creating and sustaining the cultural transformation
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Creating And Sustaining The Cultural Transformation
Robert V Berry
VP Strategic Improvement
Premier Health Partners
(937)208-2182
rvberry@shp-dayton.org
© Copyright 2005
March 3, 2005 Creating and Sustaining The Cultural Transformation © Copyright 2005 2
Premier Health Partners
>10,000 employees Largest non-governmental employer
in Dayton Multiple ambulatory care, home
care, and extended care facilities
Founded in 1932560 licensed beds
Level 2 Trauma
Good Samaritan Hospital
Founded in 1917310 licensed beds
Level 3 Trauma
Middletown Regional Hospital
Founded in 1890850 licensed beds
Level 1 Trauma
Miami Valley Hospital
March 3, 2005 Creating and Sustaining The Cultural Transformation © Copyright 2005 3
PHP Process Improvement Evolution
Merging of Teams into single PHP DivisionAdoption of SI Methodology using multiple methodologies
2001
2002
2003
2004
2005
Project successes Project successesMild collaboration Mild collaboration
Good Samaritan Miami Valleyadopts Six Sigma adopts Lean
Premier Health Partners decision to address“Strategic Improvement”
Merger with Middletown Regional(more to come)
March 3, 2005 Creating and Sustaining The Cultural Transformation © Copyright 2005 4
What Was I Thinking?
Knowing the right solution is easy…
Implementing the right solution is tough…
Transforming organizational culture
differentiates…
March 3, 2005 Creating and Sustaining The Cultural Transformation © Copyright 2005 5
Team Building On a Grand Scale
Dr Bruce Tuckman’sTeam Development Model
FormingPerforming
Norming Storming
1
23
4
Introducing a major new initiative is like introducing a
new individual to an already performing team…
Corporate dynamics change
Adoption is not guaranteed
Find your niche
Forming
“The Honeymoon”
Symptoms: No one knows your name Lack of sleep Everyone around you in “wait and see” mode
March 3, 2005 Creating and Sustaining The Cultural Transformation © Copyright 2005 7
One Chance To Make A First Impression
Why?
What?
Where?
Who?
When?
How?
Burning platform, or opportunistic vision
Selection of methodology
Global or local roll-out
Departmental structure Employee practitioners or consultants
Sprint or marathon (all at once, or slowly over time)
Outsourced projects or internal learning (or both) High or low profile
Storming
“Surviving Corporate Evolution”
Symptoms: You are “pushing” projects Fighting for credibility Excessive politics No relief from deliverables
March 3, 2005 Creating and Sustaining The Cultural Transformation © Copyright 2005 9
The “Discomfort Zone”
Intra-Departmental
• “I feel stupid” Best of the best go from being ‘A’
students to being ‘D’ students
• Nurture and recruit for key competencies/synergies Customer focus Action Oriented Learning on the fly Diversity
• Methodology confusion, misinterpretation, misuse
• Perception of floating Vision, Mission, and Goals
Inter-Departmental
• Turf Wars Quality, Mgmt Engineering, Decision
Support, Finance, Nursing, Operations, Consultants…
Who did I miss?
• Key assumptions dissolve Data availability/integrity Stakeholder buy-in Stable processes Alignment of goals
• Your presence signals their incompetence (in their mind)
• Your role Quality, cost, satisfaction,
consultant???
Norming
“Finding A Rhythm”
Symptoms: You are invited to meetings again Your team can tackle most projects without you
March 3, 2005 Creating and Sustaining The Cultural Transformation © Copyright 2005 11
Sustainability = f (Integration)
Integrate into existing business processes, systems, and structures (or build new ones)
Short/Medium Term
Operational and capital budgets Committee representation (FTE, Quality, Safety, Budget, etc) Tactical management: operations and policy meetings Link to HR systems (incentive programs, staffing) Befriend IT, Sourcing, Decision Support, Finance Plug into Balanced Scorecard process (or equivalent)
Long Term
Career path for incoming and outgoing practitioners Decentralization of expertise/competency
Performing
“Like That Will Ever Happen…”
Symptoms: Resources are being “pulled” into projects Common language throughout organization Speed and Results - Simultaneously
March 3, 2005 Creating and Sustaining The Cultural Transformation © Copyright 2005 13
PHP SI Philosophy
ProcessProcess
Y = f (X)
Customers Suppliers
Outputs Inputs
Key process attributes to consider:
Valuable? CNM, VOC, FMEA, etc…
Capable? Six Sigma (DOE, defects)
Adequate? Theory of Constraints, Workload Balance
Available? Total Productive Maintenance
Efficient? Lean (waste, speed, inventory)
All efforts follow DMAIC methodology
Lessons Learning
“Had I Only Known Then…”
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Do’s and Don’ts
Forming
Do• Obtain executive support (fanatic
preferred) Results help solidify
• Develop project pipeline
• Internal knowledge transfer
• Thought consulting (favors)
• Teach
• Learn
• Communication strategy aimed at information sharing
Don’t• Overachieve
• Over commit
• Over sell
• Preach
• Make others look bad
• Worry – just correct mistakes quickly
March 3, 2005 Creating and Sustaining The Cultural Transformation © Copyright 2005 16
Do’s and Don’ts
Storming
Do• Stick to the data/facts
• Listen to your client (the Sponsor)
• Low public profile / High private profile
• Pre-coach sponsors
Don’t• Get involved in politics
• Hog the glory (all you need is the assist)
• Engage in public conflict resolution
March 3, 2005 Creating and Sustaining The Cultural Transformation © Copyright 2005 17
Do’s and Don’ts
Norming
Do• Establish stable internal
processes Project management Project database Financial accounting rules Review schedule
• Celebrate wins
• Adjust to the environment (corporate strategy)
Don’t• Be inflexible
• Assume there is only one right answer
• Be lulled to sleep
March 3, 2005 Creating and Sustaining The Cultural Transformation © Copyright 2005 18
Do’s and Don’ts
Performing
Do• Customize your program to suit
your organization
• Competency diffusion
• Conduct process improvement on yourself
• Expose and promote your talent
Don’t• Ever assume you are performing
March 3, 2005 Creating and Sustaining The Cultural Transformation © Copyright 2005 19
What Was I Thinking?Transforming
organizational culture differentiates…
Build an organizationally integrated program that is:
ValuableCapableAdequateAvailableEfficient
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