Managing Change in a Medical Context: Guidelines For Action

Abstract

Guide Overview: The guide has been produced to make the essence of current good practice in change management available to everyone involved in changing medicine, particularly medical education at undergraduate, postgraduate and continuing levels. Its use can help facilitate change, with more effective use of scarce resources, including time. A framework is provided in which to think about the change being contemplated and the issues that should be considered. 1 Introduction The data for this guide were taken from a research project designed to take what was known about the management of change in industry and in education and to adapt it to the medical context. A hypothetical framework, of the change process in medicine was proposed and from it was derived a format for semi-structured interviews with a sample of 55 doctors, focused on particular episodes of change with which they had been involved. A list of the most frequently cited important factors in change management was compiled: thorough consultation (69% of sample); talking to people and explaining the changes (56%); and teamwork (55%) were at the top of the list. 2 A model of medical change The rank order of factors was used to derive a model of medical change, based on core activities and tactical choices, relating to: • the professional characteristics and styles • the essential steps or core activities in a change programme • the tactical or style choices that must be made (Figure 1) Core Activity Tactical Choices 1 Identify a shared problem, establish the need or benefit Seek solutions do not sell them, consultation, conjunction of local or national circumstances, lobbying.