How to Get Buy-In From Unfamiliar Department?

[KristinWW]

How do you gain buy-in for implementing a new system from a department chair when you have never worked in that area before? Scenario: ER dept chair only wants an informatics RN to implement new IT whom has previously worked in the ER.

[ZASHAGALKA, RN]

How do you gain buy-in for implementing a new system from a department chair when you have never worked in that area before? Scenario: ER dept chair only wants an informatics RN to implement new IT whom has previously worked in the ER.

Put an RN with ER experience on your committee.

See, I hate the term 'buy-in': I almost alway interpret it as meaning to push something onto nurses without having their perspective. This is an all too common problem from administrators and then they cannot understand why the resistance.

Both the ANA and the AACN (Amer Assoc of Critical-Care Nurses) stipulate that any change at the bedside MUST have input from those bedside nurses, from design to implementation.

It seems that you are upset that nurses are resisting change that they have had no opportunity to provide input upon. If you want a 'buy-in' to this change, then you must 'sell it' on terms that they can understand: how do those with direct experience to the outcomes being changed evaluate those changes?

See, people just never buy things they don't want. It's that simple. They buy things BECAUSE they are heavily advertised to and DECIDE it's worth buying. The issue here is that you've confused your agenda with theirs. If you want your agenda TO BE their agenda, then you have to actually sell your agenda. If that means placating your 'customers', then that's the art of the deal, isn't it?

I'd go back to square one and start looking at this issue from THEIR perspective and not yours. Does this product benefit them? Show them how. Is it a no-deal without their input? Put one of them on YOUR team.

Bottom line: when you use the term 'buy-in' to mean accept your agenda uncontested, then you have set both you and them up to fail. 'Buy-in' will only occur when you convince them that your agenda is THEIR agenda - and not before.

~faith,

Timothy.

[KristinWW]

Whoa, stop! ER nurses are not the issues at all, and they are tickled beyond belief that another RN will manage implementation - it's the doctor who is the chair of the ER that doesn't want an non-ER RN! The project hasn't even begun yet, either. The director of nursing all the way to the IT people are happy; it is just this one person. He has worked in the ER his whole life, and he doesn't speak to anyone else :)

[ZASHAGALKA, RN]

Whoa, stop! ER nurses are not the issues at all, and they are tickled beyond belief that another RN will manage implementation - it's the doctor who is the chair of the ER that doesn't want an non-ER RN! The project hasn't even begun yet, either. The director of nursing all the way to the IT people are happy; it is just this one person. He has worked in the ER his whole life, and he doesn't speak to anyone else :)

It's still an issue of 'sell' not 'buy'. If, as you say, the ER nurses are 'tickled beyond belief' about the implementation of this system (something I find difficult to believe - no offense - but people everywhere, not just nurses, are resistant to change) then the way to 'sell' this is to have THEM convince the ER director that this is a good change.

Have them well represented on the implementation committee.

If I understand it, your concern is that the ER doc has issues with implementation of this system because YOU are not an ER nurse. Is the system only to be used in the ER? How can you address this concern short of out-sourcing your job?

Look, when anybody 'buys into' anything, there is an implied cost. If you want to sell, you simply must justify that cost. My original advice stands: you have one agenda, the director another. If you want to sell YOUR agenda, then you have to look at the problem from the perspective of making YOUR agenda HIS agenda.

Prove to him that his concerns are being met in other ways, such as ER nurses on the implementation committee. Or prove to him that this system has been validated by other ER staff at other facilities. Can you bring in outside ER resources to validate that this system will be of benefit to this ER? Can you provide documentation of such? Can you offer to work a few shifts in 'his' ER to be brought up to speed on the problems he feels are not being addressed?

The question is this simple: what can YOU do to allay his concerns, thereby making him an ally? If the answer is nothing, he's just a conceited jerk, then the question becomes more complex, but not by much: what can you do to show the management team that you have exhausted every avenue to address his concerns?

Ultimately, this guy answers to a boss, just like you. I'm sure those bosses are invested in this process as they are spending tons of money on it, no doubt. If you can't turn him to your way of thinking, then you simply must make enough of an effort that his and your bosses can only conclude that it's his problem; not yours.

Turn on the charm and bombard him with empirical and local anecdotal evidence that the ER will be well represented and well served. If you can't charm HIM by those methods, make sure that ultimately, you charm your joint bosses. You should have the upper hand there as they are more than likely committed to the project already.

I'm just trying to help; I'm not being critical, rather, I'm merely suggesting you look at the problem from a different angle.

~faith,

Timothy.

[rninformatics, DNP, RN]

How do you gain buy-in for implementing a new system from a department chair when you have never worked in that area before? Scenario: ER dept chair only wants an informatics RN to implement new IT whom has previously worked in the ER.

Sounds like you are trying to obtain buy-in for the person on the Implementation team and not for "the System" that is to be implemented.

The ER dept head needs to understand that it wont be just one person implementing the system and that his/her expectations are unrealistic.

As the previous poster wrote do include ER clinicians in your Implementation Team.

I am an old Oncology Nurse. When I accepted a role in a Children's Hospital to implement a Clinical Information System house wide I had no Peds experience. You know the saying "I may not have all the answers but I know where to go to get them". Liken this same principle to your situation. I fully utilized the experienced Pediatrics Nurses during all the phases of the Implementation, combined with my multiple years of Systems Implementation and Project Management experience and 20 years plus clinical nursing experience. The Implantation happened on time and on budget.

I'd also suggest you publicly solicit, include and encourage the Dept Chair's input. Verbally express your desire to have his/her input as an experienced clinician and someone who knows the ER like the back of his/her hand, etc.

Encourage and nurture your "nay" sayers and those who seem resistant to the impending change as they do have valuable suggestions and frequently can uncover issues others may not have thought of. You and the Implementation team must continue to remains positive, encourage positive and proactive communication and in no uncertain terms manage expectations. There may not be an Informatics Nurse who has past ER experience but ER clinical, administrative staff can (and should) take an active role in the Implementation process and their input is needed to faciliate the process. Communicate to the dept head that the goal of the implementation is to give the ER clinicians electronic tools to help improve clinical practice and patient care – That is the reality.