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Introduction to the Organizational Change Manager (OCM) National QUERI Meeting December 12, 2008

Introduction to the Organizational Change Manager (OCM) National QUERI Meeting December 12, 2008 Carmen Hall, RN, PhD Implementation Research Coordinator PT/BRI QUERI. Adapted with permission from Harold J. Steudel Ph.D. Emerson Electric Professor in Total Quality

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Introduction to the Organizational Change Manager (OCM) National QUERI Meeting December 12, 2008

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  1. Introduction to the Organizational Change Manager (OCM) National QUERI Meeting December 12, 2008 Carmen Hall, RN, PhD Implementation Research Coordinator PT/BRI QUERI Adapted with permission from Harold J. Steudel Ph.D. Emerson Electric Professor in Total Quality Department of Industrial and Systems Engineering UW-Madison

  2. Basic Tenets of Improvement • Every system is perfectly designed to achieve the results they achieve. • To change the results, the systems must be redesigned ---changed--- improved

  3. OCM Research Model: The Four Phases of Change Initiatives 1. ProjectStart 4. Solution Implementation & Testing 2. Problem Exploration Successful Change No 3. Solution Development SolutionPlan Modify?

  4. Purpose and Uses of the OCM • Predicts & explains success of projects & organizational readiness to change • Output: forecast, explanation, actions • 15 Factors (four questions per factor).

  5. Start 1 Project launch 2 Project champion 3 Senior leader support Problem exploration 4 Middle Mgr. support 5 Staff needs & support 6 Tension for change 7 Problem exploration 8 External influence Solution development 9 Relative advantages 10 Funding 11 Flexibility of design Implementation & testing 12 Implement plan complexity 13 Staff changes required 14 Work environment 15 Testing & refinement The 15 Factors in the OCM

  6. When is the OCM most often used? • Project Analysis • At the Start • While Underway • After a Project Concludes • Points beyond

  7. How is the OCM most often used? • Organizational Analysis • Describe the Propensity to Changebased on past experiences

  8. 4 3 2 1 0 OCM Score Selection Prob Exp Soln Dev Implement -1 -2 -3 -4 Track OCM Score Changes over Time

  9. Integrative Group Process Factor selection • Propose outcome definition • Select group of experts • Construct initial straw model (phone) • Revise straw model---retreat setting • Profiles to finalize model factors --- retreat

  10. Integrative Group Process Model quantification • Assure factors are independent • Assign likelihood odd ratios to model factors– retreat setting • Identify sources of inconsistency in likelihood odd ratios ---retreat • Finalize likelihood odd ratios for the model– retreat • Assign a priori odds for model -- retreat Molfenter T. Prospective evaluation of a Bayesian Model to predict organizational change. Health Care Management 2005, 30 (3)

  11. OCM Development • Fifteen factors identified by various experts in change management. • Subjective Bayesian Model based upon the state of the 15 factors in an organization: • Predicts likelihood of success of projects • Explains organizational readiness to change. • Research-based; tested in > 500 projects. • Predictive accuracy determined.

  12. What does the OCM predict?What is success?

  13. Prediction of Propensity for Successful Change Very High Very High Success High High Chance of Project Success or Failure Medium Failure Low Low Very Low Very Low -5 -3 -1 0 1 3 5 10 -10 OCM Predictor Score

  14. Introduction to The OCM Scoring Guide Factor Yes No Project Start You and the Senior Leadership Team: 1a. Carefully selected the project 1b. Provided a very clear aim for the project 1c. Indicated that not changing is unacceptable and set a firm deadline 1d. Designated a champion(s) to make the project succeed Project Launch Project champion: 2a. Is very committed to making this project successful 2b. Has substantial power to make things happen 2c. Has substantial prestige in the organization 2d. Shows respect for the involved staff Project Champion Linkage and CommunicationSenior LeadershipLevel 3a. The project, if successful, will help the organization meet corporate goals 3b. Mechanisms have been developed to keep leaders informed and involved 3c. Leaders have endorsed the project in visible ways 3d. Leaders have committed to spend their time & resources to remove obstacles when they arise in the project

  15. Using the OCM Scoring Guide • Most common approach • Each team member completes their OCM Scoring Guide individually to score each of the factors • Requires 15-20 minutes to complete after introduction • All data are then entered into the OCM Program • Alternate • Teams talk about each factor together to come to consensus; • Yields one final answer (yes or no) for each of the factors to enter into the OCM Program; • Requires about 60 – 90 minutes to complete as a group

  16. The OCM Predictor Score: • Ranges in value from -10 to +10. • Portrays chances of project success • Failure increases as the score approaches -10. • Success increases as the score approaches +10. For example: A score of +7 means projects with this score succeed 7 times more frequently than they fail. A score of -8 means projects with this score fail 8 times more frequently than they succeed.

  17. Using the OCM Program (software) • Provides the OCM Scores (Process and Cultural Changes) and the Graphical Results:

  18. Next Steps • Feasibility & utility in VA implementation projects • Collaborate with developers to address limitations • Use and refine model

  19. For more information contact: carmen.hall@va.govPermission to use OCM within the VA has been provided by its developers, David H. Gustafson, PhD and Harold J. Steudel, PhD. Their collaboration and generosity are greatly appreciated.

  20. OCM References… Gustafson, Edwards and Phillips "Subjective Probabilities in Medical Diagnosis," IEEE Trans on Man-Machine Sys 10( 3), Sept 1969. Gustafson, Greist, Kestly and Jensen, "Initial Evaluation of Subjective Bayesian Diagnostic System," Health Services Research, Fall, 1971. Gustafson, Cats-Baril & Alemi (1992) Systems to Support Health Policy Analysis, Health Administration Press. Gustafson, Sainfort, Johnson, Sateia, et al, “The Construction, Reliability, Validity, Application and Impact of a Quality Index for Psychiatric Emergency”, Health Services Research 28(2), 1993.

  21. OCM References(continued) Gustafson D., Sainfort F., Eichler M., Adams L., Bisognano M., and Steudel H., The Developing and Testing a Model to Predict Outcomes of Organizational Change" Health Services Research, 38(2) 2003. Olsson J. “Factors Of Importance For Understanding Successful Improvement Initiatives In Swedish Health Care”[Tec Lic].Göteborg, Sweden. Quality Sciences, Chalmers Institute of Technology;2002. Olsson J. Øvretveit J. Kammerlind P. Developing And Testing A Model To Predict Outcomes Of Organizational Change. Quality Management in Health Care 12 (4) 2003.

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