Recently at work, under the direction of a new manager, my fellow Healthcare Reps and I, have been challenged to help our organization by streamlining data to the next department by uploading verifications received. By streamlining data, we (the Wellstar team) are able to show our company that streamlining data can help us to get results (payment) to our customers faster. While the overall goal is to bring the average time for payment for services to our customer from 3 years to 1 year, we have recently been celebrating a few short-term wins along the way. These short-term wins were very important as we had a few Healthcare Reps that were against uploading documents as this had never been a part of the job duties prior to this and to them, it felt like extra work that they wouldn’t have time for. A few weeks ago, one of my co-workers began complaining about having to upload several documents into an account due to the time it would take. I showed her an easier and faster way to do it. After doing so, she notified a member of the next department (at our corporate office in Atlanta) that all of the documents had been uploaded successfully. The team member at corporate responded with great enthusiasm as this cut out a large portion of waiting and she could forward the documents to SSA immediately. In order for you to understand this short-term win, normally when we receive verifications from patients or need to send in medical records or bills, it takes over one week to get to the corporate office, another 2 days to be uploaded into the system, and then finally is forwarded on to the appropriate agency. This new ability we have in uploading may take extra effort and time on our part, but hearing the appreciation from the next department and later, hearing that the patient is approved within months as opposed to years, makes it all worth it (Kotter, 2012). Prior to my new manager starting, my old manager never mentioned that we had the capability of uploading documents on our own. A mid-point victory for her that was not leveraged correctly was that we were encouraged to reach out to the patient, get verifications piece by piece, send them in by mail or courier piece by piece to corporate, and never really celebrated anything in between all of the effort we’d put into getting a patient approved than when they actually were approved (which at times was around a year later than when the initial application was taken). This new manager seems to be using all 6 ways to show that short-term performance improvements are helping the overall transition of streamlining data. She provides evidence to us that patients are getting approved faster, she often rewards us with pats on the back by telling our Director or other higher-ups with our customer that what we are doing is working better and sometimes we receive small thank-you’s such as gift cards or lunch. She is constantly asking us for feedback and helps fine-tune our overall vision and strategies, we undermine the cynics (I am on board) as the workers who were first resistent are now on board. She keeps the bosses on board and continues to build momentum (Kotter, 2012). Our in-house competitor is on their way out the door because we are doing what we do better than ever before, so our short-term wins are showing all over our hospitals right now and it’s awesome.
Change Initiatives at Work I have been fortunate enough to be a part of medicine when all it is is change. I have been a manager for the past five years at the same company and have initiated and been a part of many changes. Recently, the hospital I work for merged with several other hospitals to create a hospital system. I was asked to lead a “use case” for PA/NP’s in the organization overall to help create structure, stability, and organization to the providers that have been overlooked for their talents for a long time. Through this endeavor I am learning how to take something that is so large and break it into smaller components. I am also learning how to identify a small win. Sounds funny, but things that others think are accomplishments or wins I would never consider before to be such. Short Term Wins Short term win in my work change initiative has been what I would have considered “soft calls” in the past. Now, through Kotter and the process I am going through at work, I can see the purpose of identifying the win so that there can be engagement and momentum to continue the journey (Kotter, 2012). Our first short term win came in the way of the groups we were able to bring together. They are so diverse and they identified that they would rather unite and work together to be one voice. That is an accomplishment that I may have underestimated or overlooked in the past. With the vision of this small success brought to the surface and identified, the group can move forward knowing that this is a behavior that is now expected and set as standard. The small wins can work to set the tone for the rest of the project along the way and develop a culture for those involved. Short term win celebrations We were (and still are) behind on the Medicare Metric of Recommend our Hospital (cms.com). There were some people who formed a patient experience team and formed competitions between departments in the hospital to get their scores higher. Every month when the scores came out they would publish them and they would have a celebration on the unit that won. A banner would be placed on the unit for one month. There became some great momentum to steal the banner from the winning unit month after month. The small wins helped keep everyone engaged in the endeavor and the scores kept climbing. Not enough longer-term victories Unfortunately, just like described in Kotter, there was not enough momentum and buy in over the long term to support the culture change and the scores began to fall again. There was a major lay off in the middle of the initiative that created unease and discontent. The unions that were formed had broken and any victories were lost and regression occurred. The “dysfunctional granite wall” was not able to be broken though since momentum was lost too early (Kotter, 2012).