The cheers from our hotel room were apparently heard down the hall. We were on vacation when the results were first available. My wife was checking on the boys in the room next door when she heard me jumping up and down, hooting and hollering in our room. She ran over to find me standing alone in the middle of the room with my fists pumping up in the air, smiling ear to ear and shouting, “it worked!” I just received the results via email. What worked was an enhanced recovery after surgery (ERAS) program we implemented across our healthcare system. I described the program and its results in a previous post. We discovered how to use choice architecture as a way to accelerate the program’s adoption, and we now had the clinical results in hand. We reduced complications and readmissions. I wanted to tell the whole world how successful this was, but there was one problem. We did a great job of designing a plan to communicate the program, but not such a great job of communicating the outcomes. This, unfortunately, took a few more months than it should have.
In my previous post I wrote about how we used choice architecture to accelerate the rate of adoption of this program. (See the graph below.) This is depicted as event #1. As you can see there was another event (#2) which occurred later. When we first realized we not only improved the process steps (early ambulation and early alimentation), but also improved the clinical outcomes (reduced complications and readmissions), we hesitated to distribute the good news. It is a long story why that happened, but it was a mistake. When we finally informed the surgeons and nurses of the improved clinical outcomes, we saw a second bump in the improvement of the use of the clinical practice pathway. What we didn’t realize was that there were many who were still hesitant to implement the practice change. Everett Rogers, who developed the Diffusion of Innovations Theory, described this group as the late majority. They tend to be skeptical about an innovation and need reassurance from others that it is really worth adopting. Feedback in the form of data showing that others are not only adopting the innovation (ERAS program), but are also getting better outcomes as a result of it is exactly what they have been waiting to see.
The lesson I learned was that once your change management process produces the great outcomes you were anticipating, don’t just celebrate by yourself; share it. It just may accelerate the change you wish to see in the world.
