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Beyond the Conference Room Solution

February 14, 2013

Yet Another Example of Why Top-Down Implementation Fails

I recently read an article by @anniekarni for Crains New York Business which I found to be absolutely remarkable given everything that has been written about how NOT to implemnent change.

Without being consulted, nurses at 15 New York area hospitals including Lenox Hill Hospital and Staten Island University Hospital are being forced to white scrubs, rather than allowing the nurses to choose their own color.  North Shore LIJ says white scrubs will help patients identify nurses. 

While this may seem trivial to many, what I found interesting was not the color of the shirt, but the thought process behind it.  As
I have mentioned many times, 70 percent of all change efforts fail.  They rarely fail at the ideation stage (let’s switch to white scrubs).  Where they inevitably break down is during implementation.

And why does implementation fail?  Generally, the number one cited cause of failed implementation is the organization’s inability to overcome employee resistance.  And why do employees resist?  What most do not realize is that employees have a fervent belief that they simply know better than does management what will and will not work.
The case of the mandated white scrubs, is a classic example of what I call ‘ “Conference Room Solution.”  I can picture it now; a meeting of senior hospital leaders gathered around a conference room to discuss potential solutions stemming from the results of a patient survey.  The survey that indicated that patients and their families were often confused by the many employees that rush around emergency rooms and hospital hallways: respiratory therapists, physician's assistants, nurse managers, assistant nurses, patient care associates and others. "Unless you work in a hospital, most people cannot distinguish these people from one another," the hospital spokesman said.
The solution: the bright white top will "make it easier for patients to identify who the nurse is."  Unfortunately, nobody likely discussed the solution with an important group of stakeholders – the nurses themselves.  So what was the response of these belligerent resistant nurses – their experience told them that new bright white scrubs will accentuate blood stains, reveal undergarments and turn yellow.
"When you buy white polyester, it turns yellow," said Patricia Kane, a nurse at Staten Island University Hospital and a member of the New York State Nurses Association. "There's also the see-through factor, which is a real issue. We bend and we stretch and we push and we pull—it's not good when you have to wear white and you're wondering what the guy in the next bed is thinking."
The new dress code would affect most of the 10,000 nurses who work in the 15-hospital North Shore LIJ system. Only nurses who work in endoscopy units, operating rooms and labor and delivery—who spend most of their days in gowns—will be exempt from the new dress code, which will take effect in February, a North Shore LIJ spokesman said.
At the Lenox Hill emergency room last week, nurses joked that they planned to protest the policy by wearing brightly colored or leopard-printed lingerie underneath their sterile whites. They also complained that getting dirty with blood and other body fluids happens regularly. Those stains will stand out on white tops far more than on the dark purple and maroon scrubs many nurses favor today.
Nurses reached through their union bristled at the very concept of a mandate on how to dress. "It's demeaning to professionals to be told what to wear," Ms. Kane said. "I wore white for a lot of years as a nurse and it was always a problem."
What is the “so what” of this story?  If you want lasting organizational change, it is critical to involve the key stakeholders in the ideation process in order to get them to support a successful implementation.  Read the article http://www.crainsnewyork.com/article/20130124/HEALTH_CARE/130129945#ixzz2JU2jkBV0 - you'll be amazed.

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"When I have fully decided that a result is worth getting I go ahead of it and make trial after trial until it comes." - Thomas A. Edison

Let’s start with an explanation of the title, Beyond The Conference Room Solution. In all of my workshops and in many of my lectures, I refer to the phrase, The Conference Room Solution as a far too common approach used by organizations use to solve many of their most challenging issues.

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