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Bureau of Medicine and Surgery 2012 Resource Management and Logistics Symposium Leading through Change: Bureau of Medicine and Surgery 2012 Resource Management and Logistics Symposium Leading through Change: Aligning, Energizing, and Mobilizing your Staff June 4, 2012 Presented By: Ms. Shannon Cowsert, Deloitte Ms. Diane Holt – Comptroller Naval Health Clinic New England LT Holly Lee – Comptroller Naval Hospital Okinawa Ms. Samanthia Henderson – Naval Expeditionary Medical Command Better Business, Better Care

Agenda 1. 2. 3. 4. 5. Your role as a change leader Change management Agenda 1. 2. 3. 4. 5. Your role as a change leader Change management challenges Change management strategies and toolkit Break-out discussions Closing 2

Change Management q Context: Do. D is required to assert audit readiness by the Change Management q Context: Do. D is required to assert audit readiness by the end of Fiscal Year 2014. Usage of Standard Operating Procedures (SOPs) is an integral component in achieving audit-readiness. q Purpose: This session will prepare leaders to support their staff in the transition to using SOPs as the official Navy Medicine business standard. q Outcome: Leaders take away a “Change Management Toolkit” to help lead the change and to mitigate the potential risks involved with implementing SOPs. 3

“A leader leads by example, whether “Quote” (optional) he intends to or not. ” “A leader leads by example, whether “Quote” (optional) he intends to or not. ” – Quote source - John Quincy Adams The Challenge: How do you lead the transformation of business practices? 4

Your Role as a Change Leader q. Understand the future state vision of Navy Your Role as a Change Leader q. Understand the future state vision of Navy Medicine financial management, and the changes that will impact your staff q. Communicate information about SOPs and why they are important - Speak and act positively about SOPs - Get any resistance and concerns out in the open q. Support your staff during the transition - Arrange work schedules so that employees can attend training as scheduled - Help employees feel comfortable accessing, using, and providing feedback on SOPs - When questions come up, ask “What does your SOP say? ” q. Be patient and persistent - breaking old habits and embracing new values is difficult, and it will take time for your changes to take root 5

Change Management Challenges Naval Health Clinic New England: Ms. Diane Holt – Comptroller Challenge: Change Management Challenges Naval Health Clinic New England: Ms. Diane Holt – Comptroller Challenge: Acceptance and use of SOP’s by experienced staff Solutions: • • • Engaged all stakeholders and let them “vent” Set priorities and mandated usage Defined an action plan and established accountability Tracked progress and raised visibility Conducted spot checks Outcomes: • • • Gaining buy-in and acceptance of experienced personnel Prioritization helped reduce the anger and frustration resulting from staff being overwhelmed with a large number of new SOPs Starting to document recommended changes to SOPs to address some perceived inefficiencies 6

Change Management Challenges Naval Hospital Okinawa: LT Holly Lee – Comptroller Challenge: Translating the Change Management Challenges Naval Hospital Okinawa: LT Holly Lee – Comptroller Challenge: Translating the importance of using SOPs without offending or discrediting staff Solutions: • • • Worked backwards Educated and implemented spotlight metrics Got buy-in to “go green” and assigned a Team Lead to each metric Educated supervisors on audit readiness Posted metrics and SOPs on Share. Point Stood up an Internal Controls section to perform testing and audits Outcomes: • • • Compliance is now expected Gained confidence in executing program assessments and testing Decreased time spent providing justification for things that have been up for interpretation in the past 7

Change Management Challenges Naval Expeditionary Medical Command: Ms. Samanthia Henderson Challenge: Getting staff to Change Management Challenges Naval Expeditionary Medical Command: Ms. Samanthia Henderson Challenge: Getting staff to understand that the SOPs apply to them and should be followed Solutions: • • Educated leadership and staff on importance of SOPs Addressed SOP's during weekly management meetings Posted SOPs and metrics on share drive Sent e-mails reminding staff where the SOPs are located Outcomes: • • Utilizing most Finance SOPs Starting to look at SOPs to identify things that are not working 8

"Change is the law of life and those who look only to the past or present “Quote” (optional) are certain to miss the future. ” – Quote source – John F. Kennedy The Challenge: How do you help people move beyond the current business practices? 9

Why Manage Change? Well. Structured Processes Cutting. Edge Technology Perfect Strategy Clear Policy ? Why Manage Change? Well. Structured Processes Cutting. Edge Technology Perfect Strategy Clear Policy ? ? ? Without change management, anything may happen. 10

What is Change Management? Change management focuses on aligning individual motivation and commitment with What is Change Management? Change management focuses on aligning individual motivation and commitment with organizational goals and objectives. It is a proactive set of activities that involve and engage both leadership and staff throughout the transformation to more effectively position the organization to achieve its mission. 11

Typical Change Cycle ‘Desired Sustained Performance’ Performance ‘Make the change’ ‘Status quo’ Valley of Typical Change Cycle ‘Desired Sustained Performance’ Performance ‘Make the change’ ‘Status quo’ Valley of ‘ ‘Drop in despair’ Performance’ ‘Disruption time’ § Fear / Anxiety § Anger / Resistance § Lack of Understanding § Competing Priorities § Apathy Time 12

Change Management as Risk Mitigation Analyze Risk Change Analysis Change Targeted Solutions Accelerate Performance Change Management as Risk Mitigation Analyze Risk Change Analysis Change Targeted Solutions Accelerate Performance 13

Change Management Toolkit Risk Symptoms: What you are hearing…. Change Risks What does this Change Management Toolkit Risk Symptoms: What you are hearing…. Change Risks What does this mean for me? I’m afraid of… Anxiety / Fear My way is better. I’ve had enough. Anger / Change Resistance Why are we doing this? I’m not sure how to… Lack of Understanding I don’t have time for this. Workload / Competing Priorities My supervisor wants me to focus on… This will go away soon. Why should I care? Apathy / Lack of Motivation 14

Change Management Toolkit Change Analysis: Stakeholders Impacts Risks Who is affected by audit readiness Change Management Toolkit Change Analysis: Stakeholders Impacts Risks Who is affected by audit readiness activities and/or has an impact on its success? What does this group need to do differently? What challenges or issues could get in the way of success? Target Audience Content / Focus Areas Change Solutions 15

Change Management Toolkit Change Solutions: Change Management Challenges Anxiety / Fear Anger / Change Change Management Toolkit Change Solutions: Change Management Challenges Anxiety / Fear Anger / Change Resistance Change Possible Activities Management Strategies Enhance leadership Develop and distribute communications from local support / leadership on priorities sponsorship Integrate transactional excellence / audit readiness messages into existing meetings and forums Increase Hold “listening sessions” with staff to understand communications concerns Have one-on-one discussions with those who are most resistant Conduct SOP outreach with authors / training team Lack of Provide education / Identify SOP “super users” to coach / mentor Understanding training others Hold brown bag sessions on how to utilize SOPs to achieve transactional excellence / audit readiness Conduct SOP stand-down (training day) with 16 appropriate follow-up

Change Management Toolkit Change Solutions: Change Management Challenges Workload / Competing Priorities Change Management Change Management Toolkit Change Solutions: Change Management Challenges Workload / Competing Priorities Change Management Possible Activities Strategies Align duties to audit Review existing job responsibilities and eliminate readiness priorities or reduce non-essential activities Work with local leadership to set and communicate clear priorities Apathy / Lack Reward / recognize Use staff meetings to recognize staff who are of Motivation desired behaviors successfully utilizing the SOPs Use approved incentives to reward staff for progress towards transactional excellence / audit readiness Use local Command reward programs 17

Change Management Example Stakeholder Activity Leadership • Comptrollers • Directors For Administration (DFAs) Impact Change Management Example Stakeholder Activity Leadership • Comptrollers • Directors For Administration (DFAs) Impact • • Must certify to Activity Commanding Officer (CO) and Navy Medicine leadership that internal controls are functioning properly Staff must use and follow SOPs Risks • • • Geographic dispersal of end users Frequently rotating and deploying staff Collaboration and communication across organizational boundaries Potential Change Management Solutions • • • Identify local “super users” to coach / mentor others Include transactional excellence / audit readiness messages in new staff orientation Establish communication channels to facilitate ongoing communications with key stakeholder groups 18

“Everyone thinks of changing the world, but no one thinks of changing “Quote” (optional) “Everyone thinks of changing the world, but no one thinks of changing “Quote” (optional) – Quote source himself. ” – Leo Tolstoy The Challenge: What targeted interventions can you undertake that will compel stakeholders to change? 19

Break-out Discussion q Part 1: What are the greatest change management risks to achieving Break-out Discussion q Part 1: What are the greatest change management risks to achieving audit readiness? q Part 2: What solutions could address those risks? 20

“Great leaders are almost always great simplifiers, who can cut through “Quote” (optional) – “Great leaders are almost always great simplifiers, who can cut through “Quote” (optional) – Quote source argument, debate, and doubt to offer a solution everybody can understand. " – General Colin Powell The Challenge: How can each of you take personal responsibility for leading change? 21

Closing ? What is the one action you will take based on this discussion? Closing ? What is the one action you will take based on this discussion? 22