HTS Project Manager Ley Anne Merica, MAS, CPHQ, RN has 31 years of healthcare experience under her belt including leadership roles in various healthcare settings. She has led transition and activation planning projects from coast-to-coast covering community hospitals to large academic medical centers in bustling metropolitan cities. Tannya McFarlane is Project Coordinator with over 9 years of expertise in assisting our teams in managing meetings and providing reports, maintaining ongoing communication and information dissemination, producing meeting documents, and troubleshooting where needed.

Ley Anne and Tannya tackle 3 questions on Workflow Planning in our ongoing 3 Questions series. Based on their experience supporting new healthcare facility projects, both believe that reviewing and understanding new workflows with the aid of visuals as early as possible ensures that the staff will acquire the confidence to adapt and work in their new work environment effectively.

Q1: When the HTS Project Management team readies for workflow planning, what is most helpful in preparing the healthcare facility’s department leads for change?

A: We like to use analogies that staff can relate to such as buying a new house. A new Q1house may be bigger with an additional floor(s) and a new audio surround system, but regardless of size or technology, it will certainly have a different footprint. Surely, the new kitchen would not be set-up in the same manner as the old kitchen nor would the homeowner try to fit the old into the new kitchen. With these analogies, everyone will understand that change will take place even though the actual process may not. Paths of travel and flow throughout the new facility, as well as counter and storage space, are the most common changes. Exploring workflow upfront enables the facility to identify obstacles and challenges before moving in. HTS recommends allowing time for workflow refinement and providing an opportunity to physically practice the workflows in the new environment before taking care of patients in the new space.

Pre-work is important. The selection of the team leads and department representatives is critical to success. When the staff is asked to participate in creating future workflows in the new building, the facility sends the message that the staff’s input is valued. To be engaged in this historical, “once-in-a-career” opportunity at this early stage of the transition process is a big deal!

There are several pre-work requirements that need to be completed prior to engaging with staff for workflow planning. We begin the process with the Discovery Phase. Observing, conducting Gembas, and documenting the findings of the current state workflow is critical to determining where the future state will change, and defining the day-to-day activity impacts.  By identifying current practice, the staff has the opportunity to critically think about and influence how they will work in their new space. There is often an underestimation of the information needed to determine the future state. Key operational decisions, provider workflows, and technology/systems information are important to fully evaluate the new workflows and their impact on staff. The new space is affected by new furniture, new equipment, layout changes, technology, policy, path of travel, etc. The more information is available, the better the outcomes. This is an amazing opportunity for departments to affect positive change, utilize best practice, and prepare them to lead the orientation and training requirements for their new space.

Q2: How do you deal with staff sensitivities when workflow redesign means realigning job responsibilities such as merging job types where one takes on a new responsibility?

A: Change is hard for everyone. The opportunity to have a voice in the workflow process for the new space helps create team unity and generate positive excitement that comes with gaining a new and beautiful space.


Focus on creating efficiencies and the best workflow for the department while keeping the top of the license model in mind. Engaging the organization’s Human Resources and educators in the process can help during the pre-planning stage. Cross training or merging of roles can often be job-saving. By uncovering sensitive issues during the Discovery phase, we are able to plan better. After Discovery, a workflow purpose statement is created along with a recommended team. Having representation from the different roles and keeping the focus on the workflow charter help guide discussions. If employees are a part of the workflow process and future state development, they will have buy-in and will feel empowered as change agents. Keeping employees updated with information helps to alleviate fear and minimize rumors. Participants in workflow sessions often become the “department informants” and therefore, we highly recommend providing them with accurate messaging once the workflow is complete.

Staff sensitivities are real and should be acknowledged. Taking on the approach of “this is yours”, “own your new space”, and “think of the possibilities” alleviates fears and diminishes uncertainty.

Q3: How do you get staff to imagine life in the new environment and get excited about change so that they are able to think of efficient/innovative ways vs. accepting the mindset of “everything is working well; we don’t need to change”?

A: It is important to share floor plans early on and provide tours when the interior is far enough along to visualize the walls, distances, and general layout. Frequent updates on construction changes, technology decisions, and system decisions are mandatory. Considering that it is difficult to imagine progress or new systems without seeing the actual space, it is important to include pictures in the updates. Schedule vendor (such as a nurse call vendor) demos of new equipment to provide the guidelines for planning.


If the staff understands the “why” behind decisions, they will be better equipped to help with workflow solutions. Provide them with an understanding of what the building can offer patients and staff. For example, explain that by using LEED principles, hospitals are quieter and have better lighting with more windows. Sharing new technologies, building features, and design intent help departments understand what to expect during their day-to-day work and workflow.

The shift also seems to happen when including staff in setting up rooms. It cannot be said enough that when staff feels ownership, and/or heard, their voice is an added tool for the workflow process, paths of travel, set up, and/or design. The new facility is an opportunity to get all staff on board in the correct and right way, per policy and procedure. Getting everyone on the same page with the requirements for licensing and for providing best practice patient care in a new environment starts at the top and filters down. HTS partners with department leadership to stress the importance of positive team leadership and a unified approach. Bringing teams together becomes our focus and emphasis to ensure that optimal workflows are established for a new environment with new technologies and systems.