Barriers To Change in Health Cate

Gayle A. Mitchell, PMP

Medication Errors

• Dose Omission• Overdose/multiple dose• Under Dose• Wrong Product Strength• Expired Order• Incorrect Documentation • Wrong Product• Wrong Rate of

Administration

• Wrong Time• Wrong Patient• Wrong Duration• Monitoring Error• Wrong Form of Product• Expired Product• Incorrect Route• Nocsomial Infections• Improper Labeling

Educate Before You Medicate

A Prescription for Change

• Identify the organizational change

• Articulate the case for organizational transformation in health care

A Prescription for Change

• Detect organizational/individual barriers

• Recognize influencing factors• Address motivational theories to assist

change

A Prescription for ChangeMotivational Theories to Assist Change

• Machiavelli’s Commentary on Change• Motivation Theories

– Need Motivation – Maslow– Two-Factor Theory - Herzberg– ERG Theory - Alderfer– Acquired Needs Theory - McClellan– Reinforcement Theory- B.F. Skinner– Expectancy Theory – Vroom and Tolman

A Prescription for Change• Technology is not the sole panacea

• The human factors of change– Culture

– Alignment

– Controls

– Accountability

A Prescription for Change• Common Barriers to Change

– Fear of the Unknown– Lack of Knowledge and Understanding– Lack of Strategic Vision, Leadership and

Communications– Absent Engagement of Stakeholders– No Roadmap – Idiosyncrasies of Individual Participants– No Progress Measurements– Failure to Recognize Successes

• Overcoming Resistance to Change– Reasonable Initial Hypotheses– Organizational Readiness– Clear vision– Sense of urgency– Committed leadership– Transparent Communications – Conflict Resolution Strategies– Reinforcement

A Prescription for Change

A Prescription For Change

• What is Six Sigma?– Overview– DMAIC– Kaizen

Six Sigma

A Prescription For Change

• Why Six Sigma for this change effort?– Disruptive innovation drivers– Alignment with complex systems management– Targets 99.99975% error-free conditions– Standardizes critical incident reporting– Documented previous success

Six Sigma

A Prescription for ChangeConclusion

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