TG CAUSE Methodology for Change Management and Clinical Transformation

1. CONFIDENTIAL AND PROPRIETARY TO THE PARTIES IN DISCUSSION.
1
Contact:
sales@taurusglocal.net
drgupta@taurusglocal.com
Website:
www.taurusglocal.com

2. BOOT-STRAPPING HEALTHCARE ORGANISATION
CHANGE MANAGEMENT
C A U S E M E T H O D O L O G Y
TG will implement it’s proprietary
CAUSE methodology for
managing change in people,
process and technology.
• Consciousness of need to change
• Aspiration to support change
• Understanding how to change
• Strength to over come hurdles
and implement change
• Ecosystem to support, sustain
and adopt change
S M O O T H T R A N S I T I O N
F R O M C U R R E N T T O
O P T I M A L S T A T E
CLINICAL TRANSFORMATION
2
CAUSE
METHODOLOGY

3. BEHAVIOR CHANGE OCCURS IN SMALL STEPS AND
REQUIRES CONSTANT REINFORCEMENT
Habit
Fear
Reward
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COMPLIANCE
TIME
HABIT
Mini-
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Black-
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Wine
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Art of
Living
REWARDS
Coupon
Loyalty
Prog.
Brand
FEAR
Army
Work
Team
A
B
C
CLINICAL TRANSFORMATION
3

4. CAUSE METHODOLOGY – CHANGE MGMT
CONSCIOUSNESS OF
NEED TO CHANGE
ASPIRATION TO SUPPORT
CHANGE
UNDERSTANDING HOW TO
CHANGE
STRENGTH TO OVER
COME HURDLES AND
IMPLEMENT CHANGE
ECOSYSTEM TO
SUPPORT, SUSTAIN
AND ADOPT CHANGE
PEOPLE
It is important for the CxO
to communicate the ‘Need
to Change’. The people
must be informed by the
Head of the organization
again and again until they
are very clear in their mind
about why the change is
coming.
Leader of the organization
and every Dept Head
needs to lead by example
i.e. he/she needs to
undergo the full training
first and demonstrate that
he can adapt and adopt the
new process and
technology.
Identify Champions from the
team who demonstrate the
competence to learn the new
process and technology.
Build Trainer pool by Train-
the-Trainer concept
Institutionalize informal
learning by Buddy system.
Pair a Champion with a
person who needs extra help.
The major hurdle can
come from “People” as
they are the one who
are most affected by
the process. Top
management should
be ready to cope up
with the hurdle and
internal resistance
from this group.
Constant hand holding
and support is required
till the people
genuinely start relying
on each and the new
systems and
processes. External
support can be
withdrawn once this
ecosystem is built.
PROCESS
The CxO must inform the
team that it is not just an IT
project but many
processes are going to
change. Infact it is an
opportunity to redefine and
improve the existing
processes. Get into a
mode of continuous
process improvement.
The organization must
Aspire to support changes
in processes. Since the
organization is going
through a transition this is
an opportunity for the
organization to define
processes across the
organization.
Train the team on new
processes extensively, again
and again till it becomes
second nature to them.
Check for gaps in process
knowledge between expected
and achieved.
It’s important to realize
that processes will
break and problems
will happen when such
a major
implementation is
done. Trick is to
recognize the problem
areas before it is too
late to avoid big
failures.
The top management
needs to keep clearing
the bottle necks till all
the processes are
stabilized and the
ecosystem takes over
the self management
of the processes.
TECHNOL
OGY
The CxO must inform the
team that existing
technology tools will be
phased out and the better
technical solutions will be
brought in. This is required
because the current IT
systems are not geared to
support the massive
growth plans of the
organization.
The organization must
Aspire to support changes
in technology. CxO needs
to create a positive Buzz
about the technology
changes. Once people are
aware that technology is
there to help them, they’ll
easily accept the
technology change.
Train the team on new
technology extensively, again
and again till it becomes
second nature to them.
Use Carrot and Stick
approach to motivate people
for undergoing the training
and learning the new systems
It’s important to realize
that system will
breakdown and
problems will happen
when such a major
implementation is
done. Trick is to
recognize the problem
areas before it is too
late to avoid big
failures.
Lot of support is
required in terms of
hand holding and
training till the
Technology gets
adopted by the users
and is irreversibly
embedded into the
ecosystem.
CLINICAL TRANSFORMATION
4

5. 5
CONSCIOUSNESS OF NEED TO CHANGE
PEOPLE
It is important for the CxO to communicate the ‘Need to Change’. The people must be informed by the Head of the organization again and again until
they are very clear in their mind about why the change is coming.
How:-
1. Establishing a sense of urgency
Create a sense of urgency within the organization as in why this change is required. How it’ll help to achieve the organizational goals and
benefit the people as one organization. Define the project as the people’s project and not a department project and committing the biggest
mistake to call it an “IT Project”
1. Creating a vision
Without a coherent and sensible vision, a change effort dissolves into a list of confusing and incompatible projects. So first develop a vision
for the organization.
1. Communicating the vision
Use every existing communication vehicle e.g. Daily meetings, Weekly meetings, Emails, Printed Circulars, Posters, Coffee Time
Discussions, Lunch Meetings etc. to get the vision out. The CxO must incorporate the vision into routine discussions about business
problems with identified solutions where all the departments are involved.
The first step in managing change is building awareness around the need for change and creating a desire among employees. Therefore,
initial communications are typically designed to create awareness around the business reasons for change and the risk of not changing.
Likewise, at each step in the process, communications should be designed to share the right messages at the right time.
PROCESS
The CxO must inform the team that it is not just an IT project but many processes are going to change. Infact it is an opportunity to redefine and
improve the existing processes. Get into a mode of continuous process improvement.
How:-
1. Communicate how the Processes will change for the better with the implementation of technology
2. CxO must empower the Dept Heads together with the Quality Dept to develop a strategy for process change management.
TECHNOLOGY
The CxO must inform the team that existing technology tools will be phased out and the better technical solutions will be brought in. This is required
because the current IT systems are not geared to support the massive growth plans of the organization.
How:-
1. Start communicating why the technology will change e.g. Our target is to grow to 100 clinics in 2 years. The IT systems need to be scalable
and flexible to enable the growth and grow with the organization.
2. Communicate the new technology requirements e.g. EMR, PMS, Incentive management, ROTA, Portals etc.

6. 6
ASPIRATION TO SUPPORT CHANGE
PEOPLE
We need to focus on the primary group affected by each change project. The group’s willingness, readiness and ability to change are key factors for
success.
Aspire people within the organization to accept the change against the internal inertia.
How:-
 Forming a powerful guiding coalition
Build and Empower the Governance Model – PMO, Clinical Reference Group, Governance Council, Executive Council, Change
Management Board
 Empowering others to act on the vision
Identifying champions or change Agents from each team/ operational department to drive the change who can motivate their team better
to accept and adopt the change.
Eg:-Identify motivated physicians and operation leaders as “owners.”
 Create the sense of confidence & surety
CEO should motivate the employees by assuring them of full support and that they will be taken care of in terms of skills required to get
adapted to the change.
PROCESS
The organization must Aspire to support changes in processes. Since the organization is going through a transition this is an opportunity for the
organization to define processes across the organization.
How-
 Conduct internal Quality Audits to identify process bottlenecks.
 Encourage Center Heads, Dept. Heads and Admin Staff to document process bottlenecks and send it to the Quality Dept.
TECHNOLOGY
The organization must Aspire to support changes in technology. CxO needs to create a positive Buzz about the technology changes. Once people
are aware that technology is there to help them, they’ll easily accept the technology change.
How:-
1. CxO needs to work with Dept Heads and HR to assess the skill gaps in the organization to adopt technology e.g. Doctors unable to
understand link between data, process and technology.
2. Formulate a plan to address the skill gap
3. CxO to conduct meeting to make the organization believe that their skill gaps on technology will be taken care by training and hand holding
4. Be realistic - Tell the staff that technology is not a magic wand that is smart enough to solve their problems – rather it is a GIGO i.e. garbage
in and garbage out!
5. The system will behave the way Staff wants it, if they take pains of defining the master data and templates as inputs to the system.

7. 7
UNDERSTANDING HOW TO CHANGE
PEOPLE
How:-
 Leader of the organization and every Dept Head needs to lead by example i.e. he/she needs to undergo the full training first and demonstrate
that he can adapt and adopt the new process and technology
 Identify Champions from the team who demonstrate the competence to learn the new process and technology.
 Build Trainer pool by Train-the-Trainer concept
 Institutionalize informal learning by Buddy system. Pair a Champion with a person who needs extra help.
 Coaching and manager training for change management
Supervisors will play a key role in managing change. Ultimately, the direct supervisor has more influence over an employee’s motivation to
change than any other person at work.
 Prepare your change management team
The change management team should have members identified as champions from various departments e.g.: department heads or
supervisors.
Unfortunately, supervisors as a group can be the most difficult to convince of the need for change and can be a source of resistance. It is
vital for the change management team and executive sponsors to gain the support of supervisors and to build change leadership. Individual
change management activities should be used to help these supervisors through the change process
 Review the skillset of current employees
WRT the adoption of the change you are bringing in should assess the current technological capability of the employees for the kind and
strength of training they will require.
 Training and training development programme.
Training is the cornerstone for building knowledge about the change and the required skills. Project team members will develop training
requirements based on the skills, knowledge and behaviors necessary to implement the change. These training requirements will be the
starting point for the training group or the project team to develop training programs.
Once managers and supervisors are on board, the change management team must prepare a coaching strategy. They will need to provide
training for supervisors including how to use individual change management tools with their employees. Eg:- Training (online, classes, one-
on-one) is offered both pre- and post-implementation
• Conduct up-front training.
• Develop end-user training.
• Customize training for each user group.
Mentoring and hand-holding with continuous skill upgradation is key to adoption. The team shouldn’t feel they have been thrown at the deep end
without any safety net!

8. 8
UNDERSTANDING HOW TO CHANGE
PROCESS
How-
 Train the team on new processes extensively, again and again till it becomes second nature to them.
 Check for gaps in process knowledge between expected and achieved.
Use Carrot and Stick approach to motivate people for undergoing the training and learning the new processes
 Readiness Assessments/ SWOT analysis
Assessments are tools for a change management team to assess the organization’s readiness to change. Readiness assessment can
include organizational assessments, culture and history assessments and change assessments. Each tool provides the change
management team with insights into the challenges and opportunities they may face during the change process.
 Develop the change management plan with defined timelines for deliverables
When there are measurable deliverables with timelines it becomes easy for an organization to know if they are heading in the right path or if
things are going as expected. If more delays are occurring then at very early stage only it can help the team to take a corrective action.
 Standardize existing processes to accept the change
Processes have to be reviewed and re-defined to get in pace with the upcoming change so that the workflow is not interrupted but is
streamlined. Users should be involved in any analysis and redesign of their workflow
 Start building the to-be process SOPs to match the adoption requirements.
Once you have documented SOPs it makes it easier for people to follow the rules by realizing its importance.
 Prepare a risk management plan
Assess risk of process failures and prepare risk mitigation plans
What-if scenarios and Disaster recovery plans
TECHNOLOGY
How-
 Train the team on new technology extensively, again and again till it becomes second nature to them.
 Check for gaps in technical knowledge between expected and achieved.
 Use Carrot and Stick approach to motivate people for undergoing the training and learning the new systems

9. 9
STRENGTH TO OVERCOME HURDLES AND IMPLEMENT CHANGE
PEOPLE
The major hurdle can come from the group “People” as they are the one who are most affected by the process. Top management should be ready to cope up
with the hurdle and internal resistance from this group.
How-
 Collect and analyze feedback
Employee involvement is a necessary and integral part of managing change. Feedback from employees is a key element of the change management
process.
 Planning for and creating short-term wins-
Clearly recognizable victories within the first year or two of a change effort help convince doubters that the change effort is going to be worth all
the trouble. Short term wins keep the people motivated till the end as they can see the positive results and do not loose pace.
Early successes and long-term wins must be recognized and celebrated. Individual and group recognition is also a necessary component of change
management in order to cement and reinforce the change in the organization.
 Setting realistic targets and goals
agents/leaders can measure how well their individual units are coping with and meeting these objectives by measuring their progress against the goals.
 People skills have the highest priority during all stages of the project Employees and clinicians must be kept informed and engaged with planning and
communication
PROCESS
It’s important to realize and recognize the problem areas before its too late that might lead to failure.
How-
 Data gathering, Diagnose gaps and manage resistance.
The final step in the change management process is the after-action review. It is at this point that you can stand back from the entire program, evaluate
successes and failures, and identify process changes for the next step to be done. This is part of the ongoing, continuous improvement of change
management for your organization and ultimately leads to change competency.
 Implement corrective actions and celebrate success.
Analysis and corrective action based on this feedback provides a robust cycle for implementing change.
 Perform risk assessment.
 Resistance management
Resistance from employees and managers is normal. Persistent resistance, however, can threaten a project. The change management team needs to
identify, understand and manage resistance throughout the organization. Resistance management is the processes and tools used by managers and
executives with the support of the project team to manage employee resistance. This can be achieved by creating a steering committee within the
organization to address the issues during the change management process.
 Reward success
TECHNOLOGY
Though the hurdles WRT to technology are not very difficult to overcome, but still there can be technology issues that require support or an alternate solution.
How-
 Set up an IT support and troubleshooting team.
 Provide hand holding to the end users by creating a strong key user team that believes in the system to be implemented.
 Setting up self assessment tutorials to overcome the technology hurdles.
 Extensive, intensive 24/7 support is included at and immediately following go-live

10. 10
HEALTHCARE ORGANISATION CHANGE
MANAGEMENT
CAUSE methodology Smooth transition from current
to optimal state
CLINICAL TRANSFORMATION
CAUSE
METHODOLOGY
Daily Scrum
Feedback
Consciousness
of need to
change
Aspiration to
support change
Understanding
how to change
Strength to over
come hurdles
Ecosystem
to support,
sustain and
adopt
change
Initial Planning
Business Modeling
Deployment
Requirements
Analysis &
Design
Development,
Implementation
Testing
Evaluation
Planning
ITERATION
Change Mgmt
Configuration Mgmt

12. PROJECT PLAN FOR………………
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
0. Initial Planning
2. Iteration 1
1. Business Modeling
3. Iteration 2
4. Iteration 3
5. Iteration 4
SC 2
“Strategy and
Research Agenda”
SC 3
“Launch of Flagship Projects
and Governance Model Definition”
SC 4
“Operating Model
Definition”
SC 5
“Implementation
Plan”
Key Milestones
SC 0
“Kick-off”
9. Full Deployment
8. Iteration 7
7. Iteration 6
6. Iteration 5
SC 1
“Current Assessment and
Benchmarking Results”
Source: Arthur D. Little methodology Key Meetings
Note: Apart from the steering committee meetings, there will be periodic governance meetings as defined in the governance mechanism
Agile Project Management

13. THANKS!
13
Contact:
sales@taurusglocal.net
drgupta@taurusglocal.com
Website:
www.taurusglocal.com