By Keith Bresciani, for SCM Professionals

In healthcare operations, one phrase gets used far too often when a project hits friction:

“They’re just resistant to change.”

It usually comes up when staff push back, workflows stall, compliance becomes inconsistent, or adoption falls short of expectations. In the moment, that explanation may feel convenient. But it is rarely the full story.

What leaders often label as “resistance” may be something much more important.

• It may be confusion.
• It may be changing fatigue.
• It may be fear of unintended consequences.
• It may be a trust issue created by past initiatives that failed to account for frontline realities.

Sometimes, what looks like resistance is simply a signal that says:

Slow down. You missed something.

For supply chain reform to succeed, leaders must stop treating pushback as defiance and start treating it as data.

What Pushback Really Looks Like

Resistance is not always loud or obvious. In many cases, it does not show up as a direct “no.”

More often, it appears through quiet behaviors that signal misalignment beneath the surface:

• Workarounds that bypass the new process
• Slow or uneven adoption
• Inconsistent compliance
• Negative hallway conversations
• Passive disengagement
• Staff reverting to old habits under pressure

When leaders see these behaviors, the instinct is often to respond with more training, more reminders, more pressure, or stronger enforcement.

But that approach can make the problem worse.

People do not usually resist change simply because it is new. They resist change they do not understand, change they do not trust, or change they were never meaningfully included in shaping.

That distinction matters.

A Lesson from the Field

At one health system, a revised PAR level strategy was introduced to reduce excess inventory and improve supply turns. On paper, the logic was sound. The data supported the change. The operational case made sense.

But within a week, nurses began hoarding key supplies in lockers and drawers. Some bypassed the supply room entirely.

At first glance, it looked like defiance.

But once the team paused and asked questions, the real issue became clear. The nurses were not trying to undermine the process. They were reacting to previous backorders and supply disruptions. They did not trust that the new model would keep up with patient care demand.

To them, the change felt like another efficiency initiative that did not fully account for the pressure they faced on the floor.

So, the approach changed.

Nurse managers were brought into the design conversation. The strategy was piloted on one unit before expanding further. Replenishment windows were aligned more closely with rounding schedules.

The team adjusted the rollout around the clinical workflow instead of expecting the clinical workflow to bend around the rollout.

The behavior shifted.

Not because compliance was forced, but because trust was earned.

Why Leaders Misread Pushback

Supply chain reform often fails when leaders confuse implementation with alignment.

A process can be technically correct and still fail operationally if the people expected to execute it do not understand it, trust it, or see how it supports their work.

There are several common traps.

Assuming training equals buy-in

Just because someone attended a meeting or completed training does not mean they understand the purpose behind the change. Awareness is not the same as ownership.

Underestimating past experience

Previous failed rollouts leave a mark. If staff have seen similar initiatives create more work, more confusion, or more risk, they will naturally be skeptical the next time.

Confusing silence with agreement

A quiet room does not always mean support. It may mean people are disengaged, unsure, or unwilling to speak up because they do not believe their feedback will matter.

Treating launch as the finish line

A rollout is not the end of change management. It is the beginning. People need time to process, test, react, question, and adapt.

How to Respond Differently

When pushback appears, the best leaders do not immediately defend the plan. They investigate the signal.

Start by asking better questions.

“What is not working for you?”
“What concerns you about this process?”
“Where does this create friction in the workflow?”
“What are we not seeing from your side?”

Those questions will reveal more than another compliance report ever will.

From there, leaders should work to identify the root cause. Is the issue a workflow problem? A communication gap? A lack of trust? A staffing constraint? A technology limitation? Until the real issue is identified, the response will likely miss the mark.

It is also important to validate the feedback. Validation does not mean every concern can be solved exactly as requested. It means people know they were heard and that their input was taken seriously.

Then reconnect the team to the “why.” Staff are more likely to support change when they understand how it connects to outcomes they care about: patient care, staff safety, time savings, reliability, reduced waste, or fewer supply disruptions.

Finally, be willing to adapt the rollout.

A solution that is 90% perfect but fits the workflow will almost always outperform a 100% perfect model that no one uses.

The Real Opportunity

Labeling something as resistance ends the conversation.

Listening to it opens the door.

Every supply chain reform effort will meet friction. That is normal. The real test is how leaders respond to it.

If pushback is treated as defiance, organizations miss the opportunity to build real alignment. But when pushback is treated as information, teams can adjust faster, communicate better, and create solutions that hold up under real-world conditions.

The strongest changes do not require constant pressure.

They create momentum because people understand them, trust them, and see their role in making them work.

Field Note

The best advice I ever received from a nursing director was simple:

“Don’t mistake quiet faces for approval.”

That reminder has shaped how I approach every change effort since.

People want to be heard. When leaders listen first, they usually do not have to push nearly as hard.