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

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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?

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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

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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

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“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?

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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.

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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

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Change Management as Risk Mitigation

AnalyzeRisk

Change

Change Analysis

AnalyzeRisk

AcceleratePerformance

Targeted

Solutions

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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

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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:

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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

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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

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“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?

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Break-out Discussion

Part 1: What are the greatest change management risks to achieving audit readiness?

Part 2: What solutions could address those risks?

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“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?

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Closing

What is the one action you will take based on this discussion?

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