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2014 © ACMP All Rights Reserved | #acmp2014

IT STARTS AT THE TOP:

BUILDING CHANGE CAPABILITY AT HOUSTON METHODIST

Amber Rabo, PhD, SPHR Director, OD and Training

Houston Methodist

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OBJECTIVES

•  Discuss the “change management strategy” behind introducing change management to HM leaders.

•  Describe the top-‐down HM training strategy and how it’s leading to change management application on major internal initiatives such as ERP implementation, ICD10, and system efUiciency projects.

•  Review the impact of change management at HM to date and next steps as it evolves into an enterprise leadership capability.

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ABOUT HOUSTON METHODIST •  A faith-‐based, nonproUit health care organization formed in 1919 •  Extremely values-‐drive ICARE culture (Integrity, Compassion, Accountability, Respect, Excellence)

•  17,000 employees, 98th %ile ranking in engagement by Press Ganey •  Fortune Best Place to Work for 9 years running and the only hospital

system ranked in Texas •  Nationally ranked in 12 of 16 adult specialties, #1 in Texas, and #1 in

Houston by US News and World Reports •  Academically afUiliated with Weill Cornell Medical College •  Comprised of:

–  6 hospitals, 1 Long term acute care facility –  Houston Methodist Research Institute –  Houston Methodist Global Consulting Services –  Houston Methodist Primary Care Group, Houston Methodist Specialty Physicians Group

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VIDEO


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BUSINESS CASE

•  Healthcare reform •  Change as a leadership competency •  ERP Implementation

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CHANGE MANAGEMENT STRATEGY FOR CHANGE MANAGEMENT

Prosci’s Project Change Triangle (PCT)Copyright Prosci 2009.

© Prosci 2013. PCT is a trademark of Prosci. All rights reserved.

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PROSCI’S CHANGE MANAGEMENT PROCESS

Prosci Change Management ProcessInput:

A change to how the organization operates and does work

Output:

Individuals making changes to how they do work – from their own current state to their own future state Benefits to the organization realized

ICD -‐‑ 10

LOS initiatives

Efficiency Efforts

System Integration Initiatives

Peoplesoft Implementation


Re-‐organiza@ons

EPIC

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•  Understanding the nature of the change

•  Understanding the groups being changed

•  Creating the right sponsor model

•  Identifying risks

•  Developing special tactics

PHASE 1 – PREPARING FOR CHANGE


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•  Communication plan

•  Sponsor roadmap •  Training plan •  Coaching plan •  Resistance management plan

PHASE 2 – MANAGING CHANGE


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CHANGE MANAGEMENT TRAINING STRATEGY •  HR and OD Practitioners •  Community Hospital Executive Sponsorship* •  System Executive Sponsorship* •  Internal Practitioners: IT Directors (including PMO) •  Coaching for Nursing, etc. •  Executive Change/Strategy Retreat •  Employee Pilots

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BUILDING ABILITY Prosci Training Impact in 2013 Total Attendees

3 Day CertiUication 89 1 Day Management Coaching Workshop 232 Executive Sponsorship (4-‐6 Hrs) 18 1 Day Employee Change Management 0

ADKAR Overview (1 Hour) 215 Coaching Employees Through Change (1 Hr) 55 ADKAR E-‐Learning 46

Additional Change Training -‐ Prior to 2013 Total Attendees 2014 (to date) 64

2012 195 2011 0 2010 21 2009 19

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BUILDING AGILITY Count of Participants

Count of Evaluations

Average Overall Evaluation Rating

Practitioner CertiGication 89 67 2.87/3.00 Coaching Workshop 232 147 2.93/3.00

Overall Comments Great course, incredible amount of information but all valuable. I have learned a ton that I can apply to my projects and team immediately. Best Class I've had in quite a while; adds so much to the PM's toolkit. Thank you. Great initiative for the organization especially with so many change events under way and in the future. This training has be superbly facilitated. Although we are committed to excellence, we need change management I have never found a class to Uly by so quickly as this one. I've never been so absolutely engaged. The class was very informative and contained some great information. My hope is that the institution will all be on board Course is a bit too long

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•  Compliance audits and employee feedback

•  Corrective action and managing resistance

•  After action review and transition management

PHASE 3 – REINFORCING CHANGE


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IMPACT

System Scenario: MARS Phase

I and II

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MARS PHASE I: AAR What went well? •  Teamwork/Collaboration (Sponsor roadmap) •  On time delivery (Project plan) •  Basic functionality in place (Project plan) •  Stayed “vanilla” (Project plan)

What could have gone better? •  Training (Training plan) •  Resourcing (Project plan) •  Communication (Communication plan) •  Operating Room (OR) Adoption (Resistance plan)

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MARS PHASE II: CHANGE STRATEGIES AND COMMUNICATIONS OD Consultant Change Management Responsibilities: •  70% completion of monthly change strategy meetings with client HRDs •  85% completion of resistance groups identiUication and

implementation of mitigation strategies •  82% of leaders trained in change management Communications/Technical Training: •  88% completion of bimonthly meetings between OD and MARS

communication teams •  12% increase in communications (presentations, emails, Ulyers,

webpages, etc.) •  68% increase in participation in technical training

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MARS PHASE II GO LIVE

MARS Phase I: 2.82 ticket average per employee with access in Uirst 2 weeks of go-‐live

0 1000 2000 3000 4000 5000 6000 7000

0 50

100 150 200 250 300 350

5-‐Au

g 7-‐Au

g 9-‐Au

g 11

-‐Aug

13

-‐Aug

15

-‐Aug

17

-‐Aug

19

-‐Aug

21

-‐Aug

23

-‐Aug

25

-‐Aug

27

-‐Aug

29

-‐Aug

31

-‐Aug

2-‐Se

p 4-‐Se

p 6-‐Se

p 8-‐Se

p 10

-‐Sep

12

-‐Sep

14

-‐Sep

16

-‐Sep

18

-‐Sep

20

-‐Sep

22

-‐Sep

Daily

Uniqu

e Lo

gins

Daily

Ticke

t Cou

nt

MARS Ticket Trend

New Tickets Closed Tickets Open Cum Daily Logins

MARS Phase II: 0.25 ticket average per employee with access in Uirst 2 weeks of go-‐live

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MARS PHASE II: AAR What went well? •  Teamwork/Collaboration (Sponsor roadmap) •  Basic functionality in place (Project plan) •  HR-‐owned change strategy (Change plan) •  Go-‐live had minimal issues (All)

What could have gone better? •  Implementation consulting partner (Project plan) •  Timing of training (Training plan) •  Vanilla implementation limited capability (Project plan) •  More audience-‐speciUic communication (Communication plan)

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IMPACT

Individual Scenarios

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IMPACT

17%

49%

80%

95%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Poor(n=177)

Fair(n=441)

Good(n=561)

Excellent(n=107)

Perc

ent o

f res

pond

ents

that

met

or

exc

eede

d pr

ojec

t obj

ectiv

es

Overall effectiveness of change management program

Correlation of change management effectiveness to meeting project objectives

*Data from 2007, 2009 and 2011

© Prosci. From Prosci’s 2012 Best Practices in Change Management benchmarking report

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WHAT WE’VE LEARNED….


Jan Feb March April May June July August Sept Oct Nov Dec

2013

2014

2015

System Change Calendar

Project Readiness (Huron)

MIDAS

Biometrics/Open Enrollment

Unknown: St. Luke’s Merger

Staff FPR

EOS

ICD-‐10 TransiYon

MARS Phase II

Budget/2014 Planning

ICD-‐10 PreparaYon

Talent Management

Brand/Logo ImplementaYon

Methodist Experience

Kronos Workforce AnalyYcs

Windows 7 Rollout

Mgmt FPR

FoundaYon Campaign

Fortune Prep and Survey

Mgmt FPR Nursing FPR

EOS Pulse EOS Pulse

Flu Campaign

System IntegraYon (GE Conversion, Pharmacy, Lab, etc.)

IT System of the Future

IT System of the Future

Physician OrganizaYon Expansion MPCG

ONTRAC

AccreditaYon PreparaYons: DNV, Magnet, Pathways, Stroke, ISO, Radiology, etc.

Teletracking

PolicyTech/Document Control

MethOD ConYnuous Quality Improvement PaYent Registry

MethodistHealth.com

Service Line Strategic Planning and ExecuYon

System IntegraYon

St. Lukes ExploraYon/ Expansion Plans

RI IAM


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Immobilization

Exploration Self Doubt

Denial Anger

Begin New Process

Productivity Level

End of Old Process

Transition Period

A/D Give Information Facts, explanations, examples (who, what, when, why, how) Sell beneUits (WIIFM)

K/A provide Support/ Empathy/Training Listen reUlectively, acknowledge emotion, show acceptance. Provide alternative learning approaches

R Provide Inspiration Recognition/reinforcement, encouragement, reminders about beneUits, communicate and emphasize achievements

Acceptance

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WHAT WE’VE LEARNED

Executives

Managers Employees

Time of Change Implementation

Self Esteem, Ability to Cope, Productivity

NOT EVERYONE EXPERIENCES SAME THING AT THE SAME TIME

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WHAT WE’VE LEARNED, CONT. 1.  Change is painful

–  Larger the change, larger the impact

2.  Change creates resistance –  Reduced productivity and loss of good people

3.  Resistance patterns are predictable –  Create a comprehensive change plan to minimize performance dip

4.  You get what you manage!

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WHAT NOW? •  Department re-‐organization to include functional

change group and an additional Sr. ODC •  EPIC Implementation •  Joint Venture with Christus Health to include

addition of 2 hospitals •  Community Hospital CEO mandating change

management plan for all entity projects •  How about YOU?????


QUESTIONS?

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