Best Practices: Overcoming Implementation Challenges and Barriers

Best Practices:
Overcoming Implementation
Challenges and Barriers
Nancy Borkowski, DBA, CPA, FACHE, FHMA
Clinical Associate Professor
Florida International University
Healthcare MBA
What is Change Management?
Source: ExperiencePoint, Toronto, ON, Canada
Driving and Restraining Forces
Organizational Level
External & Internal
Driving Forces
Increased demands for higher quality
and levels of customer service
Greater competition
Higher cost of inputs
Legislation & increased regulation
Political interests
Ethics & social values
A general sense that the organization
could “do better”
Desire to increase profitability
Increase efficiency
Conflict between departments
The need for greater flexibility in
organizational structures
Restraining Forces
Change Management is about People!
Source: ExperiencePoint, Toronto, ON, Canada
Kotter's 8-Step Change Model
Kotter's model details a process
whereby managers may initiate,
direct, implement, and foster
organizational change via employee
Kotter’s 8-Steps
1. Increase urgency
2. Build the guiding
3. Get the vision right
4. Communicate for
Source: Boundless
5. Empower action
6. Create short-term
7. Don't let up
8. Make change stick
#1 Increase Urgency
The organization inspires people to
move, make objectives real and
relevant, and further their desire to
make change happen.
#2 - Build the Guiding Team
The organization gets the right people
in place as leaders with the right
emotional commitment and
understanding, and the right mix of
skills and levels.
#3 - Get the Vision Right
The organization gets the team to
establish a simple vision and strategy,
and then focus on the emotional and
creative aspects necessary to drive
service and efficiency.
#4 - Communicate for Buy-in
• The organization involves as many people as
possible, communicates the essentials, and
appeals and responds to people's needs.
• The organization de-clutters and streamlines
processes, policies, technology,
communications, etc., making it efficient
rather than overwhelming for employees.
#5 - Empower Action
The organization removes obstacles,
enables constructive feedback and
lots of support from leaders, and
rewards and recognizes progress and
#6 - Create Short-Term Wins
• The organization sets aims that are easy to
achieve in manageable chunks, manages the
number of initiatives taking place at once, and
finishes current stages before starting new
• Celebrate short term wins while working
toward an overall goal of change.
#7 - Don't Let Up
The organization fosters and encourages
determination, persistence, and ongoing
progress reporting. This can be done by
highlighting achieved and future
#8 - Make Change Stick
• The organization reinforces the value of
successful change via recruitment, promotion,
and new change leaders.
• The organization makes change a fundamental
part of the culture so people do not consider
it as foreign.
Best Practices:
Overcoming Implementation Challenges and Barriers
Much Success in Your Change Initiative!

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