The How of Change | Queen's University IRC

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The How of Change

Dr. Carol A. Beatty, Queen's University IRC
Publication date: September, 2015
The How of Change Management

After you know who will lead a change initiative, why the change is necessary and what future you are trying to create, you come to the “how”—the activities you must plan to implement the change successfully. This is tough work because of the countless details that must be thought through and included in a change rollout plan. Forget something crucial here, and your change may be in jeopardy, as is highlighted in the following case study.

Case Study: Bad Form? The Introduction of a New Client Assessment Technology

To policymakers at the Ontario Ministry of Health and Long-Term Care (MOHLTC), introducing a common computerized form to assess people for long-term health care services must have seemed relatively straightforward. After all, there was widespread agreement about the need for a tool to standardize case management and assessment practices and to promote information-sharing as a way of reducing inefficiencies, duplication and regional disparities.

Further, homecare workers had become experts at managing change: Since Ontario’s Community Care Access Centres (CCACs) were created in 1995, employees had weathered years of ongoing public reforms, culminating in the Community Care Access Corporations Act.

The Act, passed in December 2001, radically altered the focus and administration of community healthcare services. When the first wave of reforms began to flow out of the new law in April 2002, the Resident Assessment Instrument–Home Care (RAI-HC) tool was among them. The MOHLTC, expecting smooth sailing and that CCACs would easily adapt, decided that within the year all case managers would be using the new tool to assess their clients for long-term care health services.

To Ontario’s CCAC managers and employees—practised navigators of change—however, this prospect was overwhelming. For one thing, the RAI-HC was supposed to allow case managers with laptops to conduct interviews in clients’ homes and enter information about their needs for homecare and long-term care services directly into computerized forms. But case managers, with an average age of forty-five and minimal computer skills, were daunted by laptops, the complex forms and special client software. “How, within six months, are we to be confidently interviewing people by their bedsides and keying the information into the two hundred and fifty fields of the form using a laptop?” they wondered. They could picture ailing clients enduring needlessly long consultations, they became anxious about job security because they didn’t have the required computer skills, and they got more and more dispirited. They felt they’d been given no opportunity to participate in planning for change and would be blamed for a mess mandated from above when things didn’t work out.

>> This paper is one chapter from Dr. Carol A. Beatty’s e-book, The Easy, Hard & Tough Work of Managing Change. The complete e-book is now available on our website at no charge: Download