Sourcebook : 2.3 How to avoid common problems

2. Problem: Getting everyone's agreement first

The entire nursing staff need not agree to treat pain differently. Start with the staff members who will be trying the new assessment approach. In health care, we sometimes seek consensus around changes before agreement is needed or warranted, missing the opportunity to try new approaches. Participants need not agree "for all time," only for a while. Most people can make this commitment just to be cooperative.

Solution: Start with small groups and gradually add people working on the change

Find innovative staff members - the champions - who are interested in testing changes first.
Have them design and test the changes on a small scale.

Measure the results and make them visible.
Gradually bring in successive groups of participants to try the change. For example, recruit another medical group, another nursing unit, or another clinic.

This text is derived from the book Improving Care for the End of Life : A Sourcebook for Health Care Managers and Clinicians.