CEO’s ‘change sucks’ memo rapped By: Carol Sanders Posted: 7:00 PM CDT Wednesday, Mar. 27, 2019 Last Modified: 10:58 AM CDT Thursday, Mar. 28, 2019 Updates

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“Change sucks” in the Winnipeg Regional Health Authority’s “valley of despair,” but that feeling doesn’t last, its president and chief executive officer said in his weekly message to nearly 30,000 employees.

In an interview Wednesday, Réal Cloutier said his two-page missive — that riled unions and has one organization expert questioning the health of the system’s realignment process — was meant to be a frank acknowledgement of the impact change has had on health-care providers over the last two years.

“That was the intention,” said Cloutier. “One theme, and what I was trying to reinforce, was that in any industry there’s a change curve.”

A graph in the bulletin showed how change affects morale and performance over time, starting with denial and shock then falling to frustration before bottoming out in a “valley of despair” and depression, before rebounding to “experiment,” then “acceptance” and finally “integration.”

In his memo to staff, Cloutier said it’s time to say: “Frankly — change sucks.”

An expert on organization theory at the University of Manitoba’s Asper School of Business said “the valley of despair” doesn’t come up in his teachings. “That said, we do talk about a ‘threat rigidity response,’ which refers to the tendency of people facing a threat to revert to familiar patterns of behaviour that worked in the past,” said Prof. Bruno Dyck.

“It is not unusual for change to create feelings of frustration and loss, but words like ‘depression’ and ‘despair’ are strong words that I would not associate with a healthy change process.”

“Despair” is something nurses are feeling right now, but not for the reasons Cloutier thinks, said Manitoba Nurses Union president Darlene Jackson.

“They’re not feeling despair about impending change, they’re feeling despair about the change that has already happened — that they don’t have the ability to provide safe, quality patient care and go the extra mile for patients,” she said Wednesday.

“The workload is crushing,” she said, pointing to increased mandatory overtime.

Nurses aren’t opposed to change — they’ve been asking for “a seat at the table” since 2017, before the first phase of changing the system began, said Jackson. “The entire health-care transformation has been done without speaking with front-line health-care providers.”

The WRHA is now finishing up Phase 2 of its clinical consolidation, which is working to improve patient care, said Cloutier, pointing to a reduction in the average number of assessed patients waiting in hospital for a personal care home bed. (That number has fallen to an average of 20 patients at any time, from 80.)

“We don’t change for the sake of change,” said Cloutier. “We’re redesigning the system to make it better for patients.”

Real Cloutier’s letter

Cloutier said he recently attended meetings with staff at Concordia Hospital, where the emergency department is set to close in June, and Seven Oaks General, where the ER will be converted into an urgent care centre in September.

“The people who are going through it now are in the valley,” Cloutier said of the upheaval. “When you know where (you’ll be working) and which teams you’re working with, you’ll feel better.”

The way change is implemented can have a big impact on how employees feel about it, said Dyck.

“In my class, we differentiate between top-down change — where managers use their knowledge, influence and authority to develop and implement the change — and a more bottom-up approach, where a variety of stakeholders are invited to use their knowledge to develop and implement the change,” the professor said.

“I expect the latter approach to be less likely to lead to depression and despair, even though it can still lead to feelings of loss.”

carol.sanders@freepress.mb.ca

Carol Sanders
Legislature reporter

After 20 years of reporting on the growing diversity of people calling Manitoba home, Carol moved to the legislature bureau in early 2020.

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