1 Session 2: Enabling Benefits Through Change v4.0 May 2009 eHealth Benefits Management Toolkit.

1

Session 2:

Enabling Benefits Through Change

v4.0May 2009

eHealth Benefits Management Toolkit

2 Benefits Management

Session 2 Outline

Completing the Benefits

Dependency Network

Stakeholder analysis

Defining Change


Session 2 Purpose

At the end of the session, you will have an understanding of:

• how to identify broad business and enabling changes required to deliver each benefit and map them out in the Benefits Dependency Network (BDN);

• how to conduct a stakeholder analysis to ensure that the relevant groups are consulted with and identify and pre-empt resistance; and

• how to identify appropriate owners for the changes required.


Business Changes and Change Owners


Dependency Network


Defining Change


Benefits Dependency Network (BDN)

O1

Objectives

B1

B2

Benefits

C1

C2

Business changes

E1

E2

E3

Enabling changes

I1

I2

IM&T

Session 1 Session 2


Enabling Benefits Through Change

• IM&T implementation will not bring benefits on its own: define how the system will be used to make improvements to the service and what changes are required to accomplish this

• Changes definition and implementation should form part of the standard project management of the investment

• Take account of constraints and assumptions defined in the project plan when defining changes

• Ensure key stakeholders are involved in agreeing and setting the changes

• Without the underpinning process and role changes, the benefits will not be delivered


Defining Changes and Activities

Business changes: • new ways of working that are required to ensure that the desired

benefits are, and continue to be, realised. • This includes changes to processes, pathways, roles and working

relationships.

Enabling changes: • changes and activities that are pre-requisites for achieving the business

changes or that are essential to bring the system into effective operation within the organisation.

• These could be: infrastructure set up, data migration, training interventions, resolution of governance issues, decommissioning of legacy systems…


Business Changes

ACTION:

Define the changes to processes and roles required to ensure that the benefit is realised.

• what changes need to happen within the operational line and services?• what changes will be required to the activities that people do?• which roles are affected?

NEXT:

Connect the benefits to the business changes required in the Benefits Dependency Network (BDN).

If any benefits do not have associated changes, should they be included in this programme/project.

ACTION:

Define the changes to processes and roles required to ensure that the benefit is realised.

• what changes need to happen within the operational line and services?• what changes will be required to the activities that people do?• which roles are affected?

NEXT:

Connect the benefits to the business changes required in the Benefits Dependency Network (BDN).

If any benefits do not have associated changes, should they be included in this programme/project.

(B1)C1: consult patient’s

history before ordering test (clinicians)

B1: Fewerrepeat

proceduresO1: Safe

(B1)C1: consult patient’s

history before ordering test (clinicians)


Enabling Changes

ACTION:

Define the changes to governance and behaviours, the training interventions, working relationships,… required to support the business changes.

• what actions are required and when to ensure that the business changes can be implemented?

• Who will be responsible for each of them?

NEXT:

Connect the enabling changes to the business changes they support in the BDN.

ACTION:

Define the changes to governance and behaviours, the training interventions, working relationships,… required to support the business changes.

• what actions are required and when to ensure that the business changes can be implemented?

• Who will be responsible for each of them?

NEXT:

Connect the enabling changes to the business changes they support in the BDN.

(C1)E2: Doctor has

access to SCI Store(governance)

(C1)E1: Patient is

identified using CHI(Clinicians)

B1O1(C1)

E1: Patient is identifiedusing CHI (Clinicians)

C1

(C1)E2: Doctor has access toSCI Store (governance)


System Features

When considering IM&T solutions and capabilities, eHealth Leads to ensure the following questions are addressed:

• Information management: Is information being collected and stored consistently?

• Infrastructure/Physical environment: Is there adequate access to the system? Is it fit for purpose?

• Technology integration: Are the system interfaces running? Is the appropriate information being fed into and out of the system?


IM&T / System Capabilities

ACTION:

Define the system capabilities that need to be enabled to support the changes that will deliver the benefits.

• are any system capabilities not enabling any of the changes? If it costs money but does not add value, then should it be removed?

• are any of the benefits or changes on the map not enabled by a system capability? What is stopping the organisation

from implementing these right now?

NEXT:

Connect the business and enabling changes required to the system capabilities.

ACTION:

Define the system capabilities that need to be enabled to support the changes that will deliver the benefits.

• are any system capabilities not enabling any of the changes? If it costs money but does not add value, then should it be removed?

• are any of the benefits or changes on the map not enabled by a system capability? What is stopping the organisation

from implementing these right now?

NEXT:

Connect the business and enabling changes required to the system capabilities.

(E1)I1: System

Integration with CHI

(E1)I1: Systemintegrationwith CHI

B1O1 E1C1

E2


Benefits Dependency Network (BDN)

O1

O2

Objectives

B1

B2

B3

Benefits

C1

C2

C3

Business changes

E1

E2

E3

E4

Enabling changes

I1

I2

I3

IM&T

ACTION:

Are there any changes enabling more than one benefits (e.g. E2)? or benefits supporting more than one objective (e.g. B2)?...

Link them to those additional benefits to finalise in the BDN.


Stakeholder Analysis


Dependency Network


Defining Change


Stakeholder Management

Planning and monitoring are essential to good benefits management but gaining the commitment of the people who are likely to be affected is just as vital. Not identifying potential stakeholder issues may result in:

• People being defensive, refusing to acknowledge problems or blaming others rather than looking for solutions

• Constant questioning and scepticism

• Negative effect on job satisfaction and motivation

• Increase in absenteeism or staff leaving the organisation

• People not complying with the change agenda and not doing what they said they would


Stakeholder Analysis

The purpose of stakeholder analysis is to:

• identify all stakeholders whose knowledge, commitment or action is needed to realise each benefit and who should therefore be involved;

• determine perceptions of project (“what’s in it for me”, disbenefits);

• understand changes that affect the group and their motivation to achieve or resist them; and

• agree actions needed to gain the required commitment of all stakeholders and develop an action plan.


Change/Benefits Balance Analysis (JW)

NET BENEFITS BENEFITS BUT…

Should champion the project – but must be aware of implications for others and use their influence

Will be positive about benefits but concerned over changes needed – ensure sufficient enabling changes are identified to offset any resistance

FEW BENEFITS BUT… NET DISBENEFITS

Must be kept supportive by removing any inertia/apathy that may influence others negatively

Likely to resist changes – must ensure that all aspects of resistance are dealt with by enabling projects

Be

nef

its

re

ceiv

ed

High

Low

Changes requiredLow High


Identifying Stakeholders

ACTION:

Think of all the people or groups that will be affected by the change:

• Who are the key stakeholders who have a significant influence on the project?

• What business changes will they contribute to make the project successful?

• What benefits will they get, “What’s in it for them?”• How committed to success will they be? • What could they do to jeopardise the realisation of the benefit? • What could be done to discourage negative influences and support

positive ones?


Stakeholders Contribution

Engaging with the stakeholders will enable you to:

• Avoid conflict and associated delays • Identify additional enabling changes

• Refine business changes

• Refine benefits

• Formulate a benefits plan that is practical, sensible and do-able

• Prioritise efforts and understand current service performance

• Develop process ownership and gain commitment


Defining Change


Dependency Network


Defining Change


Completing the Benefits Management Templates

• Transfer and expand into more detail the information from the Benefits Dependency Network in separate templates

• Use the templates for benefits, changes and stakeholder analysis available in the eHealth Benefits Management Toolkit, or devise your own

• Share the changes and IM&T capabilities identified with relevant parties to inform the project plan and system functional specifications

• Plan training and communications to coincide with roll-out and deployment schedules


Completing the Change Template from the BDN

Change (C) or Enabler (E) ID

Change or Enabler description

… Prerequisite changes/ enabler(if relevant)

Dependent changes / enabler(if relevant)

Dependent benefit(s)

System feature(s) required

System feature(s) enabled

Enter ID number from BDN

Enter change name from Benefit Dependency Network (BDN)

… Enter the ID and name of the enabling change required to effect the change

Enter the ID and name of the business/enabling change enabled by the change

Enter name of the benefit this change enables

Enter the name of the system feature / functionality required to effect the change

Enter the name of the system feature enabled by the change

ACTION:Transfer the information from the BDN into the change template:

•What preliminary actions are required prior to the change?•What system capabilities do they require or enable?•What benefits do they support?

22 Benefits Management22

Enablers and Change Owners

Change owners:•Those who will need to mobilise change in their departments.•They will be responsible for ensuring that each change is translated to the operational line.•They will be expected to lead the change.

Enablers:•Those whose working practices need to change for the benefits to be realised and whose effort is required to ensure that each benefit is achieved.

Change owners:•Those who will need to mobilise change in their departments.•They will be responsible for ensuring that each change is translated to the operational line.•They will be expected to lead the change.

Enablers:•Those whose working practices need to change for the benefits to be realised and whose effort is required to ensure that each benefit is achieved.


Who are the Enablers and Change Owners?


Change or Enabler description

Change owner(s) … Enabler(s) …



Enter name and role of the person who will ensure that each change is translated to the operational line and is implemented

… Enter the people whose jobs will change

…

ACTION:Define and record the following information about the changes:

•Who will be responsible to ensure the changes are effected?•Who will actually implement them?


Change Implementation


Change or Enabler description … Due date

Resources required



Enter the date the change will be implemented

Enter what staff, equipment, logistics, financial resources … will be required to deliver the change

ACTION:Define and record the following information about the changes:

• When will the change be effected?• What resources will this require? Is this reflected in the “change owner”,

“enabler” and “prerequisite change/enabler” columns?


Change Management

Most of the change management will be done as part of the standard project management process:

• Use change identification to assess the amount of work required to achieve each benefit and therefore its feasibility and viability.

• Have regular discussions to ensure that these activities have been included in the project plan and that all prerequisite changes and IM&T are in place in time.

• Keep track of progress. Any delay or issues should be investigated and remedial actions identified.

• Assess effect on the realisation of the benefits and amend the BDN and other templates accordingly.


Further Reading and References

• Definitions, tables and diagrams marked (JW) are borrowed from:John Ward and Elizabeth Daniel, “Benefits Management: Delivering Value

from IS & IT Investment”, John Wiley & Sons Ltd, 2006

• Improvement Leaders’ Guide series, “Managing the Human Dimension of Change”, NHS Institute for Innovation and Improvement, 2005; http://member.goodpractice.net/ContinuousImprovementToolkit/resources/creating-an-improvement-culture/managing-the-human-dimensions-of-change.gp

1 Session 2: Enabling Benefits Through Change v4.0 May 2009 eHealth Benefits Management Toolkit.

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Transcript of 1 Session 2: Enabling Benefits Through Change v4.0 May 2009 eHealth Benefits Management Toolkit.