How is the Country's Largest Medicare Provider Preparing for Healthcare Reform?

How is the largest Medicare provider in the U.S. preparing for full implementation of healthcare reform? The answer: The system is getting serious about change, and has totally reengineered its change management efforts, making them more formal and prominent within the organization.

A few years ago, Florida Hospital Orlando recruited Gina Romero Hernandez to help lead an overhaul of the eight-campus health system's approach to change management. System leadership knew that big changes to the health system's business model were on the way, and if the organization and its staff didn't successfully adapt, the success of the system could be at risk.

Ms. Romero helped establish the system's Center for Talent Development and Organizational Change, where she is now an assistant vice president, and later recruited Deborah Novak, now an organizational capability practice leader at the Center. Ms. Novak, who along with Ms. Romero Hernandez presented at the Performance Excellence for Healthcare conference on July 30 in Chicago, said she was convinced she had to make the 1,200 mile move due to the system's commitment and passion for performance improvement.


Why change?
The Patient Protection and Affordable Care Act of 2010 helped speed efforts that were already present within the industry to bring down the cost of care, while maintaining and improving quality. Through value-based payments and other reimbursement models that shift risk to providers, from both public and private payers, the goals of the PPACA are coming to life. For providers, this means their business model, which traditionally focused on volume of services, has completed changed. As a result, business as usual for physicians and staff must also change.

However, anyone who has tried to introduce a change in an organization knows most people are resistant to change. What Florida Hospital sought out to do was create a way to help communicate, implement and sustain the changes needed for success under a new delivery model, and it has so far achieved that through its Center for Talent Development and Organizational Change.

Mastering change takes practice
Because people are naturally resistant to change, successfully instituting and sustaining a change takes practice, and often relies on a certain set of tactics to communicate the change.

"The focus is not on what is changing, but how you prepare the people for that change," said Ms. Romero Hernandez.

Educating and preparing people for change is important, even if they are resistant to it, because having employees that are knowledgeable about the healthcare environment and its challenges is better than having employees who are uncertain of the organization's, or their, future.

"The uncertainty is palpable," said Ms. Novak. "Communication helps to reign in chaos and give you a sense of control."

In order to test various change management tactics that can best give employees an understanding of the future, the changes the organization needs to make and the impact of those changes on various stakeholders, staff at the Center use simulation tools to understand various stakeholder's views, identify restraining forces and driving forces for a change, and test the effectiveness of various change management tactics.

Once restraining forces are identified (e.g., "we're too busy for a new program") tactics can be selected to address them. Identified driving forces can also be communicated, via various tactics, to the stakeholders.

"Every tactic that you use will either gain supports from one of your stakeholders or lose support from one of them," said Ms. Romero Hernandez.

More Articles on Change Management:

Successful Implementation of a New Care Delivery Model
5 Key Elements of the Mayo Clinic Best Practice Diffusion Model

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