many forms, from new software to new workflows, new EHRs,
annual coding updates, or even mergers and acquisitions—
with the latter leading to fears about job security. Additionally, HIM professionals are frequently told they need to update
their skills, credentials, and degrees in order to stay relevant
in the future. Any one of these events can distract employees
from the task at hand.
WVU Medicine’s Methany took a project management class
and used the techniques she learned to tackle a major source
of employee dissatisfaction in her workplace. Ever since her
department had implemented a new worker productivity database, she heard complaints about it. Everyone in her HIM
department, which had 237 employees at the time, had to use
the tracker, which left many feeling like Big Brother was looking over their shoulder. At that time, the tracker had been in
use for 10 years and was still meeting resistance.
Methany decided to solicit feedback from 10 percent of her
employees and asked her assistant to schedule 30-minute
one-on-one interviews with staffers, for a total of 23 interviews. This gave them the opportunity to ask Methany any
question they had about the database or any other concern.
Then in turn, she appointed each of them to be liaisons for
their own separate corners of the HIM department. The liaisons could hold additional training sessions and brainstorm
on ways to improve the use of the database, increase its effectiveness, and identify ways it improved their job performance. Methany was also very deliberate in her selection of
liaisons, in some cases choosing individuals who had an “axe
to grind” with the system.
“I figured that if I could make myself their champion, they
would spread the word… I felt that because it was such a bone of
contention with folks at the grassroots, if they could hear more
about it from their peers, it was better than me saying ‘We’re
working on it,’” Methany says.
Every liaison conducted a SWOT (strength, weakness, opportunity, threat) analysis of the tool, and Methany laid out a
roadmap, developed a milestone schedule, and wrote a charter
governing the project.
“By the time we got through the project they started performing and I took a backseat role. They started forming subgroups,
by the end of the project we were still using the same product
but made changes that gave us a lot of wins,” Methany says.
A Little Empathy Goes a Long Way
Workforce worries beyond new platform or software changes—
including concerns about future career prospects, layoffs, or
the need for more education—require a more deft leadership
approach. One reliable way for managers to approach this is to
try to put themselves in their colleagues’ shoes, and doing this
properly takes strong communication skills.
Mary Ellen “Emmy” Clancy, MHA, CCS, CMPE, CPC, CDEO,
CPMA, revenue cycle, coding, and operations consultant with
Emmy Award Healthcare Consulting, describes herself as a
“why” person—if she can understand “why” a change is being
made, she’s more accepting of it. It’s in that spirit that leaders
should be as transparent as possible when explaining decisions.
“The more you can share the better,” Clancy says, especially
when dealing with layoffs or restructuring of services. “As under-
standing creeps in, it’s easier to stomach what’s happening.”
The first step when communicating change, she says, which
addresses the “why” factor, is to use phrases such as “We
couldn’t stop this from happening,” or “We can’t afford not to
do this,” and “We have to do this because the regulations require
it,” she says.
The second step, Clancy says, is that leaders need to ask their
employees what leadership can do to offset the impact of the
change—for example, offer to be references for those whose
jobs are terminated. “That sends the message that you care and
that this is personal for everyone,” Clancy says.
It is also vital to provide as much advance notice regarding
changes as possible, and to celebrate and communicate suc-
cesses just as well as negative changes. “It’s easy to have good
news, but sometimes we’re not good with saying why this hap-
pened. ‘It’s a result of all the good work you guys have been do-
ing,’” Clancy says.
Sandra Finley, president and CEO of the League of Black
Women, specializes in training leaders on a type of transfor-
mative change management developed by the military known
as VUCA, which is an acronym that stands for volatility, uncer-
tainty, complexity, and ambiguity. Finley and a co-presenter
did a training session on VUCA and leading through change
tailored for HIM professionals during the 90th annual AHIMA
Convention and Exhibit in September 2018. Because of its ori-
gin in the military, VUCA addresses plenty of thorny questions
and has tactics for navigating ambiguity, which is useful as the
HIM industry confronts a future with a lot of unknowns. Fin-
ley compares VUCA’s approach to communication to a car or
phone’s GPS system.
“It [GPS] tells you where you are and what it understands
about distances between where you are and where you’re trying
to get,” Finley says, noting that the strategy is constantly course
correcting. “It is an inferred promise that it will not leave you…
even if it takes you through somebody’s backyard. For leaders,
the underlying promise has to be as clear as it is for the Marines.
We will not leave you. And that is the thing that’s most fright-
ening to people who have to turn the steering wheels of their
career over to other people.”
Employers can execute strategies like this through simple
steps, which many companies but especially academic medical
centers can do, such as reimbursing employees for continuing
“I haven’t worked anywhere in maybe the past eight years that
didn’t have some form of tuition reimbursement,” says Shannan Swafford, RHIT, CHDA, CCS, manager of coding process
improvement at BlueCross BlueShield of Tennessee. “It’s a viable way to make a loyal and smarter workforce. You might lose
those folks after some education, but if you’re investing in your
employees they should stay loyal.”