March 18, 2015
Jennie Evans, RN, BS, EDAC, LEED AP, Lean Six Sigma CE

Health system mergers, new payment structures, and new care delivery models driven by the Affordable Care Act are requiring organizations to change how they operate. And, our projects, whether a renovation or a new facility, add another dimension of change when we engage with the client. 

Change for any organization should be viewed as an opportunity to drive innovation and help the organization transform to a new state of being. Our opportunity to stand apart as a design firm is to help the client prepare and adapt to the new environment and operational model that we are altering or developing.   

Communication is key during change and can often be misunderstood by those on the receiving end.  

  • We send the message:  You will be moving to a new unit with private rooms.  
  • They receive the message:  If we are having larger rooms, I will have to walk further. 
  • We send the message:  Families will have accommodations to stay overnight in the patient room which is better for family-centered care. 
  • They receive the message:  Now I have to navigate around family in the room which will make my job more difficult.
  • We send the message:  Medications will be delivered to the bedside.
  • They receive the message:  We tried that before. What makes you think it will work this time?

The Prosci model for managing the people side of change has another communication example. 

A supervisor sat down with an employee to discuss a major restructuring project within the company. The supervisor was enthusiastic and positive. She covered all the key messages including the business reasons for change, the risk of not changing, and the urgency to update the system to remain competitive. 

  • The Supervisor sent the message:  This is an exciting time for the company and we are still designing the new system.   
  • Employee received the message:   She may not have a job and the company is having trouble.


Communication from supervisor to employee or consultant to client should include the impact of the change on them, their work, and their day-to-day activity.

Price Pritchett’s model for change management demonstrates how employee engagement and productivity diminishes during a project. 

 Diagram_03Communicating the need for change, the business requirements, and the code requirements among other changes is the right thing to do. And, talking honestly with our clients and user groups about the operational impacts of the new facility is a key to project success. 

A few suggestions to help our clients manage the transition are:  

  • Use lean methodology / process mapping to engage with the users to develop their new operational work flows.
  • Provide images of new spaces that demonstrate your concepts.
  • Bring simple sketches of a room comparison or room layout that demonstrates the impact of current code standards.
  • Draw ‘real time’ to demonstrate unfamiliar concepts. 
  • Validate your communication and concept are understood.
  • Remember users are likely novices who do not understand space, architecture plans or terms. 
  • Suggest client leadership to identify department ambassadors for the new project.
  • Suggest client leadership integrate organizational effectiveness leaders (change management experts) into the process early.

Change management is a process and resistance is normal. The earlier in the process that we identify miscommunications and resistance, the earlier we can adapt our leadership. 

Posted in Health
Tagged design process, healthcare architecture