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Abstract
Background and aims A series of ‘wrong site/side blocks’ (WSB) resulted in decision to implement RATO using guidelines by RA organisations. Implementing/transforming such change within our large department is difficult. We share our experience of using Kotter’s 8 Step Change Management, to implement RATO.
Methods Kotter’s 8 Step method was described to overcome organisational change failure.
Establish sense of urgency: ‘What/Why/How to’ of RATO were explained to stakeholders, emphasising medico–legal impact of wrong–site blocks/urgency of preventing harm.
Create guiding coalition: Like–minded/skilled colleagues (RA experts, Quality/Audit team, anaesthetic nurses championed this change, with senior leadership support.
Developing vision and strategy: Our Vision was zero–tolerance for WSB, preventing this ‘never event’.
Communicate this change vision: Various channels (morbidity/incident reporting meetings, email reminders) used to engage stakeholders, reiterating the RATO message.
Empowering employees for broad based action: Staff empowered with requisite skills/tools/systems to enable this change e.g. authority to prohibit procedurist from proceeding before RATO.
Generate short term wins: Transformation needs time. Short term wins help motivate staff, preventing momentum loss e.g. publicising near misses detected because of RATO.
Consolidate gains and produce more change: To sustain this change, we created more change e.g. embedding RATO briefing during new nurses/doctors’ orientation.
Reinforcing changes into our organisational culture: Implementing RATO changed our department’s ethos/culture towards procedural safety/TO diligence – all invasive procedures are now preceded by TO. Many consciously perform mental time–out when giving intravenous drugs.
Results Included with Methods
Conclusions Using Kotter’s Change Management strategy, RATO total compliance was achieved within a month of implementation.