ICD-10-CM/PCS implementation will soon be official. But reaching the designated implementation date doesn't mean that the ICD-10 change management journey is over.
Clinicians, executives and managers must continue to support cultural alignment, collaborative communication and performance improvement to realize the full promise of ICD-10.
Following are steps you can take to ensure that ICD-10 implementation leads to lasting organizational change using a tested change management process.
Cultural alignment
Make sure that you—the change architect—have expressed a commitment to long-term cultural change brought about through the ICD-10 transition. Articulate the necessity and urgency of transformation while linking any change to the organization's existing culture. Be explicit. Define what and when changes should occur while clearly articulating the roles each individual will play.
Don't be afraid of repetition. The industry is ever-changing, with ICD-10 and value-based purchasing being the significant drivers of the healthcare transformation. Even though you may have already made the case for modifications under ICD-10, it's never too late to reiterate the rationale and objectives:
- Staff will become problem solvers and use critical-thinking skills,
- Fundamental knowledge of health sciences will be more essential than ever, and
- Communication channels will open between staff who may never have engaged with each other before.
Make sure that everyone in your organization understands what change under ICD-10 will look like and what will constitute success.
In the process, you may need to disarm some well-intentioned guardians of the status quo, while mobilizing ICD-10 change agents – self-starting problem solvers – who are able to step away from the status quo because they believe in ICD-10's results and outcomes. It also means empowering ICD-10 change agents with the credibility and influence to enhance the implementation and impact of ICD-10.
Unfortunately, healthcare organizations tend to overuse or misuse their change agents. The result: change enthusiasts oftentimes morph into overburdened change curmudgeons who either back off from intense participation or quit in frustration and anger.
Leadership is the solution. Clinical, administrative, and financial leaders must set the change agenda and goals, taking full responsibility for the transition to ICD-10 and associated initiatives. Their messages to team members should resemble something like this:
"We value and reward those who embrace and participate in the change agenda for ICD-10 implementation and other initiatives—from value based reimbursement and population health, to patient engagement and performance management. Our organization must transform itself into a patient-centric business and it is through a fully-engaged change management staff that this will be successful."
Also, take time to evaluate your organization's change environment by posing the following questions:
- Talent: Does the organization have an adequate number of staff with the knowledge, skill, expertise and attitude to function as change agents to sustain ICD-10 implementation?
- Resources: Has the organization provided its change agents with adequate time, funding and support to ease the transition to ICD-10 and beyond? Has it developed systems of reward, recognition and financial incentives that will help participants feel respected, acknowledged and valued?
- Recruitment: Has the organization created a program through which it can rely on veteran change agents to recruit, mentor and coach new champions for future change management projects?
Managing the ICD-10 Transition
Never lose sight of project management essentials. Make sure that the ICD-10 transition schedule features established milestones and incremental deliverable dates that extend beyond the October 2015 deadline. Assign responsibility for the transition and subsequent evaluation of success to an ICD-10 transition team.
Identify potential barriers and pitfalls related to policy, infrastructure, technology, staffing or resources. And make sure that everyone can pose and answer the following questions related to barriers:
- What is the nature and scope of the barrier?
- What is its potential impact—on policy, people, systems, patients and providers?
- How can ICD-10 implementation team members or leadership remove or mitigate the impact of the barrier?
- Who will lead the change to remove the barrier and report back to the implementation team?
- What will it take—in financial and human resources—to remove the barrier?
Also request that ICD-10 transition team members submit regular reports to leadership that document action plans, milestones and due dates, and progress made on assignments. Because organizations find it tough to sustain change momentum for more than 18 months, it's vital to celebrate milestones and achievements. If organizations avoid appreciation and recognition, participants, including change agents, lose interest and the project goes stale. Just as important, the organization misses an opportunity to identify implementation trouble spots.
The best approach is to reward change agents and participants through every available means of persuasion. Some organizations turn to special commemorative events like lunches, dinners, picnics or outings, while others showcase project leaders within publications, social media and web sites.
Parting Thoughts
As you move through ICD-10 transition, be on the lookout for new and emerging change agents. These individuals can participate in upcoming task forces and increasingly involve change management initiatives in care delivery, payment or technology.
Engage some of the organization's culture keepers who willingly jump on the change bandwagon once executive management removes change risks and barriers.
Implementing healthcare change often fails because executives lack skill, knowledge or experience in change management. By understanding your organization's culture and how people interact within it, you can make long-term sustainable change a reality.
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