Barriers to proper practice can be broken , but understanding what keeps those barriers in place is essential to the process of dismantling them . “ People tend to make processes more complicated than they necessarily need to be .”
in an instant and the pandemic was difficult in part because it happened very quickly , and changed everything .”
Schaffzin provides a few real-world examples of barriers to implementation .
“ Healthcare personnel are experts in their practice , but that doesn ’ t make them experts in all areas and specifically in implementation methodology ,” he says . “ So , physicians or administrators oftentimes will be looked to in the healthcare system to make decisions , but they may not be trained in implementation methodology . It ’ s appropriate for physicians to dictate practice , but it ’ s less appropriate for them to say how it should be implemented . A physician in charge of a team say , ‘ I think we need to do it this way ’ or ‘ I want to do it this way ’ and they may not have an appreciation of how those actions may affect the team or their practice . Not everybody in the system may be willing to speak up if they think that physician going against evidence-based practice . Hierarchy can get in the way .”
He continues , “ In my clinical practice , when someone comes to me and says , ‘ Hey , there ’ s a problem that needs to change ,’
I often heoar two things : If I say ‘ Well , why don ’ t you tell them that ?’ They may reply , ‘ It sounds better coming from you .’ People often don ’ t like to be the messenger . Alternatively , if I ask someone to tell me what is going on , people may hesitate because they don ’ t know how I ’ m going to react ; they may think I could belittle them , or think what they tell me is ridiculous , and that would destroy their confidence and make them feel unsafe from a psychological standpoint . Or they may be afraid that I will listen to them , and then something won ’ t go right and I ’ ll come back to them and say , ‘ Well , you gave me some bad information or an inferior idea .’ To minimize the impact of this hierarchy as the physician leader I say , ‘ I can ’ t practice well unless you share your insights with me , and I promise that I will own the decision that we make .’ So , I will make the decision , and I ’ ll own it . I try to create psychological safety among people to dismantle the barrier .”
It has been documented by Lastinger , et al . and other researchers that during the pandemic , healthcare-associated infection ( HAI ) rates creeped up , and Schaffzin says he believes