HI550 Unit 10 Change Management Plan Example

Gates, Not Dates: A Unit 10 Change Management Plan That Sequences a Three-Hospital Health Information Consolidation Over Nine Months

[Student Name]

Purdue University Global

HI550: Organizational Development and Management for Health Information

Unit 10 Change Management Plan

[Instructor Name]

[Date]

Quillan Health, its phases, baselines and targets are composite; the sources cited are real.

The Sequence and Why

The consolidation runs in three phases over nine months. Coding goes first because the regional inpatient coders rated ready in the readiness analysis and because the measure that tracks coding, unbilled days, moves quickly and will show trouble within weeks. Chart completion goes second, once the coding team is stable. Release of information goes last because it depends on something that does not yet exist: a redefined role for the critical access hospital's records technician, whose readiness was rated low on every indicator. Moving release work before her new role is in place would strip away the work she is best known for before anything new is ready for her.

Table One: The Phases

1. Phase one, coding consolidation. Months one to three. Owner: system HIM director. Start condition: shared work queue built and tested, Hollis physician liaison named, the community hospital supervisor's new title and grade confirmed in writing. End condition: unbilled days at or below 5.0 and coding accuracy at or above 95 percent for four consecutive weeks.

2. Phase two, chart completion. Months four to six. Owner: chart completion lead with the medical staff office. Start condition: phase one end condition met; chart completion staff trained on the centralized deficiency queue. End condition: open deficiencies older than thirty days reduced by half and holding for four weeks.

3. Phase three, release of information. Months seven to nine. Owner: release supervisor. Start condition: phase two end condition met; critical access technician's new role defined, agreed and in place for at least four weeks; communication plan briefings complete. End condition: median release turnaround at or below six business days, measured from receipt, for six consecutive weeks.

No phase opens on a date; each opens when the last one has met its end condition, and the steering group can see in advance exactly what that condition is.

Table Two: The Knoster Check

Knoster et al. (2000) argue that complex change needs five elements together: a vision, the skills to carry it out, incentives, resources and an action plan. When one is missing, a recognizable symptom follows. Without vision, people are confused about why. Without skills, they become anxious. Weak incentives produce resistance. Short resources lead to frustration. Without an action plan, the effort starts and stops. The model was chosen over a longer step sequence because its symptoms give the steering group something to watch for between gates.

1. Phase one. Vision: present; coders understand the reason and gain a health information reporting line. Skills: present; coders already use the encoder remotely. Incentives: present for regional coders, partial for Hollis coders, who lose easy physician access. Resources: present. Action plan: present. Watch for: resistance at Hollis. Response: Hollis coders move only after their liaison is named and the surgeons can be messaged directly.

2. Phase two. Vision: present. Skills: thin; two of the four chart completion staff have never used the centralized deficiency queue. Incentives: present. Resources: present. Action plan: present. Watch for: anxiety, showing up as errors and requests for reassignment. Response: training scheduled in month three, before the phase opens, with a practice queue.

3. Phase three. Vision: partial; release specialists understand the plan but requesters outside the department do not. Skills: present. Incentives: low for the critical access technician until her role is defined. Resources: partial; the central office needs one more workstation and a fax line. Action plan: present. Watch for: resistance and frustration. Response: role definition first, equipment ordered in month five, and the communication plan's sequence for every audience.

Table Three: Losses Carried Forward

The readiness analysis named what each group stands to lose. Each loss is assigned a response and a phase.

1. Hollis coders lose the corridor route to physicians. Response: a named physician liaison and message channel. Phase one.

2. The community hospital supervisor loses her department. Response: new title and grade confirmed before announcement. Phase one.

3. Physicians lose informal clarification at Hollis. Response: query format that takes under a minute, briefed by the medical staff office. Phase one.

4. Revenue cycle leadership loses direct control of regional coders. Response: weekly unbilled days report during phase one.

5. The critical access technician loses release work and its place in town. Response: redefined role agreed with her and in place before phase three.

6. Release specialists at Hollis lose their location. Response: individual meetings with their own supervisor and schedules carried over. Phase three.

Bridges and Bridges (2016) argue that a change fails less often from the plan itself than from losses no one acknowledged. Carrying these forward phase by phase keeps the readiness work from being filed and forgotten.

The Measures Sheet

Outcome measures, with baselines and targets:

1. Discharged-not-final-billed days: baseline 5.8, target 5.0.

2. Median release turnaround from receipt: baseline six business days, target six or fewer while volume consolidates, then five.

3. Coding accuracy: baseline 95.2 percent, target at or above 95 percent throughout.

4. Open chart deficiencies older than thirty days: baseline 410, target 205.

Balancing measures, chosen to catch harm the targets might hide:

1. Records final-coded with a physician query still open, which would rise if coders chased unbilled days at the expense of accuracy.

2. Release requests that pass thirty days without an extension letter, which would show the central office falling behind while its median looks fine.

Department health watch: voluntary turnover in health information, reviewed monthly, with any resignation in a moving group discussed at the next steering meeting.

Who Can Pause the Rollout

Any member of the steering group can call for a pause, but only the system HIM director and the revenue cycle vice president together can approve one. A pause is required if a balancing measure worsens by more than half its baseline for two consecutive weeks, or if two or more staff in a moving group resign within a month. When an outcome measure and a balancing measure point in opposite directions, the balancing measure wins until the cause is understood. Kotter (1995) observed that transformation efforts often fail by declaring victory too soon; this rule is meant to prevent the opposite error as well, pushing ahead while harm builds unseen.

Limits

The baselines come from thirteen weeks of data, and seasonal volume could move them. The nine-month estimate assumes each gate is met on its first attempt; a missed gate adds at least four weeks.

References

Bridges, W., & Bridges, S. (2016). Managing transitions: Making the most of change (4th ed.). Da Capo Lifelong Books.

Knoster, T. P., Villa, R. A., & Thousand, J. S. (2000). A framework for thinking about systems change. In R. A. Villa & J. S. Thousand (Eds.), Restructuring for caring and effective education: Piecing the puzzle together (2nd ed., pp. 93-128). Paul H. Brookes.

Kotter, J. P. (1995). Leading change: Why transformation efforts fail. Harvard Business Review, 73(2), 59-67.