Your Organization May be Ready for ICD-10 . . . Are Your Employees? How to Identify Your Team's Readiness for Change

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PYA Principal Denise Hall and Consulting Manager Kristen Lilly broached the topic of ICD-10 implementation and employee readiness at the June 17 HIMSS ICD-10 Forum held in Washington, D.C.


  • 1. Page 0June 17, 2013Prepared for HIMSS Media ICD-10 Forum
  • 2. Page 1June 17, 2013Prepared for HIMSS Media ICD-10 ForumHIMSS Media ICD-10 ForumJune 17, 2013Your Organization May be Readyfor ICD-10 . . . Are Your Employees?How to Identify Your Teams Readiness for Change.
  • 3. Page 2June 17, 2013Prepared for HIMSS Media ICD-10 Forum Identify the organizational impactof ICD-10 preparation andimplementation Develop a communicationsponsorship tree Illustrate the Loss of Effectiveness(LOE) Index change readinesstool Learn preliminary steps ofdeveloping a changemanagement work planLearning Objectives
  • 4. Page 3June 17, 2013Prepared for HIMSS Media ICD-10 ForumWhy Change FailsOrganizational change initiativescontinue to experience a failurerate approaching 70%.Sources: Standish 2009, IBM 2008, Raps 2004, Beer 2003, Miller 2002, HBR 2000, Senge 1999, Strebel 1996, Kotter 1995
  • 5. Page 4June 17, 2013Prepared for HIMSS Media ICD-10 ForumOrganizational ChangeOrganizational change causes a loss of stability,which results in the development of apredictable and measurable set of symptomswithin an organization.When a significant number of these symptomsare present, an organizational loss ofeffectiveness will occur.Source: Grady, 2005
  • 6. Page 5June 17, 2013Prepared for HIMSS Media ICD-10 ForumICD-10 Organizational Impact Physician Documentation Physician Integration Physician Performance Staffing Effectiveness Assessment of RevenueImpact Process Improvement Decision Support ReportingImpact Documentation Analysis ICD-10 Education Process Improvement MonitoringPhysicianOfficePost AcuteServices Front Scheduling, Access Areas Middle Coding, CDI, CaseManagement Back Billing, ReimbursementHealthInformationManagementICD-10RevenueProcessPhysicianOperationalPlanningInformationTechnology IT Systems Capability, Communication Functionality Vendor Preparedness
  • 7. Page 6June 17, 2013Prepared for HIMSS Media ICD-10 ForumChange Management:Key ICD-10 Project StakeholdersScheduling /Access AreasHealth InformationManagementInformationTechnologyDecision SupportPhysicianAdvocateBilling &ReimbursementHuman Resources
  • 8. Page 7June 17, 2013Prepared for HIMSS Media ICD-10 ForumInitiating SponsorsChange Management:ICD-10 Sponsorship Tree Strategically legitimizes the implementation of change Ensures strategic alignment, support , and inclusion Sanctions the change in relevant area of responsibility Coordinates activity and defines consequences Orchestrates activities andconsequences within theirlocal areaSustaining SponsorsChange RecipientsLocal Sponsors
  • 9. Page 8June 17, 2013Prepared for HIMSS Media ICD-10 ForumChief Financial OfficerICD-10 Team ResourcesSample Sponsorship Tree and StructurePFS ManagerDirector of RevenueManagementManager of IT SupportDirector of HealthInformation ManagementDirector of CodingChief Information OfficerLead Sustaining SponsorSustaining SponsorsTraining &DevelopmentManagerMarketing/CommunityRelations ManagerCoding Manager IT AnalystLocal SponsorsInitiating SponsorsDirector ofPatient Financial ServicesChief Compliance OfficerPractice AdministratorPatient Access/AdmissionsManagerDecision SupportAnalystRevenue CycleManagerMarketing/CommunityRelations DirectorClinic Manager
  • 10. Page 9June 17, 2013Prepared for HIMSS Media ICD-10 ForumLoss of EffectivenessIdentify the riskMeasure therisk of changeto the individualAddress/resolvethe risk prior tochangeThe LOE Index determines the risk of change to the person,which ultimately impacts the success of change in theorganization.
  • 11. Page 10June 17, 2013Prepared for HIMSS Media ICD-10 ForumLoss of Effectiveness (LOE) IndexChange Readiness Assessment People determine the success of any change Loss of Effectiveness (LOE) Index measures six defined symptoms thatdetermine the risk of change to the person, which ultimately impacts thesuccess of change in the organizationIndividual Symptom Organizational SymptomAnxiety Decreased MoraleFrustration Loss of ProductivityRejection of the Environment Increased ConflictRetardation of Development Decreased MotivationRefusal to Participate Increased AbsenteeismWithdrawal Increased Turnover
  • 12. Page 11June 17, 2013Prepared for HIMSS Media ICD-10 ForumLOE IndexResults by Department1.001.201.401.601.802.002.202.402.60A D F G P R W AVG.Coding Information Systems Medical Records Patient Access Services Patient Financial Services Transcription Utilization Review
  • 13. Page 12June 17, 2013Prepared for HIMSS Media ICD-10 ForumLOE IndexResults by Leadership1.001.201.401.601.802.002.202.402.60A D F G P R W AVG.Director Or Manager Front Line Employee Supervisor Or Team Lead
  • 14. Page 13June 17, 2013Prepared for HIMSS Media ICD-10 ForumLOE IndexResults by Years of Service1.001.201.401.601.802.002.202.402.60A D F G P R W AVG.0 To 5 Years 6 To 10 Years 11 To 20 Years 20 Years
  • 15. Page 14June 17, 2013Prepared for HIMSS Media ICD-10 ForumLOE IndexQualitative Responses: ExamplesCommunicationIt would be helpful to have a "heads-up" prior toimplementing changes. At times, changes aremade and put into place and then those who aresupposed to follow through with these changesare informed.~Sometimes having more of a heads up toupcoming changes would be great. We haveexpressed this to our leadership before and theyhave made vast improvements to do so.TrainingI believe there should be MANDATORYtraining classes for those that thechanges are going to effect. This wouldresult in less confusion when changes areimplemented.~Training immediately prior to, during andafter implementation.~More training in all departments to makethe workflow more efficient. A betterunderstanding of why things are done acertain way.End User InvolvementThe most important thing to me is to include thepersons that the change will most affect in theprocess. Take their concerns into considerationbefore a final decision is made and the change isimplemented.
  • 16. Page 15June 17, 2013Prepared for HIMSS Media ICD-10 ForumChange ManagementWork Stream Infrastructure Impact Identification Knowledge Leveling Data GatheringAwareness &Assessment Sponsor TreeDefinition Identification ofSponsors Communication PlanSponsorship LOE Index Analysis of Results Action IdentificationEffectivenessAssessment Converge Impact &Effectiveness Training Communication /SponsorshipPath ForwardChange Management Work Stream Deliverables: Sponsorship Tree Definition and Identification Effectiveness Index Summary Results and Action Identification Enterprise Training Blueprint
  • 17. Page 16June 17, 2013Prepared for HIMSS Media ICD-10 ForumQuestions?
  • 18. Page 17June 17, 2013Prepared for HIMSS Media ICD-10 ForumContact InformationDenise Hall, RN, BSNPrincipaldhall@pyapc.comKristen Lilly, MHA, RHIA, CPHQManagerklilly@pyapc.comThank you for allowing us to share our thoughtsand expertise with you.Pershing Yoakley & Associates, P.C.(800)