Cross-training: Overcoming aversion to staff change
Cross-training: Overcoming aversion to staff change
Program’s success based on involvement, education
When Northside Hospital in Atlanta first considered its new maternity facility and cross-training program (see related story, p. 97), Beth Allen, RNC, IBCLC, manager of perinatal/family-centered care, says that forums and surveys gave management a starting list of things to consider changing. From there, each department formed task forces that included physicians, nurses, administration, and support staff to take that patient information and "evaluate everything we do. Nothing was considered an assumption. We knew that this was the time to change," she says.
Although Northside looked at other large facilities to see what they were doing, Allen says the wisest advice the group got was to create a model that was specific and unique to Northside and its patients. "There are others that had a holding location for babies, others that mandate rooming in," Allen explains. "But we knew that our mothers didn’t want forced rooming-in. We want to encourage mother baby contact, but we wanted to have nursery space for every maternity room. We would facilitate room exams for pediatricians, and would encourage them to examine babies in the room, but wouldn’t force it."
Convincing staff that this was a good thing required some effort, Allen admits. For nurses and techs, there had to be assurances that this was not some administrative mandate designed to cover up staff cuts. Convincing physicians was even harder.
Allen and her team had to persuade 400 pediatricians and obstetricians that this would be a good thing for them and their patients. "I had to spend more time with them, over a longer time, driving it home," says Allen. "They would pepper me with questions — even after the facility was nearing completion — about whether they could still do nursery exams, or would they be forced to do in-room exams. They didn’t get it — they didn’t understand that we don’t focus on do’s and don’ts."
Part of the apparent success of the new facility and training program, says Allen, comes from piloting it with the nurses who were most adaptive to change. "That meant staff did the selling for us. They came out of classes talking to their peers about what they learned and the benefits of the changes. We approached the people who were most verbal about dislikes and told them we understood their reluctance, and that they could wait to do the training. But when they saw that it was good, they would try it, and most of them have liked it."
"Over-communication" was another key to making the program work, she says. "We held meetings, wrote newsletters, and held tours. We involved staff in planning, design, and implementation. We did a lengthy orientation module which was educational both about nursing, and about policies. We gave them a manual. That was reassuring to them. It wasn’t sink or swim, but a chance to learn over time."
Subscribe Now for Access
You have reached your article limit for the month. We hope you found our articles both enjoyable and insightful. For information on new subscriptions, product trials, alternative billing arrangements or group and site discounts please call 800-688-2421. We look forward to having you as a long-term member of the Relias Media community.