Operation Monarch Leadership Playbook #4 (March 2024 edition)​

Operation Monarch Change Coalition

Thank you for taking the time to review this Operation Monarch Leadership Playbook This is the fourth in a series of toolkits created to provide you with project updates, key messages, communication tactics, resistance management coaching and other relevant information to support Niagara Health and Hotel Dieu Shaver leaders in guiding their teams through the implementation of a new HIS.

An Accountable Leader is essential to the success of the project by coaching teams in understanding the impact a new hospital information system (HIS) will have on behaviours, policies, processes, environmental and technical aspects of this transformational change.

This playbook will provide Sponsors and Accountable Leaders with information on:

• Operation Monarch timeline review

• Pulse Check Outcomes

• Training Timeline

• Super User Strategy

• Readiness and Engagement Activities

• Prosci©Change Leadership tool – CLARC

• Checklist #4 Vision Statement

Operation Monarch Timeline

One notable change in the timeline is the shift from using the term ‘Project Monarch’ to ‘Operation Monarch’. This shift is meant to demonstrate the project initiative as a corporate priority across both organizations. Using the term Operation Monarch signals to our teams that while we continue in the engage phase, we have entered the training and testing phase of the project. The next stage of the project is the activate stage which will begin at go-live on September 28th , 2024. Following go-live, we will move into the measure stage which will include optimization, sustainment and measurement activities.

The white background depicts the activities in the timeline that have been accomplished to-date. The blue section is the journey to go-live leading up to optimization and stabilization.

Training and Learning Pathway

Learning Journeys

Oracle’s Learning Framework delivers role-based learning content for end users prior to using Oracle solutions. Learning content is based on model experience and is delivered through a learning portal where learning progress and readiness indicators such as competency, commitment, and confidence are tracked.

Principles

• Provides relevant, contextual knowledge and practice opportunities

• Incorporates a staged learning, spaced repetition, and retrieval practice

• Coaches and support learners as they transfer knowledge and skill into the workflow

• Offers on-demand resources learners can easily retrieve

Approach

Training curriculum is conducted in stages which consists of role-focused asynchronous, virtual, mobile friendly, learning activities and an instructor-led session with a competency evaluation. Successful completion of the Learning Journey leads to access to the HIS.

End users receive their own role-based learning journey distributed at a 5-week cadence. Users are guided along a learning path that is divided into stages with learning activities specific to each stage.

Stage 1

•Discover

Stage 2

•Explore

Learning Labs

Stage 3

•Explore

Stage 4

•Perform

Stage 5

•Adopt

•/Reinforce

Learning labs will be conducted at various Niagara Health sites and Hotel Dieu Shaver. The in-class training sessions offered from August 6th – September 27th, 2024. Learning labs will be:

• Facilitated by Oracle Health Training Specialists

• Hands-on learning

• Labs will be two - 16 hours in length (length is role dependent)

o 16-hour session will be conducted over two days

• The Training team is coordinating end-user training requirements with managers and supervisors

• Favourites Fair and Login Labs will be scheduled to ensure logins are ready prior to go-live

Super User Program

A Super User Program is imperative to the success of Operation Monarch. Having knowledgeable, visible Super Users embedded within every unit will ensure a smoother, more efficient Go-Live.

Operation Monarch will need super users from each organization, every site and all program areas including representatives from as many roles as possible - e.g. - physicians/prescribers, clinicians, allied health, unit clerks, and staff from ancillary services.

Best practices recommend a minimum of 1 super user for every 10 users, or one Super User per unit

Super Users vs. At-the-elbow (ATE)

Super users:

• Dedicated resources from each unit, supporting their colleagues and peers for the duration of go-live.

• Will be able to troubleshoot basic issues and escalate any issues that they are unable to resolve to Operation Monarch project resources

At-the-elbow supports (ATE):

• Resources hired from outside of NH & HDS to support end-users during go-live (e.g. co-op students, contracted resources)

Super User Benefits for the Project Success Super User Participant Benefits

• The use of peers from both HDS and all NH sites in this role is essential.

• Utilizing Super Users that end-users already know is likely to make them more approachable and will aid in building a local knowledge pool, which will assist in the long-term sustainability of Operation Monarch.

• By building up confidence and experience at HDS and NH sites (or within the organizations overall), it greatly improves the success of go-live, and especially the transition to sustainment.

• Millennium will require frequent upgrades, bug fixes and enhancements on an ongoing basis. By building an internal Super User “community of practice”, they can continue to stay up to date on all changes and will become change conduits for keeping their peers informed and feeling supported.

Super users will receive enhanced training and be equipped to help their colleagues learn how to use the new system. Other benefits include:

• Enhanced system knowledge - Super Users will gain an in-depth understanding of the Millennium platform.

• Professional Growth and Recognition - Being a super user demonstrates commitment to advancing the effective use of healthcare technology.

• User Training and Support - Super users often take on the role of trainers, educating and supporting colleagues.

• System Optimization - Super Users will have the opportunity to provide feedback and suggestions for system improvements

• Increased Productivity - Super users are trained to troubleshoot and resolve issues in Millennium. This expertise empowers super users to quickly address questions and concerns minimizing downtime and disruptions.

Attributes of a Super User:

A Super User is more than a technical resource, these individuals have many difference attributes that enhance their role supporting their colleagues.

Four Phases of Super User Program

The Super User program will be organized into four phases: Recruitment, Training, Go-Live, and Sustainment.

Recruitment

• Based on initial analysis, it is anticipated that Operation Monarch will require ~188 Super Users for the duration of go-live support (approximately 4 weeks)

• Users who are interested in being a Super User should respond to the Expression of Interest request to be shared March 2024.

• End-users are requested to cc’d their managers or supervisors of their interest

Training

• Super Users will be required to attend all relevant End-User Training including Learning Journeys (rolebased online training), Outreach Opportunities (e.g. huddles, roadshows, department meetings), and Learning Labs (in-person classroom training).

• They will be encouraged to join a second classroom session to observe and support an instructor with learners, and to participate in readiness/practice opportunities (e.g., shadow charting, simulations)

Go-Live

• Super Users will provide support for their peers and colleagues and will be easily identified via provided clothing (e.g. T-shirts or vests).

• Ideally, Super Users will not have a patient assignment or other responsibilities.

• For issues beyond the scope of the Super Users knowledge, there will be a robust escalation process in place where Operation Monarch resources will be able to provide more advanced support.

• As part of the go-live, a subset of Super Users may also be asked to participate in cutover activities.

• In the week leading up to and including the night of go-live, several users at each site will be required to cut-over bedded patients into the new system.

• Super Users are ideal candidates for this work as they will have received additional training and will not have to balance patient care at the same time

Sustainment

• The Monarch team will strive to build a “community of practice” for Super Users after go-live

• More information will be shared as it becomes available.

Readiness and Engagement Plans

The readiness plan is a multi-pronged approach to build up foundational knowledge related to the technical functionality and terminology of the new HIS.

This readiness timeline showcases the different venues that are planned for the practice readiness such as, leadership forum, roadshows, open houses, lunch and learns, program and huddle in-service rounding, and post training practice opportunities. The purpose is to support our front-end users to become self-efficient and perform with confidence as an essential element to providing quality patient care at go-live.

There are three considerations for readiness:

• What’s changing? How can you support leading your team through the change? How can Operation Monarch support your program during this change?

Below is a timeline for the readiness activities. Leaders can expect announcements and invitations to these events as each date draws closer.

Leaders will be expected to participate in readiness activities in preparation for go live such as:

• Attend Roadshows and Workflow training events (Bring a Friend or Peer)

• Attend solution training events

• Understand key workflows and communicate new practices & changes

• Complete Accountable Leader checklists

Supporting Your Teams Through Change

Your role as a leader through change is to communicate and support your teams’ transition through their change journey. ©Prosci, Inc. methodology suggests five roles for leaders to consider while leading their teams

through a transformational change.

Communicator

Applying the ADKAR (©Prosci, Inc) model for communicating messages with your teams, along with tangible examples are tangible ways for you to inform your team of key messages and project updates. Using messaging from a “what’s in it for me?” perspective, drives home the messages to your team that you support and are engaged in the implementation of a new HIS.

Liaison

As a liaison, you are responsible to be the conduit of information sharing between your teams and the HIS Project Team. There are three main opportunities you can take advantage of to engage as a liaison for your team:

1. Attend  Operation Monarch Meetings, Advisory Committees (where appropriate) to obtain timely project updates that effect your team and the rest of the organization.

Accountable Leader Playbook #4

2. Participate in  working group and groups and Accountable Leader sessions to share your knowledge and expertise from the perspective as a leader on your unit.

3. Provide feedback  to Operation Monarch team members from your employees on any concerns they may have, information they are seeking and what your team needs to succeed.

Advocate

Tips on how to be an advocate to demonstrate your support for the implementation of a new HIS:

• Your visible and active support for a new HIS directly affects your employees desire for the change.

• Lead by example... attend and participate in Operation Monarch meetings, lunch 'n learns and information sessions.

• Share Operation Monarch huddle scripts with your team during huddles.

• Support and encourage Change Agent attendance at Change Coalition Meetings.

• Work with change agents on your team to creatively share project updates with the rest of your team.

Resistance Manager

In Accountable Leader session 2, we went into detail on how to support your teams or individuals on your team who are resistant to the change. Please refer to the Accountable Leader Playbook #2 for a review. In summary:

1. Listen and understand objections

2. Focus on the "what" and "let go of the how"

3. Remove barriers

4. Provide simple, clear choices and consequences

5. Create hope

Coach

6. Make a personal appeal

7. Show the benefits in a real and tangible way

8. Convert the strongest dissenters

9. Demonstrate consequences

10. Provide incentives

A coach is exactly what you would think of when you look at a leader in sport. A coaching role is to ensure your team have all the tools and opportunities to participate in the change. Below is a list of ideas to prepare your team for go-live:

• Speak about Operation Monarch at Team meetings or during 1:1s

• Ensure staff are registered for training as soon as sessions are available

• Engage Super Users and Change Agents to increase team adoption

• Address barrier points that might deter adoption

• Visit SourceNet or E-Span for timely updates

Accountable Leader Playbook #4

Accountable Leader Sessions

Accountable Leader sessions will increase in frequency and transition into important, tactical, information sessions to prepare you, as a leader, for go-live readiness An Accountable Leader check list will be created with actionable tasks to complete following each session to ensure you and your team are ready and feeling supported for September 28th, 2024.

Date

(all meetings will be scheduled 11:00noon)

April 8

May 13

June 10

July 8 & 22

August 12 & 26

September 9, 16, 18, 23, 25

Sample Topics

• Devices, Testing

• Training Updates

• Operational Readiness / Access & Flow planning

• Training Information & Reminders

• Practice Opportunities

• Introduction to Cutover

• Introduction to Go-live & the support model

• Introduction to Downtime

• Transition to Sustainment

• Reminders for go-live & cutover

• Go-live Checklist

• Operational Readiness / Access & flow

Accountable Leader Checklist #4

This checklist will help you prepare to effectively manage and prepare for the change within your program or unit These checklists will be distributed with updated playbooks at key milestones within the project Checklists will become more frequent, tactical in nature and imperative for completion as go-live draws closer These checklists will ensure you understand your role leading up to go live and that you will have the information and tasks required to support your team

For this phase, here is what you need to:

• KNOW – Information you need to be aware of, but no further action is required.

• DO – There is an action for you to take.

• SHARE – Information we ask you to share with your teams.

• SUBMIT – Submit form via this link https://forms.microsoft.com/r/ev2QZRghDJ or by scanning this QR Code with your mobile device.

CHECKLIST 4: Template

Name: Unit/Team:

Accountable Leader Playbook #4

Add

Adapt

Nudge

User role (as appropriate for your team).

Submit

Submit

Appendix A – Operation Monarch Key Messages

Project Monarch key messages can be found on Operation Monarch SourceNet page or Hotel Dieu Shaver’s E-Span page.

Appendix B – Pulse Survey Results

Total number of respondents = 1706 across both organizations and all Niagara Health sites.

Where to find more information or provide feedback

Operation Monarch SourceNet page (NH)

Operation Monarch E-span page (HDS)

Refer to the FAQs on SourceNet (NH) or E-span (HDS)

Email Operation.Monarch@niagarahealth.on.ca

SourceNet (NH) Feedback form

E-span (HDS) Feedback form

References:

1. Change Management: The People Side of Change; J.M. Hiatt, T.J. Creasey, Second edition, 2012.

2. Best Practices in Change Management: 10th Edition; Prosci Inc., 2018.

3. Leading Change, J. Kotter, 2012