Organizational Readiness Key to Change

NEW YORK—Have a solid strategy and create a step-by-step, integrated approach to change manage​ment while assessing your organization’s readiness for change, advised experts at a recent conference.

“If you don’t bring the users along, the project is likely to fail,” said Claire McCarthy, director of change management for Kaiser Foundation Health Plan Inc., on Nov. 18 at a change management conference presented by The Conference Board.

McCarthy should know. In 2003, her company launched a six-year project—KP HealthConnect, the world’s largest civilian electronic medical records implementation to date. The $4 billion software installation, which required the retirement of hundreds of legacy systems and the launch of one consolidated system, should be completed in 2009.

A Daunting Task

Kaiser Permanente has 8.7 million members and partnerships with three separate but interdependent operating companies—Permanente Medical Group, Kaiser Foundation Health Plan/Hospitals and KP Unions. It employs about 160,000 workers, including 14,000 physicians, 92,000 union members and 41,000 nurses at more than 30 medical centers and 420 medical office buildings. Each of the three entities has its own structures, policies and procedures, which meant change had to be managed around 16 separate companies and 35 unions with multiple bargaining units, McCarthy explained.

One challenge was the lack of a common definition of change management across the organization and few change management resources for managers. McCarthy said that historically, emphasis was placed on changing systems and business processes, but little planning or resources were devoted to help implement change “until after problems occur.”

Organizational Readiness Team Formed

To tackle the challenge, change management and communication directors at Kaiser Permanente set up a national organizational readiness team, which was a “top down approach” with significant executive sponsorship and dedicated resources to address the people side of large systems change, McCarthy explained. Members came from “people-focused” areas such as change management/organizational development, training, communications, HR/workforce planning, unions and workflow/process harmonization.

Senior leadership quickly sanctioned the team and the term “organization readiness” was adopted. The group was charted to serve as a catalyst, convener and facilitator, to develop a common understanding of “user readiness,” to provide clarity and “connect the dots for users to create one story,” and to sequence activities in a way that was logical for users, McCarthy said.

For example, when determining whether someone was a “ready user,” the group considered whether the staff had basic computer skills, experience with KP HealthConnect’s basic functionality and understood the impact the implementation would have on their workflow.

McCarthy said organization readiness work was recognized companywide as being key to success. Even users who initially had difficulty with the system “eventually made it” and there were no union grievances resulting from the deployment, she said.

“Union involvement from the beginning of the project was critical,” McCarthy noted.

Web Tool Added

As demand for change management information grew, Kaiser Permanente developed an internal web site to support line managers and to move change management adoption into other areas, explained Rose B. Cohan, change practice leader for Kaiser Foundation Health Plan. The web site provides consistent tools, terms and processes.

Cohan said change is “rampant” at Kaiser Permanente, with more than 120 initiatives across marketing and sales. The web site averages 1,500 hits monthly. It also gives project, IT and business managers a better understanding of “linkage of change management into planning and implementation of initiatives,” Cohan said.

What They’ve Learned

McCarthy said the “organization readiness” approach helped make Kaiser Permanente “much more collaborative and change savvy” and has been adopted by other large company initiatives. The speakers offered these change management tips:

• Develop and cascade strong senior sponsorship for people-focused work. In absence of visible sponsorship, build alliances, meet business needs and promote wins.
• Frontline supervisors and managers are crucial, so it pays to develop tools and information for them. Involve them early—train them, prepare them and communicate regularly.
• Communicate, build trust early and create a foundation for problem solving.
• Develop new strategies when roads are blocked.
• Reward desired behaviors and outcomes with both tangible and intangible rewards.
• Rely on insights from those in the field doing the “real work,” as well as from subject-matter experts.
• Review impact frequently and correct your course if necessary. Set the expectation that you will get smarter, adapt to changes and gain more support as you go.

Pamela Babcock is a freelance writer based in the New York City area.