C11 from change fatigue to energizing change through an administrative redesign initiative

Faculty/Presenter Disclosure Faculty: Terri Harrison, Anne Caron, Lisa Wan

Relationships with financial sponsors: • Grants/Research Support: N/A • Speakers Bureau/Honoraria: N/A • Consulting Fees: tap Strategy & HR Consulting • Patents: N/A • Other: N/A

Disclosure of Financial Support • This program has received no financial support. • This program has received in-kind support from tap Strategy & HR Consulting in the form of preparation and work for this presentation.

Potential for conflict(s) of interest: • tap Strategy & HR Consulting developed and owns certain products and methodologies that will be discussed in this program.

Mitigating Potential Bias • N/A

The Journey from Change Fatigue to Energizing Change June 2018

Presented by:

Terri Harrison Vice President, Consulting Services & Senior Strategist __________________ Anne Caron Director, Corporate and Administration Services __________________ Lisa Wan

Health Administration Manager

Tr a v e l J o u r n a l

Agenda

1. Project Initiation

6. The Big Reveal

2. Discovery Phase

7. Implementation

3. Post-Discovery

8. PRIME

4. Reflection

9. Real Change

5. Strategic Implementation Plan

Idea

Efficiency

Effectiveness

Presented by:

The Journey Begins…

Key Elements • RCHS identified symptoms and challenges that needed to be addressed • RCHS developed principles and desired outcomes • RCHS engaged external expertise

Principles: • Engage experts: tap Strategy & HR Consulting • Recommendations that reflect existing resources • Employee engagement Outcomes: • To improve efficiency and effectiveness • Improved client experience • Continuous improvement

The Discovery Phase…

Project initiation

The discovery phase included the following activities…

Engagement – Engagement - Engagement • Discovery interviews with senior management team and select staff • Analysis from ten-minute exercises (diary of work performed in tenminute increments) • Facilitation of an administration team focus group • The launch of the “How Can We Improve?” survey

• Validation meetings with Senior Leadership

Key Elements • tap Strategy brought their expertise and a process and structure to the initiative

Post-Discovery

Project initiation

Discovery Phase

Post-Discovery – Outcomes…

New org structure Executive Director Community Services

Primary Care

Corporate Services

New org structure Executive Director Community Services

Primary Care

Corporate & Administration Services

Presented by:

Key Elements • tap Strategy created a roadmap to identify root causes and create customized solutions for RCHS symptoms and challenges

Reflection

Project initiation

Discovery Phase

PostDiscovery

Reflection

Project initiation

Discovery Phase

PostDiscovery

Essential Activities during this Phase • Presentation at All Staff Day to update staff on steps taken to date and next steps • RCHS recognized they did not want to lose momentum, and so: • RCHS followed through with beginning to address six areas to focus on - Standardization

- Communications

- Teamwork

- Training

- Equipment

- Roles & Responsibilities

Key Elements • RCHS has the operational expertise and commitment which was layered on top of the process • RCHS took the time to reflect, study and act • RCHS followed through on advice from tap Strategy • tap Strategy’s Outcomes for RCHS: - to become more agile

- the ‘What’ and the ‘How’

Strategic Implementation Plan

Project initiation

Discovery Phase

Reflection

PostDiscovery

Essential Activities during this Phase • Use of tap Strategy’s methodology:

- Principles - Drivers (current & need)

- Desired Outcomes - Change Management plan (including Communications and Risk Management

Strategies)

Essential Activities during this Phase • Resulting in agility, engagement, solution orientation, “One RCHS” • Focus Group performed by tap Strategy (neutral third party) • RCHS identified a need to implement a new management layer also in primary care and community services - To mitigate risk - To enable implementation of the new organization structure

RCHS - Principles • Engagement & transparency • Ongoing communication & solution generation • Retention of engaged, supportive & productive staff • Allocation of resources by need, function and leading practice • Focus on client (internal and external) experience

• Maximization of processes and equipment • “One RCHS”

RCHS - Drivers Current: • Silo’s • Duplication of Effort • Role Confusion • Lack of Business Continuity • Inadequate resources • Unable to work to full scope • Few opportunities for promotion

Need: • To be scalable and nimble • Standardization • Improved communications • Increased collaboration • Clear roles and definition • Capacity building • Increased opportunities for promotion • Appropriate distribution of workload • Demonstrate Accountability

RCHS - Outcomes • • • • • •

Rewarding work environment for staff at RCHS Ensure business continuity through pooled approach/joint forces Scalable and nimble administration support to programs and RCHS Efficient resource allocation Efficient processes and equipment systems Proven accountability to funders through responsible management of resources and systems • Increased capacity and opportunities for staff • Poised to lead and adapt to health system changes and organizational growth

Key Elements • Principles, Drivers and Outcomes were expanded upon using tap Strategy methodology • Principles were well-discussed and adjusted to become evergreen • Drivers were clearly expanded upon and understood

• Outcomes established to really understand desired results and their measures of success.

The Big Reveal

Project initiation Reflection

Discovery Phase

PostDiscovery

Implement

The Big Reveal

Project initiation Reflection

Discovery Phase

PostDiscovery

Implement

The Big Reveal!

ONE RCHS approach

1. ONE Administrative team 2. Enhanced Management 3. Expanded Corporate department

One Administrative Team

• All administrative roles to come together under one team - Includes all Medical Secretaries and Medical Receptionists

Enhanced Management •

A new Management level was created, encompassing: -

A new Primary Care Manager

-

A new Community Services Manager

-

A new Health Administrative Manager

-

A new Corporate Manager

Expanded Corporate Department

• With the creation of a new Health Administrative team, all administrative roles to be under an expanded department called

- Corporate & Administration Services Department

Key Elements • RCHS vehemently followed the process and methodology

• Examined risks upfront and put in place mitigation strategies • Communications and Change Management Plans were formalized during the strategic implementation planning period

Implementation of New Structure

The Big Reveal

Project initiation Reflection

Discovery Phase

PostDiscovery

Implement

Implementation of New Structure

The Big Reveal

Project initiation Reflection

Discovery Phase

PostDiscovery

Implement

Essential Activities during this Phase • Management responsibility matrix (tap Strategy process and product) • Management job descriptions

• Recruitment • Orientation of new Health Admin Team through a retreat day: - Confidential Survey to Health Admin staff in prep for retreat day - Kick off new structure with Admin Retreat - Action Plan as a result of the Health Admin Retreat

Essential Activities during this Phase • Action Plan - Priority 1: Safety Concerns -faxing and scanning errors

- Priority 2: Business Continuity – summer vacation, sick leave coverages - Priority 3: Managing workload demands with existing resources – seeking efficiencies

- Priority 4: Future State & continuous quality improvement

Key Elements

• RCHS building real agility

PRIME

The Big Reveal

Project initiation Reflection

Discovery Phase

PostDiscovery

Implement

New Structure

PRIME

Plan

Evaluate

Monitor

Review

Implement

Essential Activities during this Phase • “One RCHS” • Directors, managers, and employees working toward the same goal, cohesively • Continuous engagement • Continual gap and needs identification

• Mindset changed to solution orientation • Quarterly management survey as part of monitoring and evaluating

• Operational realities necessitated prioritization and expedited development opportunities • Managing expectations

Key Elements • RCHS demonstrated commitment • RCHS followed advice and actioned • RCHS met regularly and kept their momentum • RCHS evaluated and measured against their pre-established measures • RCHS addressed gaps and challenges quickly and head-on

• Staff were, and are, empowered • Realization this is an evolutionary process

• Real understanding and acceptance – change is a journey not a moment in time

Real and Energizing Change

The Big Reveal

Project initiation Reflection

Discovery Phase

PostDiscovery

Implement

PRIME New Structure

Real and Energizing Change

The Big Reveal

Project initiation Reflection

Discovery Phase

PostDiscovery

Implement

PRIME New Structure

Essential Activities during this Phase

From • Role Confusion • Inconsistent Practices • Varying degrees of work distribution • Multi-tasking • Outdated technology – phone system • Team based / Silos

To • Role Clarity • Standardization • Equitable distribution of workload • Designated scanning time • Upgraded phone App – answered at multiple locations

Essential Activities during this Phase

From • Resource intensive reminder calls • Inefficient workflows • Informal staff scheduling practices • Inconsistent data standards • Admin staff flagging training needs

To • Pooled approach “One RCHS” • Automated Calling System • Elimination of waste • Scheduling based on service volumes

RCHS - Outcomes • Rewarding work environment for staff at RCHS • Ensure business continuity through pooled approach/joint forces • Scalable and nimble administration support to programs and RCHS • Efficient resource allocation • Efficient processes and equipment systems • Proven accountability to funders through responsible management of resources and systems

• Increased capacity and opportunities for staff • Poised to lead and adapt to health system changes and organizational growth

Real and Energizing Change

The Big Reveal

Project initiation Reflection

Discovery Phase

PostDiscovery

Implement

PRIME New Structure

Real and Energizing Change

The Big Reveal

Project initiation Reflection

Discovery Phase

PostDiscovery

Implement

PRIME New Structure

Real and Energizing Change

Real and Energizing Change

Key Elements • RCHS demonstrating real agility • RCHS experiencing a palpable culture change • RCHS went from change fatigue to energizing change