Introduction to Health Care Homes Webinar Series. Session 3: Change Management and Creating an Action Plan

Transcription

1 1 Introduction to Health Care Homes Webinar Series Session 3: Change Management and Creating an Action Plan

2 2 Presenter Danette Holznagel, RN, CDE, FCN HCH Planner, MDH

3 3 Objectives The participant will be able to describe the basic principles in change management theory. The participant will be able to give examples of technical and adaptive change in the heath care environment. The participant will name at least one strategy to support a care team in their process of change management. The participant will identify the steps to making an action plan in the Health Care Home certification process.

4 4 Agenda Change Management Basics Roadmap to Change Creating an Action Plan for HCH Implementation Q & A Wrap Up

5 5 Change Management Basics

6 6 Leading and Managing Change Consider: Technical and Adaptive change Predictability of change Skills, behaviors, beliefs, and habits Build a case for change Understand how to plan, implement, and manage change

7 Change Theory 7

8 The Non-Linear Nature of Change 8

9 9 Understanding Culture Change Technical Changes in process, procedures, tools (EMR) Requires application of capabilities that already exist in the system Sustainability Personal (Adaptive) Changes in behaviors, attitudes, and habits Need to learn new capabilities (knowledge, skills) deeply and broadly Sustainability

10 Technical Change = Process Improvement 10

11 11 How Does Change Affect People? All change is personal. Is there resistance and opposition or is there motivation and energy? Areas to consider: Resistance and opposition Motivation and energy Acceptance Ambivalence For things to change, someone somewhere has to start acting differently.

12 12 Personal Change = Transitions Escaping the gravitational pull of status quo Surviving the emotional roller coaster of transition Creating a change enabling structure

13 13 Status Quo The pace of change Faster they can influence the change Slower tend to become victims of the change

14 14 Essence of Transitions Transition is a journey.

15 15 What about resistance? Resistance occurs because people are being asked to: Change habits, behaviors, beliefs Experience loss and uncertainty Resistance is a natural, inevitable response, whether the change is positive or negative. Resistance is a process and must be managed not combated, solved, or overcome.

16 16 A Change Enabling Structure = Change Management Build a case for change Foster the understanding of change Clarify your expectations Anticipate some change pain Surface resistance early and constructively Celebrate your efforts!

17 The Change Roadmap 17

18 18 The Change Roadmap: Five Key Questions 1. What is the change? 2. How do we organize to manage (lead/support) this change? 3. Who (and what) will be affected by the change, and how? 4. What are the supports needed from here to there? 5. How do we navigate along the way?

19 Identify the change Select a change project Define the change Where do we want to be? (behaviors, habits, skills) Where are we now? (current state) What is the gap? What needs to be done to get to the future state? Build the measures from the driving factors and the triggers supported by the philosophy.

20 Build a Case for Change Answer these 3 questions What is changing? What are the benefits of changing? What are the costs of not being successful at this change? Create a case for the change, from an organizational perspective, then customize for each level. CASCADE the business case

21 Organize to manage change Establish key change roles and change management infrastructure Assess readiness for change

22 Cast of Characters 22

23 The Impact of Change Determine the impact of the change: On the work On the people On the formal and informal organizational structures Consider: What is affected? To what extent?

24 Leverage the change Identify the support needed: Communication Education/Training Reinforcement (Recognition and Rewards) Personal Support

25 Communication in the midst of change Provide individuals with information they need: Awareness Knowledge Action Engage the heart (stories) Engagement /feedback

26 Support systems to sustain the change Training Strategies Knowledge, skills, tools for success Nurture until outcomes achieved Reinforcement Strategies Recognition and Rewards Personal Support Stages of transition Resistance Make it easy to do the right things and hard to do the wrong things

27 Navigate the change path Utilize business case to motivate and provide sense of urgency Identify a clear, commonly held vision of the present state and the future state Use the identified structures, roles, reinforcements, and measurement system to manage the change Celebrate milestones! MP05

28 How Will We Navigate Along the Way? (Continued) Ask, What are we learning from our experiences? Use to understand and modify behaviors, habits, outcomes Questions to guide learning: What did we set out to do? (Outcome or goal) What did we expect would happen? Why? What actually happened? Why? What did we learn?

29 Implementation: Critical Success Factors

30 Resource List Switch - How to Change Things When Change is Hard By Dan and Chip Heath Broadway Books, 2010 Influencer - The Power to Change Anything By Kerry Paterson, et.al, McGraw Hill, 2008 Leadership on the Line By Ronald A Heifetz and Marty Linsky, Harvard Business School Press, 2002 Organizational Change: Theory and Practice By W. Warner Burke, Sage Publications, 2008 Managing Transitions By William Bridges, Da Capo Press, 2003 The Transtheoretical model of health behavior change Prochaska, JO; Velicer, WFAm J Health Promot 1997 Sep Oct;12(1): Motivational Interviewing, Third Edition: Helping People Change Miller William R., Rollnick S 2013 Guilard Press Model for Improvement:

31 31 Creating an Action Plan for HCH Implementation

32 32 Creating an Action Plan for HCH Implementation points 1. Conduct a gap analysis using the HCH certification selfassessment tool. Break the tool into standards and evaluate each criteria Keep in mind that innovation is our transformation goal and the HCH standards/criteria are a road map There are many ways to show and verify that you have implemented the standard/criteria. 2. Identify key people that should be involved in the implementation and transformation. Don t forget a new source of energy = your patients 3. Review your HCH self-assessment results with your team.

33 33 Creating an Action Plan- Links

34 Creating an Action Plan-Assess 34

35 35 Creating an Action Plan-the standards 4. Discuss differences and similarities between the intent of the standards/criteria *portal screen print

36 36 Creating an Action Plan 5. Identify gaps in performance - look at your gaps and brainstorm: Opportunities Barriers and challenges What can we do to overcome the barriers? What are the steps to get there? Who needs to buy in and how do we get them onboard?

37 37 Creating an Action Plan- Process 6. Small Steps 7. Ask the questions that anticipate the challenges? pushback? (low-hanging fruit)? What do we already have in place? Tools/Technology? Cost? Other competing initiatives/work? Education? Training?

38 38 Creating an Action Plan-Actionable Goals 8. Agree to a goal, or a few goals, to get started. Take measureable, achievable steps. 9. Agree on your achievable and ideal state. 10. Start a list of action items

39 39 Creating an Action Plan -Communication 11. Report findings to the group, then post the plan! 12. Re-visit your Action Plan at intervals to evaluate progress and set new goals. 13. Celebrate those small steps of change along the way! 14. Update your certification assessment tool along the way too!

40 Questions?

41 41 Introduction to Health Care Homes Webinar Series Schedule Webinar Topic Date 1 The Business Case for HCH Overview of HCH standards August 1, Patient- and Family-Centered Care August 29, Change Management Getting Started on HCH Implementation 4 Quality Improvement Engaging in Culture Change September 26, 2013 October 31, 2013