What Are Your Employees Thinking? Presentation Offers Tools for Managing Organizational Change


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Managing change, and the loss of effectiveness that often accompanies it, is a major challenge for healthcare providers in the reform era. PYA has teamed up with PivotPoint Business Solutions to offer a cutting-edge change management tool for the healthcare industry. The Change Diagnostic Index© measures six specific symptoms of behavior to gauge an individual’s readiness to accept change.

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  • Qualitative ToolsObservation(Lurking)InterviewsFocus GroupsQuantitative ToolsSocial Network AnalysisPersonality AssessmentAttachment Assessment
  • So let’s look at a couple of examples – the first small-scale and the second industry and large-scaleChange causes a loss of stability, which results in the development of a predictable and measurable set of symptoms within an organization.When a significant number of these symptoms are present simultaneously, and organizational loss of effectiveness occurs (Grady, 2005).By addressing the individual symptoms that present themselves early in the change process, organizations can avoid or mitigate the impact of those changes on achieving their enterprise objectives.
  • Macro FindingsScores for Transcription, Coding and Medical Records indicate the these particular areas are functioning as a stable environmentTheir relatively depressed anxiety/morale, development/motivation, and global change scores indicate a stability that should serve the organization well in preparing for the ICD-10 migrationParticipation for these groups was 100%, 100%, and 93% respectively Scores for Information Technology and Patient Financial Services on average hung within the high normal rangeThis average was depressed by low scores in the non-predictive symptoms. Various scores in anxiety/morale (Both) and global change (PFS) should be examined in further detailParticipation for these groups was 100% and 66% respectively Scores for both Patient Access Services and Utilization Review indicate a lack of stability in each areaFurther detail can be found on subsequent slideParticipation in these groups was 100% and 66% respectively
  • Macro FindingsMembers of the sample were evenly distributed across each of the longevity categoriesMembers of the 2nd (6-10 years) and 4th (20+ years) droved the highest total averagesThese groups typically included highly productive individual contributors and respected long term team membersTheir reaction to the impending change and transition to ICD-10 will be a key barometer of the organization’s change healthThe highest scores for each of these groups in the anxiety/morale and global change impactThe 6-10 year group scored 10% higher than its nearest cohort memberKey Take-A-WaysThe above average scores in anxiety/morale across all cohort members suggest the need address globallyThough still within the high normal range, the spike in withdrawal in the 6-10 year group bears attention
  • Finally, qualitative feedback was received by 27% of respondents. A foundational theme appeared within the response sample; a very clear appreciation for both “being heard” and “being part of the West Georgia team.” This a wonderful foundation from which to build your change and transition approach. Beyond this foundation, several opportunity themes surfaced in regards to:CommunicationTraining End User Involvement
  • Talk about importance of training tiers and applicable training per tier and development of training blueprint that also defines cost.Short-TermShare findings with PAS and UR leadership to assess portfolio of change impacting these particular groupsCreate a 90 plan to specifically address the leadership support and change impact needs that were identified in each of these areasEstablish and ICD-10 sponsorship structure to guide the organization’s progression to 10/1/13Define a short term communication plan to share findings from Change Diagnostic Index© and the specific action steps that are being taken as a resultMid-Term/MonitoringLeveraging the newly defined sponsorship structure, define a multi-layer communication design to inform and prompt those individuals impacted by the ICD-10 migrationEstablish leadership connections (ie – 8x8, focus groups, etc.) with team members in the “Experienced Individual Contributors” and “Long Tenured” categories to avoid or mitigate withdrawalInvest in change management and coaching education for management and mid-management (supervisors & team leads) to address motivation and morale Create visible forums for team members to participate in change preparation and activityMonitor volatile groups (PAS and UR)
  • What Are Your Employees Thinking? Presentation Offers Tools for Managing Organizational Change

    3. 3. 4 LEARNING OBJECTIVES: • Identify the instinctual behavioral response of individual employees who are anticipating and implementing organizational change. • Explain the physical implications of that response. • Introduce tools to support accurate identification of this behavioral response. • Discuss case studies with the audience that include integration of tools. • Define a process for integrating the response as a critical function of Change Strategy Planning and Implementation.
    4. 4. 5 THE CHALLENGE Employee satisfaction is a critical factor in maintaining high Customer satisfaction. Ironically, employee satisfaction in our globally competitive marketplace is a very complicated challenge.
    5. 5. 6 THE ANSWER The answer is rooted in the individual employees who add a unique dynamic to the organization. Change management professionals recognizing that individual employees are collectively The Organization, is a massive challenge and critical to change success.
    6. 6. 7 PEOPLE DETERMINE THE SUCCESS OF ANY CHANGE… So what are YOU attached to? • A Leader (or Leadership) • Technology (Software or Hardware) • The Business Process • An Office Space • The Lunch Group • Your Break Room • An Idea…
    7. 7. 8 THE SYMPTOMS Individual Symptom Organizational Symptom Suggested Mitigation or Intervention Strategy Anxiety Morale Enhance and Increase Support from Leadership/Sponsorship Frustration Productivity Increase Education/Training with the Identified Change Rejection of the Environment Conflict Improve Communication Retardation of Development Motivation Integrate Individual Coaching Refusal to Participate Absenteeism Increase Employee Engagement and Support Withdrawal Turnover Address Job Satisfaction and Commitment
    8. 8. 9 TOOLS TO DEFINE ATTACHMENTS Qualitative Tools • Observation (Lurking) • Interviews • Focus Groups Quantitative Tools •Social Network Analysis •Personality Assessment •Attachment Assessment
    9. 9. 10 ATTACHMENT ASSESSMENT Identify the Risk Measure the Risk of Change to the Individual Address / Resolve the Risk Prior to Change The Change Diagnostic Index© determines the risk of change to the individual employee, which ultimately impacts the success of change in the organization. Define Employee Behavioral Response and Identify Transitional Objects to Support the Process
    10. 10. 11 CASE STUDIES
    11. 11. 12 Baseline-Aug 2010 Calibration-Oct 2010 Final-Feb 2011 AverageChangeDiagnostic Index©Score Organizational Summary CASE STUDY 1- EMR INTEGRATION
    12. 12. 14 CASE STUDY 2 – ICD-10 TRANSITION • On October 1, 2014 the ICD-9 code sets used to report medical diagnoses and inpatient procedures will be replaced by ICD-10 code sets. • The transition to ICD-10 is a requirement for everyone covered by the Health Insurance Portability Accountability Act (HIPAA). • The change to ICD-10 does not affect CPT coding for outpatient procedures and physician services.
    13. 13. 15 HEALTHCARE CHANGE: ICD-10 ORGANIZATIONAL IMPACT • Physician Documentation • Physician Integration • Physician Performance • Staffing Effectiveness • Assessment of Revenue Impact • Process Improvement • Decision Support Reporting Impact • Documentation Analysis • Education • Process Improvement • Monitoring Physician Office Post Acute Services • Front – Scheduling, Access Areas • Middle – Coding, CDI, Case Management • Back – Billing, Reimbursement Health Information Management Revenue Process Physician Operational Planning Information Technology • IT Systems • Capability, Communication • Functionality • Vendor Preparedness ICD-10
    14. 14. 16 HEALTHCARE CHANGE MANAGEMENT: ICD-10 KEY PROJECT STAKEHOLDERS Scheduling / Access Areas Health Information Management Information Technology Decision Support Physician Advocate Billing & Reimbursement Human Resources
    15. 15. 17 CHANGE DIAGNOSTIC INDEX© RESULTS BY DEPARTMENT 1.00 1.20 1.40 1.60 1.80 2.00 2.20 2.40 2.60 A D F G P R W AVG. Coding Information Systems Medical Records Patient Access Services Patient Financial Services Transcription Utilization Review
    16. 16. 18 CHANGE DIAGNOSTIC INDEX© RESULTS BY YEARS OF SERVICE 1.00 1.20 1.40 1.60 1.80 2.00 2.20 2.40 2.60 A D F G P R W AVG. 0 To 5 Years 6 To 10 Years 11 To 20 Years 20 Years
    17. 17. 19 CHANGE DIAGNOSTIC INDEX© QUALITATIVE RESPONSES: EXAMPLES Communication “It would be helpful to have a "heads-up" prior to implementing changes. At times, changes are made and put into place and then those who are supposed to follow through with these changes are informed.” ~ “Sometimes having more of a heads up to upcoming changes would be great. We have expressed this to our leadership before and they have made vast improvements to do so.” Training “I believe there should be MANDATORY training classes for those that the changes are going to effect. This would result in less confusion when changes are implemented.” ~ “Training immediately prior to, during and after implementation.” ~ “More training in all departments to make the workflow more efficient. A better understanding of why things are done a certain way.” End User Involvement “The most important thing to me is to include the persons that the change will most affect in the process. Take their concerns into consideration before a final decision is made and the change is implemented.”
    18. 18. 20 PYA CHANGE MANAGEMENT WORK STREAM INFRASTRUCTURE • Impact Identification • Knowledge Leveling • Data Gathering Awareness & Assessment • Sponsor Tree Definition • Identification of Sponsors • Communication Plan Sponsorship • Change Diagnostic Index© • Analysis of Results • Action Identification Effectiveness Assessment • Converge Impact & Effectiveness • Training • Communication / Sponsorship Path Forward Change Management Work Stream Focus:  Communication plan detailed for specific audience knowledge levels  Sponsorship tree definition and identification of individuals  Effectiveness index summary results and action identification
    19. 19. 21 THE BOTTOM LINE: WHAT YOU NEED KNOW Attachment Behavior is instinctual human nature. Organizational Change interrupts our attachments. EVERY TIME. In order to understand the individual employees who are collectively the organization, we must first define their attachments. Use Qualitative and Quantitative Tools to define individual employee attachments. Create customized support during the change process through identification of organizational transitional (support) objects. Change Management Strategy cannot integrate the “human side of change” without first understanding the role of attachment behavior in the process.