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Sustainable Change through a Generational Workforce

The challenge of sustainable change is the continuation of the work in a generational workforce after the initial enthusiasm has dissipated.

To achieve sustainable change, quality improvement initiatives must be a continuous way of work. Sustainability refers to maintaining the success you’ve had during an improvement project, even in the face of adversity, lack of resources, staff and organizational turnover. The challenge is not at the onset of a quality improvement initiative, but rather the continuation of the work after the initial enthusiasm has dissipated. Quality improvement requires a significant investment in time and effort to achieve results and will succeed only if the same enthusiasm is applied to project sustainability.


To sustain improvement initiatives, use process and performance boards, standard work, and improvement huddles to help continue your project. Process and performance boards rely on the principles of visual management, which should provide simple communication so staff can easily understand and rapidly identify normal from abnormal performance. Standard work is a written/visual outline of best practices for a task (i.e. cleaning robotic arms or assembly loaner trays which will provide a framework for consistency). Improvement huddles are regular meetings with your staff to review performance boards and support a culture of improvement. These tactics encourage sustainable change.


Even when quality improvement methods are applied properly, the success of sustainable change depends largely on leadership and the staff generational experiences. Understanding how the generations accept change is at best a challenge for leaders since reaction to change differs. The acceptance of change and the willingness to embrace and sustain it is largely dependent on the experiences that employees have had in the past. No one generation is more or less likely to resist change and it’s fair to anticipate resisters to change from all generations.


According to author Jeanne Meister, author of the book The 2020 Workplace, she states that in the year 2020, five generations will be working together. Traditionalists (1900-1945), Boomers (1946-1964), Gen X (1965-1976), Millennials (1977-1997), and Gen 2020 (1997-present). Traditionalist – value Respect, Loyalty, Security, Obedience; Boomers value Competition, Achievement, Power, Ambition; Gen X’ers value Balance, Freedom, Independence, Leadership; and, Millennials value Flexibility, Security, Opportunities, Challenges.


Baby Boomers tend to be cautious of change. Their reluctance isn’t a result of not wanting to seek improvements, but as a result of the fact that many Baby Boomers lost their jobs during the recessions of the ‘80s and ‘90s, which made them wary of broad organizational changes. They also had to endure “flavor of the month” leadership changes and shifts back-and-forth in strategy which translated into a lack of enthusiasm for new changes. In principle, Baby Boomer employees may not resist the change, but they may be less excited about it than younger generations if they believe that it will be short lived.


Gen X is skeptical of leaders’ motivations and intentions when implementing change. They want to know the benefits of change, most notably to them, and what they will gain by adopting a new approach. Resistance occurs if they believe the change will hinder their ability to achieve results. If involved in the planning process, Gen-Xers will focus on setting targets for how performance can increase as a result of the change.


Millennials have grown up in a world where change is constant and where technology changes every 3-6 months. This has translated into a culture where millennial employees expect organizational change to occur quickly and frequently. Resistance to change happens if the initiative is entirely driven from the top or if there is a sense that the change is too minor and insignificant to make an impact.


Leaders should keep two concepts in mind when creating a plan to manage a multigenerational workforce; honor each generation’s unique contributions while focusing on their similarities. Encourage generations to work together and encourage knowledge sharing. Build diverse teams of all ages, gender, and cultures. These teams will learn to value and trust each other. Encourage leaders to be flexible in their management styles. Some generations want hands-off leaders, others want a more involved management style. Respecting their styles will help to create sustainable change.


Need to catch up on any PROCESS PRO articles you’ve missed? Click HERE.



  • Factors Affecting the Leadership of Process Improvement Teams in Sterile Processing By: Cory S. Nestman, BS, MS, CRCST, ACE CS Nestman, ACE CRCST – 2012 –
  • Managing change spanning generations: Enabling multi-generational collaboration and workforce transition, Abhipsa Mishra Consultant – Change Catalyst, OCM Practice, LTI,
  • Organisational Change: Generational Differences in Reaction and Commitment, Iveta Ludviga1, Irina Senņikova2, Business Department, RISEBA University, Meza 3, Riga, Latvia
  • How to Sustain Change and Support Continuous Quality Improvement, Samuel A. Silver, Rory McQuillan, Ziv Harel, et al., Clin J Am Soc Nephrol. 2016 May 6; 11(5): 916–924. Published online 2016 Mar 25. doi: 10.2215/CJN.11501015

Mark Dimengo, RN, MPA/HCA – Principle Consultant

Mark has been working at STERIS as Principal Consultant almost 3 years. As a results-oriented surgical/SPD consultant, he has over 30 years of experience and proven success toward implementing cost-containment strategies and increasing quality and customer satisfaction. His primary areas of concentration are Surgical Services Operations and Anesthesia Service Assessments. His success is a result of working collaboratively with cross-functional teams to provide implementation support for cost savings and process improvement solutions to individual hospitals, hospital networks and ambulatory surgery centers.