Why change efforts fail (and how to fix it)

I used to think any process improvement that solved a burning issue would get implemented right away. But a conversation last week made me realize how wrong I was.

I was chatting with Jennifer, a VP of CareOps at a large care organization. She admitted that while their current processes are inefficient she hasn’t pushed for optimizations. 

Why? Her staff is already overwhelmed - implementing new processes, even better ones long-term, would just burry them in the short-term.

I was floored, but I got it. She just doesn’t want to drown her team in extra work when they’re treading water as it is.

The truth is, her mindset is really common. We treat change like skydiving without a parachute instead of just part of continuous improvement. But if you're not evolving, you're moving backwards.

The bigger issue? We tend to set change efforts up for failure from the jump. Managers pass responsibilities off without support or resources. They think that simply assigning the task means real change will magically occur. Wrong.

What leaders need to do to drive real change change
Instead of tossing critical initiatives over the wall, leaders need to tear down four major barriers that impact change:

(1) The boss barrier

• What is it: When the higher-ups are either actively blocking the change or just failing to truly get behind it with real actions and resources.
• How to tear it down: Ask your boss to shadow you or let them experience the pain first-hand. 

(2) The system barrier

• What is it: The org's own outdated processes, policies, and rigid structures acting like a giant speed bump.
• How to tear it down: Leadership has to promote a mindset of continuous improvement. Make it stupid easy to implement change by cutting red tape and celebrating failures as lessons, not screw-ups to be punished. 

(3) Barriers in the mind

• What is it: The psychological roadblocks individuals face like fear of the unknown, skepticism about the new way, comfort with the status quo, and the mindset that real chang in healthcare is impossible (or takes ages). 
• How to tear it down: Showcase that meaningful change can actually happen quickly with the right support and mindset. Share relatable success stories of processes being overhauled in weeks, not years. Quantify the positive impacts to get people bought in. 

(4) Information barriers

• What is it: A lack of clear, transparent information about what's changing, why it's happening, and how it'll go down.
• How to tear it down: Explain the "why" behind the change until you're sick of hearing yourself. Share clear next steps with specific timelines. And if those timelines get delayed, communicate that with the reasons why

And before you ask - yes, these four barriers are backed by research. They come from the book "The Heart of Change". Highly recommend giving it a read. 

I've also just scratched the surface here on how to knock down each barrier. There are tons of other tactics and frameworks I can dive into for dismantling them. So let me know which one you want me to focus on first.

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Quick intro: we’re Thomas and Rik, building Awell - a low-code platform allowing care teams to design, implement and optimize care flows in days, not months. CareOps grew out of our years spent improving CareOps at innovative providers.