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Whole Health Clinical CareDay 2 Morning

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The Journey to Transformation Whole Health Clinical Care Symposium

Face‐to‐Face Course

Welcome to Day 2!

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Wholehealth.wisc.edu

Why We Are Here: Learning Objectives


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Pulse Checks

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Mindful Awareness

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9. Being the Change, Part 2: Ikigai

The Journey to Transformation

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What is Ikigai?

• A Japanese word comprised of two words

o Iki: life

oGai: value or worth; to be worthwhile

• Ikigai may be translated as finding value in living

• To find our ikigai, we consider four areas

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What you’re good

at

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What the world needs

What you’re good at

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What you can be paid for



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What you love


What you can be paid for


MissionPassion

Profession Vocation

Ikigai

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Strategies to Enhance Ikigai

• Stay active

• Cultivate good rituals

• Nurture friendships

• Live unhurried

• Practice gratitude

• Cherish wabi‐sabi

• Remember, ichi‐go ichi‐e

…and keep smiling!

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Share with a Partner!

• January 29, 2020


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Part III. Planning the Journey

The Journey to Transformation: Whole Health Clinical Care

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• SWOT Analysis Revisited

• Advanced Change Management

• ADKAR and the People Side


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10. SWOT’s Happening:

A New Lens


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Activity: SWOT Team Analyses

• Go to “A New Lens on SWOT” in your workbook

• Revisit your SWOT analysis from the Prequel

• You will have ~10 minutes

• Be ready to share with the large group

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Group sharingGroup sharing

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Movement!

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11. Our Transportation to Success


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Planning the Journey “A plan is only as good as those who see it through.”

‐Anonymous

• Your Aim statement sets your compass.

• Using the Designation Framework ideally helps your team choose the focus of your Aim.

• Your stakeholders will be critical partners in this journey.

• Typically, the next steps involves project planning.

• Overlooking the “people side” of change can be costly on many levels.

• Investing the time to integrate change management into your project plan will increase your success.


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Planning the Journey: Prosci

• Who was familiar with Prosciprior to the Prequel?

• VA has a contract with them to do training and certification in change management

• Using it for VA modernization

• Intuitive

• ...So we are modifying it for this course as well

To access training materials, can set up an account at https://store.proci.com/customer/account/login/

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Project Level: A process with deliverables used on projects to support individual change milestones.

Technically: Application of a structured process and set of tools for managing the people side of change.

Quick Review: What Is Change Management? What is ADKAR?

Organizational Level: A competency applied by leaders and managers to help employees through the people side of change.

A strategic capability to increase organizational change capacity and to accelerate changes within an organization.

Source: Prosci.com

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Why Change Management?

Source: Prosci.com

How We Will Drive Change:From the VHA Modernization Campaign Plan

• Organizational change is only as effective as the people who drive the change

• Change management will be a driving force for each of our 10 lanes of effort

• Prosci developed a clear and consistent model to measure the stages of individual change that a person must go through to adopt, embrace and use a new behavior ‐ADKAR


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Data Supports the Connection

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What are the consequences of not addressing the people side of change?

Your ideas?List them in your

workbook

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Consequences of not Managing the People Side of Change

• Lower productivity

• Passive resistance

• Active resistance

• Turnover of valued employees

• Disinterest in the current or future state

• Arguing about the need for change

• More people taking sick days or not showing up

• Changes not fully implemented

• People finding work‐arounds

• People revert to the old way of doing things

• The change being totally scrapped

• Divides are created between ‘us’ and ‘them’

Adapted from: PROSCI


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How well are individuals performing compared to the level expected in the design

of the change?

How many employees (of the total population)

are demonstrating “buy-in” and are using

the new solution?

How quickly are people up and running on the new systems, processes and job

roles?

Speed of Adoption Ultimate Utilization Proficiency

Human Factors of ROI Determine/Constrain Results

Source: Prosci.com

ROI= Return on Investment

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Connecting Change Management to Results

Project Name Purpose Particulars People

What is the project

Why we are changing

What we are changing

Who will be changing

If people don’t change how they do their job, then we ultimately won’t achieve what we set out to do from the beginning.

If people don’t change how they do their job, then it doesn’t matter what specific changes are implemented.

Adapted from: Prosci

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Prosci® Project Change Triangle™

Source: Prosci

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Project Change Triangle™ (PCT™): Expanded for executive decisions and actions

Source: Prosci

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Project Management

• Another leg of the 3‐legged stool

• May be more familiar –what are some of your experiences?

• What are critical aspects of project management?

With cultural transformation, change at an individual level is

the key to organizational change

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Project Management: A Case StudyA PACT starts using the PHI:

• The LPN has a Veteran complete it and puts in chart

• The provider sees Food and Drink is a priority (knows the Veteran is overweight).

• A MOVE! referral is made.

Questions:

1. Have they implemented a new process?

2. Have they integrated a new tool into practice?

3. Does this reflect change at and individual level?

4. Does this reflect change at an individual level consistent with delivering a WH approach to clinical care?

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Leadership and Sponsorship:The Third Leg of the Stool

• Benchmarking studies repeatedly show that the number one predictor of change success is active and visible sponsorship.

• We often talk abut “leadership support.” What does that mean?

o Is support enough?

• What about participation and sponsorship?

o What does that look like?

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Team Activity: Foundations for Change

• Complete the

Foundations for Change

Assessment in Your

Workbook

• You will have ~30

minutes, and then we’ll

discuss

• Add these to your

PowerPoint slides

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Aim Statement (Computer):


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Team Debrief: Foundations for Change

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Summing it all up: The Three‐Legged Stool

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12. Using the New Lens:

ADKAR Skills


ADKAR

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ADKAR

• Since individual change is critical for organizational change, we need a way to understand where individuals are at on their change journey

• People follow a fairly predictable path

• That path is comprised of 5 key elements or building blocks: ADKAR

Source: Prosci

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Video: An Interview About Using ADKAR

https://www.youtube.com/watch?v=L_7I03LOyyk


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The Five Building Blocks for Successful Change

Change Begins with Understanding Why

What is the nature

of the change?

Why is the change needed?

What is the risk of

not changing?

Awareness

“I understand why”

Source: Prosci

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Change Involves Personal Decisions

A decision to engage

and participate

A personal choice

What’s in it for me (WIIFM)?

Desire

“I have decided to…”


Source: Prosci

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Training on new processes and

tools

Change Requires Knowing How

Understandinghow to change

Learningnew skills

Knowledge

“I know how to…”


Source: Prosci


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Change Requires Action in the Right Direction

Achievement of the desired change in performance or

behavior

The demonstrated capability to implement the

change

Ability

“I am able to”


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Recognition and rewards

that sustain the change

Actions that increase the likelihood that a change

will be continued

Change Must Be Reinforced to Be Sustained

Reinforcement®

“I will continue to”


Source: Prosci

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ADKAR element: Definition: What you hear: Without:

Awareness Of the need for change “I understand why…”Employees ask the same question over and overHoarding of information and resources

DesireTo participate and support the change

“I have decided to…”Lower productivityIncreased turnoverDelays in implementation

Knowledge On how to change “I know how to…”

Lower utilization or incorrect usage of new systemsSustained reductionin productivity

AbilityTo implement required skills and behaviors

“I am able to…”

Employees worry whether they can be successful inthe future

Greater impact on customers and partners

Reinforcement To sustain the change “I will continue to…”

Employees revert back to old ways of doing workUltimate utilization is less than anticipatedThe organization creates a history of poorly managed change

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Prosci ADKAR Model

Source: Prosci

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Some ADKAR Tips

• Avoid leaping straight to Knowledge without adequately addressing Awareness and Desire

• ADKAR helps with how you select and shape activities based on where there is the most need

• To move forward, we need to identify the earliest barrier in the path

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Using the New Lens: Where You Are Now

• Each person will do this on their own and share back with the group

• Using the ADKAR Assessment Tool in your workbook, determine where you are in relation to your team’s Aim statement

• Take about 10 minutes

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Using the New Lens: Your Barrier Point

• Now, circle your first low score (3 or below) on the chart

• This is your barrier point

• Take a few minutes for people in your group to share these. Use generous listening – don’t try to ‘fix’

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Large Group Activity: Walking in Someone Else’s Shoes

• Consider clinicians who will be impacted by your Aim. Take their perspective

• You will move around the room in a moment.

• What do we usually do to move people forward?

• Anything that might work better?

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Small Group Activity: Change Participants & Impacted Groups

• Why is it important to consider groups your Aim

will affect?

• Using the guide in your workbook, list the groups

who will be impacted by your Aim

• Apply ADKAR to those groups – enter into

PowerPoint

• Don’t fill out the last column – we’ll get there

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Impacted Groups: Barriers and Elements


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Points to Ponder

• Who is involved?

• Who could be impacted or affected?

• Who stands to gain or lose as a result?

• Who could impact your success?

• Who needs this to succeed?

• Who might prefer this fails?

• Who will report out on this work?

• Who will care about the progress?

• Who will use your outcome data?

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Group Debrief

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Lunch!

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