7 Steps to Successful Protocols

Just as there are associated benefits with protocol-setting, there are also associated challenges with effective implementation—one of which is building team buy-in.

How many times have we heard, “We tried that and it didn’t work” or “We’ve always done it this way and there’s no reason to change”? This mindset typically prevents new or modified protocols from realizing success and the team goes back to the old, familiar, and often ineffective, processes. In order to successfully create new systems, there are necessary steps to build team buy-in and effectively navigate through the change process.

7 Steps to Build Team Buy-In
Effective protocol-setting not only improves practice processes, it also reduces workplace frustrations, performance errors, and associated costs. Protocols may be developed for any practice process.

Examples of protocols include:

• vaccinations
• inventory processing
• safety compliance
• patient care
• client service

No matter the protocol, deliberate steps need to be established to realize successful outcomes. These specific steps will help create new systems and team buy-in:

1. Practice leaders’ agreement
Practice leaders need to be in agreement when identifying and developing protocols. Any indication of disagreement among owners, associates, or practice managers will impede team buy-in. Good questions to ask include: why are we setting this protocol? Are we developing an entirely new protocol or modifying a current one? What are the expected outcomes?

2. Measurement tools
Once buy-in has been established among the leaders, it’s necessary to identify how to measure the performance. Where are we now? Where are we going? How do we measure success?

3. Develop initial protocol steps
Practice leaders may outline initial steps incorporating projected outcomes. Before launching the protocol to the entire team, capturing additional perspectives from selected employees may prove insightful. This starts the seed for team buy-in as the contributors will serve as champions for the effort.

4. Team meeting introduction
Team buy-in success relies strongly on a) the delivery of the message, b) team education, c) team contribution, and d) follow-through. Educate the team to help them understand why the protocol is important. In addition, explain how the patient and client will be impacted, how they will be affected, and what their role is in the process. Once this has been released, ask for their input. Walking through the steps or rehearsing may build their confidence. Provide them with the projected launch date, expected outcomes, follow-up plan, and terms of measurement.

5. Launch protocol and track results
The final protocol version will include team contributions. Team members will also sign off that the protocol has been reviewed with them. Practice managers will document the start date and any relevant observations concerning the process.

6. Don’t abandon: adjust
As with any new project, process, or protocol, gaps may develop or surface that may not have been anticipated. Managers will review the observations and results and then identify areas that may need adjusting.

7. Follow-up and share results
The first two steps primarily involve practice leader vision, contribution, and planning. The remaining steps all include some aspect of team contribution and participation. There may be some practice operational protocols that are not negotiable, however whenever possible, inviting team members to be part of the process will have a positive effect on the process and team-buy-in. Sharing the results of a new protocol with the team lets them know that practice leaders continue to value their contribution.

Maintain Long-Term Buy-In: Understanding Change
Practice teams often get stuck in routines; continuing processes that may not be healthy, but are familiar. Owners and managers consistently experience the trials and tribulations of breaking the “familiarity barrier” and understandably develop a reluctance to introduce anything new.

What systemically must a practice do to assist in the change process in order to maximize team buy-in and performance?

Every practice, team, relationship, and person has at some point struggled with the challenges of change. Many have pushed back on change in order to avoid the associated pain of abandoning the safety of familiarity. Change management experts have studied and attempted to identify the necessary steps to not only realize successful change but also make it stick. John Kotter is one such expert and addresses the change process in his book, Leading Change.¹

8 Steps to Navigate Change
According to Kotter, these are the steps to effectively navigate change:

1. Create a sense of urgency
Help others see the need for change and the importance of acting immediately.

2. Pull together the guiding team
Make sure there is a powerful group guiding the change; one with leadership skills, belief in action, credibility, communication ability, and analytic skills.

3. Develop the change vision and strategy
Clarify how the future will be different from the past and how you can make the future a reality.

4. Communicate for understanding and buy-in
Make sure team members understand and accept the vision and strategy.

5. Empower others to act
Remove as many barriers as possible so that those who want to make the vision a reality can do so.

6. Produce short-term wins
Create visible successes as soon as possible.

7. Don’t let up
Press on after the first success. Remain relentless with instituting change after change until the vision is a reality.

8. Create a new culture
Hold on to the new processes and ensure the team succeeds until they become a part of the culture.

According to Kotter, change within organizations is not easy. “The methods used in successful transformations are all based on one fundamental insight that major change will not happen easily for a long list of reasons.” The 8 steps in Kotter’s Change Model attempt to deal with the reasons why organizations struggle with change.

It’s Worth It
Although protocol-setting may take time, effort, and patience, the associated benefits will significantly impact the overall health of the practice. In the long-run, it’s well worth it.

References

1. Leading Change, 1st ed. Kotter J. P.— Harvard Business School Press, 1996. Kotter International, http://www.kotterinternational.com/.