AS RABBIE BURNS MIGHT HAVE SAID, the best laid plans of mice, men and veterinary practice managers will “gang aft agley”.
For the last of those three, it is often the reluctance of their own staff to embrace new clinical or administrative methods that mean proposed changes are delayed, or even abandoned.
So how can managers ensure that an idea for improving the way the business is run will be accepted by their own colleagues? That requires an understanding of the reasons why people resent change, and of strategies for persuading them to reconsider their resistance, according to speakers at the SPVS-VPMA congress.
Organisational change experts
The meeting, which opened on the day after the annual celebration of Scotland’s national poet on 25th January, featured two experts on organisational change: Margaret Burnside of Cake, a Norfolk-based management consultancy, and Richard Artingstall, director of Vale Referrals in Gloucestershire, who is studying for an MBA in the evaluation of structural changes in veterinary practice.
Mrs Burnside noted that with the possible exception of vending machines, change was inevitable in all aspects of life. Yet an oft-quoted 1995 study by John Kotter of the Harvard University business school found that 70% of change programmes introduced by US companies were failures.
“This was nothing to do with resources or budgets, it was due to behaviour. The central challenge at all stages of a change process in any business will be people and their behaviour.”
There are two main categories of change in the business, as far as its staff are concerned: intentional or imposed, Dr Artingstall suggested. The former will have been anticipated and are likely to be the result of a gradual process.
Clinical staff will generally deal well with that sort of process because they are very good at problem solving and at making decisions based on the available evidence. But vets and VNs are no better than anyone else at coping with imposed changes in their work: “It affects the limbic system, which is the way we prepare ourselves for fight or flight,” he said.
A minority of the staff members in any organisation may welcome the introduction of new ideas or processes, but the majority are likely to need persuasion and some may be fiercely resistant. All may have concerns about its effect on their working lives and in the short term there may be disruption. Mrs Burnside advised against warning staff that proposed changes would cause them serious problems.
“Most of you will have heard of the nocebo – the opposite of a placebo. In the National Health Service, it has been found that if doctors tell their patients that a treatment is going to be painful, it will be. So don’t tell your staff that proposed changes will hurt them because, guess what, they will.”
Dr Artingstall said that the process of responding to changes in working practices occurs in three stages. In the first, the pre-contemplation stage, people are not interested in even thinking about the proposals. That will only occur during the contemplation stage in which they weigh up the pros and cons for them personally before moving on to the determination stage in which they will be prepared to accept their new circumstances.
He warned that managers must appreciate that their staff will go through that process at different speeds. They must also accept that there is no point in pushing ahead with, say, a new computer system if a majority of those who will use it are still at the pre-contemplation stage.
Mrs Burnside recommended that those responsible for change projects in veterinary practices should familiarise themselves with the theories of the US psychologist William Bridges, author of Managing Transitions. This book analyses why many people will resist changes in an organisation and suggests that letting go of familiar procedures or technologies can cause significant distress.
“It is for you as managers to show leadership in coaching people through the changes. You should not dismiss as unimportant the things that many staff feel they will lose,” she said.
Three levels of resistance
Resistance to proposed changes may occur at three levels that can be summarised as “I don’t get it”, “I don’t like it” and “I don’t like you”, Dr Artingstall explained.
The lowest level opposition may be tackled by providing factual information about the potential benefits of the new approach in improving clinical results or financial performance. Those people showing “level two” resistance are responding emotionally to a perceived threat and will need reassurance that they will not be harmed by the changes. Meanwhile, dealing with a level three response is likely to be much more difficult because it indicates a loss of trust in the management. It is vital for the senior staff to begin rebuilding that fractured relationship. This is likely to be a significant test of their management skills and one that in many cases they are likely to fail. “The most common mistake is to offer level 1 solutions in providing facts and figures when the problem is at level 2 or 3, with a lack of confidence or trust,” he said.
In questions, audience members wanted to know when was the best time to inform staff members of impending developments, such as a change of ownership.
Paul Wilson, the former principal of a County Durham practice sold to new owners last year, was adamant that staff should be informed as soon as possible. In his case he had made sure that he spoke personally to every member of staff as soon as the contract was signed.
For the majority of staff members, the question to which they needed an answer was exactly the same: “Will I still have a job?”
However, in the longer term, people will want to ask more nuanced questions. Mrs Burnside advised the head of the business to ensure that senior staff are informed first of any decision, as they need to be able to answer queries about the effects of any changes on the working lives of their colleagues.
