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by Darcey Trescone, RN
Solid internal change management processes are critical in maintaining your competitive advantage in the market. After all, it is your own employees who deliver your services and have face time with both your referral sources and patients. Employee dissatisfaction due to a poorly executed EMR implementation can have a direct impact on your competitive advantage due to staff turn-over and resulting service failures. [Trescone reviews the focuses of 2 of the earlier installments of her 4-part series on managing change in the home health industry. She introduces the necessity of adopting Lewin’s Change Management Model, and other means for affecting positive change by staffpersons in one’s healthcare at home organization.]
As I outlined in part 2 of this series, “building the value proposition from top leadership down to the individual employee is key in achieving total stakeholder buy-in across your organization and achieving implementation success.” This cannot be accomplished without considering the importance of “change management.” Your Structured Implementation Team plays a primary role in change management during your selection, implementation and overall adoption of the new EMR platform.
This week, in part 3 of my software implementation series, we address a simple change management model and the responsibilities of your structured team in addressing change successfully.
Lewin’s Change Management Model
First we examine a change management model that was created in the 1950’s by psychologist Kurt Lewin. He recognized three stages of change and outlined the psychological component to each. Over the years, I have found these three phases the easiest to logically understand, teach and follow when working with homecare and hospice organizations as they adopt a new EMR system.
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- Unfreeze — Employees make an active effort to resist change and remain in their current zone of safety, which I like to think of as “frozen in the past.” Overcoming this tendency requires a period of thawing or unfreezing; it is initiated through motivation.In Lewis’s model, impactful motivation requires a “Force Field Analysis,” a framework for problem solving and planned change. The key to a successful force field analysis is understanding that a restraining force cannot be simply removed. It must be countered by increasing the driving forces (i.e. motivation) for the change.
a. Simplest example: A field clinician does not believe that a new point of care platform is better than the existing platform used. You cannot remove this belief, this restraining force, but you can fuel the driving force by explaining why the new platform is more effective and by organizing your training in how to use it.
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- Transition — Once change is initiated, employees move into a transition period, which may last for some time. I call this the phase of understanding and buy-in to the change. When the force field analysis is completed, the implementation team (aka change agents) must develop ongoing strategies to reduce restraining forces while strengthening driving forces that outline why the change is of value to the employees.Adequate leadership and reassurance is necessary for the transition phase to be successful. Without it, staff will re-build on restraining forces, making it harder for your organization to drive change.
- Refreeze — After change has been accepted and software successfully implemented, the organization becomes stable again and employees refreeze perceptions as they operate under new guidelines with a new EMR system recently put into place.
This means that the driving forces for the change outweighed the restraining forces, leading to your new EMR system being embraced, in turn allowing new habits and daily routines to be formed.
Implementation Team Structure and Their Role as Change Agents
Last week, in part 2 of this series, I explained how leaders of successful healthcare organizations embrace the concept of team structure. I outlined the implementation team structure that has worked in many new EMR system adoptions. Now, we review defined roles within this team structure and the responsibility of team members, as change agents, in delivering a successful implementation.
Executive Sponsor Leadership Style and Role
- Strengthens the driving forces; why the change needs to take place
- Embraces both an autocratic and democratic leadership style to foster both urgency and organizational engagement
- Project management provides the framework for implementing change
- Coordinates the teams and the tasks that need to occur while conducting the force field analysis
- Collaborates with the Implementation Team in understanding restraining forces while countering with legitimate driving forces to deliver successful change.
Subject Matter Experts are cheerleaders for change
- Communicate issues from the employee base (restraining forces) to both Project Management and the Executive Sponsor while assisting to carry the value message for the change (driving forces) into your employee base.
Using a framework for planned change proactively rather than retrospectively can help offset potential problems. Seeking objectivity from an outside source as your Change Agent is a valuable strategy in guiding this whole process. An outsider view on what is going well, what is going wrong, and potential risks to watch out for as the project progresses can help uncover areas both your software vendor and your team may miss.
Darcey Trescone is a Healthcare IS and Business Development Consultant in the Post-Acute Healthcare Market with a strong background working with both providers and vendors specific to Home Care and Hospice. She has worked as a home health nurse and held senior operational, product management and business development positions with various post-acute software firms, where her responsibilities included new and existing market penetration, customer retention and oversight of teams across the U.S., Canada and Australia. She can be reached at darcey@tresconeconsulting.com.
©2017 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan’s Home Care Technology Report.homecaretechreport.com One copy may be printed for personal use; further reproduction by permission only. editor@homecaretechreport.com
