Engaging professionals to deliver improved performance in a newly refurbished hospital workplace
I was lying on the gurney one evening listening to the beep of the machine just above my head. I could hear it so I was still here – my heart was still beating and whilst it was much slower and more sluggish than it should have been I was alive.
Thank goodness, – and then I noticed what was happening around me in the Emergency Room. I had been admitted to a hospital which was undergoing refurbishment change – the ER itself was being refurbished and new procedures were being implemented – and the patients just kept arriving anyway.
I have to say outright – the staff were amazing – not only towards me but also towards everyone else in the area. The teamwork between the professionals was clearly obvious, their focus on getting the best care for the patients was noticeable and their humour was apparent too.
It was then I noticed how they were interacting with their environment. Some of the areas had the new design, some were waiting for their upgrade. The behaviours were identical in both places– and the door to the new central storage room had been forced open with a box – that was serving as a rubbish bin and which was neither seen nor noticed by any of the cleaners or staff for the full five hours I lay there. Above the box was a sign saying the door needed to be locked for safety and temperature control reasons.
A study, by the National Health Service in the UK on relocating and refurbishing hospitals, found they routinely took c. 2 years to return to their previous level of performance, measured from a point 6 months prior to the actual relocation and final refurbishment.
This is not just the NHS. Similar experiences in hospitals in South Africa occured. Just after a hospital refurbishment and build project was finished, leaving a trail of frustration and bad experiences in its wake, the medical professionals and teams had had enough.
They collaborated to highlight how unworkable the new work environment was. Within 2 months they had completely spent the year’s budget in bandages – “because the cheaper ones were not available and the patients needed a bandage”. Seems petty. However it got the attention of the administrators who addressed the work process issues. It took nine months to get an agreed solution because we needed to debrief and resolve all the anger, new rituals, conflict, distrust and irritation. Not to mention game playing and posturing by everyone! It would have taken us five weeks if the issues had been identified and resolved prior to the move.
This is not just a healthcare response.
A service provider within Melbourne handled the mechanics of relocating 400 people reasonably well. Eventually the boxes arrived, the telephones were connected and management considered the move complete over a week later.
In reality it took this business two years to return to its earlier profit level – and deal with losing two key partners, battle to increase turnover demands, and stem the expense surges meaning they did not made budget for nine months. The resulting retrenchments were not a surprise and the connections to a poorly handled relocation were missed.
What leads to the decrease in performance post Refurbishment?
In most cases, the project management was good, with the “usual” project management problems affecting costs, timing, and budgets.
The longer term problems lay with the people and how they interact with the new facilities.
When a workplace is changed, the resultant changes in workflow, work practises and team dynamics take months to identify, resolve and implement. This process always takes time and it cannot be rushed. People need time to think, to identify how they feel, to work out what needs to change and finally how the changes affect themselves and those they work with.
Trying to deal with these issues once the relocation has occurred, always takes longer as people are also usually dealing with their perceptions of their work, their new environment and facilities which they may or may not be familiar with, the continuing demands from their clients/patients/colleagues and with trying to find solutions to issues they often do not fully understand. There is an associated increase in stress, anxiety, emotion and a resultant reduction in tolerance, patience and willingness to be reasonable.
Experienced together there are enough bugs to cause a serious illness!
There are some common threads that run through these examples.
Not having “change” issues dealt with prior to the move – dealing with issues before a move – gives people the opportunity to try new behaviours, new ways of thinking before they have to actually be different in the new work environment.
New work environments always influence how work is completed. Not dealing with these prior to relocating means people do not have the chance to try different ways of working nor determine which to recommend. When they move to the new environment, they tend to have 2 potentially conflicting work flows to implement. Their old one and the proposed one.
When the stated Values of the organisation are not reflected clearly in the relocation experiences nor in how the people feel they have been treated, the gap that exists between the stated and lived values creates an environment where distrust flourishes. It takes months and huge investment to recreate trust again. Low levels of trust always lead to lower levels of performance.
Recent research conducted by Harvard Business School shows 88% of managers still do not appreciate what it will take to lead their people through change. Most underestimate the effort and complexity of the proposed changes, whilst even more (92%) do not recognise the need to even deal with the change in any way other than through projects and systems.
Relocating people means their attitudes, thoughts, experiences and emotions need to be identified, shared, understood and then given the space and time to be thought through and processed.
The risk associated with not doing this timeously and proactively has both headache and financial consequences.
The ideal wish, from all parties involved, is that everyone proactively thinks differently, behaves differently and therefore performs differently in the new environment from the start.
It takes relevant change leadership across the organisation to achieve this. And then the performance recovers quicker than expected and the intentions of the workplace strategy can be achieved