Because the vision of Catholic Health Initiatives — to transform health care delivery and create new ministries that promote healthy communities — requires innovation and change, Catholic Health Initiatives has implemented a change leadership model that will help the organization to thrive on change.
“Catholic Health Initiatives’ senior leadership wants to increase the pace and success of change within the system,” said Mike McIntosh, vice president of change leadership for Catholic Health Initiatives. “They believed that Catholic Health Initiatives already did relatively well at process- and technology-related aspects of change, but needed to help people throughout the organization become more engaged in change. Our change leadership methodology, adapted from a successful methodology used by GE Healthcare, truly manages and promotes the people side of change.”
Focus on Major Strategic Initiatives
While Catholic Health Initiatives’ change leadership methodology can be used effectively throughout the organization, it is currently focused on the system’s major strategic initiatives.
Change leadership is being applied to the implementation of CHI Connect, Catholic Health Initiatives’ integrated system for the management of essential business functions, including payroll, accounts payable, core accounting, human resources and supply chain. CHI Connect will streamline these operations, help employees access information they need to work more efficiently, and leverage the collective buying power of Catholic Health Initiatives.
The Role of Leadership
With a project that brings significant change, such as CHI Connect, leadership is critical to success. Effective project management and the use of change resources, methods and tools are also essential. “All of these elements are essential to effective change, but leadership is arguably the most essential,” said McIntosh. “In driving change, there is no substitute for leadership support. Significant, lasting change does not occur without visible, committed leaders. This is the kind of leadership that Michael Rowan, Catholic Health Initiatives’ chief operating officer, is providing to the implementation of CHI Connect.”
Rowan said that it is critical to ensure that leaders and organizations are ready and capable of making necessary changes and to function effectively after the changes are made. “Achieving
alignment and commitment around a project at all levels of leadership and management is key to effective, efficient implementation and success. Without this commitment and alignment, expecting employees to readily accept and make changes — however necessary the changes are — becomes very difficult.”
The essential role of leadership in change is one reason that Catholic Health Initiatives’ process is called change leadership rather than change management. “John Kotter, the Harvard Business School professor who is an authority on leadership and change, said that producing successful change is about 80 percent leadership and 20 percent management,” said McIntosh. “You can have excellent management of the planning, budgeting and problem-solving processes related
to change, but for real success you need leaders to sponsor and champion change from the start. Leadership support for change is essential to people’s acceptance and ability to integrate change into their jobs.”
“The faster you can get all leaders on board, the better,” said Rob Cunningham, vice president of human resources at Good Samaritan Hospital, Kearney, Neb. “We conducted a one-day director’s retreat, led by our chief executive officer, to help align our leaders around the vision and desired outcomes of CHI Connect. During the retreat, we overviewed CHI Connect and conducted demonstrations. We described what success would look like for our departments, barriers to success and how leaders can help achieve success. We also discussed what we need to do individually to make CHI Connect successful. The feedback described the retreat as ‘excellent.’”
Seven Components of Change Leadership
In Catholic Health Initiatives’ change leadership methodology, change is effective and efficient when all seven components of the methodology are done well.
Following are the seven components of change leadership, brief definitions and examples of how they apply to the implementation of CHI Connect.
Using the Work-Out™ Process
Catholic Health Initiatives’ change leadership methodology includes a useful improvement methodology for CHI Connect implementation: the Work-Out process. “Successful implementation requires redesigning some processes, policies and roles in order to synchronize them with the new CHI Connect systems,” said Rowan. “It is important to start this redesign ahead of the implementation of CHI Connect technology. Change leadership can provide resources and facilitate Work-Out sessions that will help.”
A Work-Out is a one-day, highly focused meeting in which a problem is discussed by those closest to it. The group identifies major issues and barriers, then discusses solutions. The group chooses a solution to present to a sponsor: typically, the sponsor is a leader who can drive implementation of the solution. The sponsor may either accept the solution; decline to accept, sending the group back for more discussion; or ask for more information before making
“Work-Outs get people to sit down together and break down barriers so they can work productively to resolve issues by agreeing on workable solutions,” said McIntosh. “By the end of the 2007 fiscal year, there will have been nearly four dozen projects throughout Catholic Health Initiatives that include Work-Out sessions. These Work-Outs focus on issues ranging from having the right supplies in the right place at the right time to medication reconciliation to reducing emergency room wait times. At least 25 percent of these Work-Outs are related to CHI Connect, and we expect that percentage to increase as the implementation of CHI Connect continues.”
Change Agents Throughout CHI
The Work-Out process is facilitated by trained change agents located throughout Catholic Health Initiatives. “We thought about establishing mobile change agents who would travel to different market-based organizations as needed, but decided it is valuable to have at least two trained change agents located in every market-based organization,” said McIntosh. “While there may still be a need for change agents to travel from time to time to help facilitate change in other Catholic Health Initiatives locations, these resources are readily available to each market-based organization.” Catholic Health Initiatives currently has nearly 175 change agents trained in Work-Out and other elements of the change leadership process.
St. Joseph Medical Center, Reading, Pa., uses its trained change agents to help facilitate change related to CHI Connect. Scott Mengle, vice president of human resources, emphasizes the importance of spending time aligning management with the objectives of CHI Connect. “I think you can underestimate the time and effort it takes to align managers to the need for change,” Mengle said. “The 12 change agents we have trained help managers work through changes and barriers to change. We find that informal meetings between a manager and a change agent are sometimes more effective than larger meetings that use a more formal process to gain alignment.”
Catholic Health Initiatives also has seven master change agents who work full time to support the change agents and the use of the change leadership methodology. Four of the seven — Jerry Brooks, Marilyn Jones-Davis, Judy Ann Mundis Stephens and Ron Stephenson —are primarily devoted to working with CHI Connect.
The master change agents coordinate with other Catholic Health Initiatives staff to support the change leadership process, including its application to CHI Connect. These include communications, knowledge transfer and learning professionals who have also been trained in change leadership concepts, methods and tools.
What’s Next for Change Leadership
Catholic Health Initiatives will continue to apply its change leadership methodology to strategic priorities and major initiatives like CHI Connect. Change leadership is also being integrated with leadership development programs, human resources practices and other systems and processes. Leaders and change agents across Catholic Health Initiatives will continue to be engaged in order to increase understanding and application of the methodology.
“We are tracking applications of our change leadership process so that we can communicate results and share learnings. This will also help clarify when and how our leaders can use the methodology to the benefit of their organizations and their people,” said McIntosh. “Over time, we anticipate significant increase in effective and efficient change as a result of the change leadership methodology, which will ideally result in improved clinical and operational outcomes.”
- Leading Change: having a champion and leadership team who sponsor the change. With CHI Connect, leading change includes having market-based organization leaders kick off and “own” the implementation of CHI Connect within their organizations; and aligning key leaders, managers and stakeholders around project’s goals.
- Creating a Shared Need: having a reason to change, whether driven by threat or opportunity. Through monthly calls and meetings, both Catholic Health Initiatives and market-based organization leaders create understanding of the need for and the shared benefits of CHI Connect.
- Shaping a Vision: the desired outcome of a change is clear, legitimate, widely understood and shared. Market-based organization leaders develop their understanding of the vision and desired outcomes for successful CHI Connect implementation, then build common understanding and commitment through consistent communication within their organizations.
- Mobilizing Commitment: key stakeholders are identified, resistance is analyzed and actions taken to gain strong commitment. Onboarding sessions, ongoing assessments, training, communications and site visits help gain the commitment of all stakeholders in the CHI Connect implementation process.
- Making Change Last: learnings are transferred throughout the organization, with consistent, visible and tangible reinforcement of the change. Market-based organization leaders communicate successes and lessons learned during CHI Connect implementation, addressing stakeholders’ feedback and questions.
- Monitoring Progress: progress is made; benchmarks are set and realized; indicators are established to ensure accountability. Leaders regularly monitor progress toward CHI Connect project milestones and assess go-live success using operational metrics.
- Changing Systems and Structures: management practices are aligned to complement and reinforce change. Leaders ensure that all policies, systems and structures are redesigned and aligned as needed with new CHI Connect systems and processes. Effects on roles are identified and necessary changes implemented.