John O'Connor

Let’s face it: None of us really wants to change.

We sort of like ourselves the way we are. Besides, dropping old habits and picking up new ones is a real hassle. Yet there are times when it’s pretty clear that the path we are on requires at a minimum, an adjustment.

That’s certainly the case for us as people. And it’s equally true for the organizations we work for. But as we all know, “change” and “long-term care” are not exactly traveling companions. Most senior living organizations tend to stick to old habits and approaches with a stubbornness rarely seen outside a mule farm.

In fact, the unspoken mantra at many facilities seems to be that if it is not completely broken, why fix it? Especially when change might threaten employee morale, residents, families or other stakeholders.

Yet even in the long-term care arena, change is being foisted on operators. Payments in many cases are shifting from fee-for-service to bundled arrangements. Regulators are employing new tools and strategies to ensure that the best possible care is delivered. And many facilities have been forced by necessity and oppoprtunity to essentially become short-term rehab providers.

Still, an underlying resistance to change continues to persist in this field.

So how do you know when it’s time to fundamentally transform? Actually, there’s quite a bit of literature out there on the subject. One of the best articles I’ve seen lately appears in the December issue of the Harvard Business Review.

In a piece called “Knowing when to reinvent,” the authors note that five interrelated “fault lines” can indicate when the ground beneath your organization is no longer solid. These are: whether the business serves the right customers, uses the right performance metrics, is positioned properly in its industry, deploys the correct business model, and has employees and partners who possess the capabilities required for future success.

By thoroughly examining these issues, operators can gain an early warning of industry upheaval, can prepare and can adapt. Equally significant, this framework can help leaders at any long-term care organization convince various stakeholders why change needs to happen.

Even for those who embrace this tool, change will likely prove difficult and meet boatloads of resistance. Unfortunately, the alternative is to wait until a catastrophe or another external issue forces the issue.

John O’Connor is McKnight’s Editorial Director.