Stakeholder Engagement and Changing Workflows. Wendy Clark November 23 rd 2010

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1 Stakeholder Engagement and Changing Workflows Wendy Clark November 23 rd 2010

2 Change Management Essential or Desirable The process of developing a planned approach to change in an organisation. Typically the objective is to maximise the collective benefits for all people involved in the change and minimise the risk of failure of implementing the change Set of arrangements, systems, resources and processes which engage people in productive reasoning focused on creating a new future Can include: Stakeholder analysis, mapping and communication Assessing organisational readiness including history Workflow analysis and re-design Benefits identification, planning and management 1

3 Technology Enabled Change Projects the History 1980 s emergence of technology enabled change projects introduction of PAS, Pharmacy systems etc domain led 1990s growth of IT departments start of IT projects label and also the importance of benefits and change management Accompanied by growth in use of Programme and Project management methodologies and frameworks However, still seen by many as IT projects Still some expectation of not fulfilling promise so why? 2

4 Are they still failing? Evidence suggests: Engagement and leadership by Executive missing Poor programme and project management arrangements Poor business cases and specifications Inadequate resourcing Failure to recognise the importance of managing change Learning from past mistakes and building on successes What is in this for me? How do we work now and how do we want to work in the future? How are we going to make sure we realise the maximum benefit from all this resource and effort Rarely the technology 3

5 Evidence for the Prosecution Change management still not seen as essential Best intentions fail when money is tight Change management interferes with progress Common sense - does not need to be managed Responsibility of the Project Manager and Project Team We don t really understand what it is! 4

6 Times are Tough need to get wise Change management must be seen as essential How well have we managed change projects in the past can we learn? Workflow analysis and re-design will mean more efficient and productive processes and importantly safer patient care Getting stakeholders meaningfully involved means achieving benefits that make a difference to them IT is an enabler not an end point in itself what transformation is required and how In multi million pound contracts it is a false economy to not invest in change 5

7 Workflows Last 18 months working with Worcester as part of Xerox Consortium Engaged to provide change management support Readiness assessment Stakeholder analysis and engagement Workflow analysis and re-design Map current state Validate Develop future state Validate Impact analysis 6

8 Current Records Process Interaction with the Patient Journey Patient History Effort and delay of pulling, tidying, preparing and filing Updated History Records Process Pull Where is it? Tracking and searching File Patient Journey Urgent cases are seen without history forms in use! Updates Everyone wants it, only one person has it

9 The Process Stage 1 using generic patient journeys: Outpatients Elective Emergency Representative wards/departments acute and community Walkthroughs to capture data on current state Mapped using storyboards Reviewed by stakeholders to identify specialty variances Overall solution + current state workflows = Future state Aunt Sally storyboards Video on intranet, Task Force walkthroughs Validation by specialties Impact analysis 8

10 The Process Stage 2 Overall solution + current state workflows = Future state Aunt Sally storyboards Video on intranet, Task Force walkthroughs Validation by specialties Impact analysis 9

11 Future Emergency Care Records Flow Stages Other Referrals Medical Emergency Clinic 5 A&E / MIU Reception 4 Triage Treat Scan Admit 6 7 Stay Internal Transfer 9 Discharge 8 Surgical Ward Stay 13 Other Referrals EC Future v03 10 Triage Admit Theatre

12 EMERGENCY CARE FUTURE 2: A&E Treatment MINORS Pat. 1 st Minors cards in order 2 3 Record treatment on bar coded Cas Card/ Patient 1st Follow Up? No action if not YES Pat. 1 st Book appt on Patient 1 st or OASIS 4 OR 4a Transfer direct to outpatients CAS card and other A&E docs. should be scanned immediately when finished A&E Scan MAJORS 5 NO ez Notes 6 7 ICS / PACS Record treatment on Bar-coded Cas Card? Admit Query whether paper forms and bar-coded labels would be more practical YES Prepare event notes by downloading forms from appropriate admission pack and admit on Oasis if not already done Transfer to assessment unit/ward/hdu

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14 What this process has delivered Engagement with wide variety of stakeholders Understanding of what currently happens with records Other improvements on the patient journey Testing of the overall solution New workflows designed with stakeholders Benefits dependency network Where it could go wrong What needs to happen next change management planning Change Management - Essential or Desirable? 13

15 Contact Details Adam Drury Senior Consultant Tribal Change Management - Essential or Desirable? 14