Tuesday, 27 January 2009

Spread and large scale change are a battle about perception

So often we focus on the "what" needs to be spread and "who" needs to change their behaviour. My recent experience is that success is more about perception. It is more about understanding the current views of others and then working to enable perceptions that relate more closely to the desired result.

For instance, in patient safety, many healthcare staff have the perception that they are dealing with harm (a sick patient) and that death is a natural consequence, often regardless of their actions. (I knwo that is a generalisation, however, I have a point to make...) In this context where the view is one of inevitability of harm, then it is mightly difficult to implement changes aimed at reducing morbidity and mortality.

Instead, think about an organisation, or clinical team, which has the world view that it is possible to have a hospital with patients where hospital acquired infections don't happen. "Not on my watch" says the Senior Nurse. Here, their curiosity is about how to maintain a good performance, and even how to obtain it. There is a gap between their perception and their reality and they want to fix it.

So I'm wondering whether we would be better off helping with the perception change rather than asking people and teams to carry out projects designed to spread good practice and to implement large scale change. How do we "market" what we need so as to help create new world views?

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