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Welcome to the Change Management Tutorial Series
Case study - impact of effective change management
From the "why change management" tutorial series
Prosci is releasing a four-part series on "why
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change management" to provide several different perspectives on how to make the case for applying a structured approach to manage the people side of change for organizational initiatives. This series
This tutorial was the
includes: "success story competition" winner for
Correlation data on the impact of effective Prosci's 2009 Global change management Conference
Cost-benefit analysis for change The case study
management includes real data on the Case study on project impact of effective impact of effective change
change management
Helping Employees Adapt to Change at Texas Children's Hospital by Stephanie Elam and Tammy Christensen, Texas Children's Hospital
Special guest authors for the Change Management Learning Center and winners of the 2009 Global Conference success story competition
Introduction
In 2006, Texas Children's began an aggressive $1.5 billion expansion project. The expansion includes the erection of four new buildings, and the addition of new service lines and programs, leading to a large increase in employee resources. By 2010, the organization is expected to grow from 6,600 to 9,000 employees and increase medical staff by 70. Simultaneously, the organization is transitioning from a paper to an electronic medical record system. This expansion initiative is considered to be the largest ever in the United States to be completed within a four-year window.
Project Background
Texas Children's has begun the implementation of an electronic medical record system that will provide immediate access to patient records and information across the organization, thus promoting improved patient care and patient safety while streamlining efficiencies. The electronic medical record will facilitate instant communication between the primary care and specialty services while also allowing on-going access to patient information for research purposes. The first phase of the project was deployed in two major business units in the organization, impacting approximately 6,000 employees or 85% of the workforce. change management team as “on-the-ground” peer champions. The change management team provided Network members with ongoing information, reminders, and tips which they shared with their peers. Periodic meetings and conference calls allowed change agents to connect with each other and exchange ideas about how to build commitment, as well as keep the change management team informed about issues and major areas of resistance that required attention.
In addition to the Change Agent Network, the change management team developed dress rehearsal activities to help prepare end users for the implementation. The activities were set up as real-life simulations and provided an opportunity for end users to walk-though and practice system and process changes prior to implementation. The dress rehearsals were intended to help end users understand what to expect at Go-live and minimize anxiety. Additionally, the activities helped identify any potential “hiccups” that might not otherwise have been identified until the system went live, including incorrect end user security settings. Being proactive prior to Go-live was important because experiencing problems upon Go-live could have contributed to a mind-set that the system ”didn’t work” and created unnecessary resistance.
Measurement
To gauge end user commitment throughout the project, the change management team conducted four end user surveys: Baseline: Sent 6 - 8 months prior to Go-live Pre Go-live: Sent 2 weeks prior to Go-live Post Go-live: Sent 30 days after Go-live 90 Day Post Go-live: Sent 90 days after Go-live Data from these surveys will be used throughout this case study to indicate where change
Average Increase in Favorable Responses by Question - Figure 1
This comparative data indicates the benefits of employing effective change management practices. It also suggests potential best practices, including the importance of appropriate end user engagement, leadership sponsorship, and dedicated, on-going support. supported the Network by joining conference calls, participating in activities and personally thanking change agents for their time and commitment. This support proved to be critical to the successful operation of the Change Agent Network. Leadership from Business Unit 1 encouraged and held change agents accountable for fulfilling their responsibilities in the role, which ensured ongoing participation and follow-through.
Another clear example of this executive’s support was her willingness to champion dress rehearsal activities. She conducted a careful review of the planned activities to ensure they were appropriate for each area, and required participation for all end users. The simulations depended on various roles working together to complete real-life tasks, and required a significant time investment. Some locations temporarily closed during dress rehearsals to ensure staff had adequate time and attention to devote to practicing and mastering the new skills required for the implementation. Following the dress rehearsals, the executive reviewed the status report from each site.
Feedback from Business Unit 1’s leader specified the Change Agent Network and dress rehearsals were keys to the successful Go-live for her business unit. She noted the Change Agent Network increased end user engagement and helped keep end users informed by spreading key project messages. She also indicated the peer-to-peer communication was especially helpful in ensuring important messages were received and understood by end users. The visible sponsorship and participation of the executive sponsor enabled success of the activities by ensuring that leaders and end users understood the importance of managing change as well as their role in it.
Business Unit 2 implemented the new system two months after Business Unit 1. During the planning phase, leaders of Business Unit 2 were involved in the project at a high level, and their degree of sponsorship and support of change management was less visible to end users. Though the leaders agreed to engage in the same change management activities employed with Business Unit 1, they demonstrated less active support of the activities to the end users. The leaders complied with general requests, such as providing lists of users to participate in activities; however, few leaders reached out to the selected end users to show their support and encouragement, or participated in the various end user engagement meetings to demonstrate sponsorship. Throughout the phases of the project, Business Unit 2’s end user participation in Change Management activities steadily decreased.
Though leadership from Business Unit 1 publicly advocated the necessity of dress rehearsals,
Figure 2
Analysis of the Pre Go-live survey for Business Unit 2 indicated that those employees who did participate in the Dress Rehearsals were more ready for Go-live than those who did not, as indicated by Figure 3 below.
Question: I have the skills and knowledge to effectively
complete my tasks following the Go-live.
Figure 3
In addition, a comparison between the Pre Go-live results for both business units showed that Business Unit 1 had significantly more favorable results than Business Unit 2. A greater percentage of end users from Business Unit 1 reported that they understood how the implementation was going to impact them (Figure 4), had the skills and knowledge to effectively complete their tasks (Figure 5), and were ready to Go-live with the new system (Figure 6). Additionally, end users from Business Unit 1 indicated higher levels of commitment to the project, as seen by the 17% difference in favorable responses between the two units to the question: I feel that the new system will work for me (Figure 7).
Question: I understand how the new system
Figure 4
Question: I have the skills and knowledge to effectively
complete my tasks following the Go-live.
Figure 5
Question: I feel ready to go live with the new system.
Figure 6
Figure 7
As demonstrated, data from the Pre Go-live surveys for both units indicate that the effective use of change management practices and leader sponsorship of the change activities in Business Unit 1 made a significant impact to the success of the project. The activities helped raise end user confidence and ability and increase end user commitment.
Commitment to End User Engagement
Leadership from Business Unit 1 also demonstrated a commitment to end user engagement activities throughout the project. They set up project road shows and individual visits by
Figure 9
Remedial Training
Figure 10