Gauge who’s ready for change
You can’t predict every step of your change process, but you at least have to know where to start.
Since the integration idea had already seen two unsuccessful runs at UC Physicians, Boat came on board facing a skeptical faculty. To prove the plan and himself as the new leader, he knew he had to start small. And those first steps also had to be fruitful.
“As you’re talking about change, it really is important to make sure that the first change steps are successful,” he says. “You have to pick and choose carefully. If you take on the really hard stuff right at the beginning and aren’t sure you’re going to be successful, it’s pretty risky. Make sure that your first steps are doable and successful.”
To identify the low-hanging fruit with the highest potential for success, look at who will be implementing the change. At UC Physicians, those were the clinical department administrators, and Boat decided where to start the process by judging their reactions to each suggested change.
“It was a matter of saying to them, ‘Here’s what we think we can do. What do you think?’” Boat says.
He presented the hard facts to the administrators, using monthly scorecards that UC Physicians started publishing before the transformation even began. This data measured things like days in accounts payable and number of rejections. Your managers’ questions, hesitations or excitement about improving the current data is the first measurement of their readiness to change.
But you need to look beyond what they say and examine what they can do.
“You can change the entire practice, but change happens department by department and program by program within,” he says. “And so one of the things that we’re continually assessing is: Do the departments individually have management capability to effect change and to sustain change? The change has got to be durable as well as achievable in the first place.”
Boat expects his change leaders to be able to set and achieve goals and to ignite their employees. For the first piece of that, you can look at their past performance, the previous goals they’ve set and met and their ability to deal with other changes. Continue to monitor that as you charge them with increasingly larger changes.
To measure managers’ motivational skills, go straight to their employees. Boat looks for what he calls “the turbulence factor” in each department.
“One level of turbulence is that the faculty are unsettled, that they’re not getting straight answers, that they really don’t understand the process,” says Boat, who stays in touch with rank-and-file employees to gauge how communication trickles down through managers. “Another level would be discontent and a fair amount of movement in terms of employees within the department.”
Obviously, if employees are flooding out of certain departments, you should see red flags. But Boat also arranges periodic checks, like meetings between his management team and each department as well as town-hall meetings, to catch the less-obvious signals and see where the most misunderstanding lies.
If you’re staying in touch with employees on all levels, you should see which departments are informed and motivated — in other words, ready for change — and which ones are reluctant and unsure.
“The idea is to, as broadly as possible, explain the process and give people a chance to ask questions and to answer those questions,” he says.
