Changing Practice in Australia: Spotlight on Bettina Turnbull

By Timothy Cooke

Ida Fellow Bettina Turnbull applied change management principles found in the Ida Change Guide to integrate the Ida Motivation Tools into daily practice at Connect Hearing clinics across Australia.

As the Professional Development Manager for Connect Hearing Australia, Bettina Turnbull conducted training workshops on the Ida Motivation Tools for approximately 70 clinicians. Her goal was to help clinicians better understand the unique background of each client by introducing the concept of motivation into the appointment.

“I thought the Motivation Tools looked really good, and I wanted to differentiate our business from other clinics,” states Bettina Turnbull. “A lot of people think that client-centered care and good business practices do not go hand in hand, but I think they go quite nicely together. There are some larger groups where clinicians feel it is all about the numbers, the price, and what they can sell. They feel that client-centered care does not have a place in the business. But one does not exclude the other. You can still be very client-centered and still do very well in the business.”

The Motivation Tools and the concept of client-centered care were very well received by the workshop participants at Connect Hearing. After the workshops, however, most clinicians were not using the tools on a regular basis with clients. The clinicians liked the tools, but they really didn’t know how to start using them and integrate them into their current practice.

It was at this point when Bettina attended the Ida Institute’s seminar series on Managing Change in May 2012. The seminar explored the barriers to changing clinical practice and reviewed strategies to help overcome these barriers. One such strategy was the appreciative approach to change. Rather than a top-down, problem-focused approach to change management, the appreciative approach encourages group discussions to identify what works well now and to focus on doing more of that in the future. The approach often leads to more sustainable results, as change is created through shared understanding and collaboration, where all participants are involved in the change process.

The principles of the appreciative approach resonated with Bettina. She was eager to return to Australia and apply what she learned to encourage more clinicians at Connect Hearing to start using the Ida Motivation Tools on a daily basis. She decided to conduct a new set of training workshops on the Motivation Tools that incorporated many of the appreciative approach principles that are now found in the Ida Change Guide.

“Getting input from the clinicians, that was the first part of the process, and then getting the management on-board and having them understand. Also, the second round of workshops were very facilitated. Instead of telling the clinicians what to do, we discussed how we could do things in the future. We were also very open to making changes to the process,” states Bettina Turnbull. “We gave support to the clinicians after the workshop, to help facilitate the change process. We might sit in and watch a consultation discussion, and give them feedback about how it went.”

Based on clinician input, for example, Connect Hearing took existing biomedical questions usually discussed during the appointment and placed them in a reformatted Client Lifestyle Form, which is filled out before the appointment. Questions pertaining to the Ida Motivation Tools were then added to the Lifestyle Form to help prompt clinicians to explore their client’s motivation to change or lingering ambivalence.

The new process worked. After the second round of workshops, the vast majority of clinicians at Connect Hearing were regularly using the Ida Motivation Tools and client-centered methods in appointments. Clinicians found the new Lifestyle Form to be very helpful, as they now have more time during the appointment to use the tools and initiate a conversation with the client about their motivation to take action on their hearing.