From Vision to Action: Making Your Laboratory Plan a Reality

“Vision without action is just a dream.” (Joel A. Barker) Planning for your laboratory’s future is the first step in good leadership. Making that plan a reality is effective leadership. So, what does it take to implement a complex initiative across a laboratory or health system? How can you get employees on board and keep them engaged?

Within a healthcare organization, the laboratory is part of a complex system and rarely functions in a vacuum. Dependencies, interconnectedness, and a ripple effect creating unintended consequences add to the complexity. Making the plan for your laboratory a reality requires hard work. When done properly, you will have the outcome you envisioned.

Steps for effective change management

Implementing a complex plan for your laboratory has several steps.

Planning – create a vision and develop an action plan.
Pre-execution – begin change management via employee communication.
Execution – secure employee buy-in, implement the plan, and effectively manage change for staff.
Evaluation – measure results and outcomes, reinforce employee support of change so it “sticks.”

The Ambrose model for implementing complex change identifies five elements necessary to achieve progress: vision, skills, incentives, resources, and action plan. When all are present, the project will be effective.

When any aspect is missing, there can be employee anxiety, uncertainty, or outright revolt. Why would staff resist the opportunity to be involved in enhancing the laboratory? Several factors may be at work: 1) fear of the unknown, 2) staff don’t want to take on additional work or are uncomfortable performing new tasks, or 3) staff feel that additional demands will negatively impact departmental quality or patient care. At the core of each of these factors, staff are reacting and responding to change.

As a leader, it is important to weave change management throughout the implementation process. A popular change management model is the ADKAR® model from Prosci®. Aligned with the five Ambrose model aspects, the ADKAR® model applies the following steps to managing employee response to change.

A – Awareness of the need for change
D – Desire to participate and support the change
K – Knowledge of how to change
A – Ability to implement required skills and behaviors
R – Reinforcement to sustain the change

With a gap in any of these aspects, there is a predictable and corresponding staff emotional response:

Without a clear and appropriate vision, staff have no awareness of the change and will be confused. You may hear, “Why are we doing this anyway?”
When staff don’t understand why they should support the change, they will resist. When there is no desire to participate, you may hear, “This is a waste of time. Maybe if we stall, it will go away.”
Without adequate skills or knowledge, staff will be anxious. You may hear, “We aren’t able to do what is asked of us. We can’t run a complex operation like this.”
Without adequate incentives, change will occur slowly. You may hear, “Sure, it sounds great but why should I work harder? What’s in it for me?”
Without resources, staff will be frustrated. You may hear, “We are working too hard already. How can they expect us to do more?”
Without a solid action plan, including checkpoints and assigned accountability, there will be false starts and staff will feel as though they are on a treadmill, moving but never getting anywhere. You may hear, “Here we go again. Haven’t we tried this before? Been there, done that, got the T-shirt.”
And without reinforcement, you may see regression and a return to the old ways. You may hear, “I told you it wouldn’t work.”

Securing staff buy-in

Is your laboratory’s mission and vision well-articulated and understood? Is the change initiative aligned with the existing mission and vision? Frequently, staff may be reluctant to embrace a new initiative because they don’t see where they, as individuals, fit into the new plan. By involving staff early in the process, they will develop a sense of ownership and buy-in. Below are several examples of employee concerns and strategies for gaining support:

Employee #1: One of the best scientists in the department is resistant because she feels that quality and patient care may be compromised through this change. The best approach to use with this staff member is to listen to her concerns and assure her that because your mission remains focused on quality, she has a vital role on the team. She can be a valuable resource, developing processes that sustain appropriate quality and patient care.

Employee #2: He has been in the laboratory a long time and energetically gets involved with new initiatives. Repeatedly, his enthusiasm has turned to frustration as he has watched a project progress slowly or halt when encountering a roadblock. His frustration is likely due to a lack of resources. Assuming that this individual is truly supportive of the change initiative, his background and history of organizational habits and successes will be valuable as you develop the plan. A well-designed plan will anticipate the necessary resources and provide them when needed. By identifying common and potential barriers and anticipating the resources necessary to overcome these barriers, this employee will be able to engage fully in the process with hope and enthusiasm instead of frustration.

Employee #3 is a proactive and change-oriented individual. Many false starts and aborted projects have deflated her energy and caused her to adopt an attitude of “This too shall pass.” To secure her support, she must know that the plan is comprehensive and that all the details have been considered. She must also understand that she has a role in creating a successful outcome. This individual can fulfill a key role in helping to develop an action plan that will ensure timely and forward-moving progress.

A leader must develop a plan that includes the operational and human elements necessary to realize success throughout the process. Engage staff by:

Communicating the goals of the initiative.
Listening to — and validating — employee concerns.
Assuring employees they will receive the training and resources necessary to achieve the goal.
Building a team to develop a comprehensive plan and support the initiative.
Celebrating milestones and successes and communicating positive outcomes to ensure sustainability.

A laboratory initiative starts with planning, but only through effective execution and change management will the vision become a reality.