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My practice is about to change to a new electronic health record (EHR), and I can't help but feel dread. The last time we did this, it was so stressful.
I really don't want to go through it again. What do I do? How do I prepare?
Here is what I'm doing to get ready. I think it's a good strategy for managing change in general, and I hope it helps some of my colleagues as well.
1. Focus on the "why" of change
I keep reminding myself why I am doing this. Sometimes change is forced upon us, and sometimes change comes by choice.
In this case, it's a little bit of both. My company made the choice because our old system was becoming obsolete. I felt like the old system was "good enough," but like it or not, it's time to move on. This fact is out of my control. I choose to get behind it because complaining and resisting what is coming will just add suffering to the pain that comes with change.
I remind myself of my alternative. I could retire instead of going through this. Some of my colleagues might choose that, but I still want to be a practicing pediatrician. Learning a new system is necessary for me to continue.
This is going to be hard, and I can do hard things when I set my mind to it. My "why"? I want to keep practicing and caring for my patients. I want to go through this change.
2. Accept negative emotions, but don't dwell on them
Humans fear change instinctively. In addition, it requires focus and concentration to learn new things.
Documenting in my current EHR doesn't require much attention. When I'm learning new technology, so much of my attention will be focused on building new skills. However, I still need to focus on the patient's needs while I'm learning. Learning a new system is going to be mentally exhausting until new automatic and unconscious habits are created. So when I'm emotionally tapped out, it's easier to be tipped into negativity.
Acceptance of negative emotions is often an overlooked part of managing change. Don't deny or judge your feelings, don't rush through them, and don't let others force you through. When we rush through or try to avoid negative emotions, it creates a sense of toxic positivity. Just like in grieving, negative emotions are part of the change process.
But it's equally important not to dwell on the negative emotions. When we feed our negativity, we get stuck, and we spew toxicity into our environment. It's a balancing act.
Don't avoid the pain, but don't wallow in it or let it overtake you either. Go through it. There is a reward on the other side. Each of us will get there in our own time.
3. Prepare for obstacles and resistance
My self-tips:
- I will learn as much as I can in advance of our go-live date
- I will remember why I am doing this when I am frustrated
- I will plan to focus more time and energy on charting until I get the hang of it
- I will remove other responsibilities (where possible) during this time period
- I will remember that this is an opportunity to improve workflows and patient care
- I will be patient with myself when other people catch on faster than I do
- I will continue self-care routines
When I'm stressed out in the office:
- I will adjust my perspective by shifting my focus to my patient's needs
- I will remind myself that this is stressful for everyone, and we can work as a team to get through it
- I will not take it out on my staff, my patients, my family, or myself
- I will remember to take deep breaths
During change, things typically get worse before they get better. Think about the mess we create when we are in the middle of reorganizing our closet. I don't think many of us enjoy that process, but I think most of us love the orderly closet we are left with in the end.
I will keep moving forward by focusing on the finish line. I will get there!
Jennifer Shaer, MD, is a pediatrician.
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