According to Gartner, about 50% of change initiatives fail, 16% note mixed results, and only 34% report clear success.[1] However, a survey on best practices for change management found organizations that applied a structured approach to change management were 33% more likely to experience good or excellent change management effectiveness than those without a methodology.[2]
It’s clear that organizations that hope to be successful with their change initiatives need to adopt a structured and formal approach. For healthcare organizations hoping to compete in a disruptive environment, mastering the change management process is essential, particularly when it comes to rolling out new technology.
Organizational change management (OCM) is a framework for managing changes in culture, organizational structure, or business processes. OCM helps organizations adapt to systemic change driven by transformative initiatives to improve competitive advantage, correct operational deficiencies, or expand capabilities. It involves identifying and addressing the resistance that normally occurs when people are asked to change the way they are accustomed to doing things. Effective OCM ensures that changes are properly implemented and that lasting benefits are achieved and retained.
A systematic approach to OCM helps people throughout an organization adjust to new behaviors and skills. By formally setting expectations, employing tools to improve communication, and proactively seeking ways to reduce misinformation, stakeholders are more likely to accept and embrace the change.
Failed organizational change initiatives result in cynical and burned-out employees, making any future change objectives problematic. It is not surprising that the fear of managing change and its impacts is a leading cause of anxiety for executives. However, with the ever-changing nature of the healthcare industry, change is inevitable. Those organizations that can best manage these changes will be the ones that remain competitive and have the most success.
Visioning, prioritizing, planning, providing feedback, and rewarding success are the key leadership and management skills needed in any successful change initiative. By embracing a structured OCM program, organizations can overcome obstacles and provide their change initiative with a much greater chance of success.
Here are the five steps you should consider when implementing change in a healthcare organization.
Step 1: Establishing Goals
For a change initiative to succeed, key stakeholders must establish unambiguous and measurable strategic objectives along with clearly defined goals. The challenge for most executives is figuring out where to begin. A good place to start is with a joint decision-making design session. This “vision building” meeting allows the team to establish a rapport to create a shared vision and articulate the objectives until they are refined into specific goals.
Defining goals and establishing objectives engages stakeholders and commits them to the program. Goals are long-term targets that an organization wants to accomplish. Objectives are tangible milestones that can be achieved by following certain prescribed steps. Change objectives must link to the strategic objectives of the organization and have widespread and genuine support across the organization. More importantly, they must be specific, quantifiable, and actionable. If not, then the project becomes like a race without a clearly marked finish line.
Goal Setting Tips
Setting goals properly can be more challenging than most executives expect. Before a change goal is set, it should pass the following “change management litmus test”:
- Is the stated goal linked directly and unambiguously to the mission, vision, and strategic direction of the organization?
- What is the objective of the change, why is it important, and what will indicate it has been achieved?
- Who is affected by this change, and how will they react to it?
- Can the change goal be achieved internally, or will it require external assistance?
Once established, goals and objectives need to be communicated clearly and frequently to every level of the organization. There should be a documented strategy for communicating the goals and objectives as well as measuring the effectiveness of the communication plan.
Current performance in the targeted change area should be documented to form a baseline that can be used as a measure against future performance. If the performance metrics are defined properly, sponsors and stakeholders should be able to objectively determine the effectiveness of the change effort. When defining particular metrics, keep in mind that less is more, as too many can result in mired down initiatives. Case in point, a McKinsey analysis shows that organizations actually only use 29% of the metrics they claim to follow in change efforts.[3]
The key is to determine which metrics matter most for the specific program. For example, if the change is implementing new software and related processes, the goals may be tied to the new functionality available or the performance metrics the software is intended to improve. For instance, when implementing new auditing software, the goal may be “Utilize new technology to reduce our denial rate by 10%,” and the objectives might be “1. Implement prospective auditing. 2. Mine denial data to identify trends to address. 3. Provide tools to make it easier for auditing to increase the number of audits they can perform in a given time period.”
Key Takeaways
For any change management to be successful, it’s critical to first assess the organization’s current state and level of change readiness. Using that information, a change management strategy with clearly defined, quantifiable goals can then be created.
Step 2: Assembling the Change Management Team
Empowered people with specific experience and skill sets are needed to complete the necessary actions and to overcome the barriers a major change project is likely to encounter. This Change Management (CM) team will identify and communicate the various responsibilities required to achieve the program objectives.
During a change management project, individuals in the organization will fall into one of three broad categories:
- Change Implementers manage and perform the various tasks to bring about the desired change.
- Change Enablers establish and maintain the environment and conditions that facilitate the change.
- Change Recipients are the people expected to behave differently once the changes have been implemented.
Establish Your Key Drivers of Change
People are the only resources that can truly make organizational change happen. Clearly defining the key roles and expectations across the enterprise is the key to successfully implementing a change initiative. It is crucial to identify the right people to handle each of the following roles:
The Change Leader
The change leader should be sufficiently senior in the organization and be able to command the attention of the executive team. The change leader has a strong personal commitment to the success of the program and is the principal trouble-shooter with ultimate responsibility for problem and conflict resolution.
The Program Sponsor
The program sponsor is the executive’s representative responsible for ensuring that the appropriate resources are committed to solve problems and help the program succeed. This differs from the change leader because it is a tactical role, rather than a strategic one.
The Steering Committee
Along with the program sponsor, the Steering Committee shares overall responsibility and oversight for the success of the program. The committee typically represents the key stakeholders and regularly reviews the progress of the project, providing guidance where necessary, and serving as an authoritative body that can help eliminate obstacles in the path of the project.
The Project Manager
Along with the program sponsor, the Steering Committee shares overall responsibility and oversight for the success of the program. The committee typically represents the key stakeholders and regularly reviews the progress of the project, providing guidance where necessary, and serving as an authoritative body that can help eliminate obstacles in the path of the project.
Project Team Members
Project team members are responsible for completing the various project activities as assigned by the project manager. The team members are usually (but not always) representatives from the various organizational work units or departments affected by the change and are typically subject matter experts in specific operational areas.
Mid-Level Managers
Middle managers are responsible for supporting and communicating change initiatives and allocating the resources required within their area of control. They also help identify barriers to success and risks to the project. Managerial participation and support in a change initiative is essential.
Supervisors
Frontline supervisors and team leaders are the face of the organization to their employees and serve a critical role in supporting, counseling, and coaching employees throughout the change process. They are also especially helpful in identifying obstructionists and mitigating their potentially negative impact.
This team will be responsible for executing successfully on the change vision. The best results usually come from people working collaboratively in a team environment. One reason teams are more productive is that members are able to leverage each other’s strengths. Effective teams should have the right balance of natural working styles and “chemistry.” Putting together the right team is crucial in successfully accomplishing a change initiative.
Additionally, providing the right tools to allow for an easy exchange of information is a key component of implementing successful change management. Depending on the specific project and size of the team, the following applications can be helpful in supporting effective communication:
- A project management platform organizes tasks in an easy-to-read graphic format that allows everyone involved to see the current state of the project, as well as next steps.
- A central communications hub, such as Microsoft Teams keeps messaging organized for easy reference.
- A project folder can help keep training materials and other related documents organized and easily accessible by all team members.
Key Takeaways
An effective change management team works together to create a strategy to achieve the program’s objectives. With specific responsibilities that range from identifying barriers to success to coaching employees through the change process, and executing tactical activities, each role plays a crucial part.
Step 3: Implementing Successful Change Strategies
The key to organizational change management success involves a specific, targeted, and tailored approach to the needs of an organization. However, there are also common strategies that improve the chances for success of any change management project, regardless of the particular organizational requirements.
Common OCM Elements
A successful change initiative includes the following:
- Agreement on a common vision for change – no competing initiatives.
- Strong executive leadership to communicate the vision and sell the business case for change.
- A program to educate employees on how their day-to-day work will change, emphasizing improvements and efficiencies to be gained.
- A documented plan for measuring the results of the change. Key metrics must be established to help assess the effectiveness of the project.
- Establishment of a reward structure, possibly both monetary and social, that encourages individuals and groups to take ownership for their new roles and responsibilities.
The Effectiveness of Workshops
Change management workshops are an excellent way to bring attention to the initiative, address concerns, mitigate pushback, and help shape goals and objectives. Workshops also increase a sense of ownership and empowerment while breaking down barriers, improving communications, and integrating staff into the project.
Change initiatives need a force to get started and a boost to move it to each subsequent level. It is important to understand that if the driving forces are withdrawn or gradually dissipate, the program will eventually run out of steam. A “visioning” workshop is an excellent catalyst to help keep a change management project moving and on track.
Key Takeaways
Successful change management programs require strong leadership to communicate the vision and sell the need for change. Beyond this vision, employees need to be educated on how their daily work will change post-implantation, with an emphasis on improvement and efficiencies to be gained.
Step 4: Overcoming Obstacles and Resistance
Human beings dislike change. We get comfortable in our routine way of handling things and any disruption causes concern. Therefore, it’s important to understand this dynamic and be prepared for likely resistance.
Reactions to Change
It is critical to anticipate the reaction to the changes proposed and take steps to create the desired reactions. People who oppose the changes should be treated with respect, acknowledging their concerns and listening genuinely to their issues. Ways to accomplish this include:
- Choosing people with refined interpersonal skills for key project positions
- Communicating openly with employees and other change stakeholders
- Meeting resisters face-to-face as often as possible
- Pointing out unacceptable behavior without being confrontational
- Keeping commitments in order to build trust and respect
- Handling bad news proactively.
- Communicating candidly, but sensitively
Resistance to Change
No matter how carefully a change management initiative is structured, some employees will still resist the change. Members of the change management team shouldn’t take this personally and should not adopt an adversarial approach to dealing with it. But unless there is a well-planned strategy for dealing with them, the resisters can wear the project down until it eventually grinds to a halt.
The CM team must identify and manage both the ‘overt resisters’ who openly criticize and sabotage the change management effort, and the ‘covert resisters’ who quietly create problems and sow dissent in the hope that the initiative will eventually fail. The CM team must help uncover the reasons for resistance to the program and find ways to resolve them. This can be done by helping resistors work through the psychological process of change and turning them from obstructionists into active supporters of the change initiative.
Dealing with Resistance
Occasionally, the CM team discovers that the reason an individual is resistant to a proposed change is founded on a legitimate concern that had not been previously considered. This can benefit the project because it helps the project team resolve issues and avoids potential problems. It also allows the resister to see that their concerns are being taken seriously and properly addressed. This usually turns them from resisters into active and enthusiastic supporters of the change project.
Trying to “sell” change to skeptical people within the organization is not an effective strategy and will invariably fail. People usually see through this approach and feel that they are being manipulated, creating feelings of resentment leading to resistance. Instead, change needs to be managed in a way that people can accept as necessary and view as being beneficial to the organization.
Using software implementation as an example, if a user consistently points out flaws in the process, it can be helpful to invite them to help solve the challenges. This approach allows dissenters to share their concerns in a constructive manner and enables them to be part of the solution.
Key Takeaways
It’s imperative to anticipate the reaction to change and have a documented plan for how to manage potential pushback.
Step 5: Sustaining Successful Change
Launching an effective change initiative is only half the battle. The greater challenge is sustaining the gains made through a successful change effort. Adopting a principled approach that emphasizes openness, trust and integrity will ensure the lasting effects of the change program.
Principles for Maintaining Change
These five principles will help sustain a strong change effort:
- Strong Sponsorship
The change program must have the visible support of key decision-makers willing to devote resources to the program. If executive leadership demonstrates a firm commitment to the success of the change initiative, the members of the organization are much more likely to get on board. - Detailed Planning
Planning should be conducted methodically before program implementation. Plans need to be circulated and accepted by major stakeholders and the objectives, resources, roles, and risks must be clearly defined. An organized and structured approach will earn the respect of the employees and minimize resistance to the change. - Specific Measurement
Program objectives must be stated in measurable terms and program progress monitored and communicated to the key stakeholders. - Structured Support
Program implementers and change recipients have to be given the resources and supporting systems required during and after change implementation. - Committed Engagement
Stakeholders should engage in genuine two-way dialogue in an atmosphere of openness, mutual respect and trust. Everyone in the organization has a stake in the success of the initiative and the greater number of people who are invested, the more likely the change management effort will be sustained.
Techniques for Maintaining Momentum
These practical techniques can keep the change momentum going in the new operational environment:
- Align systems of reward and recognition
- Coordinate recruitment and selection criteria
- Keep employees informed about performance and progress
- Strive for quick wins
- Celebrate achievements and milestones
- Ensure managers work within the new framework
- Institutionalize the change
Common Reasons Why Change Initiatives Fail
Several factors contribute to the high rate of organizational change program failures. Avoiding these situations is the key to successfully implementing the change strategy.
Lack of executive sponsorship or senior management support
A Project Management Institute report noted that more than three quarters of projects (79 percent) at high-performing organizations had active project sponsors, compared to less than half (43 percent) at low-performing organizations[4]. Poor communication from the management team or a lack of real executive commitment leads to employees quickly losing faith in the project and the failure of the change initiative.
Lack of employee engagement in the change process
A Deloitte study[5] found that as much as 74% of transformation projects failed to achieve their full benefits due to a lack of people adoption. Executives who can marshal the support of their employees consistently have better outcomes on their projects. This is the most effective strategy an organization can use to minimize “pushback” and mitigate resistance to systemic change.
Ineffective change leaders/sponsors
For change to succeed, the Change Leader and/or the Program Sponsor need to be focused primarily on the program, working to drive the desired change across the organization. Competing priorities can be detrimental to the success of the project. In a recent survey report, 67% of respondents cited clear organization-wide ownership of and commitment to change across all levels of the organization as the key factor in a successful change initiative[6].
Underestimating the complexity of change
Changing an organization’s culture, level of innovation, or capabilities involves multiple organizational systems, departmental units, and organizational strategies. Change initiatives that fail begin with an overly simplistic ‘one-size-fits-all’ approach. A successful change strategy must be tailored to the specific needs of both the project and the organization.
Key Takeaways
Successful change management programs require broad committed engagement. To achieve and sustain buy-in, it’s important to first tackle elements that will provide quick wins. Continued open communication, as well as celebrating achievements and milestones, will help to maintain project momentum and support.
Conclusion
Implementing a successful change initiative can be challenging. Committed executive leadership, clear goals, and a dedicated change management
team are all critical components of a successful program and while the challenge may seem daunting, it is achievable.
Resources
[1] https://www.gartner.com/en/human-resources/insights/organizational-change-management
[2] “Change Management during a Platform, Process, or Digital Transformation,” Mission Control, January 18, 2022, https://aprika.com/missioncontrol/blog/change-management-during-a-platform-process-or-digital-transformation/.
[3] Michael Bucy, Tony Fagan, Benoît Maraite, and Cornelia Piaia, “Keeping transformations on target,” March 2017, https://www.mckinsey.com/business-functions/rts/our-insights/keeping-transformations-on-target.
[4] “The Sponsor as the Face of Organizational Change.” Project Management Institute, 2013, www.pmi.org/learning/library/sponsor-face-organizational-change-11131.
[5] “Organization Transformation: Deloitte.” Deloitte Russia, www2.deloitte.com/ru/en/pages/human-capital/solutions/organization-transformation-talent.html.
[6] Johnston, Alasdair, et al. “Secrets of Successful Change Implementation.” McKinsey & Company, McKinsey & Company, 20 Oct. 2020, www.mckinsey.com/business-functions/operations/our-insights/secrets-of-successful-change-implementation.
