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Change Management

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by

PSUHMC FMR

on 7 March 2014

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Transcript of Change Management

CHANGE
OBJECTIVES:
- To develop appreciation for the need to change
- To identify what drives change
- To understand responses to change and how to manage them well
Which of the following represents a healthy approach to change?
“Change happens; get over it.”
“Change doesn’t have to be disruptive; we can control it (and the people who implement it)”
“Change is difficult because it often results in a sense of “loss”; it is important to acknowledge the loss.”
“Even though change is constant, it must be “managed”; it cannot be taken for granted.”
“Any major change brings a decrease in productivity; we can shorten the depth of the “dip” and the length of time it takes if we manage change well.
Pre-Questionnaire
"Even if you are on the right track, you'll get run over if you are just standing still."
- Will Rogers
Change Drivers in Healthcare
Public health crisis
Universal healthcare
Rising costs
Medicare, legal reform
Patient expectations
Technology - dx advances
Health literacy
Pharmaceutical development
Geographic population shifts
Aging population
Immigration
Internal drivers
of change
Timothy D. Riley, MD
Penn State Hershey Good Samaritan Hospital
Family Medicine Residency
Practice Management Curriculum
Text from AAFP Residency to Reality 2012
(Exceptions cited)

Staff additions
& changes
New facilities
Strategic adjustments
New equipment
Cash flow variations
Ownership & management changes
Growth
2 out of 3 corporate change projects fail.
50 - 75% of mergers/acquisitions fail to achieve expectations.
Medical practices are not exempt from the challenges of change.
The Alarming Truth
WHY?
Cooperation
Implementation
Solution
“When you’re through changing, you’re through.”
- Bruce Barton
Is the proposed “solution” (or can it be) compatible with existing:
Processes?
Facilities?
Skills?
Goals?
Values of the organization?
Solution
To assess the Decision Process, ask:
Who needs to be involved?
Do they have needed expertise?
Are all “stakeholders” adequately represented?
Are all reasonable options being considered?
Have we allotted adequate time to evaluate options and the impact of each on the organization?
Have we identified appropriate decision criteria in advance?
Solution Quality
Fit of Solution
to Situation
Implementation
Have the “right” people been involved in creating the plan?
Are all tasks assigned?
Are the steps logistical?
Do we have “sponsors” who can champion change and answer questions? Do they have margin to do it?
Have we allotted adequate time?
Processes: Execution
Is the decision clear?
Is the implementation process clear?
Have we championed the why? Is the urgency clear?
Is the source credible?
Are we using the right media?
Are we listening?
Is there a mechanism for answering questions?
Communication
Cooperation
Responses to change
Excitement
Cooperation
Future focus
Hope
Fear
Conflict
Complacency
Lack of Concentration
Resistance
Sabotage
Confusion
Grief due to loss of
Security
Competence
Relationships
Direction
Territory
Stages of Change
Denial
Resistance
Exploration
Commitment
Change is not needed
Change is not coming
Tendency is to assume worst
Natural tendency is to resist change
Different as foreign and threatening
Bitterness if you feel unheard
Can lead to sabotage
Likely to stay here without support
Consideration of
Pros and cons
Needed steps
Accept change
Engage in facilitating
enlist
ment
stake
holders
of
Enlistment
Matters
People are more likely to commit if they:
Help make the decisions
Are involved in discussion - pre, during, and post
Are involved in forming and executing the process
Benefits of Enlisting Stakeholders
Benefit from their perspective and expertise
Anticipate challenges created by the decision
Proactively address objections
Build trust and demonstrate respect
Facilitate early adoption and ownership
How-To
Formal teams - decisions and advisory
Identify who has something to gain or lose
Address their legitimate concerns
Making It Happen
Identify Stakeholders
Assess Impact
Clarify Stages
Scope
Identify Decision Makers
Identify Change Sponsors
Plan Communication and Training
Plan
Communicate with transparency
Train
Listen
Defuse Resistance
Implement
Adapt as needed
Continue communication
Expect to be wrong
Reward/reinforce
cooperative behavior
Sustain & Reward
"The Bystander"
"The Critic"
"The Curious Cat"
"The Navigator"
Create a burning platform
“The brain is always trying to automate things and to create habits, which it imbues with feelings of pleasure. Holding to the tried and true gives us a feeling of security, safety, and competence while at the same time reducing our fear of the future and of failure,”
Gerhard Roth, "Personality, Decision, and Behavior"
Baggage
Habits
Emotions
Environment
Success
Full transcript