The Respected Consultant Who Calls It Waste
St. Aiden's Hospital is introducing a new electronic rostering system across 12 wards. The clinical directors are sceptical, believing it will reduce flexibility. The union representatives support the principle but fear unfair shift allocation. The IT team is supportive. Ward sisters are influential informal leaders; one consultant, Dr. Varga, is highly respected and has publicly called the system 'a bureaucratic waste' in a board meeting. The project sponsor is the director of nursing, who is retiring in four months. The go-live is in ten weeks. A pilot on two wards showed rostering accuracy improved, but staff satisfaction fell slightly. The change team has mapped stakeholders by power and interest but is unsure what to do next.
1. How would you refine the stakeholder analysis beyond power and interest, and what engagement strategy would you recommend for Dr. Varga and the ward sisters?
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Add attitude, influence, impact, and coalition links to the power-interest map. Dr. Varga is high power, high influence, and negative; he is not a tick-box stakeholder. The ward sisters are high influence with frontline staff and probably neutral or anxious. For Dr. Varga, seek a private one-to-one to understand the concern behind the label. It may be loss of clinical control, safety, or workload. Share pilot evidence and involve him in defining clinical rules or exceptions. If he remains opposed, contain rather than isolate him: keep the relationship and avoid a public contest. For the ward sisters, treat them as change agents. Give them early access, a feedback role, and visible recognition. Their informal reach will do more for adoption than a formal briefing. Reassess attitudes every two weeks because the sponsor's retirement changes the political picture.
2. What would you do immediately after Dr. Varga's public challenge at the board meeting?
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Do not debate him in the moment or defend the system defensively. Acknowledge the concern, state that you will follow up, and ask him for a short meeting. After the meeting, brief the sponsor and agree who owns the relationship. In the private conversation, listen for the underlying issue: loss of control, clinical risk, or legitimate workflow concern. Share the pilot data but do not use it to win an argument. Offer a concrete involvement route, such as joining a clinical reference group or testing exception scenarios. If he declines, document the position and plan to manage the risk, not to punish him. Also ask whether his challenge reflects wider clinical director concern. A public challenge often signals a coalition, so use the follow-up to map allies and waverers before go-live.