Reacting to Change

People react to change very differently, but almost everyone has a strong opinion about it. Personally, I love change and I often go out of my way to create it whenever possible. I rearrange my furniture at home every few months.  I lived and worked abroad for years; I moved so often that for three years the longest I stayed in one place was five weeks. Now, the change I look to create is less locational and more organizational and cross-cultural. Understanding how others react to change is an essential component of the process.

The Reacting to Change course focuses understanding how you and others react to change situations and how to effectively plan and create change. Acknowledging both the emotional and practical aspects of change creates the space for coworkers and employees to get on board with the new direction and plans. Allowing people to have input wherever possible and creating session in which people can ask questions, provides valuable input and a sense of ownership, which is essential to make the change last. Furthermore, giving people time to process and move into action at their own pace is essential to create buy-in. For those people familiar with the DiSC Styles, typically those who have a C or S style tend to prefer longer timelines, while those with D and i styles can handle a faster change process more comfortably.

This course determines your thinking style: constructive, passive/defensive, or aggressive/defensive. Each style is further divided into four styles, so there are twelve total. The ultimate goal is to reduce both defensive styles and to increase your constructive thinking, which leads to constructive behaviors. This assessment indicates which behavior you exemplify when in stressful situations, for instance when a change is implemented at work. If you already have a tendency for passive/defensive thinking, it indicates that you are more likely to react that way when faced with a policy change, office relocation, or anything else that causes you stress. This assessment helps you provide an action plan of where to move your thinking and behavior towards.

Change is part of our daily interaction with the world. Gaining that self-awareness and understanding of others is critical when leading people through any type of change process, whether a policy change or a merger. Woodrow Wilson said “if you want to make enemies, try to change something”. What can you do as a leader to create even higher levels of collaboration, productivity, and satisfaction through change?

-Lotte Mulder earned her Master’s of Education from the Harvard Graduate School of Education in 2013, where she focused on Leadership and Group Development. She’s currently working toward a PhD in Organizational Leadership. At ASCP, Lotte designs and facilitates the ASCP Leadership Institute, an online leadership certificate program. She has also built ASCP’s first patient ambassador program, called Patient Champions, which leverages patient stories as they relate to the value of the lab.

During my tenure in the Blood Bank, institutions have moved from immediate spin crossmatches (manual crossmatch) to electronic crossmatches (computer crossmatch). Computer Crossmatching allows the Blood Bank computer system to match donor and recipient ABO Rh type for compatibility. In order to do so, certain standards must be met. A minimum of two ABO typings must be in the system, the patient must have a negative antibody screen, and no history of ABO Discrepancies or clinically significant antibodies can exist. If any of the mentioned circumstances are present, an immediate spin or Coombs crossmatch must be performed.

Implementing this change improved turnaround times which reduced rates of delayed transfusions and elevated patient satisfaction rates. Perhaps more importantly, another patient safety initiative was created, since two ABO types need to be performed on two different specimens. This means patient identifiers are checked and confirmed on two different specimens before transfusion. While these changes aligned with the Joint Commission’s Safety goals, internally this change impacted the Nursing and Blood Bank Departments in ways that made the transition less than smooth.

The ASCP Leadership Institute’s “Reacting to Change” module uses methodology from different industries to create powerful change. Dr. John Kotter has an 8-Step Process for Change, which resonated with my experience.  Engaging & Enabling the Organization include: communicate the vison, empower action, and create quick wins.

Since our rollout of this change lacked these steps, it wasn’t as successful as it could have been. The lack of communication and proper departmental educational in-services lead some individuals within the Blood Bank to have several concerns. Older technologists worried technology would eventually take their job, and novices worried they would unintentionally harm a patient since they didn’t physically complete a crossmatch. As for the Nursing Department, most nurses did not know about this new requirement. The importance of the second-specimen requirement was seen as a nuisance rather than an improvement to patient care. Proper educational in-services were not instilled, which resulted in more questions for the Blood Bank to answer. In addition,   two specimens were drawn at the same time, which negated the utility of the second specimen. Since education wasn’t finalized prior to implementation, the nurses and blood bank staff were frustrated.

Dr. Kotter’s Engaging & Enabling is a means of collaboration. In this scenario, collaboration between departments and having an education liaison for each department could have assisted in the execution. The use of knowledgeable, talented personnel can allow both departments to cohesively provide seamless operations. Seeking out our talented staff and encouraging them to be great enriches their sense of purpose and allows us to acknowledge them for their talents.

In order for change to be effective, we have to minimize negative reactions to change. This involves communication, education and providing data-driven results. Change is inevitable, and proper execution can help make that change successful.

-Tiffany Channer honed her skill and knowledge of Blood Banking at Memorial Sloan Kettering Cancer Center in New York, NY, where she completed her 9 year tenure at Memorial Sloan as Blood Bank Educational Lead Medical Technologist III/ Safety Officer. She’s currently working as a Laboratory Lead Technologist III at Bayfront Medical Center in St. Petersburg Florida. At ASCP, Tiffany is the Mid-Atlantic Regional Representative for the Council of Laboratory Professionals Council. Tiffany was a Top Five 40 under Forty Honoree in 2015 for her dedication and advocacy to education and laboratory medicine.