Implementation Insights Blog

Implementation Management Associates help organizations around the world achieve large-scale, complex change. This blog discusses our insights into organizational change.

Friday, July 31, 2009

Organizational Change Management Should Be A Core Capability for Healthcare Transformation

There's a lot in the news right now about the need for healthcare transformation, both in the U.S. and the UK. While there are differences in the current state and the future vision depending on the country, healthcare transformation won't be successful without significant attention being paid to the implementation of these changes.

Naturally, there is focus on healthcare IT, including electronic medical records and other technology improvements, and attention on healthcare business process improvement, there's a lot less discussion on healthcare change management. How do you get adoption and behavior change in a complex organization structure involving nurses, physicians, technicians and a variety of healthcare professionals who have important work to do? Work disruption created by significant organizational change can impact quality of patient care, patient satisfaction, and patient outcomes.

If you are concerned about how to manage resistance to change (yes, it is inevitable) and how to accelerate healthcare business changes, you have to develop internal capability across the organization. Organizational change management consulting has to be focused not on doing it for you, but on how you can do it better for yourself.

These changes are not going to end anytime soon, so your organization best be prepared with a systematic and systemic approach for implementing healthcare transformation that can be repeated for the programmatic changes you will continue to experience. If you can unite in using a common framework like IMA's Accelerating Implementation Methodology (AIM) to build change agent capacity, if you can use a common language, and common deliverables across all the healthcare transformation changes you will gain acceleration and reduce the human casualties of organizational change.

We do have examples of success that we can point to in the healthcare environment where change management best practices have been applied. For example, in Australia, the New South Wales Health organization has been using IMA's AIM methodology for a variety of clinical transformations, including electronic medical records. IMA's role in institutionalizing the AIM methodology has been to provide organizational change management consulting focused on teaching change agents and sponsors involved in a variety of healthcare transformation activities how to tactically apply change management principles that will improve change readiness, sponsorship, communications and behavioral change reinforcements.

Healthcare transformation and organizational change management must be considered together in order to achieve implementation success and project return on investment.

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Thursday, February 12, 2009

Overcoming the Fear of Business Transformation


Two caterpillars are crawling side by side across the small open space of a home garden. A butterfly swoops down, and nearly touches them. One of the caterpillars, with a palpable sense of fear, exclaims, “You’ll never get me up in one of those things.”

This story is an analog for enterprisewide organization change. You know the type. It’s where we seek to dramatically reposition ourselves in the market place, or to revitalize our workforce, or implement culture change, or fundamentally redirect organizational strategy and resources. It’s the type of change that fully challenges our collective resilience. It’s the type of change that fails 70% of the time.[1]

It can fail because we select the wrong strategy. But that’s the exception. Business transformation changes such IT or healthcare transformation sub optimize because we simply do not execute strategy successfully. We over spend the allocated budget, or we over shoot our target end date, and/or we don’t deliver the essential functional or operational requirements that are expected. Alas, we don’t get the ROI for our time, money, and effort.

The Essential Ingredients for Successful Strategy Execution

Execution misfires because we lack the implementation structure, the leadership discipline, and the organizational courage to stay the course. Absent these three essential ingredients, our employees disengage and offer durable resistance to change. Organization transformation scares employees because they don’t know how they’ll end up, but they know they’ll be different. Just like the caterpillar they become fearful. Without an employee’s commitment to change their behavior, there is no change. Why not? Because, as almost everyone knows, all physical, financial, and intellectual assets are inert without people.

Though the odds of success are stacked against us, they are not insurmountable. The right implementation structure, one that helps ensure aligned and disciplined leadership, and the necessary employee reinforcement to motivate long term employee engagement, will beat the odds.

Implementation Management Associates, Inc. (IMA) has a developed a structured process called Accelerating Implementation Methodology (AIM). It is tactical, repeatable, business focused, and based on common sense. It includes a set of data-driven tools that measures the risks you will encounter when a business transformation initiative is launched. It also provides the architecture to develop the strategies and tactics to mitigate the complex set of implementation barriers inherent in transformational change.

AIM and Transformational Change

Just a few examples of key issues that would be considered when applying AIM and its tools to a transformational change are:

Define the Change -- who are the key stakeholders, how are they impacted, and what critical behaviors must be adopted to support business transformation?

Generate Change Sponsorship -- deploying a purposeful approach to gaining and sustaining widespread and aligned leadership commitment across the enterprise.

Develop Target Readiness -- developing a strategy to effectively manage resistance to change at all levels of the organization.

Build a Communication Plan for Transformational Change -- targeted communication that speaks directly to the various organizational frames of reference, thus enabling all employees to answer the “What’s in it for me?”, “What’s going to happen to me?” type questions more quickly.

Genuine business transformational change is profoundly difficult and complex. Its impacts are fully comprehensive. It can require strategic changes to structure, operations, and technology. Further, it typically demands changes in employee expectations, perceptions, behaviors, and/or skills. Moreover, the climate for transformational change is generally comprised of divisive politics, strong emotions, and entrenched resistance to change. This complexity can only be managed with a structured approach that purposefully provides practical and relevant implementation solutions. Absent a structured approach there will be no transformation, instead the outcome will “unrealized vision”, for as Ralph Waldo Emerson said, “Good thoughts are no better than good dreams, unless they are executed.”

[1] Beer, M., & Eisenstat, R.A. “Developing an organization capable of implementing strategy and learning.” Human Relations, V. 49, 597-619, 1966.
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