accelerating implementation methodology (aim) · • provide an overview of the accelerating...

Copyright © IMA 2002 www.imaworldwide.com 800.752.9254

Accelerating ImplementationMethodology (AIM)

Society for Health Systems Forum

Conference Presentation

Orlando, FL

February 21, 2003

Presented by: Byron G. Fiman, Ph.D, Principal

IMPLEMENTATION MANAGEMENT ASSOCIATES, INC.


Session Goals

1

• Develop rationale that “soft” factors drive implementationsuccess

• Provide an overview of the Accelerating ImplementationMethodology (AIM) process

• Provide an opportunity to apply AIM tool, SponsorAssessment, to your project


• Assessment of personal and cultural barriersto organizational change

• Identification of work life disruptions that are theconsequences of strategic change

• Development of strategies and tactics to minimizeanticipated barriers and leverage key strengths toincrease readiness for change

• Process to accelerate the achievement of criticalstrategic goals with less resources and fewerhuman casualties

AIM: What is it?

AI047 2


• Why does it take so long to get anything donearound here?

• Why do people resist changes even though thepayoff is so logical and obvious to me?

• Why did our project look so good to start withand now . . . ?

AIM Benefits

Why Bother?

AI049 3

Copyright © IMA 2002 www.imaworldwide.com 800.752.9254 4

Implementation of Process Change Has A Poor Track Record

• Only 30% of change initiatives produced improvements in bottom line results (1997)

• 70% of all major business change implementations have sub-optimized results (1996)

• 70% of process changes in software fail (2002)

• Less than 10% of companies implementing Six Sigma get results that affect the balance sheet (2003)

MP61

“All this is meaningless unless it is supported by people.” (2003)


Proactive: Pay now or pay later

Systematic: No silver bullet

Flexible in Style: “Ungolden” rule

AIM: Requires Executives to be:

AI048 5

Lessons Learned: Life After the Appraisal*Two Years After The Assessment

Developed Action Plans

Established Action Teams

Successful at Reassessment

Generated Disillusionment

Over Budget

Exceeded Time Frame

94%

86%

31%

46%

59%

76%

*SEI, 1995AI059 6Copyright © IMA 2002 www.imaworldwide.com 800.752.9254

• Active Senior Management Monitoring

• Tight Link Between Change and Business Goals

• Clear Goals at All Levels

• Dedicated and Respected Staff Resources

• Involvement From Technical Community

• Focus on Project Management Processes

• Early Definition and Application of Metrics

Implementation Best Practices*

*SEI, 1995

AIM Step

4

3

9

7

5

6

1

AI060 7Copyright © IMA 2002 www.imaworldwide.com 800.752.9254


Change Strategy Reengineering OutcomesDirect Performance* *

Led by Top Management Bottom-Up Strategy

Based on Clear Business Strategy

Based on Mission/Values Statement

Integrated Company Wide Set of Unrelated Initiatives

Same Approach Across Countries

Based on 3 Year or More Plan

Change Strategy and Reengineering Outcomes*

++++

+++

+

++-

0

0

* Survey of Fortune 1,000, 1999

**Cost, Cycle Time,Customer Satisfaction

AI299 8Copyright © IMA 2002 www.imaworldwide.com 800.752.9254


4.76 4.714.42 4.37 4.33

1.00

2.00

3.00

4.00

5.00

AuthorizingSponsor

Commitment

ReinforcingSponsor

Commitment

Clear ChangeDefinition

Clear BusinessRationale

GoodCommunication

Strategy

Critical Factors In Accelerating Implementation

*Identifying Best Practices: A Change Agent Survey (2002), n=156

AI297

Very Important

Very Unimportant


4.38 4.37 4.18 4.15 4.01

1.00

2.00

3.00

4.00

5.00

LowAuthorizing

SponsorCommitment

LowReinforcing

SponsorCommitment

Distractions -CompetingPriorities

UnclearExpectations

UnclearBusinessRationale

Critical Factors In Inhibiting Implementation

Very Important

Very Unimportant

*Identifying Best Practices: A Change Agent Survey (2002), n=156

AI298


Success Requires The Right Decision andManaged Implementation

DecisionWrong Right

Failure

Failure Success

FailureUnmanaged

ManagedImplementation

AI001 11


FORGET IT

NO PROBLEM

HIDE IT

Can you blame someone else?

You poorfool

Does anyoneknow?

Don't messwith it

You dumbidiot

Will you catchhell?

Did you mess with it?

Does the darn thing work?

Change Flow ChartYES

YES

YES YES

YES

NO

NO

NO

NO

NO

AI003 12

Copyright © IMA 2002 www.imaworldwide.com 800.752.9254 MP01

The Road Map Define theChange

Assess theClimate

Identify ChangeApproach

GenerateSponsorship

Develop TargetReadiness

CreateCultural Fit

Build AgentCapacity

Develop Reinforcement

Strategy

BuildCommunication

Plan

PrioritizeAction

Plan

Monitor Implement

13


Define the Change

Assess the Climate

Identify Change Approach

Generate Sponsorship

Develop Target Readiness

Create Cultural Fit

Build Agent Capacity

Develop Reinforcement Strategy

Build Communication Plan

Prioritize Action

Plan

Monitor Implement

Accelerating Implementation Cycle:Road Map & Tools • Project

Overview

• Sponsor Assessment

• Culture Assessment

• Targeted Reinforcement Index

• Implementation Plan

• Implementation Planning Summary

• Organizational Change Stress Test

• Implementation History Assessment

• Implementation Risk Forecast

• Individual Readiness Assessment

• Change Agent Assessment

HO170

• Communication Audit

14


IHA Profile #1

A Company Implementation History ProfileComposite 487 Respondents - September, 2003

Very LowLow

ModerateHigh

12%

46%

40%

2%0%

20%

40%

60%

80%

100%

Perc

enta

ge o

f Res

pond

ents

Probability of Implementation Success

15


IHA Profile #1


Section 1: Structure 1 64.4Section 2: Stress 2 55.3

Section 3: History 3 61.1Section 4: Sponsorship 4 59.6

Section 5: Target Ready 5 59.5Section 6: Cultural Fit 6 56.3

Section 7: Agent Capacity 7 65.1Section 8: Reinforcement 8 57.7

Section 9: Communication 9 59.7Section 10: Involvement 10 55.0

• Belief · 68.3

1 2 3 4 5 6 7 8 9 10 ·

40

50

60

70

Prob

abili

ty o

f Im

plem

enta

tion

Sections

Average Score 59.5

Low

Moderate

16


IHA Profile #1


1. 2.9 1. Structure is conducive2. 3.1 2. Organizational layers3. 3.4 3. Responsibility defined4. 3.4 4. Authority defined5. 2.8 5. Changes prioritized6. 2.5 6. Number of changes7. 2.7 7. Rewards aligned8. 2.7 8. Maintain focus9. 3.1 9. Related to vision

10. 3.2 10. Expect to be successful11. 2.9 11. Implement on time12. 3.0 12. Implement within budget13. 3.4 13. Business objectives14. 2.7 14. Human objectives15. 2.9 15. Establish commitment16. 3.1 16. Demonstrate commitment17. 2.9 17. "Walk their talk"18. 3.1 18. Managerial discipline19. 2.9 19. Understand impact20. 3.2 20. Anticipate resistance21. 3.0 21. Surface resistance22. 2.8 22. Manage the resistance23. 3.0 23. Concerns are valued24. 2.8 24. Understand FOR25. 3.1 25. Vision modeled26. 2.9 26. Vision reinforced27. 2.6 27. Non-political28. 3.2 28. Organization vs department29. 2.3 29. Turf guarding is rare30. 3.3 30. Agents previous success31. 3.1 31. Business/human aspects32. 3.3 32. Line management vs staff33. 3.2 33. High trust and credibility34. 3.5 34. Understand FORS35. 2.5 35. Rewards risk taking36. 2.7 36. Adequate resources37. 3.2 37. Errors seen as learning38. 3.1 38. Clear rewards39. 2.9 39. Negative consequences40. 3.1 40. Objectives are clear41. 3.1 41. Understanding of purpose42. 2.8 42. Defined at all levels43. 2.9 43. Communicate expectations44. 3.1 44. Clear vision and strategy45. 2.4 45. Involved in decisions46. 2.6 46. Involved in design47. 2.7 47. Involved in implementation48. 3.1 48. More than "lip service"49. 3.0 49. Support involvement50. 3.4 50. Implementation success

1 2 3 4 5ModerateVery Low HighLow

Structure

Stress

History

Sponsorship

Readiness

Cultural Fit

Agent Capacity

Reinforcement

Communication

Involvement

Belief

17


Reinforcement Management Tactics

Development

Salary increaseGood wages Awards Bonuses, commissions Prizes (trips, etc.) Stock/profit sharingPerksAssignment of new duties/roles Relief from unpleasant dutiesRelief from repetitionVaried dutiesPreferred equipmentAccess to trainingIncreased visibilityProject controlProfessional recognition Increased input Influence over goals/tasksAccess to information Supervise more people High level inputLarger interdepartmental role

Tangible

Tasks

Responsibilities

Exemption from policiesPersonal control over timeJob securityRelief from threat of dismissalReduction in supervisionPublic, positivePublic, negativePrivate, positivePrivate, negativeIncrease benefitsCafeteria style benefitsLonger breaksIncrease vacationTime off with/without payChallenge of a difficult taskInteresting workBeing part of a teamDoing your very bestAppreciationSolving an important problem

Control

Recognition

Personal

Intrinsic

MP59 18


Unfreezing Communication

PRESENTSTATE

1. Explain the objectives2. Explain the rationale3. Explain the time frame4. Utilize the language of the Target5. Utilize the Frame of Reference (FOR) of the Target6. Emphasize the cost of not changing7. Focus on external drivers for change, not internal deficiencies (“not your

fault”)8. Describe why you personally believe in the change9. Be specific about what is and is not changing for each Target group10. Communicate where to go for more information11. Repeat communication and check for understanding

MP61


Menu of Communication Vehicles And CharacteristicsCharacteristics

MP64

Information

Commitment

Durability

FOR-Fit

TrustVehicles

Newsletter

E - Mail

V-Mail

Town Hall

Small Group

Memo

Video Tapes

Web Page

E - BBoard

M

L

L

M

H

L

M

H

M

L

L

M

M

H

L

L

M

L

M

L

H

M

H

L

L

L

L

L

L

L

L

H

L

L

M

L

L

L

L

M

H

L

L

L

L

H

M

H

M

H

H

H

H

H

One-on-One H H H H H H

Cost

20


Cast Of Characters

Champions

Agents

Sponsors

Targets

Individuals who want the change and attempt to obtain commitment and resources for it, but lack sponsorship. Implementation can be accelerated when the other three roles are also Champions.

Implement change. Plan and execute implementation architecture. At least part, if not all of their performance is evaluated on success of the implementation.

Authorize, legitimize and demonstrate ownership for the change: possess sufficient organizational power and/or influence to either initiate resource commitment (Authorizing Sponsor) or reinforce the change at the local level (Reinforcing Sponsor).

Change behavior, emotions, knowledge, etc.

Overall Goal:The right Sponsors doing the right things, cascaded down and across the organization.

C

A

S

T

21


Unsuccessful Sponsor Strategy

Target

AuthorizingSponsor

MP17

Supr. T

CEO SA

Mgr.Mgr.Mgr.

VPVP

Supr. T TT TT T T

BLACK HOLE

Mgr.

22


Supr. T3

CEO SA

Mgr. T2ASRMgr. T2ASRMgr. T2ASRMgr. T2ASR

VP T1SRVP T1SR

Supr. T3 T3T3 T3T3 T3 T3

S SponsorA AuthorizingR ReinforcingA AgentT Target1,2,3 Target Sequence

Authorizing Sponsor

Target/AgentReinforcing Sponsor

Legend

Cascading sponsorship must occur at each level between the Authorizing Sponsor (SA) and the final Targets (T3).

There must be Reinforcing Sponsors (SR) at each level between the Authorizing Sponsor (SA) and the final Targets (T3).

Target

1

2

3

Target/ReinforcingSponsor

Successful Sponsor Strategy

23


You can’t expect to sustain top executive support without producing consistent bottom-line results…yet consistent results are unlikely without sustained top executive support.

Sponsorship Paradox

24


High Leverage (ROI) Sponsor Behaviors toDemonstrate Commitment

Expressed

Modeled

Reinforced

25


Next Steps to Accelerate Successful Implementation

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