Shinde, Archana

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.

Change management plays a crucial role in an organisation’s ability to adapt and thrive in today’s ever-evolving and fast-changing technologically enabled business landscape. Many organisations continue to struggle with effective change management, resulting in failed projects and missed opportunities for growth and development. This paper analyses the reasons why organisations frequently falter in change management efforts and provides insights into overcoming these barriers. The paper identifies a host of significant barriers to effective and successful change management. Each barrier is discussed in detail, explaining the negative effect it can have on change initiatives. Among these barriers are the lack of change management role accountability, a culture where change management is not embraced at all levels, a lack of change champions and leadership support, resistance to change, limited employee involvement, inadequate and poorly designed communications and a failure to properly integrate change management with other complementary approaches. The paper provides practical recommendations to overcome these barriers. It emphasises the crucial role of leadership in championing the change, communicating the vision and actively involving employees in the change process. It underscores the importance of a well-crafted, clear and consistent communication that can help build trust, ensure buy-in and reduce resistance. The paper also highlights the need for robust integration of change management with other complementary approaches. Furthermore, the paper underscores the significance of a centralised change management approach, incorporating tools, best practices and standardised change management practices, and setting realistic expectations to sustain change efforts over time. It stresses the need for organisations to provide the necessary resources, authority and support to staff to effectively fulfil their change management roles. In conclusion, this paper provides insights into overcoming the main barriers to successful change implementation. By implementing the suggested strategies, organisations can enhance their change management capabilities and increase their adaptability, thereby ensuring long-term success in a rapidly changing business landscape.