Advances in Medical Education and Practice (Jul 2019)
Turning the oil tanker: a novel approach to shifting perspectives in medical practice
Abstract
Lasith Ranasinghe,1 Frank JMF Dor,2–4 Paul Herbert2–41Faculty of Medicine, Imperial College London, London, UK; 2Imperial College Renal and Transplant Unit, Hammersmith Hospital, London, UK; 3Faculty of Medicine, Imperial College Healthcare NHS Trust, London, UK; 4Department of Surgery and Cancer, Imperial College, London, UKAbstract: Although health care is encouraged to follow an evidence-based approach, there are perceived instances where suboptimal practice persists in the presence of better options due to an inherent resistance to change within many health care systems. To continue striving for clinical excellence, it is important to identify deficient practices and make appropriate corrections by implementing new and improved techniques and treatments. Bringing about change, however, tends to be a long, arduous process consisting of several small and successive deviations from the norm, analogous to “turning the oil tanker”. Analyzing the methods employed by successful health care innovators has allowed the development of a “three-pronged” approach to overcoming resistance to change: 1) a determined opinion leader with a network or like-minded opinion leaders; 2) the presentation of hard evidence with adequate praise for current practice and the generation of clearly worded, specific guidelines; and 3) the use of simple reminders and continuous analysis of outcomes. Employing this three-pronged approach could lead to faster and more successful implementation of change within the health care system.Keywords: health care innovation, resistance to change, implementing change, evidence-based medicine
