Strategic Outreach

Managing Change Via Communications

Look at the Load

The list of Top 10 types of resistance in the post below is missing one big, fat factor that can squash the whole change-management equation.  The Load.  Major implementations occur in the context of all other organizational priorities competing for resources and people’s attention.  Change is also more fragile and risky if there is a history of bad implementation experiences with lingering memories of all the stress caused by poor planning and execution.

In the health care industry, doctors, nurses and other clinicians have faced a relentless onslaught of change.  Caring for patients every single day is their primary focus, but every time they turn around from the bedside or the exam room, they are confronted with another expectation. Among them, learning new documentation technology (electronic health record, ICD-10, computerized order entry), on top of time-consuming quality, safety and patient satisfaction initiatives, revised workflows and processes – it goes on and on.

Defining the climate for change is essential.  It determines organizational readiness and strategies for multi-layered sponsorship for the change.  And of course it guides the communication strategy – timing, messaging (regarding critical needs and priorities) and frequency.

elephant sits

July 24, 2015 Posted by | Change Management, Corporate Communications | , , , , , , , , | Leave a comment

My Top 10 List: Resistance to Organizational or Process Change

Two lists here. First, the top five for implementation of major technology change in a healthcare setting, for physicians and other clinicians.

  1. Fear of the unknown
  2. Dislike time commitment to get training, practice, become proficient
  3. Fear of looking incompetent amidst peers
  4. Concern about disruption to operations (patient care)
  5. Resistance to standardization (workflows, clinical content, order sets, etc.)

All of these reasons (above) relate to other industries also. Next, five other reasons for resistance that can round out my all-industry “Top 10.” (Thanks to Robert Tanner’s blog for input on this.)

  1. Loss of status or job security within the organization (believe they will be harmed by change)
  2. Non-reinforcing reward systems
  3. Peer pressure (protect the department or group)
  4. Climate of mistrust (bad history with implementations and other change)
  5. Organization politics (some have personal motives)

May 7, 2015 Posted by | Change Management, Corporate Communications, IT Process Change | , , , , , , , , , | Leave a comment

What Organizational Change Communication Is and Isn’t

Fake Memos for blog post B-sm  Fake Memos for blog post - A-sm

I recently did a presentation for CAPG (accountable care physicians advocacy group here in California) on the do’s and don’ts of communications strategy that supports change management. I began by defining the parameters.

Organizational change communication is not:

  • an increased quantity and frequency of memo announcements from executive leadership, with reminders and cheer-leading messages
  • feel good meetings and conferences with fancy PowerPoint presentations.

To be sure, the initial “decision” announcement from the chief executive that endorses the initiative and commits resources to it is important. It’s the “listen up everybody, we’re going to do this” memo, and it needs to go on record – but it will do virtually nothing to win the hearts and minds of mid-management or staff.

Organizational change communication is:

  • Communication tools/resources/support for the operating layers of sponsorship for the change – the reinforcing sponsors who influence their teams and staff.
  • Support for face-to-face interaction with peers who are champions, and change agents.

I’ll be delving into this deeper in upcoming posts.

April 20, 2015 Posted by | Change Management, Corporate Communications | , , , , , , | Leave a comment

The Black Hole in the Middle

As a communicator, one of the most enlightening aspects of training for Accelerating Implementation Methodology (AIM)  is the focus on mid-managers during change within a large organization. When they aren’t on board with a major change, they can truly represent a black hole.  Many organizations have made the mistake of going this route (below):

  1. Executive leaders sign on and sponsor the change initiative
  2. These leaders issue the edict/pep talk in a memo to all staff
  3. Mid-managers shrug their shoulders and quietly begin passive resistance.
  4. Staff listens to their managers and adopts the “who cares” attitude; indifference and resistance builds.

In any cheese-moving, game-changing upheaval, the most resistance to change will typically come from those who have the highest vested interest in things remaining the same. As AIM’s Don Harrison puts it: long-employed managers have been told for years that if they play by the rules, they’ll advance.  Now you’re changing the rules.  They’re confused, afraid, and/or angry.  That’s why our communication tools during change focus on managers – helping them to absorb it and articulate it for their staff.

Black_hole

Resistance can surface “out of nowhere.”  I’ve been part of a major organization-wide change where it was realized in the 11th hour right before go-live that a whole department was on the sidelines and hadn’t done any of the training. The department’s director calmly commented:  “Oh, didn’t we tell you, we’ve decided not to participate.”  Needless to say, that wasn’t an option.

So I’ve learned not to confuse awareness with understanding, much less subscription to the cause.  We strive in our communication programs to answer two questions:  “How does this impact me?” and “What’s in it for me?”

January 21, 2015 Posted by | Acquisition Communications, Change Management, Corporate Communications | , , , , , , | Leave a comment

Employee Integration After Acquisition – the Communications Factor

Underestimate the impact of an acquisition on the employees of the acquired organization at your own risk and peril. Just because an employee will continue to do their same job after integration, doesn’t mean that things don’t change in their work world. Often it’s dozens of things – their health & welfare benefits, retirement savings, life insurance, pay date and other HR services (or HR self-service). Their email, information and collaboration networks probably change also. Angst festers due to uncertainty, as employees wonder if their role will continue long-term within the new organization, especially if it’s a larger, more complex organization.

As your people move from being an employee of Company A to an employee of Conglomerate ABC, well-strategized communications are needed to avoid confusion, skepticism and negative perceptions about the change. This series of blog posts will explain what worked for us during the integration of 1,280 clinicians and support staff, plus about 900 affiliated physicians, at a prestigious hospital that became a part of our 33 hospital, 5-state health care system.    

The Kick-Off Strategy – Spell Out What’s Changing, and What’s Not

It is imperative to kick off the integration with a substantive communication from executive leadership that spells out what’s changing, and what’s not changing for the employee. Do this before the integration begins impacting everyone. Effective sponsorship of the change requires multiple levels of management to be actively supportive and involved, but the process starts with executive leaders. They need to not only endorse the change initiative, but also communicate its importance and the resources they have ensured are behind it.

Allow as much lead time as possible to prepare this communication. Timing is tricky – it’s a balance between getting it out early enough to alleviate staff angst and confusion, and late enough that most change factors and go-live timeframes have been solidified to make it as meaningful and helpful as possible.

The emphasis in all communications to managers and staff groups should be on the positive outcome and future for both organizations, but there should be acknowledgement of the challenges and short-term inconvenience during the change. Transparency is key.

November 25, 2014 Posted by | Acquisition Communications, Change Management, Corporate Communications, Employee Integration | , , , , , , , , , , , , | Leave a comment

Communication Tactics and Tools as Employee Integration Begins

To get employees on board during integration into a new organization, equip managers with information on the integration steps and ask them to discuss it with their staff/team. This is typically a very effective way to build awareness, depending on the organization’s culture. We prepare FAQs, Talking Points, and Timeline Overview tools to assist these core leaders.

There’s one communication, however, that you’ll want to send directly to all staff levels, without relying solely on mangers. It’s an initial “what’s changing, what’s not” roll-up communication from an executive leader that previews what happens during the integration.

Due to the structure of teams working on the integration, the tendency is to generate one memo from HR and one from Information Services (a.k.a. “IT”) explaining the changes and when they will occur. Resist the temptation to produce separate “welcomes” and combine them. An employee cares about what changes, both personally (for them and their family) and within their immediate work environment, not what department is sponsoring the change. Certain employees also will be looped into other arenas that change, such as supply chain or finance.

Another tool is an “at a glance” overview of milestones and dates (via a checklist or other vehicle) for quick reference by managers and staff. Here’s an example – part of a checklist from a recent integration I anchored.

Pathways to Providence piece

This series of blog posts explains what worked well (or didn’t) during the integration of about 2,000 clinicians, support staff and affiliated physician, at a prestigious hospital that became a part of our 33 hospital, 5-state health care system.

 

November 17, 2014 Posted by | Acquisition Communications, Change Management, Corporate Communications | , , , , , , , , , , | Leave a comment

When the change initiative changes

About our Epic Implementation at Providence Health & Services: 27 hospitals (ranging from small rural hospitals to 700-plus-bed medical centers) and 350 clinics across five state are moving to a single-build Epic Electronic Health Record system (2012-2014).

A seismic change to an organization or to its core operations is hard enough to accomplish, but from a communications standpoint, it’s even more challenging when the change initiative itself changes along the way. After going live on Epic at six hospitals and dozens of clinics within four months last year, our leadership realized that the initial, highly aggressive go-live schedule could not be maintained. Problematic areas included: building unique lab interfaces for every hospital and clinic group; getting revenue cycle processes up and running (ex: charge capture); and getting physicians across the system to agree to standardized order sets.

After having trumpeted “full steam ahead” for many months, we suddenly needed to explain the need for a 6-month pause in hospital go-lives so that the Epic team could fix, complete, or improve a whole bunch of things. Ambulatory go-live waves of clinics, however, continued during this period.

Our intention was not only committing to getting it right, but also to reinforce that we are a “learning” organization that expects mistakes, and expects to learn from them.

What didn’t change: the executive sponsors’ involvement and commitment to the objective and the program. Strategically we remained consistent; tactically we were flexible. During the inpatient go-live pause, twelve high-priority workgroups hammered out specific deliverables. Communications were open, transparent, positive, and frequent.

May 29, 2013 Posted by | B2B messaging, Change Management, Corporate Communications, IT Process Change, Tech Sector Thought Leadership | , , , , , , , | Leave a comment