Change Management: Increasing Your Odds for Success March 4, 2016

Transcription

1 Change Management: Increasing Your Odds for Success March 4, 2016 Larry Dux, CPHIMS, FHIMSS, DSHS. Director of Patient Care Informatics & Process Improvement, Froedtert Health and The Medical College of Wisconsin Community Memorial Hospital Jean Ann Larson, FACHE, LFHIMSS, DSHS, CEO and Principal, Jean Ann Larson & Associates

2 Conflict of Interest Larry Dux, BSIE, MBA Jean Ann Larson, BSIE, MBA, EDOC Have no real or apparent conflicts of interest to report.

3 Agenda Overview of change and why it is getting tougher Overview of how change impacts us as individuals Discussion of the impact of change on organizations What does this mean to change management? Impacts Use of Models: ADKAR Kotter Lewin, others An overview of common challenges and obstacles with EHR and other technology enabled implementations How to avoid being one of the 70% who fail at change implementation Best practices Lessons Learned Q&A

4 Learning Objectives Explain key change management concepts at an individual and organizational level Describe the common barriers and obstacles that can occur when implementing an EHR Develop and apply change management strategies and tactics to all projects Recognize the importance of creating a change management plan and lessons learned

5 STEPS: Satisfaction SJH Physicians Engagement Hospital Alignment 3.43 March, 2012 SJH Physicians Engagement Hospital Alignment 3.71 March 2014 National Ave 2013 (3.52)

6 STEPS: Satisfaction SJH Physicians Engagement - Clinic Work Life Balance 3.62 March, 2012 SJH Physicians Engagement Clinic Work Life Balance 3.91 March 2014 National Ave 2013 (3.63)

7 As A Critical Skill The ability to successfully manage change has become one of the most important skills needed for personal happiness, the prosperity of organizations, and the health of the planet. Daryl R. Conner, Managing at the Speed of Change

8 Change Management in The Headlines. CHIME 2015 Fall Forum: CIOs as Change Agents Going Into the Future CIO and c-suite survey results Tim Zoph stated that both CIOs and other c-suite executives agreed that CIOs need to be change agents within their organizations and c-suite executives especially perceived more than CIOs themselves did that CIOs will need to be emerging technology innovators, moving their organizations forward via technology Healthcare Informatics, Nov/Dec 2015 Vol. 32 No.6 pages 36-37

9 Change Management in The Headlines. CHIME 2015 Fall Forum: CIOs as Change Agents Going Into the Future CIO and c-suite survey results Donna Roach noted that non-cio leaders are looking for the CIO to be a change agent, creating strong personal networks, and making sure that those networks are used effectively, including knowing if someone is a resister or fence-sitter in an organization. Healthcare Informatics, Nov/Dec 2015 Vol. 32 No.6 pages 36-37

10 Change Management in The Headlines. CHIME 2015 Fall Forum: CIOs as Change Agents Going Into the Future The top leadership attributes included in the survey change management (the ability to manage, lead and achieve results in a constantly shifting healthcare environment) emerging technology and innovation (as stated above, the capability of CIOs to become true leaders in proactively pushing their organizations to adopt technologies that will transform healthcare) Healthcare Informatics, Nov/Dec 2015 Vol. 32 No.6 pages 36-37

11 Change has Changed! The components of change have changed Volume - the number of changes we have to face is greater today than ever before Momentum - the time in which change must be implemented and the time before another change becomes necessary is rapidly decreasing Complexity - the complexity of changes today is far greater than in years past

12 The Basic Axiom of Change: Whether we are conscious of it or not, our lives are the most effective and efficient when we are moving at a speed that allows us to appropriately assimilate the changes we face. This is not just the velocity at which things around us are changing, but the pace at which we can recover from disrupted expectations. Daryl R. Conner, Managing at the Speed of Change

13 Contributing Factors Seven (at least!) factors cause a dramatic increase in the magnitude of change: Faster communications and knowledge acquisition A growing world-wide population Increasing interdependence and competition Limited resources Diversifying (polarizing?) political and religious ideologies Constant transitions of power Ecological distress Increasing and sometimes overly simplistic regulatory approaches Others?

14 Types of Change Changes in mission, mandate, or strategy Changes in organizational structure Changes in levels of staffing - either growth or reduction in employment Changes in attitudes and behaviors - often referred to as culture The adoption of new methods and procedures The introduction of new technology, tools, equipment, and facilities Changes in relationships with stakeholders For us in healthcare: Changes in regulations and reimbursement which may change all of the above

15 Change Management in The Headlines. The healthcare industry is accelerating its pace of change. It feels very frenetic today, but its going to be even more frenetic. -Tim Zoph Healthcare Informatics, Nov/Dec 2015 Vol. 32 No.6 pages 36-37

16 Lessons Regarding the Personal Experience of Change Change triggers our emotions Change is stressful We hate the loss of control and uncertainty It takes time to adapt Although we seek positive change, we object to being changed But, you must transition in order to learn and grow 17

17 If you want to understand something, try to change it. -- Edgar Schein 18

18 Change vs. Transition Change is what happens to us - It is external to us Transition is internal It is how we react to change The trick is to harness change and transition in order to learn, grow and reap the positive benefits of the many changes that will happen to us

19 Phases of Personal Change Endings Letting go of the past Transition Searching for a new direction Beginnings Setting off in the new direction Anger Denial Grieving Sense of Loss Uncertainty Disorientation Anxiety Self-doubt Anticipation Excitement Energy Enthusiasm

20 21 Moving From the Comfort Zone Requires Effort EFFORT The Comfort Zone EFFORT Endings New Beginnings

21 It Starts With You!

22 23 The Good, the Bad and the Ugly List Your Negative Reactions to Change List Your Positive Reactions to Change

23 What Does Change Represent to People? Competence Confidence Status Quo = Expectations Met Change = Disruptions in Expectations Comfort Control

24 Discussion Questions How do you believe you feel about change compared to your colleagues? Family members? Are you more open to change in your life than others are? Or less so? Is your openness to change different in your professional life versus your personal life? Why or why not?

25 Possible Reactions to Change Negative Reactions Positive Reactions A sense of loss Threat to job security, satisfaction, prospects Fear of loss of control Uncertainty, insecurity Mistrust of management motives Expectation that this too will pass Perceived flaws in the approach Opportunity to make a difference Buy-in to the goal Challenge Prospect of personal benefit (e.g. job satisfaction) Dissatisfaction with the status quo

26 Lessons Regarding the Personal Experience of Change Adaptation to change is not automatic The internal process is not synchronized with external events Dealing with resistance versus helping people through change

27 Organizational Change: Froedtert & The Medical College of Wisconsin Hospitals (FMLH,CMH) Initial Start of transition to EHR 5 Separate Medical Clinic / Physician Practice Groups 2 on primary EHR 3 on separate EHR 250 separate voice recognition Hospitals (FMLH,CMH,SJH) EHR fully implemented 2 - Transition from paper to EHR 1 - Transition from EHR to EHR 2 Medical / Physician Practice Groups 2 Medical College and Community Physician groups both on the same primary HER 1 group transitioning practice Enterprise Voice Recognition System

28 Models for Change Models for change: ADKAR Kotter Lewin, Bridges and Other Why a model? Proven Good check list Lessons learned from others are built in

29 So why don t we want to change? Faced with the choice between changing one s mind and proving that there is no need to do so, almost everybody gets busy on the proof. - John Kenneth Galbraith

30 Resistance Highly emotional responses are common Anger Complaining Depression Disruptive Behavior Insecurity Self doubt Drop in energy level Difficulty focusing Cynicism about the future

31 Understanding Resistance Resistance is actually healthy; try not to react against it defensively. It is good for you: it makes you check your assumptions. It forces you to clarify what you are doing.

32 Application to EHR Implementation and Other Technology Enabled Initiatives Identify key individuals/informal leaders across the enterprise who could be strong supporters and early adopters Encourage the individuals who state they have prior experience but be aware that unlearning and relearning can be challenging Develop tactics to engage these individuals via workflow reviews, feasibility testing, quality testing, pilot training sessions, etc. and to take ownership of the change Identify those individuals who might experience significant challenges and pose potential risks to the project and organization Assess the underlying reasons or causes for their challenges (skill vs. will matrix) Develop tactics and specific strategies to provide learning opportunities and support for these individuals customize the approach to the individual

33 Best Practices Engage the key individuals/informal leaders from the very start of the project no exceptions ever! Listen, Listen, Listen this must always come first Communicate, Communicate, Communicate this increases in proportion to the complexity of the technology and/or the organizational structure Build awareness, educate, train, provide practice opportunities and provide pre go-live support Engage, inform and educate organizational leadership and garner their support and visibility Provide go-live support at the elbow Establish ground rules and consequences for inappropriate behaviors and actions

34 Overcoming Resistance Two Keys To Overcome Resistance Yes you can expect resistance to occur A free exchange of information and discussion about change will ensure minimal resistance to change initiatives. Knowledge and understanding of how resistance is born will allow for preparations to avoid or, at least, reduce resistance.

35 Strategies for Helping People Through Change Communicate the need for change - people are not in the market for solutions until they recognize that there is a problem Honor the past Identify what will NOT change Enable people to plan their own journey Ensure intensive, ongoing two-way communications Identify losses and seek to compensate Provide moral support Provide practical support

36 Lessons Learned Change is personal Each initiative is unique Maintain a can do attitude and approach Build relationships and networks Collaborate Communicate Have fun enjoy the ride!!

37 STEPS: Satisfaction SJH Physicians Engagement Hospital Alignment 3.43 March, 2012 SJH Physicians Engagement Hospital Alignment 3.71 March 2014 National Ave 2013 (3.52)

38 STEPS: Satisfaction SJH Physicians Engagement - Clinic Work Life Balance 3.62 March, 2012 SJH Physicians Engagement Clinic Work Life Balance 3.91 March 2014 National Ave 2013 (3.63)

39 Larry Dux, CPHIMS, FHIMSS, DSHS Larry Dux is the Director of Patient Care Informatics & Process Improvement at Froedtert & the Medical College of Wisconsin Community Hospital Division He holds a Bachelor of Science Degree in Industrial Engineering and a Masters in Business Administration from the University of Wisconsin- Madison. He is a Senior Member of the Institute of Industrial Engineers and a Diplomate of the Society for Health Systems, a Senior Member of the American Society for Quality, and a Fellow/CPHIMS member of the Healthcare Information and Management Systems Society. Lawrence (Larry) E. Dux Froedtert & the Medical College of Wisconsin Community Hospital Division W180 N8085 Town Hall Road Menomonee Falls, WI Phone larry.dux@froedtert.com

40 Dr. Jean Ann Larson, FHIMSS, FACHE, DSHS Jean Ann has over 25 years of experience as a healthcare executive. She has led organizational, professional and business transformations serving as an internal process engineer and consultant, a change agent, Vice President of Clinical Quality and Safety and Chief Learning Officer founding an award winning and respected Corporate university. She also served as a Senior Executive of two large healthcare organizations where she has led the functions of organizational effectiveness, process improvement, executive development, talent management, team building, employee engagement, accreditation, care management, quality and patient safety, as well as several clinical areas. She currently heads up her own consulting firm where she partners with health care organizations, executive teams, business owners, leaders and individuals to help them become more productive while helping them build their leadership capabilities and bring results-oriented strategic change into their organizations. She serves as faculty for SMU s Cox School of Business Executive Education Program. She has a BS in Industrial Engineering, an MBA and a doctorate in organization change from Pepperdine University. She is a Fellow with the American College of Healthcare Executives and a senior member of the Institute of Industrial Engineers. She is a Past-President and Diplomate of the Society for Health Systems of the Institute for Industrial Engineering and a past Vice-Chair of HIMSS. In 2014 she received the SHS/HIMSS Excellence in Healthcare Management Engineering/Process Improvement Award. She is editor of Management Engineering: A Guide to Best Practices for Industrial Engineers in Health Care and her most recent book is Organizational and Process Reengineering: Approaches for Health Care Transformation. Cultural Transformation Through Strategic Change and Leadership jeanann@jalarson.net