This article grew from decades spent observing system change efforts in human service agencies, first as a systems consultant with the Human Services Research Institute (Cambridge, MA) and, subsequently, as the director of operations with an information systems company, Danic Technology (Needham, MA). These observations were tilled as much from failure as from success. Change management is not easy. This perspective discusses change management within the confines of an organization rather than across multiple organizations. Its focus is on proactively managing the people side of organizational change, about getting individuals to do things differently: for example, moving from competency-based assessment scales to supports intensity scales; from professionally driven individual plans to consumer-driven plans of support; from paper-based to electronic forms of documentation, reporting, and billing; and from minimum standards compliance to total quality management.
The observations, although consistent with abiding theories of individual behavior and organizational development (Argyris & Schön, 1996; Beckhard, 1969; Christensen, Clayton, Marx, 2006; Edmondson & Moingeon, 1999; Miner, 2005; Senge, Kleiner, Roberts, Ross, Roth, & Smith, 1999; Weisbord, 2004) tend to the specific and are far from comprehensive. The focus is on system change strategies and tactics that I have found particularly appropriate for human service agencies and workforces.
This perspective focuses on three prerequisites for the success of any system change effort: (a) the leadership and management necessary to implement and sustain the change, (b) the positive engagement of the parties responsible for implementing the change, and (c) the level of understanding and knowledge among these parties sufficient to implement the change effectively.
Leadership and Management
Change is led from the top down and implemented from the bottom up. No matter where the seed for change germinates, if it is to succeed, it must be led by top management. Top management's understanding of, and commitment to, the change must be evident to all involved. How would you say the prospects look for the undertaking described by this contributor to a system change blog?
I am really struggling to get people on board. I have presentations to show top-level management but they don't have the time to look at them. The managing director is well into the idea but lacks all knowledge on this. I really feel like I am wasting my time. Has anyone else had this problem? How did you get the people on board? (managementlogs.com, 2007)
Actions speak louder than words. Announcements, directives, and other communications from top management are important to give voice to management's commitment, keep everyone informed, and keep the project visible. However, there is no better way to evidence that commitment than by appointing a respected and competent team to spearhead the effort. The team should be made up of “change agents” identified from the ranks of those responsible for actually making the change. Laying the foundation for the ownership of the change among those playing a central part in the change is critical.
One common mistake I see is to have project teams overrepresented by quality managers, trainers, system analysts, accountants, personnel directors, and other “back room” staff, when most of the work involved in making the change is to fall on case managers and vocational, residential, and other front-line workers. If the workload is to rest with the front-line workers, they must own and manage it. This is particularly true in the case of information system change. Too often, top management looks to information technology (IT) staff to carry the change without recognizing the need for a properly represented project team. This leads to the IT staff being viewed as the system owners; it hinders buy-in by front-line staff. Top management must avoid the sentiment in this quote from a case manager in a regional planning agency involved in changing their individual assessment system: “It's their system, not ours; they're not doing us any favors” (Human Services Research Institute, 2007).
The problem, of course, can be freeing the time of front-line workers. Direct-care workers in human service agencies are typically stretched. What I have seen work is dividing the project team into many subteams, each represented by different sets of workers and each responsible for particular parts of the change. This serves to spread the workload involved in the change and build participation at the same time. It works best when there are enough committed change agents to populate these subgroups and assure progress. Where there are not enough change agents to carry the agency-wide or where the consensus for change is not agency-wide, piloting the change in part(s) of the agency where change agents can be found is a practical tact. Pilots have the added advantage of being more manageable and, once done, provide proof that the change indeed can be made to work.
Members of the project team should carry the respect of their fellow workers, have the ability to do what is expected to promote the change, and be willing to champion it. The reality is that some changes, although necessary, engender scant support from those who must implement them. Where this is the case, resourceful agencies have successfully held out career advancement, recognition, and even monetary rewards as incentives.
It is particularly important to monitor the system change process. “People do what you inspect, not what you expect” (Benton, 2002, p. 4. All too often, executives do a good job of communicating a strong sense of urgency for the change, persuading most concerned to at least go along, if not embrace it. However, soon their attention shifts to other priorities and, before they know it, the level of enthusiasm wanes and with it the rate of progress. Top management must continue to promote the change as long as it takes for it to become established. They need to monitor progress continually.
Every system change effort must be guided by a plan with a set of key checkpoints by which to gauge progress. Including some visible checkpoints that mark early successes is advisable; it helps build momentum and can encourage those sitting on the sidelines to join in. The team leader should be expected to report on active checkpoints for the life of the project, indicating the degree to which each has been achieved and noting related obstacles to be addressed.
I am surprised by the number of change efforts that occur where there is no plan; almost always, such change initiatives are slow and often lose direction. In my experience, implementation delays, certainly to the extent that they occur without reasonable cause and explanation, tend to be taken as a sign that the change has lost its urgency or importance. After this happens, it can be twice as hard to regain momentum.
Successful change requires the constructive engagement of those involved. They must be aware of why the change is necessary and what is involved, and they need to have the desire to participate and support it. This does not just happen; it must be made to happen. One of the most successful ways to begin the process of engagement are participative planning sessions conducted by a competent facilitator, sessions in which stakeholders work together to define the purpose and scope of the change, explore its implications, and identify any hurdles. Depending on the nature of the change, the purpose might take the form of vision statements, goals, objectives, or high-level system requirements.
Nearly all human service agency executives ascribe to a participative rather than authoritative style of management; that is, they commonly seek the reactions of employees to contemplated changes. This may say something about the collaborative nature of most people in the field or the need to show staff, many of whom are underpaid and overworked, how much they are appreciated and valued. Regardless, it is an effective style for engineering change because it views staff as partners in the change and recognizes the need to share with them the reasons why the change must be made and its implications. Though such participation can hardly be expected to win support where there is no particular dissatisfaction with how things are now and where the change will be difficult for many involved, it may at least lead them to go along rather than resist.
It is particularly important that the reasons, objectives, and implications are clear and comprehensive. The common pattern I see is for management to emphasize a few of the “strongest” selling points to keep the thrust of the message strong and comprehendible. However, the more reasons that can be advanced, the more likely it is that you will hit on those reasons that resonate with additional staff. As an example, it has been gratifying to see, in the developmental disabilities field in particular, the many positive changes introduced over the years to empower consumers and families. However, efforts to introduce related changes in planning and support provision at the provider level are often pinned exclusively to lofty principles and delivered with a religious-like zeal. Although high-minded principles are enough for some, others are more attuned to practical benefits, the improvement in family attitudes, and the ability to identify more fitting supports.
“All it amounts to is more work; there's nothing in it for us” (Human Services Research Institute, 2007, p. 14). Staff are always concerned about the impact the change might have on them; these impacts must be anticipated and addressed. Uncertainty breeds resistance. Staff wonder, “How will it affect my earnings, career advancement, flexibility, authority, workload?” Of these, workload is the most prevalent concern and source of resistance by far and certainly legitimate. Human service agency staff are heavily taxed. Most changes, be they related to new data, program, or business processes, typically involve more of their time, at least during the learning process. If a new system or procedure will take time from other staff activities, even after the learning process, this should be acknowledged and some effort should be made to identify where this time might be found. If experience has shown that the changed process will not take more time or even take less time after staff become practiced, this experience should be clearly referenced.
“My job is caring for clients, not filling out forms” (Human Services Research Institute, 2005). One of the more common sources of resistance among front-line (operational) staff, certainly in the case of new information or administrative systems, is the effort required to learn and use the new or changed system. Human service workers typically begrudge, even resent, the time spent on the administrative aspects of their job. They see it as time away from consumers and as detracting from their usefulness, their value to those served. The sentiment is “don't make me think about the administrative details tangential to my job.” System change leaders should look for whatever steps might be taken to simplify or reduce such down time. In the case of information systems, if the entry or retrieval of data is complex and/or staff turnover is high, help menus and, even better, built-in wizards are musts to help users through. Absent such, postcard-sized reference notes located next to PCs can be useful.
Knowledge and Understanding
The desire or willingness to make the change is not always enough. Parties to the change must know how to go about it and have the requisite knowledge and skills to do so. Administrative tasks can be simplified but only so much. Help menus and software wizards can be developed to help users through automated data processing tasks but only so far. Training is usually a must. There are an abundance of how-to references on the organization and conduct of training, but few focus on the human aspects of the equation generally and on human service workers specifically.
The training suggestions below are geared to human service workers and are particularly important in the instruction of administrative and software systems of any complexity. They are predicated on a general observation—that most human service workers are right-brain thinkers (Sousa, 1995)— that is, more intuitive, holistic, subjective, and nonanalytical in their thinking. This, as opposed to left-brain thinkers, who are more logical, objective, sequential, and analytical. Right-brain thinkers learn differently, and the training should be attuned to their learning style. Do not worry about losing the left-brain thinkers in the process; they may be a little bored, but you will not lose them. There are two hard rules for productive right-brain engagement:
Start with the big picture. Right brains are looking for context, for something to anchor their thinking. Launching right into the details to be learned will not bring the task into focus for many of them; their minds will be left to wander. They will start behind and may never catch up. Diagrams and flow charts can be valuable aids in helping them understand how everything fits together, how the process works, where and what they are being taught fits in. Make sure to not drag it out.
Show and explain, but avoid doing. Demonstrating the process is a good way for right-brain thinkers to understand what is entailed, and explaining rather than simply presenting the steps involved helps solidify the process in their minds. However, unlike left-brain individuals, who can take quickly to detail and remember it, right-brained people need to actually do the task, or one cannot be sure that they will be able to implement it after training. Although they may profess to understand what is to be done and how, they really do not know that they can do it until they've tried. As a right-brained person, I know!
The bottom-line is that the training must involve the individuals actually performing the work involved, with some form of monitoring or testing conducted to ensure that it is done correctly. This can extend the time required to complete the training and tax the resources involved. One technological solution is to construct online training sessions with built-in tests to assure that trainees have mastered the process. Where live training is necessary, one can expand the reach of the instructor(s) by pairing slower trainees (quickly recognizable) with faster (“helper”) trainees during the hands-on segments of the training. If there is any lag in the implementation of the change and the training, this sort of pairing may need to continue after the session(s) to be sure the trainees have retained their new knowledge. However tempting, do not do it for them, or you might find yourself doing it for them for a long time to come.
There is no doubt that managing system change of any magnitude is difficult. The scarce resources and high turnover plaguing many human service agencies make change challenging. Nonetheless, I have witnessed many successful change efforts and trace much of the success to the “do's” and “don'ts” conveyed in this article. I hope the points made are enough to bring you success in your system change endeavors.
Author: John Ashbaugh, MBA (Jashbaugh@danic.com), Danic Technology, 95 Warren St., Needham, MA 02492