ONCE YOUR ORGANIZATION has created a new vision and developed strategies to achieve it, it's time to plan how that vision will be communicated. In most CME units, this new vision will require the staff to do new and different work, such as moving away from planning programs that are not learner-centered (for example, some types of hospital grand rounds) to planning activities that link quality data to physician performance. Because many stakeholders (learners, staff, faculty, and collaborators) will be affected by this new work, they need to know why change is needed. Four approaches can help:

1. Craft a communication plan

   The organization's leader must help to develop a plan that clearly articulates what is to be communicated (e.g.,the need to assist in changing physician performance); to whom must it be communicated (staff, physician faculty and learners, organizational leaders); and how (tactics). It is also important to get feedback from critical stakeholders and those who will be tasked with carrying out the plan.

2. Use multiple communication methods

   To be effective, you must take every opportunity to reinforce this new vision to staff and stakeholders and explain how your organization is implementing it. Don't limit yourself to one method of communication. Use a variety of tools such as newsletters, Web sites, e-mail, presentations, one-on-one, and fliers. The more you keep the vision in front of people, the more likely it is that it will become part of the fabric of the organization. Carefully plan and time your efforts to maximize their effectiveness with selected stakeholders, especially faculty.

3. Model the new behavior

   This is probably the most important element. It is critical to begin showing others that this is serious — change is happening, people are doing things differently. When work starts on building the new vision, a certain momentum begins to build that, it is hoped, will create more enthusiasm for the changes. Plan carefully the projects that enable you to model new behaviors (more about this in an upcoming article).

4. Create time for projects based on the new vision

   To have time to institute the new behaviors and practices, some old habits, tasks, and activities must be eliminated. It is difficult to start a new series of quality-based initiatives while being inundated with requirements related to the old work. Some creative solutions are called for to make room for the new work. Consider, for example, computerizing credit and attendance tracking at CME activities. Also, try using work groups targeted specifically at some tasks, both old and new. Brainstorm new ways to streamline or eliminate old processes and engage with new groups that deal with physician performance and quality-of-care analysis, and soon your organization will actually be living the new realities.

Joseph S. Green, PhD, is associate consulting professor, Department of Community and Family Medicine and associate dean of CME, Duke Office of CME, Duke University Medical School, Durham, N.C.; James C. Leist, EdD, is interim director, Alliance Center for Learning and Change, and associate consulting professor, Department of Community and Family Medicine, Duke University Medical School; and Robert E. Kristofco, MSW, is associate professor and director, Division of CME, University of Alabama School of Medicine, Birmingham, Ala.

To Effectively Communicate the Vision:

1. Get leaders involved

2. Say it early and often

3. Don't just tell — show

4. Make time for the new by ousting some of the old