As I worked on co-authoring Healthcare Kaizen, I dove deeper into my study of “kaizen” practices and mindsets, revisiting many core books on kaizen after years of practice in different industries. I used to define kaizen as the phrase it's most often associated with – “continuous improvement.”
Breaking down the two Japanese characters in the word, “kai” means change and “zen” means good, so kaizen can be translate to mean “good change” or “change for the better” – or, basically, “improvement.”
In giving presentations and talking to people about kaizen, the question of so-called “change management” came up.
I've said for a long time that the organizational practice of “change management” seems like a bit of a misnomer. I think this was an expression I heard from Jamie Flinchbaugh – that we don't manage change, we manage people.
I've often found that people's desire for “more change management” is polite code for “how do we force people (or convince) them to do what we want?”
So, change management often becomes a big communication campaign, trying to convince people to use a new technology or adopt a new practice.
One expression I've come across again is Meg Wheatley's expression “people support what they create” (see her saying this on YouTube). That's a powerful notion in kaizen. When everybody in the organization is involved in identifying and implementing improvements, there's no forced change management required. People take initiative and they take action because it makes their own work easier or it makes things better for customers (or patients).
Now, there are some changes, major ones, that everybody can't be involved in. Take new medical technologies like Electronic Medical Records or Computerized Physician Order Entry. Physicians are often seen as being “resistant” to these technologies and leaders try to find “change management” (which smacks of “reeducation”) to get physicians to fall in line.
Back to the definition of kaizen – meaning good change, or basically just “improvement”… all improvements are change, but not all changes are improvement. Not all changes make our work easier or more rewarding and not all changes lead to better results for customers or patients.
If a change is really an improvement, people tend to go along without being forced. I saw an article the other day about how physicians (and I'd extend this to others) don't hate technology – they hate technology that sucks. As my friend and KaiNexus colleague Dr. Mark Jaben said, physicians in the 1990s flocked to adopt cell phones, because it was way easier than stopping and getting out of the car to use a pay phone when you got paged. There's an example of a technology that wasn't perfect (“can you hear me now?”) but it provided value… so physicians adopted it.
For all of the talk about how “people hate change” (supposedly), have you noticed how many people have flocked to iPhones, Android phones, etc.? Sure, people complain about them, but it's not a hard sell to get people to adopt technologies that benefit them.
So, whether it's a new technology or a new process that you're trying to get people to adopt, instead of blaming the “resistors” and blaming the lack of change management, maybe the technology needs to be easier to use than what they had before? Maybe it needs to create value where there wasn't value or utility before?
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