Leading Change Teams

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Leading Change Teams Angie Maldonado David
Moore

Reduce Waiting  No-Shows ? Increase Admissions 
Continuation
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Why Process Improvement?

• Customers/clients are served by processes
• 85 of customer related problems arecaused by
  organizational processes
• To better serve customers, organizationsmust
  improve processes

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NIATx Four Project Aims

• Reduce Waiting Times
• Reduce No-Shows
• Increase Admissions
• Increase Continuation Rates

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NIATx Results

• Reduce Waiting Times 51 reduction
• (37 agencies reporting)
• Reduce No-Shows 41 reduction
• (28 agencies reporting)
• Increase Admissions 56 increase
  
• (23 agencies reporting)
• Increase Continuation 39 increase
• (39 agencies reporting)

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Five Key Principles Evidence-based predictors of
change

• Understand Involve the Customer
• Focus on Key Problems
• Select the Right Change Agent
• Seek Ideas from Outside the Field and
  Organization
• Do Rapid-Cycle Testing

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Effective Change Teams Characteristics

• Use Change Team to guide testing
• Needs to be a real change team
• Ensure compelling direction for its work
• Has authority and structure for work
• Works in supportive environment
• Has effective coaching
• Hackman, 2002 Leading Teams

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Understand and Involve the Customer

• Most important of all the NIATx Principles
• What is it like to be a customer? Staff are
  customers, too!
• How does a change leader help understand and
  involve the customer?

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Focus on Key Problems

• What are key agency problems/concerns (Keeps the
  CEO awake)?
• What processes have staff and customers
  identified as barriers to excellent service?
• How does a change leader ensure the change
  project focuses on key problems?

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Select a Powerful Change Leader

• Who can
• influence, be persistence, be respectful and
  authority across levels of the organization
• challenge status quo
• keep project focus
• verify results by data
• devote time to leading change projects.

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Seek Ideas Outside the Organization and Field

• Provides a new way to look at the problem
• Real creativity in problem solving comes from
  looking outside the familiar
• How can a change leader facilitate ideas from
  outside the organization and field?

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Do Rapid-Cycle Testing

• Start by asking 3 questions
• What are we trying to accomplish?
• How will we know the change is an improvement?
• What changes can we test that will result in an
  improvement?
• Model for ImprovementReference Langley, Nolan,
  Nolan, Norman, Provost. The Improvement Guide,
  San Francisco, Jossey-Bass Publishers, 1996

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Rapid-Cycle Testingcontd.

• Rapid-Cycle changes
• Are quick do-able in 2 weeks
• PDSA cycles
• Plan the change
• Do the plan
• Study the results
• Act on the new knowledge

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Detour 1

• Unclear purpose!
• Where are you going?
• How will you know you have arrived?
• Is the change project to complex?

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Detour 2

• No feedback!
• Need a clear tracking measure.
• If use IS, have a simple measure
• Need a clear target to measure.

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Detour 3

• Insufficient project support?
• Executive Sponsor
• Change Leader
• Lacking Clinical Opinion Leader
• Lacking Intake Supervisor/Staff
• Lacking Time To Do PDSA Work

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Detour 4

• No business case
• No clear tie to improving the efficiency or
  quality of services for the agency

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Detour 5

• To Large cyclesget stranded

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Detour Six

• No clear change project

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Why Process Improvement?

• Customers/clients are served by processes
• 85 of customer related problems arecaused by
  organizational processes
• To better serve customers, organizationsmust
  improve processes

20
NIATx Four Project Aims

• Reduce Waiting Times
• Reduce No-Shows
• Increase Admissions
• Increase Continuation Rates

21
Five Key Principles Evidence-based predictors of
change

• Understand Involve the Customer
• Focus on Key Problems
• Select the Right Change Agent
• Seek Ideas from Outside the Field and
  Organization
• Do Rapid-Cycle Testing

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Questions Discussion