Everyone likes progress but no one likes change
Everyone likes progress but no one likes change Organizational change and Project Management: The relationship between large organizational change and project management Cheryl Glasscock, RHIA, PMP cheryl. glasscock@childrensal. org Senior Program Manager Children’s of Alabama
Topics for Discussion • Change at Children’s of Alabama in 2012 • What is Change Management? • Why is it important to Project Management? • Who is responsible Change Management? • Ways to incorporate it into your next project
About Children’s of Alabama • • Established in 1911 Licensed for 332 beds + 48 NICU Bassinets 4, 200 + employees In 2011 – 13, 904 inpatient discharges – 658, 919 outpatient visits – 56, 028 emergency department visits – 21, 420 surgeries
CHANGE IN 2012 So how big was the change at COA in 2012?
Pediatric Campus Impact Licensed Beds NICU Bassinets Acute Care Room Size ICU Room Configuration Emergency Exam Rooms Operating Rooms CV Operating Rooms Cath/EP/IR Labs 2011 2012 Pre-Expansion 275 42 145 -281 sq ft Open Bays 35 12 0 0 Post-Expansion 332 48 315 sq ft Private Rooms 53 17 2 3
1 Q 12 2 Q 12 3 Q 12 4 Q 12 Alaris Smart. Pump Upgrade 3 M v 7. 0 Upgrade i. Connect CPOE Pilot Get. Well for Expansion Facility Health Image Exchange Am. Com Upgrade i. Connect Medication Build Voalte with Alerts Physician Documentation Cardiology PACS Soarian Scheduling, Reg. and Billing Refrigerator Monitoring N-Centaurus Chart. Maxx v 5. 6 Upgrade Soarian Decision Support SIS for CV Surgery PACS Storage Expansion (EMC) Get. Well Pilot Synchronized Clocks Application Retrofit for Expansion Pharmacy Tracker Board i. Connect Critical Care Doc. QVoice Dictation Upgrade Workstations and Printers Pill. Cam Upgrade Lab Results Interface to SIS DAS CCU (Telemetry) SIS v 5. 0. 4 Upgrade Pyxis Upgrade Pro. Car 4000 Nurse Call SIS Anesthesia syngo Workflow v 32 Upgrade See My Radiology Overhead Paging SIS Analytics SIS v 5. 0. 5 a Upgrade Data Network i. RISecure Tissue Tracking Surgery Tracker Board Cisco Phones Logician Server Replacement Voalte Pilot Wireless Network Proventix Hand Washing Pilot ISISPro Tracker Board SENSIS Implementation Doctor Master Integration from ECHO RTLS (Asset Tracking) Move into Expansion Facility i. Connect Assessments & Interventions with MPV Cardiology move to COA i. Connect CPOE 2012 Projects Surgery Mobile App RIVA Robotic IV Automation
1 Q 12 2 Q 12 3 Q 12 4 Q 12 Alaris Smart. Pump Upgrade 3 M v 7. 0 Upgrade i. Connect CPOE Pilot Get. Well for Expansion Facility Health Image Exchange Am. Com Upgrade i. Connect Medication Build Voalte with Alerts Physician Documentation Cardiology PACS Soarian Scheduling, Reg. and Billing Refrigerator Monitoring N-Centaurus Chart. Maxx v 5. 6 Upgrade Soarian Decision Support SIS for CV Surgery PACS Storage Expansion (EMC) Get. Well Pilot Synchronized Clocks Application Retrofit for Expansion Pharmacy Tracker Board i. Connect Critical Care Doc. QVoice Dictation Upgrade Workstations and Printers Pill. Cam Upgrade Lab Results Interface to SIS DAS CCU (Telemetry) SIS v 5. 0. 4 Upgrade Pyxis Upgrade Pro. Car 4000 Nurse Call SIS Anesthesia syngo Workflow v 32 Upgrade See My Radiology Overhead Paging SIS Analytics SIS v 5. 0. 5 a Upgrade Data Network i. RISecure Tissue Tracking Surgery Tracker Board Cisco Phones Logician Server Replacement Voalte Pilot Wireless Network Proventix Hand Washing Pilot ISISPro Tracker Board SENSIS Implementation Doctor Master Integration from ECHO RTLS (Asset Tracking) Move into Expansion Facility i. Connect Assessments & Interventions with MPV Cardiology move to COA i. Connect CPOE 2012 Projects CPOE Specific Projects Surgery Mobile App RIVA Robotic IV Automation
1 Q 12 2 Q 12 3 Q 12 4 Q 12 Alaris Smart. Pump Upgrade 3 M v 7. 0 Upgrade i. Connect CPOE Pilot Get. Well for Expansion Facility Health Image Exchange Am. Com Upgrade i. Connect Medication Build Voalte with Alerts Physician Documentation Cardiology PACS Soarian Scheduling, Reg. and Billing Refrigerator Monitoring N-Centaurus Chart. Maxx v 5. 6 Upgrade Soarian Decision Support SIS for CV Surgery PACS Storage Expansion (EMC) Get. Well Pilot Synchronized Clocks Application Retrofit for Expansion Pharmacy Tracker Board i. Connect Critical Care Doc. QVoice Dictation Upgrade Workstations and Printers Pill. Cam Upgrade Lab Results Interface to SIS DAS CCU (Telemetry) SIS v 5. 0. 4 Upgrade Pyxis Upgrade Pro. Car 4000 Nurse Call SIS Anesthesia syngo Workflow v 32 Upgrade See My Radiology Overhead Paging SIS Analytics SIS v 5. 0. 5 a Upgrade Data Network i. RISecure Tissue Tracking Surgery Tracker Board Cisco Phones Logician Server Replacement Voalte Pilot Wireless Network Proventix Hand Washing Pilot ISISPro Tracker Board SENSIS Implementation Doctor Master Integration from ECHO RTLS (Asset Tracking) Move into Expansion Facility i. Connect Assessments & Interventions with MPV Cardiology move to COA i. Connect CPOE 2012 Projects Impacting Pharmacy Surgery Mobile App RIVA Robotic IV Automation
1 Q 12 2 Q 12 3 Q 12 4 Q 12 Alaris Smart. Pump Upgrade 3 M v 7. 0 Upgrade i. Connect CPOE Pilot Get. Well for Expansion Facility Health Image Exchange Am. Com Upgrade i. Connect Medication Build Voalte with Alerts Physician Documentation Cardiology PACS Soarian Scheduling, Reg. and Billing Refrigerator Monitoring N-Centaurus Chart. Maxx v 5. 6 Upgrade Soarian Decision Support SIS for CV Surgery PACS Storage Expansion (EMC) Get. Well Pilot Synchronized Clocks Application Retrofit for Expansion Pharmacy Tracker Board i. Connect Critical Care Doc. QVoice Dictation Upgrade Workstations and Printers Pill. Cam Upgrade Lab Results Interface to SIS DAS CCU (Telemetry) SIS v 5. 0. 4 Upgrade Pyxis Upgrade Pro. Car 4000 Nurse Call SIS Anesthesia syngo Workflow v 32 Upgrade See My Radiology Overhead Paging SIS Analytics SIS v 5. 0. 5 a Upgrade Data Network i. RISecure Tissue Tracking Surgery Tracker Board Cisco Phones Logician Server Replacement Voalte Pilot Wireless Network Proventix Hand Washing Pilot ISISPro Tracker Board SENSIS Implementation Doctor Master Integration from ECHO RTLS (Asset Tracking) Move into Expansion Facility i. Connect Assessments & Interventions with MPV Cardiology move to COA i. Connect CPOE 2012 Projects Impacting Physicians Surgery Mobile App RIVA Robotic IV Automation
1 Q 12 2 Q 12 3 Q 12 4 Q 12 Alaris Smart. Pump Upgrade 3 M v 7. 0 Upgrade i. Connect CPOE Pilot Get. Well for Expansion Facility Health Image Exchange Am. Com Upgrade i. Connect Medication Build Voalte with Alerts Physician Documentation Cardiology PACS Soarian Scheduling, Reg. and Billing Refrigerator Monitoring N-Centaurus Chart. Maxx v 5. 6 Upgrade Soarian Decision Support SIS for CV Surgery PACS Storage Expansion (EMC) Get. Well Pilot Synchronized Clocks Application Retrofit for Expansion Pharmacy Tracker Board i. Connect Critical Care Doc. QVoice Dictation Upgrade Workstations and Printers Pill. Cam Upgrade Lab Results Interface to SIS DAS CCU (Telemetry) SIS v 5. 0. 4 Upgrade Pyxis Upgrade Pro. Car 4000 Nurse Call SIS Anesthesia syngo Workflow v 32 Upgrade See My Radiology Overhead Paging SIS Analytics SIS v 5. 0. 5 a Upgrade Data Network i. RISecure Tissue Tracking Surgery Tracker Board Cisco Phones Logician Server Replacement Voalte Pilot Wireless Network Proventix Hand Washing Pilot ISISPro Tracker Board SENSIS Implementation Doctor Master Integration from ECHO RTLS (Asset Tracking) Move into Expansion Facility i. Connect Assessments & Interventions with MPV Cardiology move to COA i. Connect CPOE 2012 Projects Impacting Nursing Surgery Mobile App RIVA Robotic IV Automation
CHANGE MANAGEMENT What is Change Management and why is it important?
What is Change Management? An approach to transitioning individuals, teams and organizations from a current state to a desired future state.
Risks without Change Management Project Level • • Project delays Missed milestones Budget overruns Impacted quality Rework Lost cycles of productivity Project fails to deliver results Organization Level • • • Stress, confusion, fatigue Drama! Lost cycles of productivity Reduced morale Reduced involvement Loss of valued employees Reduced quality of work Perceived failure Lack of change saturation Lack of adoption
Components of Change Management • • • Manage/mitigate change to the individual Managing the message of the change Managing expectations Operational/Infrastructure change Changes to authority and responsibility Alliances Policies and Procedures Resource changes Overall culture
Variety of Models • Prosci – Awareness, Desire, Knowledge, Ability, Reinforcement • Kotters – Create Urgency, Form Coalition, Create a Vision, Communicate, Remove Obstacles, Short term Wins, Build on Change, Anchor the change • Mc. Kinsey 7 - shared values, strategy, structure, systems, style, staff, and skills • Emergence One – Integrated approach to project and change management
History of Change Management • Hawthorne Studies (1920 s) Lighting and productivity • Coch and French (1940 s) Resistance to change • Lewin (1950 s) - Unfreeze, Change, Refreeze • Kuebler-Ross (1960 s) – Shock, Denial, Anger, Bargain, Depression, Acceptance
HAPPY IS NOT IN SCOPE …and ultimately, that is not really the most important part of the story.
CHANGE MANAGEMENT Isn’t that the Project Managers job?
What PMs do… • • • Initiate Plan Execute Monitor Close • Largely task related • Not necessarily focused on human and political issues • Project management success is not necessarily the same as project success. - Enhancing and Unifying Project and Change Management, Jarocki
Project Management vs Change Management Initiating Integration Management Scope Management Time Management Cost Management Quality Management Resource Management Communication Management Risk Management Procurement Management Planning Project Management Responsibility • Charter • Sponsorship • Initial scope/deliverables Executing Monitor/ Control Closing Change Management Opportunities • Sponsor level ownership and commitment • Define a vision change management
Project Management vs Change Management Initiating Integration Management Scope Management Time Management Cost Management Quality Management Resource Management Communication Management Risk Management Procurement Management Planning Project Management Responsibility • Resources • Deliverables • Work definition • Schedule • Quality metrics • Communication plan • Risk identification • Procurement Executing Monitor/ Control Closing Change Management Opportunities • Acquire skilled resources • Develop Change Management Plan • Begin to identity impacts • Political • Operational • Develop the message/Send initial message • Coordinate with other project milestones • Buy in from key leadership
Project Management vs Change Management Initiating Integration Management Scope Management Time Management Cost Management Quality Management Resource Management Communication Management Risk Management Procurement Management Planning Project Management Responsibility • Execute the work • Communicate • Status • Risks • Issues • Training • Testing Executing Monitor/ Control Closing Change Management Opportunities • Execute Change Management Plan • Manage the message • Saturate the environment • Understand your audience • Simulation • Elevator speech • Provide feed back loop • Mitigate political or operational impacts
Project Management vs Change Management Initiating Integration Management Planning Project Management Responsibility Scope Management • Change in scope Time Management • Change in resources • Change in budget Cost Management Quality Management Resource Management Communication Management Risk Management Procurement Management Executing Monitor/ Control Closing Change Management Opportunities • Monitor metrics • Enforce expectations • Communication • Commitment • Involvement • Coordinate message with other project milestones • Coordinate the message with other organizational initiatives
Project Management vs Change Management Initiating Integration Management Planning Project Management Responsibility Scope Management • Close out surveys Time Management • Contract close out • Finalizing documentation Cost Management Quality Management Resource Management Communication Management Risk Management Procurement Management Executing Monitor/ Control Change Management Opportunities • Continue to monitor adoption Closing
OUR FIRST ATTEMPTS AT CHANGE MANAGEMENT How did that work out for you?
1 Q 12 2 Q 12 3 Q 12 4 Q 12 Alaris Smart. Pump Upgrade 3 M v 7. 0 Upgrade i. Connect CPOE Pilot Get. Well for Expansion Facility Health Image Exchange Am. Com Upgrade i. Connect Medication Build Voalte with Alerts Physician Documentation Cardiology PACS Soarian Scheduling, Reg. and Billing Refrigerator Monitoring N-Centaurus Chart. Maxx v 5. 6 Upgrade Soarian Decision Support SIS for CV Surgery PACS Storage Expansion (EMC) Get. Well Pilot Synchronized Clocks Application Retrofit for Expansion Pharmacy Tracker Board i. Connect Critical Care Doc. QVoice Dictation Upgrade Workstations and Printers Pill. Cam Upgrade Lab Results Interface to SIS DAS CCU (Telemetry) SIS v 5. 0. 4 Upgrade Pyxis Upgrade Pro. Car 4000 Nurse Call SIS Anesthesia syngo Workflow v 32 Upgrade See My Radiology Overhead Paging SIS Analytics SIS v 5. 0. 5 a Upgrade Data Network i. RISecure Tissue Tracking Surgery Tracker Board Cisco Phones Logician Server Replacement Voalte Pilot Wireless Network Proventix Hand Washing Pilot ISISPro Tracker Board SENSIS Implementation Doctor Master Integration from ECHO RTLS (Asset Tracking) Move into Expansion Facility i. Connect Assessments & Interventions with MPV Cardiology move to COA i. Connect CPOE 2012 Projects CPOE Specific Projects Surgery Mobile App RIVA Robotic IV Automation
COA Lessons Learned • • • Not an established practice at COA Questions about the value vs cost Perceived as ‘warm fuzzy’ effort No clear vision No dedicated resources Resources inexperienced with Change Management • Resources brought into project too late • There was LOTS more than just CPOE going on
On a positive note… • • • Initiated Change Management efforts for CPOE HR and Corporate Communications resources Change Management training Existing modes of communication Created opportunities specific to milestones Took advantage of multidisciplinary team
CHANGE MANAGEMENT How to incorporate something that provides value to your project
Incorporating Change Management Vision Impacts Plan Message Expectations Consistency
Incorporating Change Management Establish the Vision Impacts Plan Message Expectations Consistency • Include these discussions in your initiating phase • Eliminate perception of “warm fuzzy” • Sponsor ownership • If no, add it as a risk • Sponsor’s vision of Change Management
Incorporating Change Management Vision Understand the Impacts Plan Message Expectations Consistency • Work with sponsor to identify the impact of the change • Politically • Operationally • On the individual • Other initiatives • Identify audiences • Consider communication differences
Incorporating Change Management Vision Impacts Plan/Execute the Plan Message Expectations Consistency • Define reasonable deliverables and metrics • Acquire appropriate resources and skill sets • Think about resources beyond a formal Change Manager • Train team on Change Management basics • Budget
Incorporating Change Management Vision Impacts Plan Manage the Message Expectations Consistency • Different than a communication plan • Look for existing communication processes • Saturate the environment with the message • Ensure the consistency of the message
Incorporating Change Management Vision Impacts Plan Manage the Message Expectations Consistency • Think about the message in relation to project milestones • Understand how the message may change as you progress through the project
Incorporating Change Management Vision Impacts Plan Message Set Expectations Consistency • With all levels of leadership • With all levels of users • Realistic • Clear
Incorporating Change Management Vision Impacts Plan Message Expectations Monitor Consistency • Monitor metrics • “Word on the street” • Reinforce expectations • Never underestimate the grapevine!
YOUR THOUGHTS ON CHANGE MANAGEMENT? Questions?
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