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  • Part 3 – Holistic Deployment Readiness & Healthcare.gov: What not to do



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    February 18th, 2014

    This is the third post in our multi-post series on holistic deployment readiness and Healthcare.gov.  To read the previous entry, please click this link.

    Process Readiness:

    Process ReadinessIn many ways, Process Readiness is the most surreptitious risk to manage when preparing for a major deployment or change.   Core project readiness is inside the typical Project Manager’s core scope of focus, and if you are willing to listen, stakeholders are generally quite good at sharing their People Readiness Concerns.   Long term ownership teams are often in place to address sustainability with transition plans (although certainly not always!). 

     

     

     

    Process becomes the most dangerous to a project when the words “end-to-end” become involved.  For example, I was involved in the implementation of a new warehouse management system.  Our team had a core focus on process and documented the key changes to their business processes.  This would include how they are putting away inventory, picking, packing, and shipping to their customers.  The team was not, however, interested in documenting processes with external touchpoints.  When we went live with the system, we had not documented how the scanning process would change for the third party logistics partners that they used.  This caused significant delays in processing inventory, over allocations of existing inventory, and increased costs due to shipping delays. 

    See the Whole PictureThis example shows the importance of shining as bright a light as possible on all the touchpoints to your system that you can find.  What reports are people getting out of the old system? Which customers and vendors are involved? Will their needs be supported by the system?  What changes are they willing to make, and which ones aren’t they willing to make?  Do your processes look different during the first phase of deployment vs. the long term solution?  How are you training your team to support these changes?  All of these questions need to be answered to successfully manage process during a major deployment.

    Looking at the Healthcare.gov rollout, we can see several process shortfalls.   First amongst them is the great deal of confusion about enrollment procedures. The process variation (14 states utilizing their own exchanges, 36 using Healthcare.gov) added significant complexity and should have required more outreach to end users.  Additionally, when the technical hurdles and issues with the website were identified, the go-to-manual procedures were inaccessible or not understood by the majority of potential users.  The data integrity issues on the 834 files sent to insurers also points to a lack of complete end-to-end process understanding.

    People Readiness:

    People ReadinessExpectations management is the first and most important principle of getting people ready for a change.  If you cannot align the expectations of your stakeholders with what will be provided, or if your stakeholders don’t believe you can deliver what you promise, then the battle is already lost.

     

     

     

     

     

    It’s tough to find a better example of expectations management then this, “If you like your plan, you can keep it”.  This message was communicated thoroughly and an expectation was established that the project team would meet this commitment.  There are a variety of reasons that this has become an issue.  Some say it is due to insurers reducing paperwork by creating a new equivalent plan rather than modifying the existing ones, others say that the regulations are merely eliminating plans that don’t provide any significant coverage, or that was simply a broken promise.  Regardless of the cause we now get to see several recovery strategies:

    · Clarification:  Sometimes you can get away with this one.  I spoke wrong, what we meant was, in practice.  This strategy has a better chance of succeeding with minor gaps or when the team has a high level of credibility based upon previous successes.

    4A's· Mea Culpa: The next step is slightly more effective and used for bigger mix-ups.  You admit that mistakes have been made and express sympathy to the impacts caused.  People are more likely to be understanding if you can honestly admit where you have screwed up. Give your team credit for understanding the big picture, and not everyone can be a winner from every change.  If they understand why a sacrifice needs to be made, they are more likely to go along with it.  That said, without offering a solution, the effectiveness of an apology alone is admitted.

    · Alternatives, Mitigation:  The most effective approach, offering a solution or alternative to a problem.  The best of these can leave a stakeholder more satisfied then if there was a problem. 

    Example: I had booked a hotel and arrived extremely late and tired from my flight, only to find out the hotel had been oversold and I did not have a room.  Just as I was preparing to shift into irate argument mode, the hotel clerk explained that they had made a reservation and paid for a room at a competing hotel for me.  They had reversed the charge for the room I had reserved, given me 10,000 points in my loyalty program account for my troubles, and had a shuttle waiting to take me to the other hotel.  Rather than being upset, I was happy with my great fortune!  Think about this principle when crafting your mitigations and alternatives to a problem, “How can I offer an alternative that was even better then original expectations?”

    A skilled deployment manager can avoid many people readiness issues, but some cannot be prevented.  Perhaps the most common is a history of changes that have gone poorly in the past.  If the last 5 projects completed were over budget and late, you will have a tough time convincing people that your project will be on time.  To do this, you first need to identify why the previous projects struggled.  Did they lack clear objectives?  Did the scope change constantly?  Were resources insufficient or not trained?  Once you know what the previous issues were, you can then draw distinctions between past failures and your project.  Then, once you have hit a milestone, celebrate it!  Let people know that their work is appreciated and how well the project is going. 

    (Never forget, people love food. I once brought in orange creamsicles for a project team after completing an early set of process definition sessions.  The team made some jokes about feeling like they were back in school, but not one of the creamsicles was left at the end of the day!)

    Another critical aspect of deployment success is to have visible and active sponsorship from your leadership.  Leadership can set a tone for your project, both positive and negative.  It is nice if a leader comes to a kickoff meeting and gives a speech about the project, but that is a starting point to sponsorship, not an end point.  If a leader says a project is a high priority, then pulls resources off the team to attend to other tasks, it shows how the project is truly valued.  The engaged leader needs to provide resources to the project accordingly, coach people through their resistance to change, and remove roadblocks identified by the team. This engaged leadership can build a sense of inevitability around your project, that change will come whether an individual likes it or not, and makes it easier to bring people along into the future.

    Engaged leadership is not something that just happens, it must be cultivated!  A deployment manager needs to strategically assess their organization and understand which leaders will be influential to the project.  Individual action plans should be developed so that leaders know what meetings they need to attend, communications need to be sent, and which team members may need coaching.  If the leader is too busy to write a policy change memo, write it for them and have them approve it.  If they aren’t familiar with resistance management (which is often the case for mid-level supervisors who interact the most with end users of a solution) provide them training.  Take accountability for building executive sponsorship and you will be amazed with the results.

    There are countless tools, methodologies, and factors to focus on when preparing people for change (Prosci’s ADKAR methodology is a personal favorite).  But if you remember to manage expectations, establish credibility, and cultivate active sponsorship, you can address most people readiness challenges that you may face.

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    Mike Lien, PMP, is a Consulting Manager who is an expert in managing large scale process improvement projects at MSS.  To find out more about how MSS can help your organization manage major deployments and changes, contact us at info@msstech.com.

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    MLA: Lien, Mike. “Part 3 – Holistic Deployment Readiness & Healthcare.gov: What not to do.” MSS. MSS. Blog. 08 April 2015.
    APA: M Lien. (2014, Feb 18). Part 3 – Holistic Deployment Readiness & Healthcare.gov: What not to do.