Spreading Change at the System Level

Eventually, you want process improvement and the desire to improve access and retention to permeate your entire organization. To do that, you need to start with a small, strong group of interested staff who can work with providers to identify the changes that you need to make to help move the data points you are tracking at the provider level. You want to choose your first projects carefully so that the project is relatively simple and the impact is large. Don’t worry—if you do a walk-through and get feedback from providers—there will be lots to choose from.

Once you have some early successes, it is time to get others engaged in the process. You may have enough enthusiastic volunteers after some early big wins that it is even easier to put together your second Change Team than it was the first. Even if this is not the case, choose another team appropriate for a particular project and begin addressing another issue in the same manner. After several rounds of Change Projects, you will have taught the process to many if not all of your staff and you can begin to address many problems in the same manner. If you are lucky, people will begin to suggest that you set up a Change Project for practically everything and your job will be to identify what can be solved without a process.

Spreading Change

1. Announce your intention to use process improvement internally and make a big deal about being chosen for the Change Team.
2. Participate as actively as possible in the first few Change Projects. Ensure that everyone knows that the Change Leader speaks for you (the Executive Sponsor) and has access to you whenever needed. (Don’t pick a Change Leader that you don’t feel comfortable empowering in this way.)
3. Change something that will affect staff workload as well as improve provider-level and client-level interactions (e.g., reducing paperwork seems to help everyone). Let people know that reducing their workload means that more time and attention will available to work on improvement projects. This is not a sneaky way to eliminate jobs.
4. Announce the results of the first Change Project. Celebrate the project with recognition and food if you can.
5. The first project may go through several change cycles before you are fully satisfied. If it will take a long time, go ahead and get started on a second project with similar fanfare.
6. As Change Projects grow, make communicating where various projects are in process and sharing change data a part of regular meetings. Post results in a prominent location. Reward staff participation and celebrate success.
7. Gradually spread the technique to all units that you oversee by creating new Change Teams for new projects. Make sure teams are cross-functional so that people learn from each other and so that the ideas generated do not improve the work of one unit and create more work for another.