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Change management - the most important and most undervalued part of any IT implementation

Lydia Murray Chief Information Officer September 2013

A case study of the Medical Examiner Offices change management

The Importance of Change Management


The technology solution will work technically I promise.
But will anyone use it?

Project Management manages the technical change


Change Management manages the people change

Transforming Cook County

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Thoughts on Change Management

Change management is the processes, tools and techniques for managing the people-side of implementing a new system.

Change management is not:


A project newsletter. Training. Easy.
Change Management: Transforming Cook County

Projects fail because we roll out a system that functionally works and we try to get change by rules and policies without addressing an organizations culture or individuals interests and motivations.
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Enter ema

Change Management in the Medical Examiners Office

Change Management: Transforming Cook County

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Challenges in the Medical Examiners Office


Cook County Morgue Inspection Reveals Disturbing Night Shift Shenanigans
Posted: 10/17/2012 4:44 pm Updated: 10/18/2012 8:59 am

Inspectors on a surprise visit to the Cook County morgue caught night shift workers asleep on the job and watching movies on county computers, according to report released Tuesday by county Inspector General Patrick Blanchard. On the May 3 visit to the already beleaguered Cook County morgue, inspectors found certain overnight intake workers "nodding off" and napping out cold while at their post; others were watching a Bruce Lee movie instead of working. The Chicago Tribune reports county investigators also found

"thousands of hidden documents dating as far back as 2004" that were supposed to have been entered into a computer.
All but one of the employees seen sleeping have been placed on temporary suspension. According to the Chicago Sun-Times, further interviews on the matter revealed that such behavior is not an isolated occurrence. The Medical Examiner's office has been under a microscope ever since reports of bodies being "stacked in a storage cooler" surfaced earlier this
Change Management: Transforming Cook County Page 6

Medical Examiner New Case Management System $1.1M new system Vendor is LabLynx Inc.

Subcontractor is cgn global


Entirely focused on change management

Change Management: Transforming Cook County

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Medical Examiner Change Management Approach


Using the Prosci ADKAR Model Awareness Desire Knowledge Ability Reinforcement
Awareness of the need for change Desire to participate and support the change Knowledge on how to change Ability to implement required skills and behaviors Reinforcement to sustain the change

Also includes both Lean process improvement methodology, process mapping and Kaizens
Change Management: Transforming Cook County Page 8

Process mapping education

Change Management: Transforming Cook County

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Making the change visual and prominent

Change Management: Transforming Cook County

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Transforming Cook County

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Keys to Medical Examiner System Success


Well written RFP that included Case Management as a focus
RFP No. 13-18-046 Medical Examiner Office Reengineering and Case Management Solution

Clear contract with vendor; budget for change management activities Strong Executive Leadership; Dr. Cina is a champion for the new system Change management implementation is the focus not just project management implementation
Change management needs are driving the project plan rather than development or configuration needs

Go Live is in May 2014


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Closing thoughts Projects succeed or fail based on the quality of change management dedicated to a project. Get yourself a budget director who understands change management and the importance of it in funding an IT project. Change management shouldnt be an afterthought include it at the concept stage. Focus your procurement around buying change management the system is secondary. Change Management requirements and needs should be in your specification documents/RFPs.

Change Management: Transforming Cook County

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Thank you!

Lydia Murray Chief Information Officer Cook County lmurray@cookcountyil.gov (312) 603-1400

Illinois Framework
16 LARGE-SCALE CHANGE: PEOPLE, PROCESSES

Presenter: Kathleen Monahan, Director, Illinois Framework

Session: IT Transformation Monday 9/30 2:30 pm Illinois Framework

9/30/2013

Agenda
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Framework Overview
Stakeholder Engagement Crucial Conversations Governance Leading Change Lessons Learned

Illinois Framework

9/30/2013

Framework Overview
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The Framework is a seven-agency collaborative Human Services Healthcare and Family Services Aging Children and Family Services Public Health Commerce and Economic Opportunity Employment Security

Goals: Simplify and expedite consumer access channels, allowing critical information to flow when and where it is needed. Empower clinicians and caseworkers with comprehensive casework management tools to improve outcomes. Develop a comprehensive, roles- and rulesbased approach to data access, protecting client privacy and confidentiality. Provide business analytics and data-driven decision support to enhance planning, capacity, and program evaluation. Coordinate policies and share services across the HHS enterprise. Improve performance management and streamline service reporting.

Illinois Framework

9/30/2013

Framework Overview
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Illinois Framework

9/30/2013

Current Framework Activities


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Project
Child Support Modernization (KIDS) Planning and Support
Department of Healthcare and Family Services

Description
Provide strategic planning functions for the ongoing KIDS modernization project Identify a maturity model, budget estimates, and project risks for KIDS modernization Develop a plan for statewide change management to implement as the MMIS upgrade project progresses

MMIS Organizational Change Management


Department of Healthcare and Family Services

Framework Interoperability and Integration Project

Establish and implement a project governance model for the Framework Ensure that interoperability and integration efforts undertaken through the Framework and institutionalized and maintained for the Illinois healthcare and human service programs Create an enterprise-level Advance Planning Document for the Framework to plan for an interoperable health and human service delivery system Secure increased Federal funding for Framework planning functions

Enterprise Advance Planning Document (EAPD)

Illinois Framework

9/30/2013

Coordinated Methodology
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Engagement
Actively engage all key stakeholders Provide essential feedback to the planning process Promote information sharing through inclusiveness and transparency

Planning
Create enterprise approach to healthcare and human services Advance a culture of interoperability among Illinois HHS agencies Identify and provide resources and insights toward interoperability

Governance
Develop equitable and sustainable forum for key decision-makers in strategic planning, prioritizing, and implementing recommendations

Illinois Framework

9/30/2013

Framework Approach
Three Coordinated Efforts
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Stakeholder Engagement Framework Planning Governance Interoperability Team


Illinois Framework

Interacting with stakeholders at all levels Multi-year endeavor in parallel with ACA elaboration

Foundation is the MITA and NHSIA architectures

Critical to effecting change in a cross program / agency environment Funded by an Interoperability grant from ACF

9/30/2013

Managing Change
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The Framework means Large Scale Change


Foundational Coordinated efforts in responding to regulatory shifts Organizational Understand impact of change Involve key stakeholders Clear and frequent communication to alleviate concerns Promote service culture Vigilant focus on customer needs Business Processes Identify commonalities Coordinate policies across programs Technology Service Oriented Architecture Focus on results Use the data to win hearts and minds

Illinois Framework

9/30/2013

Framework Stakeholder Engagement


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GOALS

1) Introduce the Framework and its goals to stakeholders across Illinois. 2) Gather feedback to design a system that works well for the people who will use it.
3) Initiate an ongoing dialogue about the Framework that will continue through implementation (and beyond).

Stakeholders include service recipients, providers, advocates and state employees.

DRAFT Chicago Town Hall Conversations, August 2013

Listen and Learn


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Illinois Public Health Institute Customer Focus Groups and Town Hall Meetings for provider community and state employees 24 meetings with over 700 people since May Network of over 1200 stakeholders in 2011 World caf approach Fosters inclusiveness Develops trust and creates champions Collects vital stories for our work Its all personal connects complex concepts to real people Reinforces mission to help customer/client Establishes common ground between management and labor Input into next steps Building cadre of enthusiastic supporters Framework champions = key messengers
Illinois Framework

9/30/2013

Framework Governance
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Framework Governance

Governance structure partially defined by Inter-Governmental Agreement Executive Steering Committee


Chaired by State CIO Seven Agency Directors plus ACA implementation leadership (IES, HIE, MMIS) Make financial and policy decisions Towards the development of an enterprise approach

Operational Committee / subcommittees/ workgroups

Centers of Excellence
Design and develop a sustainable governance model for IL Framework Ensure that interoperability and integration efforts undertaken through the Framework are institutionalized and maintained for Illinois healthcare and human services programs Share our work with other states engaged in similar work
9/30/2013

ACF Interoperability grant


Illinois Framework

Framework Governance
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What does Governance mean in this environment? Membership Responsibilities Decision Making Communication within and beyond the Framework governance structures Frequency of meetings and time commitment Formal change management focus
Illinois Framework

9/30/2013

Attributes of Good Governance


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Shared Vision Executive Leadership Formalization of Structure Clear Decision Making Adaptable Transparent Communications and Processes
Illinois Framework

9/30/2013

Lessons Learned
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This is new territory for everyone Agreement to act as an Enterprise Focus on ongoing engagement and change

management critical PMO structure is necessary Developing Centers of Excellence


Around Framework critical data sharing issues Build leaders Develop state capacity

Illinois Framework

9/30/2013

Maturity Models
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EMC
Initial
Envision Define & Plan

APHSA
Regulative
Key policies Reactive

Supply Focused
Build & Deploy

Collaborative
Works across agcy/program boundaries

Service Focused
Operate & Refine

Integrative
Coordinate services Proactive approach to problem solving

Demand Focused
Measure & Manage

Market Focused
Optimize

Generative
Provider/client partnership Identify opportunities Strengthen communities

Illinois Framework

9/30/2013

Contact Information
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Kathleen Monahan Framework Director


Kathleen.Monahan@Illinios.gov 773-383-6946

Learn more about the Framework and the

Governance work:

http: //illinoisframework.org/

http://illinoisframework.org/illinois-framework-resourcelibrary/

Illinois Framework

9/30/2013

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