Tag Archives: Change management

Lessons Learned in 2012 – No. 3: Anything can happen (and usually does)

31 Dec

This year I’ve created a range of training materials for projects that have usually involved some aspect of change, whether that has been a software upgrade or a new piece of technology. At times, it has been an exhilarating experience, where I’ve felt at the hub of change. In fact, I believe you could easily make the argument that training is the most important part of any change management process.

However, while I’ve become an expert in designing training materials that help the learner with change, I’ve also become comfortable working in an ever-changing project environment. In healthcare, projects rarely go to plan, anything can happen and usually does. The best example of this was the flood in the emergency department at Surrey Memorial Hospital (SMH) during November, 2012. The flood happened in the morning of the second week of training on the Vocera communication device. After weeks of scheduling classes, creating and printing posters, developing training scenarios, and revising lesson plans the project was put on hold. Deflating, yes. But at the same time quite the experience!

Next week, training restarts. I’m taking the “anything can happen (and usually does)” approach.

Here is my favourite write-up of the flood from the Emergency Department at SMH:

Six members of the ED Team shared moments from their experience of being on the ground when disaster struck in Surrey Memorial Hospital’s Emergency Department. Team members include: Julie Dufton, ED Manager, Tracey Aune, ED Coordinator, Lesley Young, Clinical Nurse Educator, Jessica Kromhoff, Project Lead RN, Sue Davis Clerical Supervisor and Clare Havers, Clinical Nurse Educator.

There was a persistent note of passion, pride, gratitude and a little residual shock that resonated in their voices as they shared details of that morning.

“I was gathering a report for the bed meeting when I received a call from Caitlin about a water leak in the acute room of the ED,” said Tracey Aune. “Thirty seconds later I walked into the unit to see water pouring out of the corner of the glass window.”

“I felt a moment of panic inside and then the need to act kicked in,” Tracey said. She joined others in grabbing stretchers (most patients were bed-ridden, some with cardiac monitors) in the acute area of the ED and quickly moving patients into the corridor to safety.

“There was a long line-up of stretchers down the hallway and I had the last stretcher in the line. I suddenly looked back and saw the wall break and water come gushing in. The water broke through the wall with such force it swept away everything in its path and almost immediately the water was up my knees.”

“It was like a Tsunami,” said Jessica. “When I heard the Code Orange called I came to the ED and walked into the water. Furniture and other items came floating towards me. We were anxious that the whole wall might give way.”

Clare, who saw the glass window collapse, called a Code Orange (for Disaster) and then called the fire department and RCMP.

She also used the Vocera, a new hands-free personal communications device to alert all the ED staff on shift of the emergency. “We’ve been testing this new system for use in the new ED and what a test this was in seeing how it would work in a real life situation,” Clare said.” It worked great.”

Lesley was just about to leave the ED when she saw the first trickle of water. She thought maybe a toilet had overflowed.

“Then the window gave way,” Lesley said. She took on the role of directing people out of the ED and moving them as far down the corridor away from the ED as they could go. “We just kept moving until we hit doors.”

There could have been utter chaos in the department, but instead there was a calm urgency in the directions given and the subsequent actions taken. “Everyone listened and people were doing whatever they could to help. Some were damming areas, others were using towels to sop up the water and porters were pushing water down the hallway to get it out of the ED,” said Sue.

“And it wasn’t just the front line but also leaders who helped us through this,” said Tracey, adding that people came from other departments as well to see what they could do to help.

While the first group of patients was being transported to another area, water flooded the entire ED, and other ED patients outside of the acute area started to become concerned.

“It was really important for us to reassure the patients who were wondering what was happening and who were waiting to be moved. Some were petrified and we kept talking to them to let them know they would be okay and it helped them relax a bit,” Lesley said.

Once all the patients were safe, staff went back into the water to get patient charts, equipment and whatever else they could think of that they would need to continue taking care of their patients.

“Then came the task of figuring out who is who and who needed to be on a cardiac monitor and who needed to be moved to a unit,” Tracey said.

“The site response was amazing,” said Julie. “From the initial response to the Code Orange to moving patients to the wards, everyone pitched in to support us. It was a massive team effort.”

“I’m very proud of our ED team and our entire site and grateful to our local emergency services for their extraordinary response to this disaster,” she added.

“The reaction and response was really amazing,” added Lesley. “It was like there was a central consciousness shared by everyone.”

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How to change course mid-stream

2 Oct

Change is perhaps the keyword in regards to instructional design. Typically we design courses, forging various strategies to enhance learning transfer all in the name of change. However, sometimes as an instructional designer change itself is hard to do.

Take for example a course that I have been auditing over the last couple of weeks. The course had been designed months in advance. The lesson plans had been signed-off and the trainers approved. Yet, when the course was implemented, something didn’t feel right. Although the trainers covered the content expertly, middling feedback from learners caused concern.

Interestingly the feedback centred on the trainers covering too much content and not providing enough context. Learners wanted to know what change would mean to them and where they worked, but not what change meant overall.

Based on this feedback we began to redesign the course mid-stream (half-way through an intense two-week training period). Instead of content, we started with scenarios. Via these scenarios learners became more engaged in the course, embracing change with greater confidence.

Is redesigning a course mid-stream easy to do? Of course not, you’ll face uncertainty and doubt. But when you listen to the final feedback of your learners, the change is worthwhile.