Description
Change management is an approach to transitioning individuals, teams, and organizations to a desired future state.
Aligning Process Redesign and Change Management with Project Management (System Implementation Projects)
Kim Brant-Lucich Director of Process Redesign St. Joseph Health System Information Services HIMSS 2009: Project Management Pre-Conference Workshop
St. Joseph Health System Highlights
?
?
? ?
?
? ?
$3.4 billion in revenues 14 hospitals in 3 states Licensed beds range from 35 to 1,352 Home health agencies, hospice care, outpatient services, skilled nursing facilities, managed care operations, and multiple physician organizations 18,500 FTE's 1,500 affiliated physicians In FY 2006, SJHS provided more than $226 million in community benefits*
* Does not include 235 million unreimbursed costs for Medicare patients.
4/4/2009
HIMSS 2009: Project Management Pre-Conference Workshop
Page 2
Today’s Objectives
? ?
?
Understanding of process redesign and why it’s done Understand why we use change management
Learn how process redesign and change management
align with the Project Management phases (and the System Development Life Cycle)
?
Review process redesign and change management steps
4/4/2009
HIMSS 2009: Project Management Pre-Conference Workshop
Page 3
What is Process Redesign? - A Definition
Process Redesign is the practice of changing existing processes to support business objectives and, specifically, to improve performance measures such as cycle time, cost, quality, and service.
4/4/2009
HIMSS 2009: Project Management Pre-Conference Workshop
Page 4
Process Redesign helps system implementation projects achieve desired objectives and stakeholder requirements
?
Improved process (cheaper, better, faster)
?
Decrease in cycle time Reduction of errors Higher (and more consistent) quality
? ? ?
? ? ?
More effective use of resources
Increased stakeholder (customer, employee) satisfaction User adoption (by involving user in design) Improves data management and tracking
?
Establish metrics up front
?
4/4/2009
Determine what success means
HIMSS 2009: Project Management Pre-Conference Workshop
Page 5
Why don’t system implementation projects automatically include process redesign?
Process? This is an I.T. project. The business side does all the process work. System engineer
We just don’t have the time to make a bunch of process flows that are just going to sit in a notebook. Department director
We can’t afford to hire a bunch of consultants to draw pictures. We just need a new system.
Executive sponsor
How can we look at our current processes? We don’t even know what they are. They’re not written down anywhere.
Frontline worker
Judy is the only person who knows the process and she’s out on medical leave.
Process improvement? That’s why we’re putting the system in – so our process will improve.
System engineer
We know that we should think about processes, but we just don’t have enough time or money.
4/4/2009
Project manager
“Veteran” employee
HIMSS 2009: Project Management Pre-Conference Workshop
We did that once – documented all our processes. By the time we were done, the process had changed so our flows were all wrong.
Page 6
What is Change Management? - A Definition
Change management is the process of applying knowledge, tools and resources to manage the people aspects of transition to a future state. This includes the development of communications, training, and rewards.
4/4/2009
HIMSS 2009: Project Management Pre-Conference Workshop
Page 7
Why do Change Efforts Fail? (A CIO View)
Resistance by Employees
Inadequate Sponsorship Unrealistic Expectations
65% 72%
82%
Poor Project Management
Business Case not Compelling Project Team Lacked Skills
46%
54%
44%
Scope Expansion / Uncertainty No Organizational Change Plan
Silos/No Horizontal Process View IT Perspective not Integrated
10% 20% 30% 36% 40%
44%
43%
41%
Source: Deloitte CIO Survey
Change Leadership issues are noted in RED
50% 60% 70% 80% 90%
% of Firms
4/4/2009
HIMSS 2009: Project Management Pre-Conference Workshop
Page 8
How will I know when change management is needed?
? ? ? ?
Does your project impact people? Do you anticipate resistance? Will the people need new skills?
Will employees be affected differently? Does the entire company need to know about the project/change?
?
4/4/2009
HIMSS 2009: Project Management Pre-Conference Workshop
Page 9
What Happens When There is Change?
Pre-program Conditions
Implementation Project
Post Go-Live
Productivity
What People Think Will Happen
With Effective Change Management
What Actually Happens
Time
Change Management efforts aim to minimize time spent here
HIMSS 2009: Project Management Pre-Conference Workshop
Page 10
4/4/2009
What does a “change manager” do?
? ?
Align leaders and sponsors around a common vision Advise, engage and support stakeholders and develop champions through early involvement Understand business requirements as it relates to “people” Assess and analyze issues and impacts of change
Design, facilitate and implement various interventions to minimize the impact of change Develop, implement, monitor and track change management plans and communication and training plans
HIMSS 2009: Project Management Pre-Conference Workshop
Page 11
?
?
?
?
4/4/2009
How do we ensure that process redesign and change management are part system implementation projects? The Solution:
?
Make it Easy! Make process redesign and change management
part of the project management lifecycle Create and disseminate standard reusable tools,
?
?
templates, workplans and training materials
?
Develop a core team of skilled business process
analysts and facilitators who can support multiple
projects
4/4/2009
HIMSS 2009: Project Management Pre-Conference Workshop
Page 12
Use your cultural/readiness assessment to identify target pilot business areas prior to implementation
4/4/2009
HIMSS 2009: Project Management Pre-Conference Workshop
Page 13
Consider conducting a cultural or change readiness assessment
4/4/2009
HIMSS 2009: Project Management Pre-Conference Workshop
Page 14
Consider creating a team structure to allow for process redesign and change management resources
Project Reporting Structure
Program Management Office
Steering Committee
Dir, Process Redesign & Change Mgmt
Executive Sponsor
Project Manager
Change Manager Communications Lead
Business Process Manager Process Analyst Process Sub-teams
System Analyst
Technical Lead
Training Lead
Roles may be consolidated.
4/4/2009
HIMSS 2009: Project Management Pre-Conference Workshop
Page 15
Process Redesign and Change Management should be integrated with the Project Life Cycle, providing a roadmap for project managers and team members.
C U R R E N T
Project Management / Project Life Cycle
Initiation Planning Design Development Implementation Closure
Process Redesign
Problem / Needs Assessment
Current State Process Assessment
Future State Design Gap Analysis
Feedback Loop
Process WalkThrough
Process Implementation
Integrated Process Test
Go-Live
Assess, Measure Redesign
F U T U R E
V I S I O N
S T A T E
Communicate “Need”
Secure Buy-In
Plan for Action
Build Training Tools
Train and Monitor
Communicate, Celebrate and Reward
Sustain Change
Change Management / Communication and Training
4/4/2009
HIMSS 2009: Project Management Pre-Conference Workshop
Page 16
Decomposing the Methodology:
Process Redesign
Project Management / Project Life Cycle
Initiation / Planning Analysis Design Development Implementation Closure
Process Redesign
Problem / Needs Assessment
• Problem assessment and Measurement • Identify metrics • ID key stakeholders • Go-No-Go project decision/scoping
Current State Process Assessment
• Gather Data from all Sites and review current processes • Best practices research • Site visits • Identify commonalities across sites • Identify leading practices • Define key metrics and benchmarks • Decision point • Use leading practice • design future state • use system defined process • Business requirements definitions
Future State Design Gap Analysis
• Review current processes • Create “standard” or common process • Future State Visioning OR gap analysis • Incorporate best practices • Identify process gaps (between existing and “standard” or between existing and “future state”) • Develop process scenarios • Define how metrics will be tracked
Process WalkThrough
• Develop / define real-life process scenarios • Walk through processes using scenarios. • Identify gaps • Modify processes
Integrated Process Implementation Process Test
• Develop tools to implement new processes (training, P&Ps, process models, timeline) • Roll out new processes • Test processes and system • Document gaps • Update process flows, workflows, etc.; ensure policies and procedures are updated to capture process changes
Go-Live
Assess, Measure Redesign
• Review metrics – analyze results (are we getting desired benefits; if not, how can we modify work)
• Monitor adoption of process changes • Capture and document lessons learned • Modify processes as needed
4/4/2009
HIMSS 2009: Project Management Pre-Conference Workshop
Page 17
Decomposing the Methodology:
Change Management
Project Management / Project Life Cycle
Initiation / Planning Analysis Design Development Implementation Closure
Change Management
Communicate “Need” Secure Buy-In Plan for Action
• Develop Detailed Change Mgmt Plan • Update Comm Plan
Build Training Tools
Train and Monitor
Communicate, Celebrate and Reward
• Celebrate short term wins • Communicate stories, metrics, etc.
Sustain Change
• Identify adoption barriers • Revise Training and Communication Plans • Communicate and reward successes • Measure gains
• Define • Communicate stakeholders vision and • Develop message for communication change plan • Educate and • Develop sense of Share best “urgency” practices • Build guiding team – ID advocates, sponsors • Pain assessment • Change Readiness Assessment
• Complete • Train users on Change processes Management , • Monitor user Communication understanding and Training • Revise training Plans tools • Develop Training materials
4/4/2009
HIMSS 2009: Project Management Pre-Conference Workshop
Page 18
Process Redesign and Change Management
Success Stories Web-Enabled Referral Management for Physician Group
Initial goals were identified for the Referral Management Project.
? Reduce
time required to process patient referrals ? Improve patient and physician satisfaction with the process ? Electronic communication between referring and consulting clinicians ? Linkages to results and reports ? Sharing of ambulatory lab and radiology results
4/4/2009
HIMSS 2009: Project Management Pre-Conference Workshop
Page 20
The approach for Referral Management followed the integrated Process Redesign/Change Management Methodology
Current State Process Assessment
Process Redesign
Future State Design Gap Analysis Process WalkThrough
Feedback Loop
Problem / Needs Assessment
Process Implementation
Integrated Process Test
Go-Live
Assess, Measure Redesign
?
Identified need for referral management application through ongoing physician and patient satisfaction assessments
Change Management
Communicate “Need”
Secure Buy-In Plan for Action
Build Training Tools
Train and Monitor
Communicate, Celebrate and Reward
Make Behavior Stick
Page 21
4/4/2009
HIMSS 2009: Project Management Pre-Conference Workshop
Our approach was aligned with the SJHS Process Redesign / Change Management Methodology.
Process Redesign
Future State Design Gap Analysis Process WalkThrough
Feedback Loop
Problem / Needs Assessment
Current State Process Assessment
Process Implementation
Integrated Process Test
Go-Live
Assess, Measure Redesign
?
Evaluated current process(es) and identified opportunities to increase process efficiency
Change Management
Communicate “Need”
Secure Buy-In
Plan for Action
Build Training Tools
Train and Monitor
Communicate, Celebrate and Reward
Make Behavior Stick
Page 22
4/4/2009
HIMSS 2009: Project Management Pre-Conference Workshop
Our approach was aligned with the SJHS Process Redesign / Change Management Methodology.
Process Redesign
Future State Design Gap Analysis Process WalkThrough
Feedback Loop
Problem / Needs Assessment
Current State Process Assessment
Process Implementation
Integrated Process Test
Go-Live
Assess, Measure Redesign
?
?
? ?
Designed future state process Reviewed Referral Management application functionality and process (future state), defined gaps between future state and existing practice Defined requirements for application customization Modeled processes, defined metrics and measured baseline
Change Management
Communicate “Need”
4/4/2009
Secure Buy-In
Plan for Action
Build Training Tools
Train and Monitor
Communicate, Celebrate and Reward
Make Behavior Stick
Page 23
HIMSS 2009: Project Management Pre-Conference Workshop
Our approach was aligned with the SJHS Process Redesign / Change Management Methodology.
Problem / Needs Assessment Current State Process Assessment
Process Redesign
Future State Design Gap Analysis
Process WalkThrough
Process Implementation
Integrated Process Test
Go-Live
Assess, Measure Redesign
Feedback Loop
?
?
?
?
Identified target “change champions” for first implementations Interviewed users, implemented application and trained users in phased rollout process Partnered with vendor to define and redefine solution, based on user understanding and acceptance Defined process for capturing metrics on ongoing basis
Change Management
Build Training Tools
Make Behavior Stick
Page 24
Communicate “Need”
Secure Buy-In
Plan for Action
Train and Monitor
Communicate, Celebrate and Reward
4/4/2009
HIMSS 2009: Project Management Pre-Conference Workshop
Our approach was aligned with the SJHS Process Redesign / Change Management Methodology.
Process Redesign
Future State Design Gap Analysis Process WalkThrough
Problem / Needs Assessment
Current State Process Assessment
Process Implementation
Integrated Process Test
Go-Live
Assess, Measure Redesign
Feedback Loop
? ?
Conducted phased roll-out of application Conducted one-on-one training
Change Management
Communicate “Need” Secure Buy-In Plan for Action
Build Training Tools
Train and Monitor
Communicate, Celebrate and Reward
Make Behavior Stick
Page 25
4/4/2009
HIMSS 2009: Project Management Pre-Conference Workshop
Our approach was aligned with the SJHS Process Redesign / Change Management Methodology.
Process Redesign
Future State Design Gap Analysis Process WalkThrough
Feedback Loop
Problem / Needs Assessment
Current State Process Assessment
Process Implementation
Integrated Process Test
Go-Live
Assess, Measure Redesign
?
Continue to measure physician and patient satisfaction on annual basis, capturing referral management metrics, measuring against baseline
Change Management
Communicate “Need” Secure Buy-In Plan for Action
Build Training Tools
Train and Monitor
Communicate, Celebrate and Reward
Make Behavior Stick
Page 26
4/4/2009
HIMSS 2009: Project Management Pre-Conference Workshop
A key benefit of the Referral Management program was reduced cycle time in a fully deployed model.
Pre-Implementation 46.5 – 51.5 min.
Post-Implementation 10 to 11 min.
Manual – 3 min. Manual – 15 min.
Manual – 1 min. Manual – 3 min.
Automated – 1 min. Automated – 3 min.
Manual – 1 min. Automated – 0.5 min.
Manual – 1 min.
Automated – 0.5 min.
Manual –2 min.
Automatic – 0 min.
4/4/2009
HIMSS 2009: Project Management Pre-Conference Workshop
Page 27
A key benefit of the Referral Management program was reduced cycle time in a fully deployed model (continued).
Pre-Implementation 48.5 – 51.5 min. Post-Implementation 10 to 11 min.
Manual –0.5 min.
Manual – 15 min.
Automatic – 0 min.
Automatic – 3 min.
Manual –4 min.
Manual –2 to 5 min. Manual – 1 min.
Automatic – 0 min.
Automated – 1 to 2 min. Automated– 0 min.
Manual – 1 min.
46.5 – 51.5 min.
4/4/2009
Automated – 0 min.
10 to 11 min.
Page 28
HIMSS 2009: Project Management Pre-Conference Workshop
Post implementation, time required to process a referral was reduced by a range of 35.5 to 41.5 minutes.
60 50
Referral Management Process
Pre-Implementation Post Implementation
Savings: 35.5-41.5 mins 10 - 11 46.5 - 51.5
Total Min
40 30 20 10 0
Complete Referral Request
Verify Eligibility/ Benefits
Determine Provider Type
Determine Service Type and Urgency
Fax to UM
F/U with UM on Status *
Distribute Requests
Verify Eligibility/ Benefits
Enter info into IDX
Review referral and approve, pend or deny
Route
Receive and distribute fax
Referring Physician
RPRA Referring Physician Referral Admin
Utilization M anager
Specialist's Office
* Does not occur in all instances, or process time varies 4/4/2009 HIMSS 2009: Project Management Pre-Conference Workshop
Page 29
While using the Web for Referral Management, users may also connect (link) to results and reports.
Once on the Web Portal, physicians and clinicians may also use it for:
? ? ? ? ? ?
Web Portal Users 600 500 400 300 200 100
Jan 2003 Feb 2003 Mar 2003 Apr 2003 May 2003 Jun 2003 Jul 2003 Aug 2003 Sep 2003 Oct 2003 Nov 2003 Dec 2003 Jan 2004 Feb 2004 Mar 2004 Apr 2004 May 2004 Jun 2004 Jul 2004 Aug 2004 Sep 2004 Oct 2004 Nov 2004 Dec 2004 Jan 2005 Feb 2005 Mar 2005 Jun 2007
? ?
?
? ?
Viewing patient insurance data Hospital lab results Transcribed reports Ambulatory lab information Patient hospital admitting Obtaining industry data and information Communication with patients Secure messaging Care management Imaging data Ambulatory Radiology Results
228% Increase in users since “go-live” of Referral Management; 25% increase in physician usage.
0
2003
2004
2005
375% Increase in web portal sessions since “golive” of Referral Management (as of June 2007)
2003
2004
2005
4/4/2009
HIMSS 2009: Project Management Pre-Conference Workshop
Page 30
Roadmap for Failure
What happens when there is not sufficient focus on process redesign, standardization or change management…
The initial “vision.”
Implement a common enterprise-wide Human Resources Information System that allows St. Joseph Health System Human Resources to move from multiple disparate payroll/benefits systems to a fully integrated HRIS. Common HR processes will be implemented throughout SJHS. Significant change management across the enterprise will be required to ensure the successful rollout of the new system.
4/4/2009
HIMSS 2009: Project Management Pre-Conference Workshop
Page 32
The reality. System implementation project was not managed by I.T. The “lowest priced” outside consulting firm was engaged to perform implementation Best practices were not identified Processes were not evaluated, improved or standardized as part of the implementation All effort was geared toward “go-live” target dates Change management resources were not engaged Higher than anticipated implementation cost
?
?
? ?
? ? ?
4/4/2009
HIMSS 2009: Project Management Pre-Conference Workshop
Page 33
The result.
al rn s e t e Ex titi En
al rn te s Ex titie En
KR ON OS GL and DSS
Benefits Benefits Tring. Recruit Tring. Adm. Core Wrkfce. Core Recruit Adm. HR HR Wrkfce. Benefit Ben PR Tring. T&L* Queen PR s Tring. efits Recruit T&L* Recruit Sonoma Adm.Core Adm Core Wrkfce. HR Wrkfce. HR PR T&L* PR T&L*
ID
M RE S - gm t. Q
m Mg t.
ID
OS KRON d DSS GL an
Benefits Tring. Recruit Adm. Core Wrkfce. HR PR T&L*
l na r te ies Ex ntit E
Benefits PR Tring. T&L* Recruit Adm. Core Wrkfce. Benefits HR Benefits Sys. Off. Tring. St. Joseph Tring. Recruit PR T&L* Adm. Recruit Core Wrkfce. Benefits(Orange) Adm.Core Tring. Wrkfce. HR Recruit HR PR Adm.Core T&L* PR HR Wrkfce. T&L* Hert. Cntrl. PR T&L*
Benefits Mission Tring. Adm. PR Recruit Hert. Nrth. Adm. Core Wrkfce. Benefits Tring. HR Recruit Covenant Adm.Core St. Jude HR Wrkfce. PR Humboldt T&L
St. Mary
RES -Q
Ex En ter t itie nal s
• Multiple system configurations (20+) • Multiple data formats, reports and interfaces • Excessively high support and operations costs • Inconsistent quality • HIGHLY dissatisfied “customers”
4/4/2009
HIMSS 2009: Project Management Pre-Conference Workshop
Page 34
What happened next.
?
Launch of “S&S” (Standardization and Stabilization) Program to:
?
?
?
?
?
Addressing existing cost drivers of HRIS Production support time to contain current costs Enable risk mitigation and future cost avoidance through infrastructure stabilization Define and communicate roles and responsibilities for application support and management (local and enterprise) Improve ease of use/reliability of query reporting for ministries Prepare SJHS for Version upgrade, and evaluation of e-applications and other HRIS functionality
HIMSS 2009: Project Management Pre-Conference Workshop
Page 35
4/4/2009
Questions?
4/4/2009
HIMSS 2009: Project Management Pre-Conference Workshop
Page 36
doc_226697374.pdf
Change management is an approach to transitioning individuals, teams, and organizations to a desired future state.
Aligning Process Redesign and Change Management with Project Management (System Implementation Projects)
Kim Brant-Lucich Director of Process Redesign St. Joseph Health System Information Services HIMSS 2009: Project Management Pre-Conference Workshop
St. Joseph Health System Highlights
?
?
? ?
?
? ?
$3.4 billion in revenues 14 hospitals in 3 states Licensed beds range from 35 to 1,352 Home health agencies, hospice care, outpatient services, skilled nursing facilities, managed care operations, and multiple physician organizations 18,500 FTE's 1,500 affiliated physicians In FY 2006, SJHS provided more than $226 million in community benefits*
* Does not include 235 million unreimbursed costs for Medicare patients.
4/4/2009
HIMSS 2009: Project Management Pre-Conference Workshop
Page 2
Today’s Objectives
? ?
?
Understanding of process redesign and why it’s done Understand why we use change management
Learn how process redesign and change management
align with the Project Management phases (and the System Development Life Cycle)
?
Review process redesign and change management steps
4/4/2009
HIMSS 2009: Project Management Pre-Conference Workshop
Page 3
What is Process Redesign? - A Definition
Process Redesign is the practice of changing existing processes to support business objectives and, specifically, to improve performance measures such as cycle time, cost, quality, and service.
4/4/2009
HIMSS 2009: Project Management Pre-Conference Workshop
Page 4
Process Redesign helps system implementation projects achieve desired objectives and stakeholder requirements
?
Improved process (cheaper, better, faster)
?
Decrease in cycle time Reduction of errors Higher (and more consistent) quality
? ? ?
? ? ?
More effective use of resources
Increased stakeholder (customer, employee) satisfaction User adoption (by involving user in design) Improves data management and tracking
?
Establish metrics up front
?
4/4/2009
Determine what success means
HIMSS 2009: Project Management Pre-Conference Workshop
Page 5
Why don’t system implementation projects automatically include process redesign?
Process? This is an I.T. project. The business side does all the process work. System engineer
We just don’t have the time to make a bunch of process flows that are just going to sit in a notebook. Department director
We can’t afford to hire a bunch of consultants to draw pictures. We just need a new system.
Executive sponsor
How can we look at our current processes? We don’t even know what they are. They’re not written down anywhere.
Frontline worker
Judy is the only person who knows the process and she’s out on medical leave.
Process improvement? That’s why we’re putting the system in – so our process will improve.
System engineer
We know that we should think about processes, but we just don’t have enough time or money.
4/4/2009
Project manager
“Veteran” employee
HIMSS 2009: Project Management Pre-Conference Workshop
We did that once – documented all our processes. By the time we were done, the process had changed so our flows were all wrong.
Page 6
What is Change Management? - A Definition
Change management is the process of applying knowledge, tools and resources to manage the people aspects of transition to a future state. This includes the development of communications, training, and rewards.
4/4/2009
HIMSS 2009: Project Management Pre-Conference Workshop
Page 7
Why do Change Efforts Fail? (A CIO View)
Resistance by Employees
Inadequate Sponsorship Unrealistic Expectations
65% 72%
82%
Poor Project Management
Business Case not Compelling Project Team Lacked Skills
46%
54%
44%
Scope Expansion / Uncertainty No Organizational Change Plan
Silos/No Horizontal Process View IT Perspective not Integrated
10% 20% 30% 36% 40%
44%
43%
41%
Source: Deloitte CIO Survey
Change Leadership issues are noted in RED
50% 60% 70% 80% 90%
% of Firms
4/4/2009
HIMSS 2009: Project Management Pre-Conference Workshop
Page 8
How will I know when change management is needed?
? ? ? ?
Does your project impact people? Do you anticipate resistance? Will the people need new skills?
Will employees be affected differently? Does the entire company need to know about the project/change?
?
4/4/2009
HIMSS 2009: Project Management Pre-Conference Workshop
Page 9
What Happens When There is Change?
Pre-program Conditions
Implementation Project
Post Go-Live
Productivity
What People Think Will Happen
With Effective Change Management
What Actually Happens
Time
Change Management efforts aim to minimize time spent here
HIMSS 2009: Project Management Pre-Conference Workshop
Page 10
4/4/2009
What does a “change manager” do?
? ?
Align leaders and sponsors around a common vision Advise, engage and support stakeholders and develop champions through early involvement Understand business requirements as it relates to “people” Assess and analyze issues and impacts of change
Design, facilitate and implement various interventions to minimize the impact of change Develop, implement, monitor and track change management plans and communication and training plans
HIMSS 2009: Project Management Pre-Conference Workshop
Page 11
?
?
?
?
4/4/2009
How do we ensure that process redesign and change management are part system implementation projects? The Solution:
?
Make it Easy! Make process redesign and change management
part of the project management lifecycle Create and disseminate standard reusable tools,
?
?
templates, workplans and training materials
?
Develop a core team of skilled business process
analysts and facilitators who can support multiple
projects
4/4/2009
HIMSS 2009: Project Management Pre-Conference Workshop
Page 12
Use your cultural/readiness assessment to identify target pilot business areas prior to implementation
4/4/2009
HIMSS 2009: Project Management Pre-Conference Workshop
Page 13
Consider conducting a cultural or change readiness assessment
4/4/2009
HIMSS 2009: Project Management Pre-Conference Workshop
Page 14
Consider creating a team structure to allow for process redesign and change management resources
Project Reporting Structure
Program Management Office
Steering Committee
Dir, Process Redesign & Change Mgmt
Executive Sponsor
Project Manager
Change Manager Communications Lead
Business Process Manager Process Analyst Process Sub-teams
System Analyst
Technical Lead
Training Lead
Roles may be consolidated.
4/4/2009
HIMSS 2009: Project Management Pre-Conference Workshop
Page 15
Process Redesign and Change Management should be integrated with the Project Life Cycle, providing a roadmap for project managers and team members.
C U R R E N T
Project Management / Project Life Cycle
Initiation Planning Design Development Implementation Closure
Process Redesign
Problem / Needs Assessment
Current State Process Assessment
Future State Design Gap Analysis
Feedback Loop
Process WalkThrough
Process Implementation
Integrated Process Test
Go-Live
Assess, Measure Redesign
F U T U R E
V I S I O N
S T A T E
Communicate “Need”
Secure Buy-In
Plan for Action
Build Training Tools
Train and Monitor
Communicate, Celebrate and Reward
Sustain Change
Change Management / Communication and Training
4/4/2009
HIMSS 2009: Project Management Pre-Conference Workshop
Page 16
Decomposing the Methodology:
Process Redesign
Project Management / Project Life Cycle
Initiation / Planning Analysis Design Development Implementation Closure
Process Redesign
Problem / Needs Assessment
• Problem assessment and Measurement • Identify metrics • ID key stakeholders • Go-No-Go project decision/scoping
Current State Process Assessment
• Gather Data from all Sites and review current processes • Best practices research • Site visits • Identify commonalities across sites • Identify leading practices • Define key metrics and benchmarks • Decision point • Use leading practice • design future state • use system defined process • Business requirements definitions
Future State Design Gap Analysis
• Review current processes • Create “standard” or common process • Future State Visioning OR gap analysis • Incorporate best practices • Identify process gaps (between existing and “standard” or between existing and “future state”) • Develop process scenarios • Define how metrics will be tracked
Process WalkThrough
• Develop / define real-life process scenarios • Walk through processes using scenarios. • Identify gaps • Modify processes
Integrated Process Implementation Process Test
• Develop tools to implement new processes (training, P&Ps, process models, timeline) • Roll out new processes • Test processes and system • Document gaps • Update process flows, workflows, etc.; ensure policies and procedures are updated to capture process changes
Go-Live
Assess, Measure Redesign
• Review metrics – analyze results (are we getting desired benefits; if not, how can we modify work)
• Monitor adoption of process changes • Capture and document lessons learned • Modify processes as needed
4/4/2009
HIMSS 2009: Project Management Pre-Conference Workshop
Page 17
Decomposing the Methodology:
Change Management
Project Management / Project Life Cycle
Initiation / Planning Analysis Design Development Implementation Closure
Change Management
Communicate “Need” Secure Buy-In Plan for Action
• Develop Detailed Change Mgmt Plan • Update Comm Plan
Build Training Tools
Train and Monitor
Communicate, Celebrate and Reward
• Celebrate short term wins • Communicate stories, metrics, etc.
Sustain Change
• Identify adoption barriers • Revise Training and Communication Plans • Communicate and reward successes • Measure gains
• Define • Communicate stakeholders vision and • Develop message for communication change plan • Educate and • Develop sense of Share best “urgency” practices • Build guiding team – ID advocates, sponsors • Pain assessment • Change Readiness Assessment
• Complete • Train users on Change processes Management , • Monitor user Communication understanding and Training • Revise training Plans tools • Develop Training materials
4/4/2009
HIMSS 2009: Project Management Pre-Conference Workshop
Page 18
Process Redesign and Change Management
Success Stories Web-Enabled Referral Management for Physician Group
Initial goals were identified for the Referral Management Project.
? Reduce
time required to process patient referrals ? Improve patient and physician satisfaction with the process ? Electronic communication between referring and consulting clinicians ? Linkages to results and reports ? Sharing of ambulatory lab and radiology results
4/4/2009
HIMSS 2009: Project Management Pre-Conference Workshop
Page 20
The approach for Referral Management followed the integrated Process Redesign/Change Management Methodology
Current State Process Assessment
Process Redesign
Future State Design Gap Analysis Process WalkThrough
Feedback Loop
Problem / Needs Assessment
Process Implementation
Integrated Process Test
Go-Live
Assess, Measure Redesign
?
Identified need for referral management application through ongoing physician and patient satisfaction assessments
Change Management
Communicate “Need”
Secure Buy-In Plan for Action
Build Training Tools
Train and Monitor
Communicate, Celebrate and Reward
Make Behavior Stick
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4/4/2009
HIMSS 2009: Project Management Pre-Conference Workshop
Our approach was aligned with the SJHS Process Redesign / Change Management Methodology.
Process Redesign
Future State Design Gap Analysis Process WalkThrough
Feedback Loop
Problem / Needs Assessment
Current State Process Assessment
Process Implementation
Integrated Process Test
Go-Live
Assess, Measure Redesign
?
Evaluated current process(es) and identified opportunities to increase process efficiency
Change Management
Communicate “Need”
Secure Buy-In
Plan for Action
Build Training Tools
Train and Monitor
Communicate, Celebrate and Reward
Make Behavior Stick
Page 22
4/4/2009
HIMSS 2009: Project Management Pre-Conference Workshop
Our approach was aligned with the SJHS Process Redesign / Change Management Methodology.
Process Redesign
Future State Design Gap Analysis Process WalkThrough
Feedback Loop
Problem / Needs Assessment
Current State Process Assessment
Process Implementation
Integrated Process Test
Go-Live
Assess, Measure Redesign
?
?
? ?
Designed future state process Reviewed Referral Management application functionality and process (future state), defined gaps between future state and existing practice Defined requirements for application customization Modeled processes, defined metrics and measured baseline
Change Management
Communicate “Need”
4/4/2009
Secure Buy-In
Plan for Action
Build Training Tools
Train and Monitor
Communicate, Celebrate and Reward
Make Behavior Stick
Page 23
HIMSS 2009: Project Management Pre-Conference Workshop
Our approach was aligned with the SJHS Process Redesign / Change Management Methodology.
Problem / Needs Assessment Current State Process Assessment
Process Redesign
Future State Design Gap Analysis
Process WalkThrough
Process Implementation
Integrated Process Test
Go-Live
Assess, Measure Redesign
Feedback Loop
?
?
?
?
Identified target “change champions” for first implementations Interviewed users, implemented application and trained users in phased rollout process Partnered with vendor to define and redefine solution, based on user understanding and acceptance Defined process for capturing metrics on ongoing basis
Change Management
Build Training Tools
Make Behavior Stick
Page 24
Communicate “Need”
Secure Buy-In
Plan for Action
Train and Monitor
Communicate, Celebrate and Reward
4/4/2009
HIMSS 2009: Project Management Pre-Conference Workshop
Our approach was aligned with the SJHS Process Redesign / Change Management Methodology.
Process Redesign
Future State Design Gap Analysis Process WalkThrough
Problem / Needs Assessment
Current State Process Assessment
Process Implementation
Integrated Process Test
Go-Live
Assess, Measure Redesign
Feedback Loop
? ?
Conducted phased roll-out of application Conducted one-on-one training
Change Management
Communicate “Need” Secure Buy-In Plan for Action
Build Training Tools
Train and Monitor
Communicate, Celebrate and Reward
Make Behavior Stick
Page 25
4/4/2009
HIMSS 2009: Project Management Pre-Conference Workshop
Our approach was aligned with the SJHS Process Redesign / Change Management Methodology.
Process Redesign
Future State Design Gap Analysis Process WalkThrough
Feedback Loop
Problem / Needs Assessment
Current State Process Assessment
Process Implementation
Integrated Process Test
Go-Live
Assess, Measure Redesign
?
Continue to measure physician and patient satisfaction on annual basis, capturing referral management metrics, measuring against baseline
Change Management
Communicate “Need” Secure Buy-In Plan for Action
Build Training Tools
Train and Monitor
Communicate, Celebrate and Reward
Make Behavior Stick
Page 26
4/4/2009
HIMSS 2009: Project Management Pre-Conference Workshop
A key benefit of the Referral Management program was reduced cycle time in a fully deployed model.
Pre-Implementation 46.5 – 51.5 min.
Post-Implementation 10 to 11 min.
Manual – 3 min. Manual – 15 min.
Manual – 1 min. Manual – 3 min.
Automated – 1 min. Automated – 3 min.
Manual – 1 min. Automated – 0.5 min.
Manual – 1 min.
Automated – 0.5 min.
Manual –2 min.
Automatic – 0 min.
4/4/2009
HIMSS 2009: Project Management Pre-Conference Workshop
Page 27
A key benefit of the Referral Management program was reduced cycle time in a fully deployed model (continued).
Pre-Implementation 48.5 – 51.5 min. Post-Implementation 10 to 11 min.
Manual –0.5 min.
Manual – 15 min.
Automatic – 0 min.
Automatic – 3 min.
Manual –4 min.
Manual –2 to 5 min. Manual – 1 min.
Automatic – 0 min.
Automated – 1 to 2 min. Automated– 0 min.
Manual – 1 min.
46.5 – 51.5 min.
4/4/2009
Automated – 0 min.
10 to 11 min.
Page 28
HIMSS 2009: Project Management Pre-Conference Workshop
Post implementation, time required to process a referral was reduced by a range of 35.5 to 41.5 minutes.
60 50
Referral Management Process
Pre-Implementation Post Implementation
Savings: 35.5-41.5 mins 10 - 11 46.5 - 51.5
Total Min
40 30 20 10 0
Complete Referral Request
Verify Eligibility/ Benefits
Determine Provider Type
Determine Service Type and Urgency
Fax to UM
F/U with UM on Status *
Distribute Requests
Verify Eligibility/ Benefits
Enter info into IDX
Review referral and approve, pend or deny
Route
Receive and distribute fax
Referring Physician
RPRA Referring Physician Referral Admin
Utilization M anager
Specialist's Office
* Does not occur in all instances, or process time varies 4/4/2009 HIMSS 2009: Project Management Pre-Conference Workshop
Page 29
While using the Web for Referral Management, users may also connect (link) to results and reports.
Once on the Web Portal, physicians and clinicians may also use it for:
? ? ? ? ? ?
Web Portal Users 600 500 400 300 200 100
Jan 2003 Feb 2003 Mar 2003 Apr 2003 May 2003 Jun 2003 Jul 2003 Aug 2003 Sep 2003 Oct 2003 Nov 2003 Dec 2003 Jan 2004 Feb 2004 Mar 2004 Apr 2004 May 2004 Jun 2004 Jul 2004 Aug 2004 Sep 2004 Oct 2004 Nov 2004 Dec 2004 Jan 2005 Feb 2005 Mar 2005 Jun 2007
? ?
?
? ?
Viewing patient insurance data Hospital lab results Transcribed reports Ambulatory lab information Patient hospital admitting Obtaining industry data and information Communication with patients Secure messaging Care management Imaging data Ambulatory Radiology Results
228% Increase in users since “go-live” of Referral Management; 25% increase in physician usage.
0
2003
2004
2005
375% Increase in web portal sessions since “golive” of Referral Management (as of June 2007)
2003
2004
2005
4/4/2009
HIMSS 2009: Project Management Pre-Conference Workshop
Page 30
Roadmap for Failure
What happens when there is not sufficient focus on process redesign, standardization or change management…
The initial “vision.”
Implement a common enterprise-wide Human Resources Information System that allows St. Joseph Health System Human Resources to move from multiple disparate payroll/benefits systems to a fully integrated HRIS. Common HR processes will be implemented throughout SJHS. Significant change management across the enterprise will be required to ensure the successful rollout of the new system.
4/4/2009
HIMSS 2009: Project Management Pre-Conference Workshop
Page 32
The reality. System implementation project was not managed by I.T. The “lowest priced” outside consulting firm was engaged to perform implementation Best practices were not identified Processes were not evaluated, improved or standardized as part of the implementation All effort was geared toward “go-live” target dates Change management resources were not engaged Higher than anticipated implementation cost
?
?
? ?
? ? ?
4/4/2009
HIMSS 2009: Project Management Pre-Conference Workshop
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The result.
al rn s e t e Ex titi En
al rn te s Ex titie En
KR ON OS GL and DSS
Benefits Benefits Tring. Recruit Tring. Adm. Core Wrkfce. Core Recruit Adm. HR HR Wrkfce. Benefit Ben PR Tring. T&L* Queen PR s Tring. efits Recruit T&L* Recruit Sonoma Adm.Core Adm Core Wrkfce. HR Wrkfce. HR PR T&L* PR T&L*
ID
M RE S - gm t. Q
m Mg t.
ID
OS KRON d DSS GL an
Benefits Tring. Recruit Adm. Core Wrkfce. HR PR T&L*
l na r te ies Ex ntit E
Benefits PR Tring. T&L* Recruit Adm. Core Wrkfce. Benefits HR Benefits Sys. Off. Tring. St. Joseph Tring. Recruit PR T&L* Adm. Recruit Core Wrkfce. Benefits(Orange) Adm.Core Tring. Wrkfce. HR Recruit HR PR Adm.Core T&L* PR HR Wrkfce. T&L* Hert. Cntrl. PR T&L*
Benefits Mission Tring. Adm. PR Recruit Hert. Nrth. Adm. Core Wrkfce. Benefits Tring. HR Recruit Covenant Adm.Core St. Jude HR Wrkfce. PR Humboldt T&L
St. Mary
RES -Q
Ex En ter t itie nal s
• Multiple system configurations (20+) • Multiple data formats, reports and interfaces • Excessively high support and operations costs • Inconsistent quality • HIGHLY dissatisfied “customers”
4/4/2009
HIMSS 2009: Project Management Pre-Conference Workshop
Page 34
What happened next.
?
Launch of “S&S” (Standardization and Stabilization) Program to:
?
?
?
?
?
Addressing existing cost drivers of HRIS Production support time to contain current costs Enable risk mitigation and future cost avoidance through infrastructure stabilization Define and communicate roles and responsibilities for application support and management (local and enterprise) Improve ease of use/reliability of query reporting for ministries Prepare SJHS for Version upgrade, and evaluation of e-applications and other HRIS functionality
HIMSS 2009: Project Management Pre-Conference Workshop
Page 35
4/4/2009
Questions?
4/4/2009
HIMSS 2009: Project Management Pre-Conference Workshop
Page 36
doc_226697374.pdf