One of Yale Medicine’s organizational priorities is to develop change-ready talent. Like other healthcare organizations in the United States, Yale Medicine must thrive in a constantly changing landscape fraught with rapid workforce consolidations and team expansions, frequently updated business processes, and balancing staff coverage with staff development time, to name a few. Over the past two years, the Learning & Development Group at Yale Medicine applied change management approaches to build an adaptable workforce ready to take on challenges within Yale Medicine and the larger global healthcare industry.

Changing Job Focus to Enhance Patient Access

In 2019, Yale Medicine launched a major initiative, the YM CARE Center, which centralized all patient coordination, scheduling, and referrals for its clinical departments. This meant the organization’s staff, who were previously embedded within a clinical department, would now work in a new location, using new technology, as part of a new team with new colleagues and new leaders.

Using an adapted version of the Prosci ADKAR Model, management and staff were onboarded into their new roles at the YM CARE Center through training experiences focused on the Yale Medicine patient-centered promise of We Care. Through periodic townhalls as well as department meetings with bargaining units and Yale Medicine leaders, management and staff developed a strong awareness of the why behind the organization’s change initiative. In each informational session, management and staff expressed a desire to participate in building the CARE Center because they heard patient testimonials describing the frustrations and challenges with making an appointment or accessing the care.

To support addressing these myriad changes, a “tiger team” was created to focus specifically on building knowledge through a new training experience. The program would need to include soft skills training as well as training on new technologies. The staff was experienced with Epic, Yale’s electronic medical record system, but new technologies were being added, including a sophisticated new phone system, a third-party guided scheduling application, and modified Epic workflows. Staff had to learn new skills and unlearn some old ways and old habits of doing work. In addition to collaborating on training content development, the team focused on how to transition staff through the change.

Management and staff attended multiple days of training and simulations. The first one consisted of participating in a standards of excellence course, which included a leader introduction to the new CARE Center as well as expected standards and behaviors, with a focus on empathy. This was followed by a day and a half of CARE TEC (tools for engagement and coordination), which targeted the technologies staff would use in service of the patients. This training included functional approaches as well as scenario-based instruction, which provided learners the opportunity to emulate their new roles, using the standards and behaviors from the earlier class, combined with the new technologies. Post training, learners went to the CARE Center for a “dress rehearsal” of their new abilities, roles, and technologies. Staff received simulated patient scenarios as calls into the CARE Center to practice responding using the standards and tools they had been trained on. Finally, support and training staff were on hand for the “go live” of each clinical area to provide reinforcement of the new skills where needed. Results of the training were immediate. What had started out as a significant, anxiety-invoking series of changes resulted in staff who were highly engaged and able to provide a standard of care to patients that was nothing short of excellent.

Moving a Fragmented Workforce to a Unified New Space

In 2020, more than 500 Yale Medicine administrative staff will be consolidated from various office locations throughout New Haven County into two brand-new corporate facilities within the Yale University downtown campus. While the new locations are modernized open workspaces, this move represents a significant change and could bring some significant disorientation and stress. Most managers and staff involved in the move have already experienced significant change throughout the past several years, including corporate service centralization, reorganization, and rebranding.

A blended organization development approach consisting of three elements fostered an environment that helped people lead themselves and one another through this significant change. This approach included formal change training, leadership and staff communication toolkits, and a live orientation of the new facility with guided tours.

Yale Medicine L&D resources were certified in the DDI Interactions Management framework to conduct formal training for leaders and staff. More than 60 leaders participated in the Driving Change course, which focused on how to share ways to speed up the change acceptance process by communicating changes with the rationale and expected benefits, sharing reactions and feelings, and helping people understand and focus on what they could influence and control. More than 400 staff members attended DDI’s Embracing Change course, which reviews the typical phases of change and presents techniques people can use to lead themselves through change and influence one another. Both courses include a self-assessment that provides learners their change IQ, which contributes to their knowledge of their default reaction to change. Storytelling and case examples are key components in formal training and learners discuss change success stories from successful companies like Amazon and change struggles from companies like Blockbuster.

The Yale Medicine leadership toolkit included such items as change management talking points (gleaned from the formal training), schematic diagrams and floor plans of the new facilities, and planning guidelines. The planning guidelines included such items as staff seating charts, FAQs, updated policies and procedures for the new spaces, and employee engagement materials (such as signed welcome cards). The Yale Space Planning team partnered with L&D to organize and conduct scheduled leadership and staff information sessions and townhalls. In addition, periodic organizational-wide surveys on artwork, conference room names, furniture, fabrics, and lighting allowed leadership and staff to give input on the design of the new spaces.

One week before the big move, staff will participate in a live orientation of the new facility. To maintain operations, intact teams of management and their staff will rotate through two live orientations and scheduled tours per day. Fred Borrelli, Yale Medicine’s chief administrative officer, will present a keynote reinforcing the why of the move to the new facility and provide further context. Volunteers from the employee engagement committee will conduct guided team tours and demonstrate how to use the new collaborative and open workspaces. They will also provide the policies for the new spaces as well as where to find additional resources (for example, housekeeping schedule, noise volume, and cubicle cleanliness).

Involvement Is Key

At Yale Medicine, involving leaders and staff in a variety of activities throughout the change process is essential. Even though most change initiatives are inevitable, much of which is driven by a combination of industry-related external and internal forces, the more people believe their feedback is heard and that they have a genuine feeling of choice, the sudden impact and possible negative emotions associated with change become more manageable. Throughout the past two years of various talent development initiatives, the leaders and staff at Yale Medicine have taken greater ownership in their acceptance and readiness to change in the evolving healthcare industry.