Change Management: What leaders need to know about fear

By Laura Wilson, RN, BSN, COS-C SimiTree Managing Director, Operations Consulting 

Oh, the times they are a-changin’ 
- American singer-songwriter Bob Dylan

Community-based care agencies face change from every direction. We overhear talk of the “before times” – before the pandemic. Things will get back to normal someday. But what is normal? The goal for home health and hospice leaders is to learn how to lead through change versus hoping things will get back to whatever normal is or was. Leaders today will need the soft skills necessary to thrive in guiding their teams through planned and unplanned change.

Change is happening on a personal, global, and organizational level. Agencies had to quickly pivot to new ways of meeting patient needs with the onset of COVID-19. Many of these changes are now being formalized into permanent process. To successfully implement planned change, today’s leader must think through and carefully plan each step and communication to ensure the desired outcome is obtained and sticks. Employee resistance should be expected and prepared for.

Why do people resist change? Change happens to all of us every single day. Resistance generally is based on one emotion – fear. People fear the unknown. Perhaps they won’t be able to adapt. Maybe it’s a sense of loss that comes with change. Maybe it’s an actual loss of a job or status. Sometimes the fear is based in self-esteem concerns. And anyone who has moved an office around knows the disruptions which occur because of the change in the office environment. Most all can be traced back to fear. Resistance to change shows up differently in different people. The work of leadership is to identify these behaviors and create an environment and communication that answers and reduces these fears. Behaviors commonly seen during change can be anger or emotional flare-ups, people actively mobilizing others to resist, team members being insensitive with each other, obvious disengagement, employees not meeting key performance requirements, or outright undermining of the project. The leader must be sensitive to these issues and determine if they are because of the organizational change or are there personal issues involved.

Resistance to change is a normal human behavior and should be expected. These aren’t bad people or bad employees, there are simply still unknowns in the planned change. If you expect resistance, you can plan for it. Communication and listening skills are critical. During change you cannot over communicate. What you don’t tell your team they will fill in for themselves, adding details, and it often doesn’t even resemble the truth. And you need to listen. Really listen to people’s concerns. Don’t talk. Don’t answer. Listen. Employ empathetic communication which is considering the change from the team member’s perspective and understanding their issues and concerns as they experience them. Understanding is critical for keeping your team engaged, decreasing their stress and conflict, and maintaining quality care. Remember:

  1. Leaders influence emotions.
  2. Emotions drive people.
  3. People drive performance.

People undergoing change naturally default to the way they’ve always done things before. If it worked before, surely more of it would work better now. They’ll often take an action and expect a certain result. When the expected result isn’t achieved, we naturally try it again. Think about giving directions to someone whose first language isn’t yours. You try to simplify and give the directions. When they don’t understand, what do you often do? Provide the same directions only louder and slower. We’re not thinking about why they don’t understand. We do what amounts to more of the same until the conversation spins out of control. Psychologists call this an “extinction burst” and that clearly describes an action that’s not going to work. Take time to listen, to understand what isn’t working. In doing so you often learn ideas and solutions you might have previously missed.

Finally, define your change and identify a strong change management model to guide you. Some well-known change management models include the Kurt Lewin Model, the ADKAR Model, Kotter’s 8-Step Change Model, or Stephen Covey’s 7 Habits of Highly Effective People. However, how you go about the change is equally as important as what you do. Communicating the need for change and the process you will use effectively is vital to accept the change you wish. As a leader it starts with you. Examine your feelings and how you react to change. It’s important that you model a positive attitude and steadiness to reassure others. And it never hurts to call in a professional to navigate change successfully. Wishing you great success in your effective change management.

Laura Wilson, RN, BSN, COS-C SimiTree Managing Director

By Laura Wilson, RN, BSN, COS-C
SimiTree Managing Director, Operations Consulting

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