CHANGE MANAGEMENT 2014PRESENTED BY:

DR. VICTORIA GRADYTHE GEORGE WASHINGTON UNIVERSITY

KRISTEN LILLY, MHA, RHIA, CPHQPYA

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WHAT DO A PLANE CRASH, A DESERTED ISLAND, AND A VOLLEY

BALL HAVE TO DO WITH ORGANIZATIONAL CHANGE?

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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.

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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.

WHY?

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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.

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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…

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THE SYMPTOMS

IndividualSymptom

OrganizationalSymptom

Suggested Mitigation or Intervention Strategy

Anxiety MoraleEnhance and Increase Support from Leadership/Sponsorship

Frustration ProductivityIncrease Education/Training with

the Identified Change

Rejection of the Environment

ConflictImprove

Communication

Retardation ofDevelopment

MotivationIntegrate Individual

Coaching

Refusal toParticipate

AbsenteeismIncrease Employee

Engagement and Support

Withdrawal TurnoverAddress Job Satisfaction

and Commitment

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TOOLS TO DEFINE ATTACHMENTS

Qualitative Tools• Observation (Lurking)• Interviews• Focus Groups

Quantitative Tools• Social Network Analysis• Personality Assessment• Attachment Assessment

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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

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CASE STUDIES

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Baseline-Aug 2010 Calibration-Oct 2010 Final-Feb 2011

Organizational SummaryA

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CASE STUDY 1- EMR INTEGRATION

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CASE STUDY 1 (CONT.)

All Rights Reserved - Reproduction Request Contact Grady&Grady, LLC13

Baseline-Aug10 Calibration-Oct10 Final-Feb11

Front Office

Baseline-Aug10 Calibration-Oct10 Final-Feb11

Floor Nurse

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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.

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HEALTHCARE CHANGE: ICD-10ORGANIZATIONAL 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

PhysicianOperational Planning

Information Technology

• IT Systems• Capability, Communication• Functionality• Vendor Preparedness

ICD-10

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HEALTHCARE CHANGE MANAGEMENT:ICD-10 KEY PROJECT STAKEHOLDERS

Scheduling / Access Areas

Health Information Management

Information Technology

Decision SupportPhysician Advocate

Billing & Reimbursement

Human Resources

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CHANGE DIAGNOSTIC INDEX©

RESULTS BY DEPARTMENT

A D F G P R W AVG.1.00

1.20

1.40

1.60

1.80

2.00

2.20

2.40

2.60

Coding Information Systems Medical Records Patient Access ServicesPatient Financial Services Transcription Utilization Review

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CHANGE DIAGNOSTIC INDEX©

RESULTS BY YEARS OF SERVICE

A D F G P R W AVG.1.00

1.20

1.40

1.60

1.80

2.00

2.20

2.40

2.60

0 To 5 Years 6 To 10 Years 11 To 20 Years 20 Years

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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.”

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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

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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.

DR. VICTORIA GRADYTHE GEORGE WASHINGTON UNIVERSITY

KRISTEN LILLY, MHA, RHIA, CPHQPYA