• Creating a Culture of Change in Your Practice: Creating Productive Tension

    Written By:

    Rhonda BuckholtzThis is Part 2 of a three-part series about creating a culture of change in your practice.

    • Part 1: Building Trust
    • Part 3: Making Key Changes & Wins in Our Practice coming in September

    Trust is the essential foundation for building cultural change in our practice. Once trust has been nurtured and built, we can move on to the next important step: creating productive tensions or willingness to change. While improvement requires that we be willing to change, it’s also the most challenging part of the process. We not only have to change ourselves, but we also have to be skilled in influencing others—our employees, physicians and outside stakeholders—to change.

    Creating tension doesn’t mean creating chaos. What we are trying to do is empower our employees to speak up when things aren’t working. We need them to trust us enough to offer up not only problems but possible solutions. One strategy is to set the following ground rules for meetings and interactions:

    1. Put an end to the “this is the way we have always done it” mentality.
       a. This toxic way of thinking can break down a practice. To counteract this, enable employees to question processes and offer improvements.
    2. Don’t discount ideas that have been tried before.
       a. Perhaps a suggestion has been tried before and failed. An employee may have a new suggestion that might make it work.
    3. Allow all stakeholders to have a voice.
       a. Don’t shut down employees. Always actively listen.
    4. People are not the problem.
       a. Break down a problem. You’ll usually find that the issue is actually a process or broken policy.

     The ability to change requires that we constantly be willing to question ourselves and our current business processes. Change management expert Jim Stuart says, “To achieve a goal you have never achieved before, you must start doing things you have never done before.”

    As practice administrators, we need to be willing to take ourselves out of our comfort zones. Think about those New Year resolutions. How often have you been able to keep one? Change is hard. Changing yourself is hard enough, influencing change in others takes perseverance. Consistency is key.

    According to the book “The Five Dysfunctions of Teams,” there are common issues that tear down our teams. As we discussed earlier, building trust will remove these dysfunctions and allow us to create the positive tension we need for improvements.

    Here are the five dysfunctions that you should try to avoid in your practice:

    1. Absence of trust
    2. Fear of conflict
    3. Lack of commitment
    4. Avoidance of accountability
    5. Inattention to results

    Focus on the important issues, create accountability and then act on lead measures—the highest impact goals you must accomplish. Remember that lag measures are about narrowing your focus down to achievable and actionable goals.

    Once you’ve created this new practice culture, you will be able to influence key stakeholders and gain the buy-in necessary to make those hard changes. Create a practice culture that values trust, listening, questioning and trialing new changes without fear of failure. Then, you can begin to make the changes necessary in your practices that allow for long-term growth and success.

    About the Author

    Rhonda Buckholtz CPC, CRC, CPMA, CDEO, CHPSE, CPCI, COPC, CPEDC, CGSC, CENTC has more than 30 years of experience in healthcare, working in the management, reimbursement, billing, and coding sectors, in addition to being an instructor. She was responsible for all ICD-10 training and curriculum at AAPC. She has authored numerous articles for healthcare publications and has spoken at numerous national conferences for AAPC, AMA, HIMSS, AAO-HNS, AGA and ASOA. Rhonda is the chief compliance officer for Century Vision Global and also provides transformational services and revenue integrity for Ophthalmology practices.