Influencer: Leading the Charge
Influence and change in behaviors at first one may think, awe that's easy just tell them what you want changed. This strategy may or may not get the change you desire or you organizations needs. Every organization needs a leader, the coach or major general to lead the charge of vital behavioral changes and influence those non-believers. My job is to influence and change behaviors of our industry peers to better train our students. A task not taken lightly, some these peers have been doing it this way for over 20 years. So why do we have to change, the old has always worked just fine. My job as the leader of the pack is to guide them into a change of behavior by pulling on their heart strings, touching them personal and showing them the change will improve all parties involved. Those parties include SJC students, the clinical sites and ultimately the patients. The change in behavior I seek is to increase student training in electronic medical records and lab rotation within the classroom and clinical sites. The change in behavior toward this new blended learning model will shift the mindset of instructors, clinical site preceptors and students. As a model for leading the way to behavior change, I will be using Joseph Grenny's book the Influencer: The new science of leading change.
Change attitude to change behavior
Keys to Success
Instead of relying on chance we will look at the three keys to success followed by all influencers.
1. Focus and measure. This key demands for the influencer to stay focus on the end result and be passionate about measuring it.
2. Find vital behaviors. Find two or three fundamental actions that create the greatest amount of change. This task will involve recruiting instructors and site preceptors, who understand the why, how and need for change by increasing student training.
3. Engage all six sources of influence. This last key gives the resources needed to actually get industry peers to change vital behavior I've identified, all the while making them believe it's their idea.
Key: Focus and Measure
My focus is to have students trained in electronic medical records (EMR). The integration of an EMR training will award the student, the soft skills required in the EMR office setting. These soft skills include but are not limited to data entry, ease of following the EMR matrix, patient and office confidentiality (HIPAA).
We will use several measures to achieve the desired results. Weekly evaluations on an Excel spreadsheet will be used to measure and track student progress. The evaluations consist of input from instructors, physicians, and preceptors to the clinical coordinator. Eight week reports from the EMR software and patient surveys will complete course assessment for each student as well as an Exit evaluation. The results of evaluations and reports will be accessible to the student through course Blackboard site. The student must complete a passing grade under the program guidelines to move to the next level core course.
The behavior of clinical sites / preceptors will be measured as well. A time sensitive clock will be placed on completion of weekly evaluations, completion must be done at end of week. This gives the student have ample time to change and adaptive to the evaluation recommendations. No longer will an evaluation sit for over a week without constructive feedback to students.
Key: Vital Behaviors
- Notice the obvious Use the EMR / IT support staff with each clinical site to aid in the training. All clinical affiliates have some type of EMR system use their experts in their system. The use of webinars on EMR training to supplement training. The student needs to understand more than one system; as there are several out there being used across Houston, Texas, US and Canada.
- Look for crucial moments The heavy load of clinic scheduling can be the crunch time. No time to train, No time to answer questions and no time to "babysit" the student. Let's get the student trained before those crazy "full moon" clinic days, so they can function and give support to the clinical staff instead of appearing to be a burden.
- Learn from positive deviants Learn from those who produce better results with the same tools. Seeking out those clinics running efficiently and see how they manage over-load of clinical days with training students. Look at their EMR system, is it a system the student is familiar with or used in previous rotations. Allow time for constructive discussions in the meetings between all site preceptors and the college. The preceptors, who are successful in the juggle, can share ideas and feedback to those struggling.
- Spot culture busters Watch for inappropriate behaviors, that currently challenge cultural norms. In the health care we would be looking at falsifying medical records. Unfortunately, there is more falsifying or inaccurate completion of records than the industry will admit. There needs to be an open and honest discussion on the input of accurate and quality information into a patient's medical record. Students should be comfortable reporting a inacceptable issue at a site as well as the preceptor reporting an issue with a student to the clinical coordinator. Both parties need to understand the college policy on the standard of care but more importantly the higher legal actions to account for personnel. Falsifying medical records is punishable by law.
Key: Six Sources of Influence
1. Personal Motivation Make the undesirable desirable
Give the preceptors choice of training methods due to the type of EMR system use in their clinic.
Give the new preceptors samples of training methods.
Better trained student relieves the preceptor to deal with their other duties sooner.
The trained student in two years will be a highly sought out future employee, with the preceptor as one of the trainers.
Scoring the highest ranking in the clinical affiliates race of productivity.
2. Personal Ability Surpass your limits
Provide support to the struggling preceptor by offering additional training with the clinical coordinator.
Give the preceptor blank and sample weekly / exit evaluation to have perfect practice.
Allow the preceptors and instructors to share in personal experiences and questions during meetings. Giving the more experienced preceptor, the ability to provide insight to the group ie sharing of office policies and procedures.
Encourage the discussions between the clinical site and college instructors, no one can tell the story better than the ones on the ground working alongside the student.
Demand full attention of preceptors and students while taking and entering a patient's medical history into the EMR system.
Weekly feedback to the students and preceptors on the training results.
3. Social Motivation Harness peer pressure
Use of patient's survey on student engagement during their exam to praise the student and clinic for excellence in care.
The program's Medical Director will conduct meetings to ensure accountability of instructors, preceptor and clinical coordinator and to praise the presence or absence of vital behaviors.
Use feedback from clinical affiliates physicians on students achieving learning outcomes to share with the group.
Share with the group the success of students who have graduate and passed certification exams.
4. Social Ability Find strength in numbers
Use of emails and text message giving instant aid during difficult and good times between preceptor and clinical coordinator.
Use of social media, sharing training ideas, advantages and disadvantages of particular EMR systems in the industry,
locally and with international ophthalmic training programs.
During accreditation process having two outside reviewers to assess and suggest changes in the EMR training with extended lab rotations and service learning lab rotations.
We are stronger in numbers to produce a quality employable student.
5. Structural Motivation Design Rewards and Demand Accountability
Reward the clinical site with a returning student upon their request. Benefit of having someone rotate through who already knows the system.
Reward the clinical preceptor with the chance to win free continuing education credits or an ophthalmic book of their choice for their work and commitment.
Give kudos in the weekly emails on job well done for the week and from patient surveys.
Clinical sites who do not meet our strict criteria:
Will not receive a returning or new student for the next rotation.
Could lose their affiliation with the program and college.
6. Structural Ability Change the Environment
Availability of EMR / IT support in each clinical site for preceptors to have students re-train as needed.
Availability of sending students back to the college for re-training and / or have student removed all together from the clinical site.
Weekly meeting electronically and face2face meetings every two weeks with clinical coordinator to discuss the effectiveness of the student's training.
Electronic weekly reports on the success at each clinical site along with feedback on what needs improvement.
Conclusion
San Jacinto College Eye Care Program is the leader in training the next rockstar eye care profession, where that be a scribe, diagnostic tech, work-up tech, optician and or applying to Optometry school. Saving sight for all the world to have a clear vision. As the lead faculty member, my leadership will influence the clinical coordinator, clinical sites and the students hearts and minds into becoming the best in the nation.
In closing, I will share a favorite quote
" Leadership is the art of getting someone else to do something you want done because he wants to do it." - Dwight D. Eisenhower
References:
Patterson, K., & Grenny, J. (2013). Influencer: The new science of leading change, Second Edition. McGraw-Hill Education.
Meier, J. D. (n.d.). Vital behaviors [Blog]. Retrieved from http://sourcesofinsight.com/vital-behaviors