(1274 words) May 2024.

Not long after the NHS celebrated its 75th anniversary, there continue to be calls for transformation within the institution. Embracing change is essential for all healthcare workers. And understanding how change impacts your practice will enable you to guide everyone towards the best outcomes, for sustainability and beyond.

Change can be defined as a process where something is altered. This simple concept sits at the centre of pivotal moments and decisions, both within dental practices and outside of them.

Every practice can benefit from taking the initiative to implement change – from fresh staff or new procedures to the relocation of equipment and furniture or switching to different products. There’s a lot to the process of change, including how it is first encountered, the speed at which it happens, the barriers to change, and its impacts.

So, how to change? Understanding which approach is best and knowing when to use it will help your practice not simply navigate change but thrive as a result.

Selecting the right strategy for your practice

You can play a role in identifying how your practice responds to change. Is it the most effective strategy? Is it the right time for it? Answering these questions is essential to help you guide your practice towards better outcomes for patients and the planet.

Change strategies can be reactive or proactive. Reactive change management is a strategy that takes place in the presence of an unexpected situation, forcing change out of necessity. On the other hand, proactive change management occurs when you anticipate potential future needs to capitalise on opportunities for improvement.

The discussion surrounding these two change management strategies often places them as opposing choices. However, each strategy has its advantages: proactive change management offers smoother transitions, whereas reactive change management increases the team’s flexibility and encourages more innovative solutions[i].

Is your practice evolutionary or revolutionary?

It is important to recognise whether your practice requires change at an evolutionary pace or a revolutionary pace – categories originating from the much-cited Harvard Business article by Larry Greiner[ii]. Both types of change may occur in a dental practice, so chat with your team and pick the pace that best suits the outcome you seek.

Change at a more revolutionary pace will be rapidly carried out, often by senior members of the team who do not need to consult with the wider team. On the other hand, when change is enacted at an evolutionary pace, it will be gradually implemented, often collaboratively, and any member of the practice – dental nurses or otherwise – can drive it forward.

The good news is that evolutionary-paced change seems to be favourable, because it allows all staff members to be involved throughout the process. A 2020 study[iii] found that including healthcare professionals in the change process led them to feel “prepared for the change and recognise the value of the change,” which may be something you identify with as a dental nurse.

Moreover, research conducted by CleanCert Hygiene revealed that priorities within the general industry and priorities for practice staff often don’t align. We found that different practice team members valued certain areas of change, such as sustainability, more highly. By utilising an evolutionary-paced change response, members feel empowered to enact the changes that are most important to them and encourage other team members to get involved.

Knowledge is power 

When implementing change, it’s important to seek knowledge through resources like CPD training, conferences, and other additional research. This will help ensure the change is evidence-based, with specific aims, and an understanding of potential consequences.

There may be an argument that being uninformed about the change could offer a spark of unexpected innovation. However, it is more likely to lead to poor management decisions, hasty implementations, and a limited understanding of the decision’s consequences. Properly informed change mitigates potential risks, maximises positive outcomes, and provides more control in navigating the change process.

Furthermore, staff at your practice are likely to believe in the importance of being informed, as all job roles listed “developing knowledge” or gaining qualifications as their top three professional goals for the coming year. This was either related to furthering their own skill base or educating their patients on better oral health practices.

Barriers and consequences 

Ensuring the practice is properly informed about changes ahead allows a smooth pathway towards change and the opportunity to anticipate consequences.

But limited knowledge is not the only barrier to change, with a recent study finding that “most barriers [to change are] related to problematic delivery structures,” including a lack of motivated staff available to implement the change[iv]. Another study conducted in 2018 found a similar result, that the limitation in resources was the greatest barrier to change, being mentioned by 86% of those who were interviewed[v].

The studies noted a few methods to combat this, such as involving the team in decisions, providing adequate training, and increasing enthusiasm for the change. These suggestions align with the advantages of evolutionary-paced change, highlighting the importance of a collaborative approach with a knowledgeable team leading the decision-making process.

Additionally, considering the potential consequences of the change is essential to reassure those concerned, including disseminating the benefits to stakeholders, patients, and the whole practice. It also enables the change to become proactive, as your practice can anticipate future challenges and opportunities that may arise because of the change process.

Using simple changes to tackle large problems

Complex changes may seem tempting to reach for, but focusing on changes that are simpler to execute will increase the likelihood of success [vi]. Bear in mind that these easier-to-implement changes can often be a crucial part of a larger, long-term strategy.

For example, a practice may want to make changes towards being more sustainable, a factor shown to have high importance for many in the decision-making process according to a CleanCert Hygiene survey. But even with the team on board, big goals like achieving net zero or eliminating carbon emissions can seem overwhelming or even impossible.

Smaller changes like switching to non-toxic decontamination products are simple but effective in the journey towards becoming a more sustainable practice. If team members express interest in a change, take advantage of the motivation and consider seeking simple solutions that maximise positive consequences. Remaining open to change is paramount for your practice to continue to evolve and best serve your patients.

For further info, please email: sales@cleancert-hygiene.co.uk

[i] Zhigang Fan, Dong Wu & Xiaobo Wu (2013) Proactive and reactive strategic flexibility in coping with environmental change in innovation, Asian Journal of Technology Innovation, 21:2, 187-201, DOI: 10.1080/19761597.2013.866316

[ii] Greiner, L.E. (1998). ’Evolution and Revolution as Organizations Grow. Harvard Business Review. (May)

[iii] Nilsen, P., Seing, I., Ericsson, C., Birken, S.A. and Schildmeijer, K. (2020). Characteristics of successful changes in health care organizations: An interview study with physicians, registered nurses and assistant nurses. BMC Health Services Research, 20(1), pp.1–8, DOI: 10.1186/s12913-020-4999-8.

[iv] Busetto, L., Luijkx, K., Calciolari, S., Ortiz, L.G.G. and Vrijhoef, H.J.M. (2018). Barriers and Facilitators to Workforce Changes in Integrated Care. International Journal of Integrated Care, 18(2), DOI:10.5334/ijic.3587.

[v] Tappen, R.M., Wolf, D.G., Rahemi, Z., Engstrom, G., Rojido, C., Shutes, J.M. and Ouslander, J.G. (2017). Barriers and Facilitators to Implementing a Change Initiative in Long-Term Care Using the INTERACT® Quality Improvement Program. The Health Care Manager, 36(3), pp.219–230. DOI: 10.1097/HCM.0000000000000168

[vi] Tappen, R.M., Wolf, D.G., Rahemi, Z., Engstrom, G., Rojido, C., Shutes, J.M. and Ouslander, J.G. (2017). Barriers and Facilitators to Implementing a Change Initiative in Long-Term Care Using the INTERACT® Quality Improvement Program. The Health Care Manager, 36(3), pp.219–230. DOI: 10.1097/HCM.0000000000000168