Bring Everyone On Board

When you introduce the idea of performing validated screening, the first issue you will likely have to deal with is a reluctant staff. At CHB, staff resistance to a validated screening program was initially high, with the most common arguments against it being:

• lack of time to implement an additional procedure
• impression that existing identification methods are adequate
• dislike of algorithm-directed referrals that are perceived to replace clinical judgment

Communication was the key to overcoming this reluctance. Among other things, we introduced screening on a trial basis and actively solicited staff feedback throughout the implementation, asking questions such as “What would make this easier for you?” We incorporated feedback into the practice flow and, within a matter of weeks, staff reluctance virtually disappeared.

We address overcoming obstacles in practice in the Pointers from Practice section of this tool kit.