Tagged: #change_management
- This topic has 18 replies, 13 voices, and was last updated 1 year, 5 months ago by Tanatorn Tilkanont.
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2022-09-29 at 3:43 pm #38433SaranathKeymaster
Please give an example of a system in your organization (either successful or fail)—this could be the same system you mentioned in the previous topic discussion (Topic 1). Do you think that the organization appropriately managed the change or not? Think about ADKAR model that we just learned.
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2022-10-03 at 11:46 pm #38509Zarni Lynn KyawParticipant
As I’ve written in the Topic 1, since in my case, there is a failure in the first time and successful in the second time, I would say that my organization appropriately managed the change during the second time.
Using the ADKAR model for retrospective analysis
Awareness –> Although executive team were aware of the platform like SignWell can help improve efficiency of a project, it is not a widely accepted or some people are not aware (not convinced) during the first time of implementation.
Desire –> during the first time, there is no necessity or urgent need to implement organization wide change (some people desire to stick to the status-quo) but it was completely changed once COVID-19 strike.
Knowledge –> during the first time, we didn’t fully invest in PDF, video, FAQ and on-site support, so many people don’t have the proper knowledge to use the system effectively.
Ability –> during the first time, many people are hesitant to use the system because they are afraid to make a mistake but with proper coaching, practice and time, it became an essential part of our daily routine.
Reinforcement –> we now train all the new employees how to use the SignWell platform since day 1 and we host a troubleshooting session once every two months (down from once every month because many people master the system already)-
2022-10-11 at 12:57 pm #38620Boonyarat KanjanapongpornParticipant
Thank you for sharing from the initial to adjusted state of implementation. This shows the necessary of building the desire from individual to embrace the system which could motivate people to learn and adjust themself to the change.
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2022-10-06 at 11:44 am #38554ABDILLAH FARKHANParticipant
The system I’ve elucidated in the previous topic discussion has appropriately experienced change management although I was not involved during the transformation process. But according to my research, it mirrors the ADKAR building blocks but was driven by the desire to adopt a new method that was more practical for most people including those who are digital-illiterate people and health workers with limited computer skills.
Since the old-fashioned system was poor and inefficient in responding to a rapidly changing pandemic, so the digital approach was the only centerpiece manner. In a nutshell, previously our ministerial office had faced a lack of ways how to attract people to be fully vaccinated, how the healthcare physician can reach the patients during area closures, how to increase the number of daily tests, and how the airport health authority can determine fit travel status. And the desire to create a new digital method could pick all of these needs and bring advantages for health workers and people.
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2022-10-08 at 9:31 am #38581PREUT ASSAWAWORRARITParticipant
I would like to use the failed project that I have previously mentioned in the recent topic discussion. It is about implementation ICU request system. There are many factors leading to failure of the project. I will discuss the factors relevant to ADKAR model as following.
1. Awareness
This is the most important factor leading to failure in our project. The ICU bed availability does not match with its demand. There are many patients who need to be admitted in the critical care unit but they have to be in general wards, however, we have no solid information to demonstrate the ICU bed shortage. Therefore, we need a solid evidence to support our hypothesis, for example, numbers of patients who were requested for ICU transfer but were refused due to ICU unavailability. We need to record this information in the information system. But our residents does not get the point of gather information to support evidence of ICU shortage. They refuse to fill in the form.2. Desireร
I would like to admit that there is no motivation in residents tน use the system. Moreover, it is perceived as an increased workload that they have never seen the benefit of doing so. Therefore, this might be a powerful resistance to the project.3. Knowledge
4. Ability
I think they have basic knowledge in using the system. We might introduce them to use it in basis.5. Reinforcement
To maintain the system, we have to integrate it in the hospital information system that provides the needed information automatically such as hospital number, laboratory data, diagnosis, etc. So the users only fill in little more information that need to make the decision for acceptance to the ICU.Thank you
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2022-10-08 at 1:48 pm #38582Kawin WongthamarinParticipant
From the previous topic, I’ve been talking about the online test result notification system for COVID-19. If analyzing that topic according to the ADKAR model, it will be found as follows.
Awareness: Everyone who works in the field, who comes in contact with COVID-19 patients every day, wants to reduce the amount of time they meet with the patient as much as possible to reduce the chances of getting infected. For the patients themselves who do not know whether they are infected or not, they would like to reduce the time spent in close contact with the people who come to wait for testing as well. Therefore, awareness among stakeholders is clear and easy to understand.
Desire: When everyone realizes, they want to reduce the amount of time they have to spend together. However, the problem is not easily solved. Both frontline workers and patients are unable to fulfill their wishes on their own.
Knowledge: I’m not sure in detail whether the solution came from listening to the voices of the frontline workers or from some other way. Finally, the solution came from the hospital administrators who had the idea to change the conventional lab report format to the online format.
Ability: The executives have to arrange a half-day training session to teach on-site personnel to use the system. Moreover, the system is designed to be easy for patients to use.
Reinforcement: In this process, there was no apparent reinforcement. But it’s successful because everyone is aware and wants to make this system happen in order to reduce the workload.
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2022-10-09 at 11:35 am #38601Boonyarat KanjanapongpornParticipant
I will use Free ATK dispensing system implementation from my first discussion as an example of management change in my organization.
It wasn’t a complicated system. However, the project involved creating one more task for everyone who already had their own routine job. In the private pharmacy store, there are not only healthcare workers. Pharmacists have to work with Non healthcare workers (store manager and general staff). There was management change to create effective implementing of the new system along with other routine work. The management change can be clarified by ADKAR model below.A: Hierarchy communication was used to raise awareness and inform about the project from NHSO to the main company office in BKK, followed by Store Manager and other staff.
D: Because of the incentive from ATKs dispensed and increased visits of customers, this project lifted the daily transactions in pharmacy store. These motivated and pushed the desire of staff to cooperate with the project.
K: Training for applications had been provided for store manager and pharmacists before the implementation.
A: The application and process of service wasn’t complicated. However, working as a team increased pharmacist ability to maintain good service. When there were more tasks, the Manager had to equally divide the work among staff positions. For example, Pharmacist mainly focused on ATKs dispensed while others managed the queue.
R: Resources support from the main company helped staff to maintain quality service. During that time the amount of customers tripled because the implementing was successful, the main company allowed extra hours for staff or paid part time workers so staff available didn’t feel too exhausted.-
2022-10-12 at 8:32 pm #38674Kansiri ApinantanakulParticipant
Thank you for sharing.
Your project visualized the support for all level of stakeholders including healthcare professionals and non-healthcare professional. -
2022-10-24 at 3:52 pm #38828Tanatorn TilkanontParticipant
As there were more users for the ATK-free application, the more cost for the requirement of more staff and additional overtime work. I like the way how they also managed further resources support such as recruitment for part-time and allowing payment for extra hours of the current staff.
Thank you for sharing.
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2022-10-11 at 11:57 pm #38639Tanyawat SaisongcrohParticipant
Reflecting on the success of RamaEMR implementation, the example that I mentioned in topic 1, I think our project lead team had worked their best on the change management. To look at the detail in ADKAR model;
Awareness; Changing from paper-based medical record to EMR is a big deal in our practice but it is not actually new in terms of IT implementation in our hospital. We’ve been using other software in particular department for a decade and we keep continue improving the IT project. With the communication between dean to members via intranet, lead care team meeting for project progression and monthly department meetings, we have digital mindset and aware of digital transformation, the change for good in the future as one of the leading healthcare institutions.
Desire; I think we have a strong corporate culture and with the good awareness and very supportive team, most of us seem to desire to use it and work through it together.
Knowledge; At the beginning of usage, the IT team provide the software introduction session for the users.
Ability; Then at the time we hand on using the software, the IT team was around to help. Fortunately, probably half of users in every department are still young and open-minded for IT. These group members are fast IT learner and handle the software very well and they can also support the senior one at the moment until we are all familiar to use this software.
Reinforcement; During the implementation, they keep improving the software and take the comment from users for adjustment the software interface and also give overall feedback of usage to the department.-
2022-10-12 at 2:09 pm #38656Siriphak PongthaiParticipant
What you have mentioned in awareness is good to know. The leaders have so much potential in encouraging others for changes. Yet, by having an opened mind people could make the change smoothly.
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2022-10-12 at 5:06 am #38643Hazem AbouelfetouhParticipant
In my project example in topic 1, the Drug Stock Management System. According to ADKAR model, The awareness of the change to a better tracking system and benefits were clear for hospital staff but not for patients. Not all hospital staff had the desire to change the old paper-based system, especially those who didn’t want to use a computer and login into a system instead of adding data to a paper form. Many training and meeting were conducted for all staff to have the required knowledge to use the new system effectively. The ability to implement the change increased over time. Regarding the reinforcement, It took a long time to sustain the change than expected. Overall, the organization managed to implement the change but many improvements were needed.
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2022-10-12 at 1:58 pm #38655Siriphak PongthaiParticipant
A computerized provider order entry (CPOE) for chemotherapy/biotherapy regimen, that was implemented in my department, is successful.
I think the organization has appropriately managed the change. By following ADKAR model:– Awareness: Every healthcare providers related know why we need change. This is because we need to minimize medication errors. Therefore, those involved are aware of the change.
– Desire: There is a group of physicians desire to use the system but some of them still prefer in writing an order. Therefore, we really motivated them in using the new system.
– Knowledge: By implementing the system, we have provided knowledge on how to use the software appropriately. Yet, we run on a simulation training to let them perform on their own.
– Ability: The system seems complicated for someone. However, we informed them that we are available if they need one-on-one assistance on how to use the software. In addition, we told them that we are standby for any IT troubleshoot.
– Reinforcement: We have always been encouraging them on using the CPOE. By doing this, a group of physicians, who first desire to use the system, also encourage another group to start using the system. Moreover, we have always been updating chemotherapy regimens per NCCN guideline to have an up to date data available on the program.
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2022-10-12 at 8:30 pm #38673Kansiri ApinantanakulParticipant
Thank you for sharing ka.
Your project is very interesting.
It’s very impressive that the system is up to date per NCCN guideline.
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2022-10-12 at 8:26 pm #38672Kansiri ApinantanakulParticipant
Please allow me to use the same example from previous post which is the mobile application for monitoring visit report (MVR) writing.
The user is all CRA in my organization.
In my point of view, the change has been managed well. This project is successful and well-maintained.
Considering ADKAR model,
Awareness: All CRA are aware of the need for change or subsequent updates of the application. This application is designed to simplify the MVR writing and ensure the GCP compliance.Desire: In every update, some of CRA might not be happy with the new patch to be lunched. However, the training program/communication has been provided to ensure everyone is on the same page.
Knowledge: Every new patch lunch would accompany both online and F2F training to ensure the user understanding.
Ability: Not only training for each new patch provided, but also the workshop and refresher training to enhance user ability
Reinforcement: The leadership team support the implementation for the application and keep the clear message for the intention
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2022-10-12 at 11:04 pm #38683SIPPAPAS WANGSRIParticipant
I’ll use the project from previous topic, an iSuandok system.
Awareness — During the COVID-19 pandemic, a social distancing measure was encouraged. This system has allowed patients to appoint and receive notifications about their treatment process starting from appointing to medication delivery. Thus, this system has used this issue as an advantage to raise awareness of reduction in social contact as their strength.
Desire — People often want to shorten their time spending in a hospital. Having a system which help them throughout the hospital visit process really saves them a lot of time.
Knowledge — The system is easy to use and user friendly. There are always user manual guide and tooltips provided every where in the application.
Ability — similar to the knowledge section
Reinforcement — this application receives feedback from users and now this system also extends to employees as well. It is integrated to a new EMR system, enabling authorised health care staffs to perform simple tasks such as managing appointments.
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2022-10-16 at 7:17 am #38713SaranathKeymaster
Great! Thank you all for sharing.
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2022-10-24 at 3:43 pm #38827Tanatorn TilkanontParticipant
Please refers to the previous post for the implementation of the change from paper-based records of medication errors to electronic records of medication errors.
I think the change was managed properly, considering ADKAR model as the following details.
Aware: In order to manage the change of this workflow in the project, users have taken problems of using paper-based documentation of medication errors into their consideration. These include slow and time-consuming workflow, and difficulty of handwriting interpretation. Users and stakeholders are aware of the change to improve these into more streamlined, fast, and less-time consuming workflow.
Desire: The stakeholders and administrators of the organization support collaborative work on this project among IT Team and users of the system, most of them are pharmacist.
Knowledge: By collaboratively work with the project, IT Team and pharmacist integrate knowledges of system design into the workflow. Analyze the bottle-neck and issue in the current workflow, then develop solutions.
Ability: Annual training and hands-on session of the system was planned.
Reinforcement: By providing great user experience of the system, it can provide sustainability to the system usage. Also, feedbacks are continuously collecting to improve experience, ease of use, and providing support system.
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