September/November 2006

Transforming Health Care: Vision and Culture

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Catholic Health Initiatives’ vision is to live out its mission by transforming health care delivery and by creating new ministries for the promotion of healthy communities. “The heart of our vision — the transformation of care delivery and the creation of new ministries — by definition requires innovation and change leadership,” said Kevin Lofton, president and chief executive officer of Catholic Health Initiatives. “For Catholic Health Initiatives, innovation and change leadership are about being able to do things differently — and better,” said Herb Vallier, senior vice president and chief human resources officer. “It’s about improving the care we provide for our patients and residents and their families. It’s about our ability to continuously improve clinical quality and patient safety. It’s also about improving productivity and operating efficiencies — reducing cost and saving time.” Lofton said that for an organization to thrive on change, the capacity for innovation and change must be forged in the organization’s culture. “This type of culture expects innovation and change of its leaders, and encourages, supports and rewards them accordingly,” he said. “In this type of culture, leaders have the incentives, resources and rewards they require to drive and accomplish change. We know that not every attempt to innovate and change is successful, but we want our leaders to know that it is safe to try.” To help galvanize change leadership skill development across the organization, Catholic Health Initiatives, is working with GE Healthcare as a strategic partner. “GE Healthcare is sharing with Catholic Health Initiatives the methodology and tools it used to create a world-class organization dedicated to change leadership,” said Vallier. “We believe that GE is achieving the kind of change leadership that we can learn from. GE’s Change Acceleration Process (CAP) and Work-Out™ approach to accelerating change have helped them increase productivity and improve customer satisfaction. We believe that our capacity for innovation and change can grow from their shared experience and knowledge.” Change Leadership: Delivering Strategic priorities Putting change leadership at the center of delivering strategic priorities requires integrating a rigorous change management model into standard leadership practices and behaviors. A common methodology is essential for making change routine rather than the exception. “Business imperatives call for change; having a model for change helps leaders manage, realize and accelerate the change,” said Mike McIntosh, vice president of change leadership. “The model brings a proven, consistent and disciplined approach to change leadership.” Change Acceleration Process (CAP) Change efforts are continuously at work in most industries, and certainly in health care. But while some change efforts proceed smoothly, others do not. “The most common reason that major change initiatives fail is that the people-related issues are not addressed,” said McIntosh. “It’s not that the process or the technology failed — it’s that the people didn’t become engaged in or accept the change. The acceptance of change is absolutely essential to success, but the leaders who drive change usually spend more time on the technical aspects of the process, assuming that the people involved will just ‘get on board.’ More often than not, that’s a mistake.” The change leadership process that Catholic Health Initiatives is adapting from GE Healthcare focuses on acceptance. “GE has found that two-thirds of quality efforts fail from lack of attention to the cultural and people side of change, so it is important to devote considerable time and effort to that area,” said Bob Cook, vice president of human resources and master change agent. “Just telling people ‘We have to change’ is not enough. Their acceptance, nderstanding and support are essential.” GE’s Change Acceleration Process addresses these issues. The illustration at right describes the process, including the considerable focus on “leading change” in the top half: creating a shared need, shaping a vision and mobilizing a commitment. Organizational communication processes are integrated throughout the model. All of these components are designed to build acceptance, accountability and support for change. Work-Out™ Work-Out™ is a concentrated, team-based decision-making and empowerment tool used to resolve issues and improve processes. A team of experienced, knowledgeable people with a stake in an issue or problem is chartered to develop solutions and action plans in a single meeting. The team is empowered by a sponsor and key stakeholders to proceed with implementation and is accountable for action plans and outcomes. To help support and guide the process, Catholic Health Initiatives already has trained four master change agents, with three more in training; 80 change agents from around the organization, including 43 from national groups and 37 from market-based organizations; and a total of 50 sponsors from national groups and market-based organizations. Inaugural Work-Out™ Experience: Cindy Tame, sponsor of Catholic Health Initiatives’ inaugural Work-Out™, said the participants found value in having a full day dedicated to focusing on the problem and solutions. “The information technology (IT) organization had goals to resolve urgent help desk incidents within 24 hours and high-priority incidents within 72 hours, and to meet those goals 95 percent of the time,” she said. Representatives from key IT service areas came together to brainstorm about barriers to meeting the goals and to identify and prioritize solutions. “By bringing together the diverse service groups within IT, we discovered there were diverse interpretations of the incident management procedure,” said Cindy. “The outcome of the Work-Out™ includes improvements in procedures, training programs and reporting as well as a help desk system enhancement. The ultimate goal is to provide consistent quality service to our customers, and this process is moving us toward that goal.”

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The Time to Resolve: Urgent and High Incidents Work-Out™ group included (seated, left to right) Herb Kruger, David McCurdy, Marlin Howell, Cindy Tame, Michael Perdue, (standing, left to right) Martin Alvarez, Marita Schifalacqua, Mark Buhrer, Mark Leno, Ed Levy, Duc Chu, Bob Cook, Patti Wallace and Jay Williams.

Change Acceleration Model and CHI Connect The process is also being applied to the implementation of CHI Connect. This massive project requires coordinated change and resource management across the system. The Change Acceleration Model will help ensure the most effective implementation, providing methods and tools that national and market-based leaders can use to create an environment for an accelerated, successful transition to newly implemented systems. “Understanding the need for change, the desired outcomes and benefits and how individual jobs are impacted are key to realizing the maximum potential of CHI Connect and ensuring efficient implementation,” said Michael Rowan, chief operating officer for Catholic Health Initiatives. “Tremendous effort and participation across the system went into the design of CHI Connect and related business processes. However, there will likely be processes and policies at individual market-based organizations that will need to be adjusted to ensure alignment with new CHI Connect processes. Work-Out™ will provide an effective, results-oriented methodology to address issues and process changes that may arise during CHI Connect implementation.” Master change agents are working to help Catholic Health Initiatives and market-based organization leaders address the “people side” of the changes associated with CHI Connect. “Effective communications are critical to gaining commitment, acceptance, accountability and ultimately an accelerated rate of change,” said McIntosh. “Transferring learning from initial CHI Connect experiences to future implementations is important to create more effective implementation processes as we move forward.” Next Steps: Strategies for the Near, Intermediate and Long Term The future of Catholic Health Initiatives’ change leadership initiative is well planned. Near-term strategies for the next 12 to 24 months include continuing to refine leadership’s role; building awareness and understanding of change leadership concepts, methods and tools; applying the process to a variety of situations that require change; sharing learnings and successes; and measuring progress. Strategies for the intermediate term – two to five years from now – include integrating change leadership with Catholic Health Initiatives’ key leadership, management and operational systems; continuing to drive the understanding and application of the initiative; developing and applying change leadership concepts, methods and tools; monitoring and learning from measures of progress and success; and applying lessons learned from early applications of the change leadership process. Long-term strategies have a timeframe of five years or more. They include developing new leaders and managers; continuing to develop and apply change leadership concepts; and applying learning to further accelerate change and organizational transformation.