Modernising Service Delivery The Challenge of Integrated Change

Modernising Service Delivery The Challenge of Integrated Change Masterclass Series Office for Health Management Dr. Joe Mc. Donagh Trinity College Dublin 6 April 2004 © 2004, Dr. Joe Mc. Donagh, Trinity College Dublin

The Mandate for Strategic Change Is Far Reaching n n n n ‘… the structures we have today were designed over 30 years ago …’ (Michael Martin, T. D. , June 2003) Rationalization of existing health service agencies Reorganization of the Department of Health and Children Establishment of a new Health Services Executive Establishment of a new Health Information Quality Authority Devolution of budget responsibility Modernization of supporting processes © 2004, Dr. Joe Mc. Donagh, Trinity College Dublin

Focusing on ICT Is Necessary but Not Sufficient n n n n ICT deployment is central to delivering the transformational change programme But health systems have been poor adopters of ICT has historically been viewed as an expense Increasingly being viewed as a creator of business value Greater degree of ICT coordination is needed for the future Significant increase in levels of ICT investment is needed Comprehensive approach to strategic change must accompany all change initiatives Core principles apply to all strategic change initiatives © 2004, Dr. Joe Mc. Donagh, Trinity College Dublin

Effective Transition Management Is Essential to Success Where are we now? How will we manage the transition? Where are we going? © 2004, Dr. Joe Mc. Donagh, Trinity College Dublin

But Transition Management Can Be Very Challenging 80% of systems delivered late (*2. 22), over budget (*1. 89), reduced functionality (*. 59) Around 40% of developments fail or are abandoned Current State 60% do not fully address training and skills requirements Less than 25% properly integrate business and technology objectives Desired Future State 80 -90% do not meet their performance objectives 10 -20% meet all success criteria © 2004, Dr. Joe Mc. Donagh, Trinity College Dublin

Delivering Strategic Change Is Not Easy n ‘In order to achieve further progress on SMI/DBG, a fundamental assessment of change management supports at both central and departmental level is required’ (Evaluation of the Strategic Management Initiative, 2002: 32). n ‘In particular, the need for a central-level change champion to maintain momentum and rigor should be explored’ (Evaluation of the Strategic Management Initiative, 2002: 32). n ‘The implementation process has been characterised by: n A fragmentation of the rollout at central and departmental level. n An insufficient conviction in some Departments / Offices of the need for change - combined with a sense that the status quo was acceptable’ (Evaluation of the Strategic Management Initiative, 2002: 32). © 2004, Dr. Joe Mc. Donagh, Trinity College Dublin

And the Modernization Agenda is Becoming More Demanding n n n n Customer-centric service delivery is the vision Nurturing an integrated service management approach is essential Integrated multi-channel service distribution is core Integration and transformation of public services is assumed Emphasis is on integration across agencies Involves significant upfront investment Necessitates addressing significant impediments to change © 2004, Dr. Joe Mc. Donagh, Trinity College Dublin

Integrating Modernization and e. Government is Essential Customers Channels e. Broker Departments / Offices Health and Children Services catalogue Services manager Customer data vault Education and Science Social, Community & FA Revenue Commissioners Justice Equality and LR Enterprise, Trade & Emp Finance; Environment / LG Public Enterprise; Defence Agriculture, Fisheries, RD © 2004, Dr. Joe Mc. Donagh, Trinity College Dublin

But the Obstacles are Formidable n If Government is to achieve the vision of improved services more efficiently delivered, then it must take steps to overcome a number of barriers (Electronic Government Services for the 21 st Century, April 2001) n Otherwise the nightmare scenario of high investment without improved services will not be avoided (Electronic Government Services for the 21 st Century, April 2001) n There are formidable organizational impediments to this change management agenda (High Payoff in Electronic Government: Measuring the Return on E-Government Investments, May 2003) © 2004, Dr. Joe Mc. Donagh, Trinity College Dublin

Executives Respond to This Challenge in Diverse Ways Vision Rational Architect Humanist Blueprinting Strategic capability Strategic integration Reward/coercive power Detached from reality Emancipating Participative change Social integration Referent power Unrealistic expectations Designing Optimising solutions Technical integration Technical expert power Alienation & discord Bargaining Cultivating compromise Political integration Affiliative power Rather unpredictable Engineer Broker Action © 2004, Dr. Joe Mc. Donagh, Trinity College Dublin Social

Competency Development Is A Prerequisite To Success Vision Humanist Architect Strategy and policy Governance Infrastructure Programme management Organization development Collaborative change Communicating change Process consultation Rational Social Project management Services management Process engineering Systems engineering Coalition building Benefits management Managing consultants Performance auditing Engineer Broker Action © 2004, Dr. Joe Mc. Donagh, Trinity College Dublin

And Success Has Its Own Particular Integrative Pattern Vision Humanist Architect 3 Strategy and policy Governance Infrastructure Programme management Organization development Collaborative change Communicating change Process consultation Rational 4 2 Social Project management Services management Process engineering Systems engineering Coalition building Value management Managing consultants Performance auditing Engineer Broker Action © 2004, Dr. Joe Mc. Donagh, Trinity College Dublin 1

Thank You for Listening Dr. Joe Mc. Donagh Senior Lecturer in Strategic Change and IT Trinity College Dublin Phone: +353 -1 -6082330 Fax: +353 -6799503 Joe. Mc. Donagh@tcd. ie © 2004, Dr. Joe Mc. Donagh, Trinity College Dublin