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You may be dreading change in your workplace, from new management to staffing shortages, to new services. Perhaps, you've already been warned some of you will be afraid and resist the change. To not just survive but thrive in the midst of change, you need to become a change agent. It's easier than you might think.
What is a Change Agent, Anyway?
A change agent is something or someone bringing about change. In business, it might be a consultant who alters the way senior management thinks about a problem at a strategic retreat.1 This role can be adaptive or creative, adjusting to or initiating change. But a change agent can also be external, including reimbursement rule changes, regulations, contract changes, competition and market forces.
Sometimes, the two definitions are intertwined, even personal. New surgical services may demand more of your blood bank, a new point-of-care testing program may expand your laboratory into other departments, or a sudden illness may create a critical gap in your staff. These are not senior level management changes, even for larger laboratories, and they mean more than simply reading a memo.
For you to be a change agent, you may want to first consider what change isn't.
Common Myths About Change
What does change represent? Here are a few of the many myths about change:
- It isn't a big change--change affects us all differently; even small changes can have a negative impact unless everyone is involved.
- It isn't personal--but all change is ultimately personal, because it affects working conditions, perceptions or outcomes. It affects you.
- Change is motivated by fear--compelling, positive visions of the future are a much stronger impetus to change.
- Change is motivated by facts--change is better inspired by emotional stories than facts.2,3
 Finally, it is a myth that crisis motivates change. According to Edward Miller, MD, the dean of the medical school and CEO of John Hopkins University, Baltimore, most patients recovering from coronary bypass surgery don't change their lifestyle, even though benefits of doing so are obvious. Annually, there are 600,000 bypasses and 1.3 million angioplasties in the United States, but these procedures rarely prevent heart attacks or prolong lives.4 So, even life-threatening heart disease--a crisis indeed!--doesn't make people change.
If change happens--and it will--then it may be big, it will be personal, and you won't agree willingly to change because of fear, facts or a looming crisis. You'll want to be involved, and you'll need to see the outcome as positive.
A Practical Example
Let's consider the above: new surgical services increase the need for transfusions. Perhaps, you work in a small hospital that has recently expanded to offer orthopedic surgery, including knee arthroscopy and total hip replacement. The demand for blood and components has doubled.
The narrative from administration is pure myth: this change is inevitable and planned (not a big change); it's a simple matter of ordering more blood to be on hand and increasing staff (not personal); not adding the services could mean loss of revenue leading to layoffs (fear); a cost analysis and revenue projection shows that this won't happen, and the change can happen with minimal impact according to models in other hospitals (facts). Besides, it has to happen now (crisis).
Here's the reality: it means big changes in your budget, ordering and equipment; possibly collecting autologous donations; training new people to work in your blood bank or expanding services to include antibody identification; developing an optimal surgical blood ordering schedule to ensure blood and components are available. And you may realize intuitively the laboratory is more likely to be motivated by narratives of how these services will help your patients than administrative mythology.
Live In the Future, Change the Present
To make the above or any other radical change a success, you need to look forward with a positive vision of what the outcome will be. The clearer that vision, the more likely it will happen. This mindset means getting everyone in the laboratory involved. A change agent, therefore, is a leadership role.
As one IT software director puts it, "a change agent lives in the future, not the present."5 A vision--in the above, how the blood bank changes, who does the work and how it affects patients--shapes action. Management has a key role in communicating that vision.
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