What’s going on?
I work on the Project Management team for the construction of a new State Psychiatric Hospital (SPH) called the Neuro Diagnostic Institute (NDI). The NDI will serve as a replacement hospital for the current Larue Carter Hospital, which has existed since 1948. When I first began working on the project, I assumed we were simply going to be thinking about activities related to the physical construction of the building, but quickly realized that Organizational Change Management (OCM) would be the key factor to the project’s success.
OCM is a framework to manage new business processes in a system and changes in organizational structure or cultural changes within an enterprise. The shift to the NDI from Larue Carter will change the daily work processes of over 200 employees, some of whom have worked at Larue Carter for many years. Below are several examples of the change that staff are experiencing.
Staff will work in a brand-new building located 10 miles away from Larue Carter. The NDI shares a campus with Community Hospital East (CHE), so just learning where to park will be new. The NDI is designed with open concept shared staff workspaces. Employees who once had their own office will now share space with others. The hospital units are arranged differently, so staff may not be working with familiar patients or coworkers.
Job requirements and competencies will change due to new technology. The NDI is transitioning from a paper medical record system to an electronic medical record (EMR) system. Patients in psychiatric environments require observation and documentation for things like medication distribution, regular 15-minute safety checks, incident reporting, and meal time observation. What was once done on paper will occur on computers and iPads at the NDI. The NDI will utilize a new communication method through a device called Vocera, which is a hands-free, voice activated badge. The overhead paging system used today will no longer exist.
How is this change managed?
Staff at all levels of the client’s organization experience anxiety and stress effects from the change. Much work is required to develop new hospital processes, recruit for new job positions, conduct or participate in training, educate the public, coordinate activities with outside vendors, and still provide patient care. Below are several examples of strategies used on the NDI project.
Communication with staff has been important throughout the project. Distributing the appropriate information, to the appropriate stakeholders, at the appropriate time is critical. A project communication strategy was created to ensure that current staff was frequently updated as to how the upcoming changes may impact them. For example, as the NDI staffing model was developed, staff were informed where they would be working at the NDI. Training schedules were developed and communicated to staff. A system was developed for staff to submit NDI related questions or concerns and obtain feedback. A change of this magnitude also impacts many external entities that work with the SPH. Communication strategies were also implemented to ensure all outside entities were frequently updated on the NDI progress and impact to the current processes used and changes needed for the opening of the new hospital.
It has been important to obtain input from all levels of the organization when developing future state processes and policies. Oftentimes the staff member performing a job function may have a different perspective than the manager. Conducting these discussions at different organizational levels ensures details are not missed. Education and training have been critical. Due to the new policies, equipment, technology, and work environment, a typical current Larue Carter staff member is required to take as much as 15 total hours of training to function at the NDI.
Strong teamwork across different departments and entities has been a key factor for the project. Opening a new hospital is not a one-man job. The leadership team has clear ownership of tasks and responsibilities and are discussed at weekly Steering Committee meetings. People have stepped up to help in areas unrelated to their formal job role. For example, once it became clear a training schedule and program needed to be managed, the Pharmacy Director took on the responsibility. Administrative staff have also volunteered to become trainers and super users to assist with training in areas unrelated to their department.
In summary, change is scary for everyone. Change can occur in multiple ways simultaneously. Organizational Change Management has proven to be an integral component of the NDI project and I’ve witnessed the challenges involved first hand. It is hard work to keep up with all the change at once, but by proactively utilizing different strategies, a clear roadmap has surfaced, guiding the way to a successful hospital opening in 2019.