On-Demand Learning Lab - Implementing & Sustaining Change Across Disciplines-August 2025 Learning Lab Recording

Video Transcription

Video Summary

NACU’s final Live Learning Lab in a three-part change management series focuses on implementing and sustaining change across healthcare disciplines through three lenses: quality/safety (Dr. Samantha Crandall), performance improvement (Lean Six Sigma Black Belt Dr. Bri DeBose), and executive leadership (CNO Lindsay Ryan).<br /><br />Speakers emphasize matching the right improvement method to the problem—using PDSA for unclear problems, RCA/DMAIC for unknown root causes, Six Sigma for variation, Lean for waste reduction, ADKAR for behavior change, and A3 for structured storytelling and cross-team alignment. Examples include improving ED EKG quality by identifying positional variation, and scoping a pressure-injury initiative by narrowing from all pressure injuries to device-related cases to make the work feasible and sustainable.<br /><br />They warn against “solutioning” too quickly without defining, measuring, and analyzing, which wastes resources and damages morale. A readiness assessment is highlighted: leadership support, employee engagement and training, financial/ROI considerations, communication and feedback channels, organizational history/culture, and resource availability with an adaptable plan.<br /><br />Middle managers are positioned as critical “sense-makers” who translate strategy into workable frontline action. The group discusses burnout as a safety risk and notes resistance often signals overload or lack of voice; mitigation includes prioritization, co-design, celebrating wins, and reducing “pebbles in the shoe” (small friction points).<br /><br />Data storytelling should drive action: tailor messages to frontline staff, experts, and executives, and connect metrics to real patient impact. Agility is framed as “learning fast” via small pilots and pivots (e.g., adjusting a virtual nursing program; improving SDOH screening by reducing questions and leveraging technology). Sustainability requires both systems (daily management, EHR integration, accountability) and culture (role modeling, recognition, psychological safety).

Keywords

change management in healthcare

quality and patient safety improvement

Lean Six Sigma

PDSA cycle

root cause analysis (RCA)

DMAIC methodology

ADKAR behavior change model

A3 problem solving

middle manager sensemaking

sustaining change and daily management systems