Success Rolls Down the Stream: The Senior Management at Collective Buy-In Part I

Everybody in the healthcare industry dreams of a situation like this:

There is overwhelming evidence that a protocol needs to be amended.  Two physician consultants initiated the drafting of the protocols.  All concerned departments and personnel gave their input for revision to ensure reliability and consistency. The new protocol itself went through several iterations.

The head of a unit where the new protocol is to be utilized gives it a final nod and a promising future. The final output has been promptly disseminated to the right people.

The new protocol is looking nice and clean; the clinical pathway outlines communication expectations, covers all clinical criteria, and addresses concerns.

The new protocol gets a 5-star rating for achieving desired outcomes.

It seems like the perfect dream, but in reality, this scenario of revising or developing a protocol is more of a nightmare to everyone concerned, especially to the senior management who literally feels like they have already pushed their hardest trying to move a mountain to no avail.

In real life, we often say that people resist change. But taking the analysis a step further, we can conclude that it is not the change per se that people resist. It is more of people resisting being changed themselves to embrace new things.

There are some changes encountered in life that people can do nothing about. These are easier to accept and adapt to, acts of God perhaps or maybe developing trends where people just go with the flow. On the other hand, some changes are required.  Enforcing change as part of process improvement is one thing, and getting people to change the way they think and act to embrace the change is another. The latter is such a humongous to an almost impossible task for the senior management. Getting employee buy-in becomes like chasing the end of a rainbow.

Challenges When Rolling Out Initiatives


Certain factors prevent senior management from getting the buy-in that they need to initiate change and achieve goals. Let’s take a look at some of these barriers that confront them:

1.       Lack of support from staff and middle management

Let’s face it. If the suggestion of change comes from the top of the hierarchy, no one dare speak against it, but the senior manager sees the staff and middle management in a group meeting looking at each other in the eye with their brows raised. Ultimately that means no one would budge to get anything done. This staff skepticism and resistance is especially evident if people feel like they have been dumped on with new responsibilities or if the institution is already known for its poor employee engagement practices.

2.       Lack of know-how or expertise on new methodologies to support their leadership

Most of the time the senior managers, being right in their positions, know exactly what to do. The thing is, sometimes they are not aware that there are already existing services that can make their tasks feasible and a lot easier. Sometimes, it’s just restructuring that they lack, or a simple upgrade of their existing technology.

3.       Internal resources lacking or deficient to roll out initiatives

Everyone seems to have their hands full with something. Enforcing change is an added responsibility to those who would be tasked to carry out the actions. There may even be times when no one from within the hierarchy is an exact match to manage continuous process improvement. This deficiency within the organization can also be as simple as not having the right software for documentation or information dissemination.

4.       Budget constraints and hesitancy to invest on new methodologies

While senior management sees the need for a collective buy-in to enforce change, they themselves, though unknowingly, resist new ways on how to deal with these challenges. It can be because of a tight budget, or that they are doubtful of the effectiveness of proposed strategies. They look for evidence of a potential success that unfortunately is not available to them.

To a larger extent, these barriers negatively affect the healthcare delivery system. It’s like a ripple effect that consequently leads to both client and employee dissatisfaction, misallocated budgets, and increased senior management frustrations.

What can be done about it? Part II of this series will tackle ways on how these barriers can be overcome and how ManageUP gets into the picture of being instrumental in enforcing the changes that the organization needs.