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Integrating Project, Change Management and Process Improvement 

Supporting the Transformation Agenda One Step at a Time

Stephen Barbazuk, PMPBC Financial Healthcare Professionals Society Conference & AGM October 3, 2011

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Resilience

The property of a material to absorb energy when it is deformed elastically and then, upon unloading to have this energy recovered.

The positive ability of a system or company to adapt itself to the consequences of a catastrophic failure caused by power outage, a fire, a bomb or similar event.

There must be something else more meaningful to us …

Resiliency ‐My recent application

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The ability for an organization or individual to absorb the impact of a change and adapt in such a way to return to an equal or greater state of performance efficiency.

External drivers of change put internal pressure on an organization to be resilient 

Drivers of Change

Environment

MarketplaceRequirementsFor Success

BusinessImperatives

OrganizationalImperatives

CulturalImperatives

Leader & EmployeeBehaviour

Leader &Employee Mindset

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Leaders must also attend to the internal drivers and the people dynamics in order to support resilience within the organization

Drivers of Change for Healthcare

Patient safety & clinical quality The move toward digitization Demographic changes Workforce issues Financial challenges The quest for excellence

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Transformational Change

radically changes the way services are provided

alters the institution's culture by changing selected underlying assumptions 

is deep and pervasive and therefore affects the whole institution

is purposeful and occurs over time

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Quality Assurance

Quality Improvement

Process Redesign

Reengineering

REW

ARD

S

RISKS

DEVELOPMENTAL CHANGE

TRANSFORMATIONALCHANGE

TRANSITIONALCHANGE

Magnitude of Change

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CRISISMANAGEMENT

Types of Change

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SC

ALE

DURATION

Ada

ptiv

e

LongShort

Sys

tem

ic

REVOLUTION

OPPORTUNISTIC IMPROVEMENT

VISION-DIRECTED

EVOLUTION

Types of Projects

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ME

THO

DS

WE

LL D

EFI

NE

D

GOALS WELL DEFINED

NO

YESNO

YES PAINT BYNUMBERS

MAKING A MOVIE

GOING ONA QUEST

WALKING INTHE FOG

Supporting Resilience and Change with Integrated Project Management

Strategy-Mission, vision, values-Strategic plan-Resource allocation for new investments-Balanced scorecard

Bridging Strategy and Operations

Project managementProcess improvement Change management

Sustained Operations

-Continuous improvement-Strategic management

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People Processes

Structure &Technology

Transformation Support

Project Management

Process ImprovementChange Management

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Project Management

The application of knowledge, skills, tools and techniques to project activities to meet the project objectives.

Accomplished through iterative processes Project Phases & Knowledge Areas

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Project Lifecycle Phases

Formalize the need/opportunity to be addressed

Authorizing the project

Defining and refining objectives

Coordinating people and other resources

Ensuring project objectives are met

Formal acceptance of the project

Controlling

Initiation

Planning

Executing

Closing

Feasibility

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Project Lifecycle Phases “Feed” One Another

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Initiation Planning

Controlling Executing

Closing

Feasibility

Project Lifecycle Phases are not Discrete

Time

Initiation

Planning

Execution

FeasibilityControl

Closing

Leve

l of A

ctiv

ity

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PM Knowledge Areas

IntegrationManagement

Time Management

Cost Management

QualityManagement

HumanResource

Management

CommunicationManagement

RiskManagement

ProcurementManagement

ScopeManagement

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The Challenge

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Art

Science

Triple Constraint

TIMECOSTHow Much? When?

What Exactly? How Well?

PERFORMANCE(scope & quality)

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Destructive Intervention

Constructive Opportunity

Adding Value vs. Cost of Change

Initiation ExecutingPlanning ClosingOpportunity to

add value

Cost

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Processes

Structure &Technology

Process Improvement

Transformation Support

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Process Improvement 

A systematic, disciplined improvement approach that critically examines, rethinks, redesigns, and implements the redesigned processes of an organization to improve efficiency or performance

Plan‐Do‐Study‐Act (aka Deming wheel) Process Improvement techniques:

Process mapping & gap analysis Value stream mapping Lean manufacturing Operational reviews

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Process Improvement Technique:PDSA Implementation Model

What are we tryingto accomplish?

How will we know thata change is

an improvement?

What changes canwe make that will

result in an improvement?

Plan

DoStudy

Act

www.ihi.org

(1) Plan the change to be testedor implemented

(2) Execute the plan and collect data

(3) Study the data before andafter the change and reflecton what was learnt

(4) Act on what was learnt andplan the next change cycle

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A P

DS

HunchesTheories

Ideas

Changes that Result in

Improvement

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Continuous Improvement & Ongoing Iteration of Learnings

HunchesTheories

Ideas

Changes that Result in

Improvement

Gradual Rollout & Iteration

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Pilot on Small Scale

Implement on Larger Scale

Scalable to Rollout

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Eliminating waste from workflow Sources of waste:

Waiting Overproduction Rework/Repair Motion Processing Intellect Inventory Transportation

Process Improvement Technique: Lean

People Processes

Structure &Technology

Change Management

Transformation Support

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The process, tools and techniques to manage the people‐side of business change to achieve the required business outcome

Combination of various change models John Kotter, Leading Change William Bridges, Managing Transitions Andersen & Ackerman, Being First Prosci

Change Management

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Change Management

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Time

Per

form

ance

Denial

Anger

PessimismDespairSkepticism

Testing

Acceptance

Informed Optimism

Initiative Complete

Degree ofDisruption

Duration ofDisruption

CHANGEEVENT

Shifting Perspective on Change

Managed& Controlled

Us against Them

Define ChangesFor Others

Shared Vision& Game Plan

LeadershipModeling

Collaboration & Participation

Safe & Supportive

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Change Process & Management

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Enabler

What failuremay look like

WhatSuccess

may look like

Reinforcement/Sustainment

to keep thechange in place

Abilitychange

daily

Knowledgeof how tochange

Desireto participateand supportthe change

Awarenessof the needto change

ADKAR®

Phases of Change

Vision, needfor change

Benefits“WIIFM”

Skills & Behaviors

Change Support

(resources & time)

Measurement/Feedback/

Recognition/Rewards

Confusion NoInterest

Anxiety False-starts Frustration

False-finishes

Understanding Motivation Engagement CommitmentConfidence

* ADKAR is a registered trademark of Prosci www.change-management.com

Stakeholder Analysis

Who are the stakeholders?

How are the stakeholders impacted?

What reactions/issues can we anticipate with the stakeholders?

What needs to be done to move/influence/support 

the stakeholders?

HighNeutralLow

What are the stakeholders’level of current supportand level of influence?

Stakeholder Influence

Stakeh

olde

r Sup

port

Stakeh

olde

rs

Impact & Influence of StakeholdersHIGH

LOW HIGH

`Supporter

Supporter

Advocate Advocate

BystanderBystander

Bystander Resister Resister

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Stakeholder Strategies

Stakeholder Influence

Stakeh

olde

r Sup

port

SUPPORTERSCan positively affect the project• Strategy → Involve

ADVOCATESWill positively affect the project• Strategy → Partner

BYSTANDERSLeast able to influence the project• Strategy → Monitor

RESISTERSCan negatively affect the project• Strategy → Consult

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The Project Manager’s Diverse Role

Sponsor

Operational Lead

Other Stakeholders

Staff

ProjectManager

Spo

nsor

ship

R

oadm

ap

CoachingC

hang

e A

ccep

tanc

e &

Trai

ning

StakeholderManagement

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Change Management

Time

Per

form

ance

Degree ofDisruption

Duration ofDisruption

CHANGEEVENT

Understanding

Motivation

Engagement

Confidence

Commitment

Integrating Change & Project Processes

36Adapted from Prosci

Execution

Planning

Initiation

Feasibility

Close-Out

Desire Knowledge Ability ReinforcementAwareness

People Dimension

Bus

ines

s/P

roje

ct D

imen

sion

Plan

Do

Sustain

Prepare

SuccessLearn

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Thank You!

Questions?

Contactstephen@barbazuk.com604‐329‐6800

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