Pace yourself
After identifying your change leaders, you need to set the proper pace. If you look at the change process as a journey, you’ll understand that you have to be flexible and pace yourself. What started as a one-year goal at UC Physicians, for example, now spreads two or three years into the horizon.
Sure, some changes got fairly solid consensus right away, and those were easier to execute quickly. For example, the process of credentialing physicians — which includes establishing their qualifications at various sites — was fairly repetitive, not to mention costly and time-consuming, across each department. Most of the leaders agreed that it could be simplified by centralization. So that change was relatively easy to make.
“There are certain things that you can just do by declaration or fiat,” Boat says. “And there are certain things that you have to do by piloting it and picking an area that’s ready for change and has the leadership in place to ensure that that change is really going to be successful.”
Choosing those areas is a combination of two things: Your evaluation of which managers are poised to drive change and a clear plan of what the change will be.
“It comes down to confidence, and confidence is a mixture of this sense that you know how to do it, rather than you have to figure out how to do it and test it, and … the readiness of the programs,” Boat says. “So if everybody is saying, ‘Yeah, we’ve got to do that,’ you can probably push it through fairly quickly. If people are saying, ‘Eh, I don’t know if that’s going to work,’ then taking the more incremental approach is probably the best thing to do.&
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For example, a handful of the departments had honed effective billing and collecting processes, but others were struggling to get on board. So Boat centralized the six departments with more polished systems into one revenue cycle management process. He knew that pushing everyone onto a new financial platform before they were ready could quickly damage the bottom line.
Piloting programs can also serve as a trial run if you’re not entirely sure how the change will look. Using your manager evaluations, start with the departments that seem poised for change. Establish checkpoints upfront so you can track the progress of the pilots.
“Executing on the plan really means that you have to have firm endpoints and you have to have timelines to achieve those endpoints,” Boat says.
Work with experts on each subject in your company to establish reasonable, achievable goals. When you’re piloting an idea as a trial, though, it’s especially important that each step shows obvious progress.
Measure the results constantly against those goals. That requires honesty with the rest of the company, especially when there’s no success to communicate.
“It’s being bold enough to say, ‘We’re going to do this, but we’re also going to be on top of whether it’s achieving what we want or not. And if it isn’t, we’re going to back up and we’re going to take another run at it from another direction,’” Boat says. “Being ready to make mistakes, to recognize them and correct them promptly is important. And to do that, you have to have really good outcomes data.”
You can always readjust goals depending on those outcomes. And, of course, when you do find the right solution, the pilot can also be a demonstration, convincing skeptics to buy in.
“More often than not, we ended up piloting things. And then when people saw that it was useful and successful in other programs, they were much more ready to jump on board and make the change,” Boat says. “There are always going to be skeptics in any process like this, but the more success we have, the less skepticism there will be.”
