Lisa Thomson

Today’s post-acute leaders are leading their organizations through turbulent times —  healthcare reform, new reimbursement strategies on the horizon, ACOs, need to establish strategic partnerships or relationships and the overwhelming influx of external government oversight – CMS and OIG!. And many leaders, like myself, have found that we are in a position of learning while leading. The success of our operational strategy depends on our knowledge of these changes and their impact to our organization, while designing a successful implementation strategy for change and improving quality and financial outcomes. 

Prior to implementing a successful change strategy, it is important that we understand industry, regulatory and reimbursement initiatives.  In my previous article, I focused on a leaders need to arm themselves with knowledge – keeping abreast of new federal initiatives/regulations/oversight   which included a “must read” list.  These prescriptive changes coupled with increased consumer demands, strategic positioning and partnerships as well as an increased push towards community-based care are forcing post-acute leaders to serve as the catalyst for change.   

Strong leadership is a vital ingredient to any successful organizational or system change. The below tactics serve as a guide for post-acute care leaders as they design and implement change processes in their organization:

  • Clarify change – be clear about why a change is needed and being implemented.  Ask yourself and your leadership team – “Will it include leadership/job content, responsibility, new–unknown–tasks, new methods of working, new skills, new relationships, threats to current operations, new training, retraining? Will it be something that involves re-thinking what the purpose of the organization is, or should be?  Will it involve designing of new service delivery models or service lines?” 
  • Build the case for change – Develop an outline of what the organization will look like at the end of the change.  Outline a clear case which identifies quantitative and qualitative needs, barriers, and performance metrics in terms of business objectives. Link these to a vision of where the organization will be if change is successful.
  • Communicate need for change – Lay the ground work as to the need and importance of what is being changed. Your team at ALL levels needs to have a clear vision based on where your organization is now (current state) before you take them where you want them to be (desired future state).
  1. Define, document and specify the change
  2. Anticipate and address staff responses to change
  • Develop a team – Successful change occurs when a leader creates a plan and develops an action-oriented team. Select a team with a mix of technical competencies, personal communication styles and levels of seniority.  Appoint a lead who will help streamline the plan as well as the actions necessary for implementation. 
  • Identify barriers – acknowledge and address organizational, operational and clinical barriers to change. Determine staff knowledge and competency to achieve change.  
  • Design an action plan – A successful plan needs to contain the following:  vision (future state), scope (what needs to change), action steps/tactics, barriers, time frame, resources, people (who is affected and who can implement), communication strategy, training and monitoring process.
  • Determine communication strategy – Ongoing communication from leadership and change team throughout the process is critical for successful implementation.  Ensure that your change plan has solid communication strategies which are initiated at the beginning of the process and continues through performance improvement activities.  Feedback is important and necessary. 

Whether you are contemplating an organization wide change or implementing a best – practice protocol in a single clinical system, success in implementing and managing change is reliant on a leader’s ability to design a successful implementation strategy. 

Readiness for 2013 begins now.  As leaders we need to arm ourselves with knowledgekeeping abreast of new federal initiatives/regulations/oversight, determine organization implementation strategies and monitor our outcomes in order to stay viable in the new health care environment.  

Lisa Thomson is the vice president of strategic initiatives at Pathway Health Services.