Define the Roles and Responsibilities of the Change Facilitators
A lot of people have gone further than they thought they could because someone else thought they could.
—Zig Ziglar
Depending upon the model and the structure that you design for the excellence journey in your organization, you need to develop job descriptions for all positions (as per the approved budget) that will be directly responsible for supporting the implementation. Whether you are redefining an existing role or creating a new position, it is good practice to first develop a broad outline of responsibilities for the position before creating a detailed job description. Create a summary in a before and after format for all positions expected to undergo change. A sample ready-reckoner template to create a responsibility change is provided in Table 7.1. Include the current job title, the number of existing positions with the current job title, the category of responsibility, and the percentage of the total available work time that the individual is expected to spend on that category of responsibility. On the right side of the template, fill in the same fields as above, but this time do so with the future state in mind. This helps in identifying overlaps and missed opportunities in the new job description created.
Table 7.1Example of a Template for Mapping Current and Future State Job Responsibilities
A real application of the above template at Hospital Heal reflecting sample job positions is shown in Table 7.2.
Table 7.2Mapping Current and Future State Job Responsibilities at Hospital Heal
Once all the adjustments have been made and the categories of responsibilities finalized, detail the activities under the respective categories to create a job description for the position.
At Hospital Heal, job descriptions were created for all individuals who were part of the centralized core team, performance management, and decentralized team of value stream coaches that supported the operational teams to implement management system elements (discussed in Chapter 16) and other improvement initiatives. Given below is a sample job description for a value stream coach developed at Hospital Heal.
PURPOSE OF THE POSITION
The value stream coach is a high-profile role for a defined period of thirty months in which the successful incumbent participates in a “graduate” program with the intent of being absorbed into a suitable operational/ administrative role within the organization once the assignment has been completed. During the initial six months of this period, the individual will receive education in lean management, lean thinking, project facilitation, project management, researching best practices, data analysis, critical incident management and audit, risk assessment and evaluation, patient/family engagement, accreditation, policy and forms, and communication management.
This individual works with the respective functional teams to support quality improvement initiatives under the philosophy of More Time to Care and in alignment with the Strategic Plan. The individual works collaboratively with the senior leadership team, physicians, psychologists, programs, and service leaders/teams among others in making successful transformational changes by facilitating group discussions; by analyzing current business process and work flows; by identifying opportunities for improvement; and by designing, developing, testing, and implementing change ideas through the application of leading-edge quality improvement strategies and techniques.
KEY ACTIVITIES AND RESPONSIBILITIES AND APPROXIMATE PERCENT OF TIME:
A. Facilitating process improvement sessions/meetings: 20%
–Conduct current state value steam/process mapping workshops to identify opportunities for improvement.
–Analyze current business process and workflows.
–Brainstorm ideas from teams to develop countermeasures for overcoming issues in the existing process.
–Review adverse events/near misses. Make recommendations to mitigate risk, enhance safety, improve quality, and ensure implementation of recommendations.
–Leverage domain expertise from process owners to develop innovative solutions for workflow optimization.
–Develop, pilot, implement, and sustain new processes.
B. Coaching and mentorship: 20%
–Align and prioritize projects with strategic directions.
–Educate teams to develop the problem statement. Establish project metrics and project charter.
–Support teams through knowledge transfer on the application of Lean/project management tools.
–Support teams through knowledge transfer on the application of Lean/patient and family–centered care tools.
–Develop standard work.
C. Change management: 20%
–Manage complex relationships with sponsors and stakeholders.
–Develop effective communication plans to manage stakeholder expectations.
–Educate teams on benefits of Lean management.
–Encourage and implement standard work.
–Develop a problem-solving culture based on data and best practices across the organization.
–Encourage and recognize contributions from teams and celebrate their learnings.
D. Improvement projects/initiatives management: 15%
–Provide leadership support to quality and process innovation facilitators and project managers.
–Successfully deliver complex, multiphased, multidisciplinary projects by balancing scope, time, cost, and quality.
–Design, develop, test, and implement change ideas using the Lean philosophy.
–Manage multiple projects to completion.
–Develop dashboards for internal and external report-outs.
–Maintain inventory of improvement initiatives in knowledge database.
E. Managing internal/external mandates: 10%
–Audit ROPs (required organizational practices) for accreditation to ensure compliance and measure for improvement.
–Manage expectations of internal mandates such as reporting to the board of directors and senior leadership team.
–Manage expectations of external mandates such as ministry, primary healthcare bodies, and other providers.
–Develop, implement, and manage policies and forms where required.
F. Patient/family/community engagement: 15%
–Capture voice of patient/family/community to increase understanding on the need for change.
–Ensure all processes are examined from the patient lens.
–Foster and maintain community partnerships.
–Engage community partners to improve access and flow.
–Implement processes to support a patient and family–partnered care environment.
–Develop, implement, coordinate, and evaluate engagement strategies for patients and families.
Sensei Gyaan: Don’t rush while developing this foundational component or else it will come back to bite you later, severely. Create an instrument that provides clarity, is robust enough to avoid overlap and confusion, and at the same time is agile enough to meet the evolving need of the business.