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Better Business, Better Care
Bureau of Medicine and Surgery2012 Resource Management and Logistics Symposium
Leading through Change: Aligning, Energizing, and Mobilizing your Staff
June 4, 2012
Presented By:Ms. Shannon Cowsert, Deloitte
Ms. Diane Holt – Comptroller Naval Health Clinic New EnglandLT Holly Lee – Comptroller Naval Hospital Okinawa
Ms. Samanthia Henderson – Naval Expeditionary Medical Command
Agenda
1. Your role as a change leader
2. Change management challenges
3. Change management strategies and toolkit
4. Break-out discussions
5. Closing
2
3
Change Management
Context: DoD is required to assert audit readiness by the end of Fiscal Year 2014. Usage of Standard Operating Procedures (SOPs) is an integral component in achieving audit-readiness.
Purpose: This session will prepare leaders to support their staff in the transition to using SOPs as the official Navy Medicine business standard.
Outcome: Leaders take away a “Change Management Toolkit” to help lead the change and to mitigate the potential risks involved with implementing SOPs.
“Quote” (optional)– Quote source
“A leader leads by example, whether he intends to or not.”
- John Quincy Adams
The Challenge:How do you lead the transformation of business practices?
4
Your Role as a Change Leader
Understand the future state vision of Navy Medicine financial management, and the changes that will impact your staff
Communicate information about SOPs and why they are important- Speak and act positively about SOPs- Get any resistance and concerns out in the open
Support your staff during the transition- Arrange work schedules so that employees can attend training as
scheduled- Help employees feel comfortable accessing, using, and providing
feedback on SOPs- When questions come up, ask “What does your SOP say?”
Be patient and persistent - breaking old habits and embracing new values is difficult, and it will take time for your changes to take root
5
Change Management Challenges
Naval Health Clinic New England: Ms. Diane Holt – Comptroller
Challenge: Acceptance and use of SOP’s by experienced staff
Solutions:• Engaged all stakeholders and let them “vent”• Set priorities and mandated usage• Defined an action plan and established accountability• Tracked progress and raised visibility• Conducted spot checks
Outcomes:• Gaining buy-in and acceptance of experienced personnel• Prioritization helped reduce the anger and frustration resulting from staff
being overwhelmed with a large number of new SOPs• Starting to document recommended changes to SOPs to address some
perceived inefficiencies6
Change Management Challenges
Naval Hospital Okinawa: LT Holly Lee – Comptroller
Challenge: Translating the importance of using SOPs without offending or discrediting staff
Solutions:• Worked backwards• Educated and implemented spotlight metrics• Got buy-in to “go green” and assigned a Team Lead to each metric• Educated supervisors on audit readiness• Posted metrics and SOPs on SharePoint• Stood up an Internal Controls section to perform testing and audits
Outcomes:• Compliance is now expected• Gained confidence in executing program assessments and testing• Decreased time spent providing justification for things that have been up for
interpretation in the past7
Change Management Challenges
Naval Expeditionary Medical Command: Ms. Samanthia Henderson
Challenge: Getting staff to understand that the SOPs apply to them and should be followed
Solutions:• Educated leadership and staff on importance of SOPs• Addressed SOP's during weekly management meetings• Posted SOPs and metrics on share drive• Sent e-mails reminding staff where the SOPs are located
Outcomes:• Utilizing most Finance SOPs• Starting to look at SOPs to identify things that are not working
8
“Quote” (optional)– Quote source
"Change is the law of life and those who look only to the past or present are certain to miss the future.”
– John F. Kennedy
The Challenge:How do you help people move beyond the current business practices?
9
Why Manage Change?
Without change management, anything may happen.10
What is Change Management?
Change management focuses on aligning individual motivation and commitment with organizational goals and objectives.
It is a proactive set of activities that involve and engage both leadership and staff throughout the transformation to more effectively position the organization to achieve its mission.
11
Typical Change Cycle
‘Desired Sustained
Performance’
‘Status quo’
‘
‘Make the change’
‘Valley ofdespair’ ‘Drop in
Performance’
‘Disruption time’
Time
Per
form
ance
Fear / Anxiety Anger /
Resistance Lack of
Understanding Competing
Priorities Apathy
12
Change Management as Risk Mitigation
AnalyzeRisk
Change
Change Analysis
AnalyzeRisk
AcceleratePerformance
Targeted
Solutions
13
Change Management Toolkit
Risk Symptoms:
What you are hearing…. Change Risks
What does this mean for me?I’m afraid of…
Anxiety / Fear
My way is better.I’ve had enough.
Anger / Change Resistance
Why are we doing this?I’m not sure how to…
Lack of Understanding
I don’t have time for this.My supervisor wants me to focus on…
Workload / Competing Priorities
This will go away soon.Why should I care?
Apathy / Lack of Motivation
14
Change Management Toolkit
Stakeholders Impacts Risks
Target Audience Content / Focus Areas
Change Solutions
Who is affected by audit readiness
activities and/or has an impact on its
success?
What does this group need to do
differently?
What challenges or issues could get in
the way of success?
Change Analysis:
15
Change Management Toolkit
Change Solutions:Change Management Challenges
Change Management Strategies
Possible Activities
Anxiety / Fear Enhance leadership support / sponsorship
Develop and distribute communications from local leadership on priorities
Integrate transactional excellence / audit readiness messages into existing meetings and forums
Anger / Change Resistance
Increase communications
Hold “listening sessions” with staff to understand concerns
Have one-on-one discussions with those who are most resistant
Conduct SOP outreach with authors / training team
Lack of Understanding
Provide education / training
Identify SOP “super users” to coach / mentor others
Hold brown bag sessions on how to utilize SOPs to achieve transactional excellence / audit readiness
Conduct SOP stand-down (training day) with appropriate follow-up 16
Change Management Toolkit
Change Solutions:Change Management Challenges
Change Management Strategies
Possible Activities
Workload / Competing Priorities
Align duties to audit readiness priorities
Review existing job responsibilities and eliminate or reduce non-essential activities
Work with local leadership to set and communicate clear priorities
Apathy / Lack of Motivation
Reward / recognize desired behaviors
Use staff meetings to recognize staff who are successfully utilizing the SOPs
Use approved incentives to reward staff for progress towards transactional excellence / audit readiness
Use local Command reward programs
17
Change Management Example
Stakeholder Impact Risks
Activity Leadership•Comptrollers•Directors For Administration (DFAs)
• Must certify to Activity Commanding Officer (CO) and Navy Medicine leadership that internal controls are functioning properly
• Staff must use and follow SOPs
• Geographic dispersal of end users
• Frequently rotating and deploying staff
• Collaboration and communication across organizational boundaries
• Identify local “super users” to coach / mentor others• Include transactional excellence / audit readiness messages in new staff orientation• Establish communication channels to facilitate ongoing communications with key
stakeholder groups
Potential Change Management Solutions
18
“Quote” (optional)– Quote source
“Everyone thinks of changing the world, but no one thinks of changing himself.”
– Leo Tolstoy
The Challenge:What targeted interventions can you undertake that will compel stakeholders to change?
19
Break-out Discussion
Part 1: What are the greatest change management risks to achieving audit readiness?
Part 2: What solutions could address those risks?
20
“Quote” (optional)– Quote source
“Great leaders are almost always great simplifiers, who can cut through argument, debate, and doubt to offer a solution everybody can understand."
– General Colin Powell
The Challenge:How can each of you take personal responsibility for leading change?
21
Closing
What is the one action you will take based on this discussion?
22