There's a useful change equation attributed to Michael Tushman
Dissatisfaction x Vision x Process > Cost
Cost of change may be one form of resistance to change. The model is explained more here on the online Trainingzone:
What has this got to do with the services for brain injury?
Brain Injury services sometimes don't improve because of a problem somewhere in this equation.
For example, if we are entirely satisfied with the way things are then there will be no impetus to change things. An irritation or cause of dissatisfaction is an important driver for change. If we as clinicians are entirely happy, then I suggest we need to take our heads out of the clouds... I recommend browsing patient-online forums where you can quickly see our brain injury survivors are not entirely happy. They write about feeling misunderstood, not listened to, or confused, and therefore we need to come right to the groundlevel, not stuck in the clouds, but fully engaged with the needs of our service users.
We have a vision for equitable services with access to excellent care for all, with our members able to draw on best evidence and guidelines. Again without a vision for a future state that is better-than-now, services will continue to do what they have always done and not improve. Leadership has a key role in developing a vision for future service quality. I am proud that our Network is giving a chance for people to think about their roles as leaders in the field of neurorehabilitation.
These good ideas will go nowhere if we don't have a process to achieve change. The process may have many steps and so we do need to identify a "first step". In our network I have been impressed by our group's determination to take these first steps. Using a private social media platform (that is only open to members) we have structured our list of topics - fatigue, vision, return-to-work, working with people with aphasia, etc., so that we can share resources.
"How do you assess.... problem A?" asks one member. A chat room for clinicians, a place to encourage one another, and chance to debate - nothing terrifically surprising- one of the members has probably already solved this problem.
Inquisitive people and good software are two of our key assets.
It's an evolving process, but at least we do have a process to positive impact - in the use of our social media platform - we can track what we have achieved so far and discuss and record our thoughts about the future.
In a few weeks time we will be gathering with a focus on driving and vision after brain injury.
So overcoming the cost or inertia that impedes developments has become possible - in my view something to be proud of!
Les også tidligere blogginnlegg:
Being a brain injury radical!