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How do you create change when you’re not in charge?

2 August, 2017

Author: Chris Woodgate, ISAS Officer

Goldfish jumping out of bowl

Who is in charge?

Is it your line manager, their line manager, the radiology manager, the chief executive, NHS England, the Department of Health, or A N Other (eg evil Galactic Empire. Yes, I like Star Wars)?

Do you need to know who is in charge to create change that benefits your patients and service? Going back to the ‘evil Empire’ I would say, “The only thing necessary for the triumph of evil is for good men to do nothing” (Edmund Burke), so perhaps doing nothing and leaving it to others is not a good option?

When you look around you on the first hour of your shift/ working day do you see inequality, unsafe practice, waste, a better way to do something?

If so, can you be bothered to do something about it and do you need to know who to complain to get them to change it?

Change is, at its core, a people process. So how do you create change when you are not in charge? A few ideas are outlined below;

  • Challenge the existing beliefs and assumptions you and others have. Why do you do something the way you do; is it ‘custom and practice’ or is it evidenced based. Is it comfortable or challenging? Questioning why something is done the way it is allows you an understanding of how you may be limiting your possibilities without knowing it.
  • How can you influence others; when you are working day to day your example of questioning process (in a positive way) and behaving in a dynamic way is the best influence ever. It will get you noticed!
  • Do your homework/research; eg use the imaging standard to measure your practice against, look for new techniques and challenges in professional journals. If you have the evidence, it is easier to convince others that they should have a look at what you are suggesting.
  • Try and find a sponsor; find a colleague who has a wider sphere of influence than you, who may have tried to do or succeeded in change in the past. Ask them why they think they did/didn’t succeed. Ask them to check out your idea; they probably want to do that any way before they stick their neck out for you. Ask someone you trust and respect and be prepared to share the ‘glory’.
  • Do you know who your audience is? If so, make sure you articulate your ideas in a way they will understand. After many years in the NHS I have learned that we speak ‘radiographer’, nurses speak in ‘nurse’, doctors speak in ‘doctor’ etc. You may need a translator to get your ideas across disciplines. For example, audit to one group of professionals may not have the same meaning to another. If you want to get them on-side, what is the ‘win’ for them, what is the agenda they are working too that would fit with yours?
  • Empathy and diplomacy may be needed; you don’t want to leave a trail of broken dreams in your wake. Others may have tried and failed, others may have a different agenda and others may have a vested interest in the status quo. Sometimes it is good to listen to the history of a process before destroying it.

The challenge: working with your colleagues and others to find opportunities to create change in the areas that you can influence. Testing your beliefs and assumptions, work together to identify what is within your span of control and your sphere of influence and what isn’t.

Create little victories that can build upon each other over time, and don’t be afraid of failure that just lets you know one way it won’t work, keep trying till you find the way it will work.

The best motivator of all, have some fun doing it!

Why not give it a go?

The Imaging Services Accreditation Scheme

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