.

The more important “end result” was not that we met the objectives of these two somewhat awkward taglines but rather the experience and knowledge gained in initiating and successfully tackling change management. The group's ability to support one another, work collectively, communicate effectively, make adjustments, and avoid problems allowed us to navigate the minefield with no casualties.

Other changes that followed encompassed everything from supply usage and procurement to procedures, instruments, and organizational structure. As a result of the experience handling the automation change, including acknowledging and addressing fear and uncertainty, purposeful staff involvement in decision-making, and opening communication lines between departments, these new changes were implemented smoothly and set the stage for future projects. The department took pride in its ability to handle any challenges that came its way.

Hats off to the staff for their attitude and determination. When COVID shook our world in 2020 and required operations to pivot to a new paradigm that we had never experienced, we were ready.

The role of the company

It is also important to highlight the company’s significant role in our change management journey, as they were compelled to adapt and change as well. As previously mentioned, the company was in a tough spot, as their marketing strategy and cost justification for a laboratory to invest in their product was primarily based on time savings and potential staff reductions. Our lab administration met with the company representatives to address this single-pointed approach as a “non-starter.” We requested that their presentation to the hospital administration for capital purchase justification refrain from mentioning or implying staff reduction.

We requested that the company use a different marketing strategy to present cost justification to the administration.

For our laboratory, staff reduction was not our objective. Our external environment had recently changed, creating a challenging situation for our operations. Two neighboring hospitals had recently closed their doors, resulting in an increase in test volumes at our laboratory as patients and doctors shifted to new providers. The hospital administration had compelled us to “Do More With Less” while we needed to provide laboratory services to a larger clientele. We requested that the company use a different marketing strategy to present cost justification to the administration.

This request left the company scrambling, as the product was new on the market, and a full realization of what it could do for the customer, especially in process optimization, was unknown at the time. There was substantial potential, but automation and software programs of this type were new to the market, and widespread acceptance of the functionality and confidence in the software program was not yet established in the industry (though this happened within a year).

The purchasing justification, however, had to address our current requirement to handle an increased number of specimens and results without increasing staffing levels. At meetings with lab and hospital administrators, the explanation and advantages of their product needed to emphasize the use of automated processes.

We wanted them to emphasize the new capability to handle and filter thousands of tests and results from the increased volumes without introducing errors, elevating stress, or requiring additional staffing. If their product’s application was implemented, a bonus would be the ability to “redeploy staff” to perform technical procedures currently sent to outside laboratories. The presentation and commitment from the company to support the automation and software implementation to achieve this success put them “on the hook” for helping us meet this goal.

Their willingness to enter into a partnership with the laboratory meant that both successes and failures, gains and pains, were experienced by both sides.

Collaborating with the company on the presentation and justification for the system, we collectively provided the administration with a vision of what a mid-sized hospital laboratory could accomplish with automation and software previously used only in large hospitals and commercial laboratories. The presentation was successful, and the administration approved the project, which led to the implementation of the change management project and process described above. The company was a key stakeholder in the project. Their willingness to enter into a partnership with the laboratory meant that both successes and failures, gains and pains, were experienced by both sides.

The staff discussions and involvement mentioned in the story produced a “user wants and needs” list. These requests from the laboratory staff impelled the company to increase the capabilities and functionality of their software beyond their initial projections. Numerous ideas and possibilities were exchanged, options offered and tested, and the best solutions employed. The company and the laboratory benefited from shared knowledge throughout the process. It was a learning and growth experience for everyone involved.

The project's combined success for the laboratory and the company, coupled with our experience in change and change management, was shared with other laboratories during their visits to us. Key concepts, including addressing fear, fostering combined input, ownership of changes, and the willingness to adjust and optimize outcomes, were widely shared during numerous conversations and presentations.

The strategy, approach, commitment, and partnership change benefited the company and the hospital. Stepping out boldly, addressing the initial fear, and embracing the vision head-on was exciting and challenging. Their minefield to navigate was much larger than just our single laboratory. The laboratory industry was watching and learning from our partnership's collaborative approach and successes as we helped usher in the era of automation, robotics, and digitalization. That pathway continues to evolve today in the medical instrument industry as change is a constant, and the ability to thrive in this environment is the key to success.

Susan Dawson is a recently retired Laboratory Director with over 40 years of experience. She is the founder of Accomplish More Consulting Services (AMCS). This story is from her first book, Growing Into Leadership: Lessons Learned Along the Way" available through Amazon and Barnes and Noble online.

Connect with Susan Dawson on LinkedIn here.