Practice change projects involve various stakeholders at the organization or community level. They include individuals affected by the proposed change and those with vested interest in the project outcomes. The different stakeholders must collaborate to achieve the project objectives (Norris et al., 2017). At the organizational level, the stakeholders in the future practice change project would include healthcare staff, executives (Medical Director, Director of Nursing, and Director of Clinical Services), patient and family members. At the community level, the stakeholders would include healthcare providers, religious leaders, and community organizations. Interprofessional collaborations (IPC) would allow the successful completion of the change project by bringing together a unique set of skills and expertise. However, there may be some hurdles in the implementation of the practice change project due to the stakeholders’ diverse perspectives on pertinent issues and other related factors.
Possible Barriers in the Implementation of Proposed Practice Change
Ineffective and insufficient communication is one of the factors that may hinder the successful adoption of a change intervention. Most times, the stakeholders do not operate in close proximity; hence, it is impossible to communicate the project objectives, timelines, and other crucial details in one sitting. For example, the change agent may need to devise effective ways of ensuring that the healthcare professionals, patients, and external stakeholders such as community leaders receive adequate information about the project within the set timelines. If communication fails, the project is bound to fail. This is because the stakeholders may not put much effort in the project if they do not understand its objectives, their responsibilities in the implementation process, or the changes they need to adopt. A study by Geerligs et al. (2018) identified impaired communication processes as one of the barriers of implementing change in the healthcare sector, mainly because of the complexity of interdepartmental communication.
The lack of resources is another factor that may interfere with the implementation of a future practice change project. At the organizational level, stakeholders tasked with assigning resources such as healthcare managers may not be willing to finance the project. Instead, they may redirect the available resources to projects that they consider more valuable. In the community level, resource limitations may occur if community organizations or business leaders do not contribute to the project through manpower, finances, or otherwise. In a study to assess the barriers to implementing a change initiative, resource scarcity emerged as the most significant barrier (86%), compared to factors such as stakeholder resistance, poor leadership, and technical issues (Tappen et al., 2017). Therefore, it is crucial to prepare for challenges concerning the availability of personnel and other practicalities.
Further, individual beliefs, attitudes, and perceptions may be a significant barrier to the implementation of the change intervention. The stakeholders, including patients, healthcare professionals, religious leaders, and business leaders, have diverse perceptions and beliefs about issues relevant to the proposed project. For example, patients may oppose the project if it is against their longstanding beliefs and practices. Other stakeholders may also have a negative attitude towards the proposed change and the change implementation process. It is crucial for all the stakeholders to recognize the importance of the proposed intervention and see that their input and interest are considered in the implementation process. There should be healthy relationships among the stakeholders. As Nilsen et al. (2020) notes, passive or reactive relationships among stakeholders or the complete lack of relationships, hinder the implementation of change interventions. The project is unlikely to succeed without stakeholder integration.
Geerligs, L., Rankin, N. M., Shepherd, H. L. & Butow, P. (2018). Hospital-based interventions: a systematic review of staff-reported barriers and facilitators to implementation processes. Implementation Science, 13(36), 1-17. https://doi.org/10.1186/s13012-018-0726-9
Norris, J. M., White, D. E., Nowell, L., Mrklas, K., & Stelfox, H. T. (2017). How do stakeholders from multiple hierarchical levels of a large provincial health system define engagement? A qualitative study. Implementation Science, 12(1), 1-13. https://dx.doi.org/10.1186%2Fs13012-017-0625-5
Nilsen, E., Stendal, K. & Gullslett, M. K. (2020). Implementation of eHealth technology in community health care: The complexity of stakeholder involvement. BMC Health Services Research, 20(395), 1-13. https://doi.org/10.1186/s12913-020-05287-2
Tappen, R. M., Wolf, D. G., Rahemi, Z., Engstrom, G., Rojido, C., Shutes, J. M., & Ouslander, J. G. (2017). Barriers and facilitators to implementing a change initiative in long-term care using the INTERACT® quality improvement program. The Health Care Manager, 36(3), 219–230. https://doi.org/10.1097/HCM.0000000000000168