Change Management In Healthcare

Sitting in Epic’s massive UGM auditorium, the 100+ new AI features didn’t feel exciting. They felt overwhelming. Because it’s clearer than ever: AI is on an exponential curve, while humans and healthcare orgs are stuck on a flat line, barely nudging the slope. The gap isn’t a technical one — it’s change management. And until someone closes it, AI will keep sprinting ahead. I’ve rolled out tech to physicians for a decade. The hardest part is never the software; it’s the change management. Especially in healthcare, where you can’t just close the office for an "AI inservice." Doctors are already sprinting — 100 patients a week, fires everywhere — and just when they finally get comfortable with one workflow, someone moves the button they’re supposed to click. The most common complaint I hear? 𝘏𝘦𝘺, 𝘺𝘰𝘶 𝘮𝘰𝘷𝘦𝘥 𝘮𝘺 𝘤𝘩𝘦𝘦𝘴𝘦! Which brings me to the paradox doctors live every day: 👩⚕️ There’s no time for doctors to train or learn — because that means lost revenue. Everyone wants max efficiency out of us, but also zero errors. 📱 Tech companies brag about “hallucination-free copilots” but won’t take responsibility when they’re wrong. The fine print: the clinician is always liable. 👨⚕️ Doctors are left carrying the load: supposed to instantly learn, perfectly apply, and reconcile both demands — while still doing the actual job. And if you think AI will just replace doctors? All you’ve done is shove the change management onto patients. Good luck with that. Need proof this isn’t just doctors? Linkedin News says 41% of professionals report AI’s pace is taking a toll on their well-being — and more than half say learning AI feels like a second job. The ultimate winners here are those who can educate and do change management the best.

So much of what we need to accelerate change in US healthcare is a new management culture. The starting point for building a new management culture is acknowledging limitations with our current culture—regardless of the sector. Having worked across all sectors of healthcare, I reflect on some cultural impediments holding us back: 1) Slow pace of execution: we have convinced ourselves that change needs to be slow, deliberate, and measured. We let the perfect be the enemy of the good. While the nature of operations that influence life and death require measured action—we sometimes forget that inaction can sometimes be just as damaging to the lives of the people we serve. 2) Avoiding hard decisions: so many leaders and leadership teams know the right thing to do—but fail to do so for fear of disruption of some kind. So dysfunction perpetuates ad infinatum. As hard as making the hard decision sometimes is—living with the consequences of not making these hard decisions often creates more pain in the long-term. 3) Passive Aggression: so many cultures perpetuate silence in decision-making meetings. Leaders engage in meetings after the meeting to have further discussion and decisions that are made are relitigated opaquely in a private setting. When there is an implicit belief that anyone can change or reverse a decision once it has been made, people don’t respect decisions when they have been made and inaction becomes the norm. 4) Committee-led Disempowerment: so many cultures disempower leaders by requiring decisions be made by committees instead of individuals. Great cultures instinctively understand that the quality of some decisions is improved by committee work, while the quality of other kinds of decisions is significantly degraded. 5) Leadership: the days of the player-coach in healthcare have given way to excessive hierarchy where many leaders are unwilling to roll up the sleeves and see what the real work of their teams is like. They are more content to “direct” it from afar. As a result we have lots of people overseeing work they know little instinctively about—and they don’t know basic details that they should. What are other cultural attributes of the healthcare industry that need reform? What do you think about this list?

Which one of these reasons shows up most in your organization? Change doesn’t fail because people are incapable—it fails because leaders misunderstand resistance. Here’s the truth: Resistance is not defiance. It’s emotion. It’s data. It’s human. If you're seeing pushback, here are the 7 real reasons why—and what that resistance is trying to tell you: --------- 1️⃣ They’re Grieving What’s Being Lost. Resistance often signals mourning of familiarity, identity, or comfort. In change, so often we experience the loss before the gain. 2️⃣ They Don’t Understand the “Why” and the ‘Why Now’. Clarity and transparency matter more than ever. 3️⃣ They Feel Left Out of the Process. In the age of AI it’s less about change management and more about change engagement. 4️⃣ They’re Already in a Survival Loop. Change fatigue is real. When they’re already maxed out, even small changes can feel like added weight. 5️⃣ The Emotional Impact Was Never Acknowledged. Change stirs up real feelings: fear, anger, anxiety. Ignoring them doesn’t make them disappear—it makes them louder. And this isn't a one-and-done exercise. Emotional expression must be welcomed along the journey. 6️⃣ They Believe This Will Just Fade Like the Last Change. Change fatigue is real. If your org is always shifting without follow-through, people will wait it out rather than lean in. 7️⃣ They Don’t Trust Leadership. If past change efforts felt performative or broken promises were made, resistance is self-protection. Trust is built—or broken—through consistency. --------- ✅ Resistance is not the problem. It’s the invitation. When leaders meet resistance with curiosity instead of control, they unlock the emotional fuel to power change forward. ♻️ Repost to spread the truth about resistance. 🔔 Follow Cassandra Worthy for daily posts on Modern Change Leadership and Resilient Culture.

 In the 911 reactive culture in many hospitals, this is a breath of fresh air. Herewith snippets from the article: "What we've been advocating for is the idea of moving away from a more reactive culture to a more systematic, proactive culture" to advance patient safety, Komal Bajaj, MD, chief quality officer at the New York City-based health system's Jacobi hospital, told Becker's. In line with this, the health system has started conducting success cause analysis to better understand the factors that contributed to a favorable outcome — a twist on a common methodology used to review safety failures.    Meanwhile, relatively few organizations have processes in place to learn what led to a favorable outcome and how to integrate strategies to promote safe outcomes in the future. This is where success cause analysis comes in. "There are millions of things that go right every day" that healthcare organizations stand to learn from, Dr. Bajaj said. Success cause analysis is a structured approach to do that, and it is resonating well with staff, she said. "It's a work in progress," Dr. Bajaj said. "The point is to start somewhere."  Leaders at NYC Health + Hospitals are finding the approach is emerging as a way to involve front line staff, patients and families — who are not always involved in root cause analysis — into quality and safety processes. Additionally, it's a way to give employees who do lead RCA work a chance to be involved in the positive outcomes, Dr. Bajaj said, which can ease some of the third victim syndrome that may occur among teams that are involved in reviewing negative events." Bringing those who do the work together with those who analyze the work should not be a novel idea. Understanding the successes is an important process and mindset to adopt. I like it a lot. 🌟 #rootcause #employeeengagement #patientsafety #changemanagement #hospitals #leadership #healthcareonlinkedin #successcause #teams

My AI lesson of the week: The tech isn't the hard part…it's the people! During my prior work at the Institute for Healthcare Improvement (IHI), we talked a lot about how any technology, whether a new drug or a new vaccine or a new information tool, would face challenges with how to integrate into the complex human systems that alway at play in healthcare. As I get deeper and deeper into AI, I am not surprised to see that those same challenges exist with this cadre of technology as well. It’s not the tech that limits us; the real complexity lies in driving adoption across diverse teams, workflows, and mindsets. And it’s not just implementation alone that will get to real ROI from AI—it’s the changes that will occur to our workflows that will generate the value. That’s why we are thinking differently about how to approach change management. We’re approaching the workflow integration with the same discipline and structure as any core system build. Our framework is designed to reduce friction, build momentum, and align people with outcomes from day one. Here’s the 5-point plan for how we're making that happen with health systems today: 🔹 AI Champion Program: We designate and train department-level champions who lead adoption efforts within their teams. These individuals become trusted internal experts, reducing dependency on central support and accelerating change. 🔹 An AI Academy: We produce concise, role-specific, training modules to deliver just-in-time knowledge to help all users get the most out of the gen AI tools that their systems are provisioning. 5-10 min modules ensures relevance and reduces training fatigue.  🔹 Staged Rollout: We don’t go live everywhere at once. Instead, we're beginning with an initial few locations/teams, refine based on feedback, and expand with proof points in hand. This staged approach minimizes risk and maximizes learning. 🔹 Feedback Loops: Change is not a one-way push. Host regular forums to capture insights from frontline users, close gaps, and refine processes continuously. Listening and modifying is part of the deployment strategy. 🔹 Visible Metrics: Transparent team or dept-based dashboards track progress and highlight wins. When staff can see measurable improvement—and their role in driving it—engagement improves dramatically. This isn’t workflow mapping. This is operational transformation—designed for scale, grounded in human behavior, and built to last. Technology will continue to evolve. But real leverage comes from aligning your people behind the change. We think that’s where competitive advantage is created—and sustained. #ExecutiveLeadership #ChangeManagement #DigitalTransformation #StrategyExecution #HealthTech #OperationalExcellence #ScalableChange

In healthcare, innovation isn’t just about shiny apps or breakthrough devices. The most impactful innovations can involve rethinking how an entire system works—while still keeping it running. That’s the challenging truth facing large US health systems like Advocate Health and Sutter Health. With mounting pressures—rising costs, staff shortages, and digital-first competitors—these organizations are finding that focusing only on incremental change won’t cut it. They’re building enterprise-wide innovation ecosystems designed to unlock creativity at scale. I explore what they’re doing in a new article for Forbes (a link is in the Comments below). At Advocate Health, for example, this means going beyond pilot projects or siloed innovation labs. Their approach includes: - Strategic partnerships with startups and accelerators - Internal investment funds and innovation districts - Tech transfer capabilities to bring discoveries to market - Leadership development programs built around tools like Jobs to Be Done, human-centered design, and the business model canvas It’s a significant shift—embedding innovation not just in strategy decks, but in the day-to-day work of solving persistent pain points. Teams aren’t just testing new tech. They’re tackling the real “struggling moments” for patients, clinicians, and administrators alike—from vendor inefficiencies to emergency room backlogs—and redesigning care delivery around those needs. One key lesson? Change happens when innovation teams forge close ties with operational leaders and treat them as co-creators, not gatekeepers. That approach opens the door for adoption and scale—critical in a sector that can be both risk-averse and in dire need of reinvention. In a future where innovation methods are as standard as EHRs and MRIs, standalone “innovation departments” may become obsolete. But, until then, health systems that build these capabilities now will be better equipped to navigate uncertainty—and lead the industry transformation already underway. The takeaway for innovators everywhere: When facing entrenched systems and high stakes, don’t just think different—build systems that work differently.

A few years ago, I worked with a hospital that was struggling with high turnover rates and low morale. People simply didn't feel valued or heard. Our strategy was aimed at reshaping organizational culture, and we believed the key to this transformation was leadership development. We coached leaders on conducting regular one-on-one check-ins with team members, which provide opportunities to discuss progress, address concerns, and invite feedback. We stressed the need for leaders to recognize people for their efforts and the pivotal role they play in the organization. We guided leaders on fostering psychological safety, ensuring an inclusive environment where everyone feels comfortable sharing ideas and asking questions. Over time, things started to change. People not only felt recognized, but they also began to communicate more openly, bring forward ideas, express concerns, and collaborate. Morale rose, turnover decreased, and quality improved. This transformation aligns with what neuroscience teaches us. Our brains naturally thrive in environments that foster trust, respect, and positivity. Leaders who tap into this understanding not only create better work environments but also elevate overall team performance. I encourage healthcare leaders to focus on the culture they are building. See the difference it makes in your teams and the care your patients receive. Strong teams and strong cultures lead to outstanding results, which means a healthier healthcare system for all. Have you experienced a similar transformation in your organization? What have you found effective in boosting culture? Share below! #Healthcare #Leadership #teamwork #Leadershipdevelopment

Change Resistance isn't your enemy. It is valuable intelligence about your transformation. According to Prosci research: The #1 reason employees resist change isn't stubbornness. It's lack of awareness about why change is happening. When employees resist transformation: - They're not being difficult - They're expressing legitimate concerns - They're signaling engagement, not apathy - They're providing crucial feedback Here's what successful transformation leaders understand: 1. Prevention Beats Reaction Organizations that plan for resistance are more likely To meet transformation objectives than those who don't. Address concerns before they become roadblocks. 2. Awareness Drives Adoption Transparent communication about the "why" behind transformation People support what they understand. 3. Focus on Root Causes Resistance typically stems from: - Fear about job security - Lack of clarity about personal impact - Disengaged leadership - Comfort with current state Address these directly instead of symptoms. 4. Engage Early and Often Organizations that involve employees in transformation planning See higher adoption rates and significantly less resistance. Involvement creates ownership. Transformation success depends not on eliminating resistance, But on leveraging it to strengthen your approach. Leading transformation? DM me "TRANSFORM" to discuss strategies for turning resistance into engagement.

Clinical Research Needs a Reality Check, R3 Is Here Wake-Up Call: The new ICH-GCP R3 guidelines just dropped, and if you’re still running trials like it’s 2010, you’re already behind. R3 demands risk-based approaches, decentralized elements, and true patient-centricity. Yet, the industry keeps dragging its feet. Why? Because disruption is uncomfortable. What Needs to Change, Now: 1. Stop Wasting Time on Outdated Monitoring R3 prioritizes risk-based monitoring (RBM). If you’re still obsessed with 100% SDV, you’re part of the problem (minus some early phase oncology- if you know, you know). Solution: CRAs need to evolve into data-driven strategists. Equip yourself with skills in data analytics and centralized monitoring tools to spot trends before they become risks. Learn to read the signals, screen failure rates, dropout patterns, and query spikes tell a story. CRAs who identify these trends early will be the ones leading trials, not just monitoring them. 2. Decentralized Trials Are the Standard, Not a Nice-to-Have Still forcing patients into endless site visits? R3 says adapt or get left behind. Solution: Break into roles shaping the future: - Decentralized Trial Coordinator - Telehealth Study Manager - Remote Monitoring CRA 3. Patient-Centricity: Less Lip Service, More Action R3 is clear: trials must fit patients, not the other way around. Solution: Target roles like: Patient Engagement Lead, Design protocols around real lives. Your Next Move: Master R3: Knowledge of ICH-GCP R3 guidelines = competitive advantage. Target Future-Proof Roles: RBM specialists, DCT experts, and patient-centric strategists are the future of research. Think Like a Trendspotter: The best CRAs don’t just report data, they predict the next move. The Real Question: Are you disrupting the industry, or waiting to be replaced by those who will?

I killed my first healthcare startup by building the wrong thing. The technology was perfect. The implementation, not so much. Here's what happened and what it taught me: 2016: Built a voice analysis platform to detect depression and neurological disorders. Groundbreaking AI. Published papers. Perfect accuracy in lab conditions. The problem? I built it for the healthcare system I wished existed, not the one that did. Mistake 1: I optimized for tech publications instead of clinical workflows ↳ Doctors needed simple, fast results ↳ I gave them complex algorithms and research papers ↳ Beautiful science, unusable in practice Mistake 2: I underestimated integration challenges ↳ "Just add this 15-minute assessment" sounds simple ↳ In reality, it broke existing appointment schedules ↳ Staff training took months, not days Mistake 3: I ignored the human element ↳ Nurses loved it, doctors were skeptical ↳ One resistant physician killed adoption for entire clinics ↳ I focused on convincing administrators instead of end users The turnaround: My next company, I considered my clinical experience working in clinics for years before writing a single line of code. I watched how doctors think, how nurses multitask, how patients behave. I built for Tuesday at 3 PM with a full waiting room, not Monday morning with perfect conditions. The result? technology that disappeared into workflows instead of disrupting them. What I learned: Healthcare innovation isn't about building the most sophisticated technology. It's about understanding the messy reality of patient care and designing around it. The best healthcare technology is invisible. It solves problems without creating new ones. Sometimes the simplest solution that works beats the most elegant one that doesn't. ⁉️ Have you ever seen great technology fail because of poor implementation? ♻️ Repost if you believe simple solutions often beat complex ones 👉 Follow me (Reza Hosseini Ghomi, MD, MSE) for lessons from healthcare technology trenches Citations: Wroge et al. IEEE EMBC 2018, Tracy et al. J Biomed Inform 2020