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The Managed Care Insider eNews
Volume Three Number 3
March 2001
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This edition of The Managed Care Insider eNews deals with change. To many, change
brings challenge, fear, and resistance. In our example of a name change for a
health plan with little or no brand image in the community, the fear of the overwhelming
needed changes to documents, regulatory agencies, and more, as well as the fear
of the unknown relative to public response to a new name, were dealt with using
the ten-step process described below. These steps can be adapted to dealing with
any change within an organization and are offered as a "how to" for
those of our readers dealing with the challenges of change. As always, we invite
your comments to insider@scheur.com.
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Ten Steps to Fast Change: What an Organization Can Learn From Snow Removal
By Robert S. Eichler
While much of the country is enjoying the first days of spring, looking forward
to crocuses, daffodils, dogwoods and summer, another half-foot of snow is falling
on my home town in New Hampshire. The snow will have to be removed: from sidewalks,
doorstops, streets and walkways. In the next few hours, people will shovel, plow,
shove, snow-blow and blaspheme. It doesn't matter that it will all melt within
the next few weeks. (In fact, that knowledge often makes the task of snow removal
more aggravating in late winter.) However, today, this morning, now, school buses
must get through; people must go to work; mail, goods and services must be delivered.
So, we all put shovel blade to snow drift and start digging.
What is always amazing in the aftermath of a snowfall is that within a few hours,
indeed, all the work is done. Without diminishing appreciation for the careful
planning and preparedness of the state and local worker teams who anticipate
the need, coordinate the routes, and deploy the labor to clear community thoroughfares,
there is a substantial amount of work performed by each member of the community
without a feasibility analysis, project plan, management oversight, or quality
assurance. The work gets done. And it gets done in addition to the other planned
daily tasks.
This snow removal analogy can serve as a model for fast change in business operations.
There are projects and moments in an organization's history when a drastic, wide-reaching,
and fast-moving change is needed without time to organize, analyze, develop a
project plan, and manage it through to completion. As an example, The OATH -
A Health Plan for Alabama (formerly Health Partners of Alabama) took on such
a project when it changed its name last November. Market studies showed that
as long as the plan kept its old name, it was promulgating a negative brand image,
digging in to its own marketing failure. The need was immediate to become The
OATH, a promise for better healthcare in Alabama. We accomplished this change
-- from roll-out of the idea to the staff, through state and agency applications,
through changes in documents, correspondence, MIS, phone system, signage, stationery,
promotional items, and launch of marketing campaign -- in three weeks rather
than the traditional 90+ days.
The "fast change" model follows a pattern uniquely its own, without
many of the MBA-sanctioned controls on project planning and change management,
with some additional risks to the project, and with some similarities to the
way we all remove snow when it falls. Here are ten steps to follow when implementing
the fast change model.
1. Communicate the vision, scope, and components requiring change to the ENTIRE
organization. Without time to analyze change implications, management cannot
be assured it knows of each element that requires change. Best let everyone know
and become involved.
2. Emphasize that all details of the change will need to be addressed. Employees
will immediately internalize the implications of the change and understand what
needs to be done from within the purview of their own orbit of control. Each
person asks, "What am I responsible for? Will it need to change?"
3. Do not try to manage (or even identify) each element required to change. Delegate
responsibility and authorize each person to make the necessary changes within
his/her business function.
4. Rely upon a strong foundation of teamwork and mutual trust. It gives you,
at your desk, permission not to worry about whether ordering new stationery (not
your usual job) is getting done. Trust that the person ordering stationery is
doing that task while you are doing yours. At the same time, if your task is
simple, and you see that your neighbor needs help with his or hers, be willing
to pitch in. (Shovel your neighbor's walkway if he/she is not able.)
5. Do not expect to coordinate all tasks to synchronous completion. With limited
to no oversight on each element, various components of change may be completed
at different points in time. It will be important to identify any that are contingent
upon one another and establish some sub-work groups to handle and manage these
coordinated sub-tasks. Although all tasks should be aiming toward the single,
high priority deadline of the entire project, internal task deadlines will not
be able to be managed.
6. Expect that not all tasks will be completed. Communicate the priorities criteria
by which sub-groups and individuals should make decisions, as there will be not
time for oversight or review. For example, changing the logo on forms and correspondence
that go to external customers is more critical than changing forms used internally.
7. Realize that risks will be increased for failures. Typical failures will be
individual items along the way, as well as for the project overall. Without a
feasibility study at the front end, you won't know if, for a fact, all high priority
items CAN be accomplished in the proposed timeframe. Note well: Fast change will
not work in an organization with serious operational or management malfunctions.
It depends upon each person understanding his/her job and doing it well.
8. Make provisions for damage control and follow-up: Damage control for what
may appear to the outside world to be a clumsy and uncoordinated change effort
(which, after all, is what it may be). Follow-up for the low-priority items that
didn't get completed by deadline.
9. Expect that other project timelines will slip. After all, management is placing
highest priority on this particular change. Do communicate the expectation that
routine operations should not have to suffer. After all, we get our walk shoveled
of snow and still get breakfast made, eaten (maybe not cleaned up), children
dressed, and all out the door to school and work.
10. Celebrate. A town seldom recognizes the amount of work it takes to get every
sidewalk cleared, every fire hydrant dug out. A company, on the other hand, should
acknowledge, recognize, and value the extra-ordinary efforts of all of its employees
to pull off a large-scale change.
Successful fast change in an organization is possible. We did all of the above
in Alabama to change our name to The OATH in three weeks, where we don't even
have much experience shoveling snow.
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About the author: Robert S. Eichler is an expert in managed care operations and
systems, assisting clients in tracking information flow, designing effective
resource allocation, functionally analyzing system applications and evaluating
system strategies. His talents in system analysis, conversion and operations
re-engineering are combined with his organizational redevelopment skills and
his ability to mentor and motivate employees.
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Speaking Engagements:
April 12, 2001
Orange County Employee Benefit Council
Irvine, CA
Topic: "Managed Care in the Maelstrom: Remedy for a Floundering Business"
Speaker: Barry S. Scheur
May 17, 2001
Alabama Association of Health Underwriters Convention
Sandestin, FL
Topic: "Managed Care and Alabama: Allies or Adversaries?"
Speaker: Barry S. Scheur
September 9, 2001
NAHQ's 26th Annual Educational Conference
Reno, NV
Topic: "Resuscitating Managed Care: Getting Off Life Support and Recovering
Credibility"
Speaker: Barry S. Scheur
If you are interested in contracting either Barry Scheur or any SMG/VHPG associate
for your organization, please contact Nancy Belle at nbelle@scheur.com
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Sites and Sounds on the 'Net
SMG has no ownership of, nor does it endorse the following sites. This information
is presented as a resource for subscribers. In keeping with this issue's focus
on performance improvement, we present the following sites which cover this area.
SMG has no ownership of, nor does it endorse the following sites. This information
is presented as a resource for subscribers. In keeping with this issue's focus
on dealing with change, we present the following sites that cover this area.
"Coping With Corporate Change," a relevant article posted in the online
Raleigh-Durham Business Journal, October 16, 2000, at http://triangle.bcentral.com/triangle/stories/2000/10/16/focus1.html
The Journal of Strategic Change, subscribe-only information available at http://www.interscience.wiley.com/jpages/1086-1718/
From the UK, The Leadership and Organizational Development Journal at http://www.mcb.co.uk/lodj.htm
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End of PART ONE of ONE, The Managed Care Insider eNews,
Volume Three, Number 3.
Scheur Management Group (SMG) is one of the most experienced specialized healthcare
operations management and business revitalization consulting firms in the country.
Our expertise is in time-sensitive analyses, strategic business and market planning,
operational re-engineering, and communications, as well as implementation of
start-ups, expansions, and new products. The firm's clients cover the spectrum
of insurers, managed care organizations, physician groups, integrated delivery
systems, hospitals, employers, governmental entities, vendors, and other providers.
Contributing to this edition is Robert S. Eichler. Editing and Research by Judith
Jaffe. Production Coordination by Nancy K. Belle.
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