Engaging Stakeholders. Going Beyond Conventional Wisdom

Transcription

1 Engaging Stakeholders Going Beyond Conventional Wisdom

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3 The Complexity of Healthcare Healthcare the most complex of any industry Peter Drucker.

4 The Risk of Silo Mentality Healthcare complexity can lead to a strong silo mentality.

5 What is change management? A structured approach that helps 6-sigma teams manage the human aspects of change in order to: Anticipate and manage issues effectively Provide positive outcomes Use some tools and techniques to Analyse present state Define future state Develop a transition plan

6 How do people feel when faced with change? Annoyed Feel alone The focus on what they are losing (see it as a threat, not an opportunity) There is a limit to the amount that one can handle All people are at different levels of readiness Revert to the old behaviour when the pressure is off Doubt they have the resource, time, energy, money or skills to handle the change

7 Change and Improvement Do Not Come Easy Basic premise Physics tells us Human nature Why? Therefore The greater the resistance To improve we must continuously change For every action (change) there is an equal & opposite reaction People resist change (i.e. look for excuses, wait and see, etc.) Because change takes people outside their comfort zones The more you change the greater the resistance The more difficult it is to improve

8 The two greatest questions when preparing for a change campaign Put yourself in the shoes of the stakeholder and answer the Question: Key Stakeholders What s in it for me? W.I.I.F.M.? What s against my interest? W.A.M.I.?

9 How do we recognise Value? The customer must be willing to pay for the activity The activity must transform the product or service in some way The activity must be done correctly the first time

10 What is Stakeholder Management Stakeholder management is a set of techniques that harnesses the positive influences and minimises the effect of the negative influences Differentiate between motive and expectations Understand the roles each stakeholder will play at each stage of the project. Revolving alliances Picking the right fights Communication, Communication, Communication!

11 Identifying stakeholders Patients Regulatory Bodies Management and staff Suppliers Media Funders Government Board of Directors Local Community

12 Stakeholder Priorities Not all stakeholders have the same expectations the same motives are equal

13 Stakeholders: CEO HSE/DBF Ambulance Service Stroke Consultants Stroke SpRs Stroke CNS ED Consultants ED SpRs ED CNM3 ED Nurses ED Admin Staff Radiologists CT Radiographers SHO s Medical Records Operations Switchboard IMS department Laboratory power / role high low 1 6 keep satisfied minimum effort 17 low (blocker) high (supporter) interest / position key players keep informed 13 15

14 Stakeholders Influence Who? will be adversely affected by potential environmental and social impacts in the project s area of influence? are the most vulnerable among the potentially impacted, and are special engagement efforts necessary? What? stage of project development will the stakeholders be most affected (e.g. design, implementation) are the various interests of project stakeholders and what influence might this have on the project? Which? stakeholders might help to enhance the project design or reduce project costs? stakeholders can best assist with the early scoping of issues and impacts? Who? strongly supports or opposes the changes that the project will bring and why? is it critical to engage with first, and why? is the optimal sequence of engagement? AND - Whose opposition could be detrimental to the success of the project?

15 Enablement Tactics for your toolkit demonstrate competence buffer from the team advocate for those who can't ensure traceability of agreements, requests, or decisions make sure there is a structure to engage make visible lost time (or other impacts) due to delayed responses encourage delegation of authority if possible look for informal settings to access busy stakeholders

16 Stakeholder engagement allows Project teams to manage the politics that often come with large complex projects. It helps to win support for your project and eliminates a major source of project and work stress

17 Project Stakeholder

18 The Lean Six Sigma Model? define measure analyse improve control Define the problem Measure process map the problem area and set up data collection Analyse analyse data, identify root causes of problems, identify waste Improve draw up improvement and implementation plans Control monitor and control risks of solutions failing, handover

19 SIPOC

20 UNDERSTAND THE PROCESS AT A HIGH LEVEL

21 Stages in the analysis 1. Identification of Stakeholder groups 2. Identification of the Stakeholder interests in the project 3. Categorisation with regard to criticality 4. Analyzing critical stakeholders and identification of actions/strategies 5. Communication Plan

22 Decision Time! This pyramid of decision making authority assists with differentiation of stakeholders by level of influence over the success of the project. The degree of influence over a change initiative increases with the position on the pyramid. Consult for Authority Involve for Commitment and expertise Consider for Stakeholder Roles in Decision response or input Making Inform for understanding Degree of Influence Enlist for communication and dissemination 22

23 Key Project Stakeholders Approvers: Sponsor, Business Owner, Budget Holder Blockers: Other Functions who control aspects of the process, legal, regulatory Influencers: Key individuals who will be listened to by the Approvers and Blockers We need to identify all the Key Stakeholders early on so that we can plan how to engage them

24 Kurt Lewin s change model Unfreezing Moving Refreezing

25 RACI Once stakeholders have been identified the team must determine to what extent stakeholders must be involved in the project (participation, direction, input, inform). A RACI chart is used to capture that information. Responsible: execute, participate, do work. Accountable/approval: provide direction, approval for Responsible party. Consultation with this party required, must have some input. Inform: Responsible party should inform this group of actions.

26 No Stakeholder Define Measur e Phase Analys e Improv e 1 CEO I I I I I 2 Director of Nursing C I I I I 3 Directorate Nurse Manager C I I I I Control Comments 4 CNM from the Pilot wards C A C A A Stakeholder meeting involvement 5 Staff Nurse C R I R R 6 Head of Portering I I I I I 7 Pharmacy Porter C R I A R Stakeholder meeting involvement 8 Head of Pharmacy C I C C C 9 Pharmacy Operations Manager I I C C C 10 Pharmacy Dispensary Manager C R C A A Stakeholder meeting involvement 11 Dispensary pharmacist I R C R R Definitions: Responsible - work to achieve the task Accountable - ultimately answerable for correct & through completion and delegates the work to those responsible Consulted - opinions sought Informed - kept up-to-date on progress

27 The Kano model Basic Quality: These requirements are not usually mentioned by customers. These are mentioned only when they are absent from the product. Performance Quality: provides an increase in satisfaction as performance improves Excitement Absent Satisfiers Customer Satisfaction + Delighted Fully implemented Performance Basic Kano Model Excitement Quality or wow requirements : are often unspoken, possibly because we are seldom asked to express our dreams. Creation of some excitement features in a design differentiates the product from competition. - Disgusted

28 Kano Model used to identify from patients what do they want from a service Frustrating- Having to Contact out of hours Straight to Respiratory Ward Contact in hours What explain to do our patients want from a Access service? junior doctors when breathless, history taking Straight to Respiratory Ward, Management Plan Listen To Delighter ( unspoken ) Right Right Time Performer Basic ( unspoken )

29 When you have the basics 1. Engage in issues that matter 2. Be ready to act 3. Engage the right stakeholders 4. Engage empowered representatives 5. Seek shared value 6. Agree rules of engagement 7. Manage exceptions 8. Provide adequate resources 9. Choose the right formats 10. Act fairly Listen to (critical) stakeholder views Build trust Be open Be accountable Look beyond the engagement

30 Remember Lean is simple and systemic project teams alone cannot change organisations they must be part of an infrastructure designed to assist in the overall organisational strategy

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