Identify a change
In 2008, the Light Electronic Action Framework, process improvement software was created to digitize paper-based processes. The Department of the VA used this platform when faced with day-to-day and emergency situations (Kanowitz, 2018). Susan Hall, the VHA Chief Learning Officer for the LEAF Program presented about the program in a YouTube video. She comes across as very confident in the ability of this program. She describes the new program as “a no brainer,” which provides “clean data entry” using an “intuitive design” (Hall, 2018). Hall also claims the new process will reduce administrative process time by 50%. Additionally, in the video Hall (2018) boasts about the cost avoidance of $18.8 million over 8 years because LEAF is a program where there are no licensing fees, no paper or ink, it is easy to build/set up/maintain and requires less man-power is involved all around. Listening to this video, it seems too good to be true.
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The LEAF process has been applied to many other aspects within the day to day business operations at our facility from work orders for broken chairs to organizing volunteers during a natural disaster (Kanowitz, 2018). I have evaluated the process change from an email group request system to a website LEAF request system. The problem it addresses is the amount of collateral work that is hard to track and manage and a streamlined method to accomplish each request.
I was surprised at how little advertisement there was for this new process across the facility. My department manager sent a message to a few small email groups, and assumed it would be distributed to the hundreds of employees who we would like to use this process. For the first three weeks there were 18 requests sent via the new method. I saw that word was not getting out so, with the permission of my department manager, I created a personalized signature block that advertised and provided a link to the new information and updated all of the facility guidance containing the process to make the information current. While I suggested that all HIM staff use the personalized signature block containing the advertisement, my manager did not agree and only allowed three people to use the personalized signature block. I was sort of bummed that this suggestion was not accepted. It created a little bump in the road for distributing the information. After updating the facility information, and the signature blocks of the three main people, the number of requests improved to 10 per day and continued to climb. I was surprised at how those few things made such a quick difference. It made me see how many people read the email signature blocks of three people and that the facility documents were actually read. I was very happy about that feedback. It gave me some motivation.
My interviews included one from my manager, who introduced me to the system. She was very enthused about keeping track of work that used to go incalculable. She had big plans for the data, although she could not work the report options. I asked her many questions about the features and asked how things would be tracked but she was not aware of all of the technical things, just that she could see what was going on. I was surprised to see later that she did not want to do the work to promote the new method. When the system was new, she was energetic about it, but quickly it lost its sparkle to her.
Another interview I conducted was from the employee answering and completing the requests. She isn’t particularly technology savvy and was concerned that everything would be overwhelming as soon as the process went live. She had many fears and concerns in her head that were increased by the fact that the facility had been pushing this change and that she wasn’t being told anything other than the facility is pushing the change. The employee was afraid about things that the manager wasn’t concerned about, including security of PHI, back up access, and missing request information. The employee was afraid to use the signature block promoting the change as she wasn’t sure it was a good idea to promote the process. With my persistence, encouragement, time, and help, she got on board. When the process was rolled out, at first, she was not thrilled, as it seemed that now she had two places to look for requests instead of just one. This employee still has a hard time keeping track of all of the requests, but the ones submitted through LEAF are answered in order, completed quicker, and there is no confusion as to if the request was completed. This employee also talks about her efforts in trying to help people submitting requests to use the new process. She said that she feels bad that she could not assist people with their questions as she had no idea what the user side looked like and again was not confident with computers. Actually, the task of assisting people had then been assigned to me, although I had never seen the submission side either.
I also “interviewed” myself because I became very involved. It turns out that the program is not “a no brainer” as Susan Hall (2018) had explained. I found the icons unfamiliar looking, the flow was not intuitive and the verbiage and instructions were confusing. After what seemed like a lot of running around, coaching people, encouraging people, problem solving, figuring things out and what not, I decided that my opinion about this change was important too. Throughout the process I noticed myself at first excited, enthusiastic, and interested. I have tried to be patient, helpful, understanding, consistent, and reliable regarding this new process. Now, after walking people through the process, having to figure out things on my own, basically becoming the contact person for this system was not that fun or rewarding. I have kept myself in this project, although it does not belong to me for a few reasons. One was that this project had no leadership from within the department. I was looked to for guidance and I still don’t know how I ended up there. If it was going to run as best it could, I would need to do something. I didn’t want to see my co-workers struggle. I saw that my co-worker needs the help and encouragement and she has put me in a place where she relies on me. (I guess people just automatically see me as a leader and good reference!). If she weren’t asking me questions, I’d have dismissed this process change. Another reason that I have kept following up with this change is because of this class! If I didn’t have to see how this was going, again, I’d have done something else. I realized that due to my own frustration I just wanted to stop using the new technology. I was not accepting the change myself, because there were growing pains in figuring this out. I had to lead myself and I wasn’t expecting that either. The real problem, I felt, was that I couldn’t fix anything and that I had to wait on whoever would be able to fix the problems we ran into but no real contact with anyone to make sure my issues were even relayed. Another issue was that I didn’t have a choice. This was the new method and it was going to have to work.
Analyze the Data
This change did not follow any of the models discussed in class. An intradepartmental method for this change was never thought out. What would have worked well would have been any actual method. In the class discussion about change models there are certainly many that would have been a good choice. One method that seems to fit well here is the McKinsey 7S framework. When I read about this framework in the beginning of class, it sounded too complex and how it would be applied wasn’t clear. Now it is clear to me how you would apply the 7S to create change in an organization. The 7Ss of McKinsey are structure, strategy, systems, skills, style, staff, and shared values (MindTools, 2018). I would first evaluate the change by looking at the structure; meaning the current workflow, the projected workflow, the stakeholders, and the process as a whole. Identifying these things would enable me to put together a strategy. Should this change take place on a Monday, at night…what works for this structure? Systems meaning everything involved, anything that remotely touches this process should be identified. Skills; what skills do we have, what skills do we need to implement this the best way, what skills are required for future maintenance. The staff need to be trained, given resources, given encouragement. Actually, they could probably use a few therapy sessions about the change too and time to grieve and process the new. Shared values are our goal. How do we see this project in the future? What is it going to take to move forward successfully? These are questions that arise thgouth evaluating the 7S McKinsey framework.
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One thing that I really noticed through putting this paper together was the lack of communication. It is ironic that we had an employee survey facility wide, and the largest complaint was communication. I can see the results and trouble that poor communication causes in this project specifically. It causes extra insecurity, lack of trust, resentment, discouragement, and just lots of problems. I believe I have learned what not to do as far as communication, however, I’m not sure that I have found something that I can do to build my communication skills.
I did learn a lot from this project. I am glad that I had the experience to learn change management by watching a change that I didn’t necessarily have to manage. I got to observe. I got to ask questions. I wish that I could give feedback to where it would be taken and used, but that isn’t really possible in this instance. This change would have gone smoother if the people initiating it were involved in its completion. This means outside of the department. The lack of change management was clear from the start and it just continued down through levels and levels of management.
- Hall, S. [Veterans Health Administration]. (2018, Nov) VHA talks: LEAF . Retrieved from https://www.youtube.com/watch?v=2nFY9DH9_iw
- Kanowitz, S., (2018, May). Digitizing VA processes from the ground up. Retrieved from https://gcn.com/articles/2018/05/10/va-leaf.aspx
- MindTools. (2018). The McKinsey 7-S framework: Ensuring that all parts of your organization work in harmony. Retrieved from https://www.mindtools.com/pages/article/newSTR_91.htm
- Veterans Health Administration, (2016). VHA innovation program ebook – VA connected care. Retrieved from https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&ved=2ahUKEwjZr530i4DfAhVsUt8KHWHSAzwQFjAAegQIAhAC&url=https%3A%2F%2Fconnectedcare.va.gov%2Fsites%2Fdefault%2Ffiles%2FeBook_Innovation_Portfolio_FY16Q1_FINAL.pdf&usg=AOvVaw1sNuMRNTZk82Bjfm0Fygsj
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