The HIMSS Change Management Task Force provides a Technology Adoption Change Management Framework, including components necessary to move an organization from present state through HIT implementation transition, to a transformed state post implementation. The framework provides lists and specific integrated Project Management & Change Management activities, along with corresponding tools. http://www.himss.org/asp/topics_focusdynamic.asp?faid=321
In an effort to add to the “applied science” and tools to the growing Change Management healthcare literature, allow me to offer a working change management approach for healthcare projects.
As most healthcare project veterans will attest, healthcare organizations are slow to make process change. Understanding this history, will allow the PMO/project team to protect your application investment. A Change Management Strategy must have an application specific focus, e.g., CPOE, ERP, ICD-10 coding, Business Intelligence, etc., and be designed to assist the healthcare entity in making the most effective use of their human resources, (automated) processes and technology to maximize the healthcare system’s investment in the application.
Change Management Approach
A proven and defined, yet flexible Change Management methodology must have a continuous focus on the healthcare system’s history, culture, and business objectives. All parties must work as partners to assist the PMO/project team in defining a comprehensive change management strategy, plan, and delivery model to provide the project the ability to achieve beneficial change. In short: It is about COMMUNICATION and UNDERSTANDING.
The four-phased Change Management approach below is designed to assist both the PMO/project team and the business owners/stakeholders to successfully accept and adopt the new application/technology, functionality, and associated new ways of doing business. These phases include:
Phase 1 — Change Readiness Evaluation
Successful change requires that the methods, techniques, strategy and implementation tactics be tailored to the particular history, culture, and personalities of the health system. Prior to defining a change strategy, the project team must first understand the organization’s culture in terms of readiness and capability for change.
Tools. Leverage surveys, focus groups and interviews to gain an immediate understanding of how the communication of previous change has been regarded by stakeholders. The Change Readiness Evaluation will reveal perceptions about the capability of the health system to incorporate and sustain change. The knowledge of stakeholder perceptions allows for the creation of a Change Management Strategy and subsequent Change Management Plan that addresses the health system’s needs and mitigates risks at the onset to enhance the likelihood of a successful implementation. Also, during the Change Readiness Evaluation information should gathered as to the communication vehicles and format that stakeholders find the most useful.
The Change Readiness Evaluation serves as a starting point to measure future communication effectiveness and improvement.
Phase 2 — Change Management Strategy
Using the knowledge gained in the Change Readiness Evaluation, the PMO/project team develops a Change Management Strategy customized for the health system. The Change Management Strategy defines the change and communication activities required to move the health system from project start-up through implementation. The Change Management Strategy is aligned with the implementation plan to ensure communications are delivered in conjunction with project milestones.
Tools. The Change Management Strategy must include:
- Target audiences of the people in the organization who will be impacted by the change
- Vehicles for communication or tools to be used to reach the target audiences
- Topics for communication based upon information received during the Change Readiness Evaluation
- Risks and barriers identified during Change Readiness Evaluation
- Project plan of communication activities
- Communication activity structures and components
- Samples of communication activities
- Change team roles and responsibilities
The Change Management Strategy serves as the guideline for the development of the Change Management Plan. The Change Management Strategy and subsequent Plan must be flexible and responsive to meet information needs as they arise. Continual assessment tools (formal and informal), structured customer monitoring, user forums, together with two-way communications help ensure flexibility.
Phase 3 — Change Management Plan
Following the approval of the Change Management Strategy, the PMO/project team should develop a Change Management Plan to provide tasks, actions, and details of the required materials to be developed to meet communications needs, as well as the schedule/logistics for communications.
The Change Management Plan must define members of each of the target audiences who will be affected by the change. Keeping in mind that distinct target audience may have different information requirements (read as “training!”).
The Change Management Plan must be revised as the implementation project progresses based upon the specific needs of the target audience and the communication objectives of the health system for that target audience.
Tools. The following areas must be covered within the Change Management Plan:
- Target audience members
- Types of communication
- Outline and objectives for each communication
- Amount of communications needed by each target audience
- A list of communications materials
- Communications resources, including the Change team and Change Agents
- Communications facilities (if needed)
- Communications schedule
- Media required
Phase 4 — Change Management Delivery and Re-evaluation
With the Change Strategy and Plan in place, the PMO/project team assists the health system with the development of communication
materials, events, provides guidance and counsel regarding the delivery of change management.
Tools. The PMO/project team develops proven communication materials such as:
- media treatments
- celebrations (kick-off, milestone events and go-live)
Communications are developed to ensure that key messages are included consistently to ensure that stakeholders understand changes, from the process through the impact on their role within the organization. The PMO/project team supplies the tools and resources to ensure the change plan is delivered.
Throughout the delivery of change management, communication methods are evaluated at various stages to ensure the most effective delivery of information – in reference to content and delivery mechanism. Two-way communication allows information to flow to target audiences and for target audiences to provide feedback to the PMO’s Change team, providing stakeholder involvement and enabling program changes to ensure communication effectiveness. Constant feedback allows the PMO/project team to manage and mitigate unexpected problems. Frequent assessments must be made to ensure that the communicated message is reaching its targeted audiences effectively. As the PMO/project team becomes aware of the unique needs of each target audience, these needs are documented and incorporated into future communication efforts.