Jasperson, Jan C.

Implementation of Epic as an integrated electronic health record and revenue cycle management system was the largest software implementation in the history of Mayo Clinic. It converged thousands of workflows, eliminated hundreds of legacy systems and affected thousands of end users across Mayo Clinic campuses. Strong physician leadership, project management and deliberate change management were important components in this US$1.5bn project. Mayo’s leadership used a distinctive approach to prepare staff to make these important changes. At the beginning of the project, leaders developed a deliberate and robust change management strategy and formed a team focused on change management and communications. The change management team comprised Mayo Clinic health systems engineers, who know healthcare and Mayo’s culture and values and have expertise in systems engineering and quality improvement principles. The team developed an approach using various tools to support operational readiness and change readiness and to communicate important messages throughout the project cycle. In this paper, crucial components of the project for successfully managing the people side of change are described: development of an approach to change management that fits the organisation, creation of a dynamic team with the right skills mix and execution of appropriate timing of tactics.

In 2018, Mayo Clinic completed the largest transformational project in its 150-year history. Mayo Clinic was prepared to take on the implementation of new software systems (Epic Systems Corp) as an integrated electronic health record (EHR) and revenue cycle management (RCM) system across all sites of the enterprise. Three foundational teams were launched for this project: leadership, project management and change management. In a project such as this, a common pitfall is to focus completely on the system and lose sight of the end users. For Mayo Clinic, the people side of change was at the forefront of the project. A robust change management team was budgeted, staffed and engaged with an experienced outside consulting partner. A goal for the change management team centred on the best way to measure the change management impact and the degree to which it was making a positive contribution in driving successful adoption of the new EHR and RCM system. With literature lacking in this area, the team moved forward with courage and quickly learned that the easy part was the development of a survey with questions mapped to the six components of the change management strategy and the phases of the awareness, desire, knowledge, ability, reinforcement (ADKAR) Model (Prosci Inc). The hard part was building the infrastructure to visually display millions of rows of data that needed to be positioned, filtered and analysed for all affected locations. The authors share the methods to measure change and explain the importance of developing a comprehensive and robust means of gathering and displaying large volumes of change management data at the project onset. This paper prepares the reader to confidently develop an organisational framework to measure and report the effectiveness of a change management strategy.

As project leaders plan large, transformational initiatives, impacted departmental leaders are often forgotten. Operational leaders are in need of a practical, concise guide to prepare for project activities and allocate resources. The Plummer Project change management team of Mayo Clinic created a single source of timelines and tasks with links to more detailed information, termed a ‘playbook’ for operational leaders. The tool was dynamic and provided the operations-relevant project timeline, required preparedness activities and essential references. This paper analyses the format and content of this playbook to assist other organisations with the execution of complex projects. The playbook provided clarity, efficiency and cohesiveness with deep benefits to the project team and organisation.

The value of a shared service organisation (SSO) is recognised in transactional functions across manufacturing, technology and finance. Successful application of an SSO in healthcare is limited, particularly in professional, non-transactional functions. This article explores the application, effectiveness and challenges of creating an SSO in a fast-paced, dynamic environment. The Department of Management Engineering & Internal Consulting (ME&IC), a team of engineering and consulting staff at Mayo Clinic, completed its SSO journey by leveraging lessons from Mayo Clinic and various industries. Methods to implement a successful SSO included a literature review, customer and leadership interviews, and cross-industry benchmarking. ME&IC converged and streamlined its services, expenses, infrastructure and service delivery; realised economies of scale; translated best practices; and optimised staff talent. The SSO enabled customer responsiveness and performance excellence by integrating talent, processes and technologies. An effective SSO supports policy standardisation, agile decision-making, strong change management, consolidation of shadow groups, resource alignment with strategic priorities and more accurate measurement and benefits realisation. To achieve success, SSO models must be adapted to organisation culture, leadership commitment and service delivery expectations. The systematic transition to an SSO and lessons learned by ME&IC are broadly transferable to professional groups across industries.