Trusted Care Change Management Communication Toolkit

Background:  The United Stated Air Force Medical Service (AFMS) is currently going through a cultural transformation to become a highly reliable organization (HRO). Pioneered in the nuclear and aviation industries, high reliability requires the steadfast focus by the entire workforce on identifying potential problems and high-risk situations before they lead to an adverse event. This transformation calls for a shift in the culture of AFMS, engraining principles and practices of high reliability and specific safety behaviors into daily activities of Airmen across the enterprise, such as actively engaging leadership, fostering a culture of safety, focusing on continuous process improvement, and keeping patients at the center of all care. The goal of this transformation reflects AFMS’ unwavering commitment to the well-being of their patients, staff and communities they serve.

Program background:  To help set in motion the immense culture change required for the AFMS to become an HRO, AFMS executive leadership established a multifaceted behavior change initiative, called Trusted Care, to provide custom guidance and communication tools designed to normalize HRO practices proven to decrease preventable patient and provider harm in the medical setting among all Airmen, while also educating leaders throughout the organization to change their own behavior.

Evaluation Methods and Results:  The Trusted Care team took the approach to combine multiple change management communication resources into a comprehensive, customizable, living toolkit. The toolkit provides foundational key messages, tools and embedded templates to help execute a proactive, transparent and consistent way to engage staff throughout an organizational transformation. The approach is operationally agile and will evolve over time to reflect and address needs as they arise. Rather than step-by-step phases, the plan presents three focus areas designed to increase buy-in, anchor changes, and reward new/desired behaviors. During construction of the toolkit, the program team engaged the AFMS command leaders over several months to standardize resources, ensuring that the toolkit met the needs of target audiences, and to incorporate it into an existing and accessible platform. At this time, Trusted Care is one month into deployment of the toolkit. Response from the end users is positive, and anecdotal feedback indicates that the toolkit has both increased awareness of HRO principles and mobilized staff to begin adopting HRO practices.

Conclusions:  Moving forward, the Trusted Care team will solicit feedback and update the toolkit accordingly. The program intends to use the same methodology behind the toolkit to create similar change management communication materials, such as a comprehensive guide to help brand AFMS as a highly reliable organization, with targeted instructions as well as videos, posters, fact sheets, email templates, and event agendas that promote a culture of safety and zero harm.  

Implications for research and/or practice:  Both the development process for the toolkit, as well as the product itself are easily replicable for health organizations undergoing major change like AFMS. The effort has even sparked wider interest across the entire Military Health System, including the Army and Navy’s respective leaders, who believe this change management communication approach would work well for their own high reliability culture transformation initiatives.