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a practical guide to

organizational change

inter-agency collaboration and implementing evidence-based practice

{coming up

intro to org change &

implementation

team formation &

key roles

needs assessment

tools

strategic planning &

goal setting

implementing change

planning for

sustainability

please note:

This double session is based upon a five-part, web-based, self-paced

training series funded in part by the National Institutes of Drug Abuse

and the Substance Abuse and Mental Health Services Administration.

The opinions expressed are strictly those of the presenters; no official

endorsement by NIDA or SAMHSA should be inferred. The full training

will be available in the coming months via the Addiction Technology

Transfer Center website.

We welcome any feedback you might have about this workshop’s

content and visuals.

presented by:

Nicole Janich, M.S.W., nicole.janich@asu.edu

Adrienne Lindsey, M.A., DBH, adrienne.lindsey@asu.edu

Michael Shafer, Ph.D., michael.shafer@asu.edu

Tom Litwicki, tlitwicki@helptucson.org

intro to

organizational change

& implementation

a few words on implementing evidenced-based practices

Part 1

{coming up

key terms

point #1

point #2

point #3

(Mike to fill in)

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team formation &

key roles

forming change teams, and identifying leaders and key players

Part 2

{coming up

key terms

change team

formation

key roles

part I: key terms

(Allen, Foster-Fishman, & Salem, 2002; Hackman & Wageman, 2005; Rycroft & Malone, 2004)

change team

A change team is (ideally) a group of individuals from several

agencies, across multiple disciplines and various organizational levels,

working together to complete one or more tasks toward a shared goal

or objective.

key terms

(Greenhalgh, Robert, Macfarlane, Bate & Kyriahkidou, 2004; Kitson, Harvey, & McCormack, 1998)

champions/opinion leaders

Champions or opinion leaders are individuals within an agency

who have the ability to influence others’ attitudes and behaviors

towards the change objective due to their status or knowledge

within their agency.

key terms

external facilitator

The person who enables a group to work

more effectively in the process of

undergoing organizational or inter-

organizational change.

The external facilitator provides

structure, focus, and direction for the

group, while enabling group decision

making and maintaining focus on tasks

and the process of change.

(Loftus-Hills & Harvey, 1999; Kitson et al., 1998)

key terms

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change team leader

The Change Team Leader is

an optional leadership

position within the change

team who facilitates the

change team alongside the

external facilitator, and assists

and supports the external

facilitator with operations

and logistics.

key terms

part II: change team

formation

intra-agency change team

internal single-agency change teams

inter-agency change team

multi-agency change teams

types of teams

inter-dependency

of providers

consumers access

multiple providers

improved linkages

& relationships

improved access

to care

inter-agency team benefits

leadership support

“Without hospitable

leadership…core

implementation

components cannot

be installed and

maintained.”

–Fixsen et al. (2005)

executive

support

motivating others

resource

acquisition

staff management

troubleshooting assistance

goal articulation

empowering

others

sustainability assistance

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{partner

agency

considerations

trust

relationship

quality

referral stream

existing

contract

proximity

information

sharing

team member

characteristics

interest

voluntary

participation

tenure

subject matter experts

strong communication skills

organizational

influence

availability

strong relational skills

team size

≈ 7-10 members

organizational

needs assessment

evaluating organizational barriers and facilitators to change

Part 3

{coming up

needs

assessment

purpose

needs

assessment tools

group activity #1

part I: needs

assessment purpose

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needs assessment defined

a comprehensive evaluation of an agency or

organization’s current practices, policies, and

outcomes, relative to a specific goal or

endeavor, ideally informed by agency client

data and staff input, in preparation for

organizational change.

(Kuali’I & Ocampo, 2008)

needs assessment

needs assessment purpose

1) identity barriers & facilitators to change

2) inform the process improvement plan

data sources

SWOT analyses

brainstorming

interviews

walk-throughs

surveys

flowcharting

focus groups

needs assessment

part II: needs

assessment tools

flow charting defined

visible representations of the path a

consumer takes through multiple

agencies operating within the same

treatment system, denoting spots in

which key decisions are made (such

as a referral or termination) and the

subsequent parties involved in the

decision making process.

needs assessment

walk-through defined

purposeful, structured passage

through each layer of one’s

agency/organization from the

perspective of the consumer (this might

include waiting in a waiting room,

taking part in an intake, etc.), utilizing

observations to make suggestions for

improved practice.

(NiaTx, 2014)

needs assessment

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conducting a walk-through

1. identify change team members who will

participate (facilitator optional)

2. establish the date, time, and location

3. ensure that staff at the agencies are aware

of the walk-through

4. walk-through the agency as if you are a

client; collect a copy of any assessments or

measures that are used, etc.

5. document observations

6. share your observations with the rest of the

change team at the next scheduled

meeting

needs assessment

information to collect

1. how does the process feel (from the

perspective of the consumer)?

2. how much time is required for each

step (e.g. waiting in the lobby, intake

assessment, etc.)?

3. is there value in each step?

4. what was surprising?

5. what were strengths in the system?

6. what should be improved upon?

needs assessment

SWOT analysis defined

Strengths, Weaknesses, Opportunities, and Threats (SWOT) analyses

are commonly used in strategic planning processes to evaluate the

barriers and facilitators agencies might encounter when attempting to

implement a new change.

(NiaTx, 2014)

strengths weaknesses

opportunities threats

focus

intervention

around these

be prepared

for these

needs assessment

communicating needs

assessment findings

• synthesize the findings from all those

who participated

• present to executives/agency

leadership

• make recommendations based on

your findings, prioritizing key needs

• findings and recommendations should

inform the upcoming process

improvement plan

needs assessment

group activity #1

Strengths, Weakness, Opportunities, & Threats (SWOT) analysis

group activity #1

SWOT analysis

1. review the provided case study

2. individually identify the inter-agency team’s strengths,

weakness, opportunities and threats pertaining to their intended

goals (HINT: their goals or mission are in the last paragraph)**

-record on your worksheet

3.share your findings with your group

-have one group member record the responses from each

member

4.share your findings with the larger group

**Please use artistic liberties and feel free to provide additional detail

about the agencies or the environment (e.g. budgeting concerns,

political/legislative environment, staffing issues, etc.).

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How did the process of conducting a

SWOT feel? What was your experience

like?

What didn’t work well? What worked

well?

debrief: group discussion

discussion & questions

session #2

welcome back!

strategic planning

& goal setting

developing a successful plan

Part 4

{coming up

key terms

roles

process improvement

planning

writing goals &

objectives

group decision

making strategies

part I: key terms

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key terms

process improvement plan (PIP)

Defines tasks that will lead to outcomes

consistent with the goals and objectives

selected for process improvement.

Includes:

• identifying high priority process

improvement targets

• developing action plans

• establishing timelines

• designating individual and collective

responsibilities for the change process

key terms

consensus decision making

The process by which group members

come to agreement on acceptable

decisions/plans/goals which take

into account the social and political

issues at play among group members.

Ideally, group consensus will also

generate a feeling of togetherness

and commitment towards decisions.

key terms

nominal group technique

A group decision making process

that includes identifying problems,

generating solutions, and making

decisions part II: strategic planning

facilitator role

establishing trust

ensuring

fairness

team motivation

identifying good goals

resolving conflict

focus

balancing agendas

gentle reminders

accountability

change team

roles

identifying

organizational

needs

prioritizing

goals

generating goals to

address needs

identifying problems

communicating change

assigning tasks

action planning

creating timelines

implementing goals

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process improvement planning

identify goals

develop objectives

determine action steps

action steps:

who? what? when? where?

when? how?

measurement:

evidence of completion &

level of success

document level of

success in goal

attainment

PIP: purpose statement

PIP: writing good goals

components

• goals

• objectives

• action steps part III:

group decision making

nominal group technique

facilitated

brainstorming

• individual free

writing—as many

ideas as possible!

• group discussion

• idea ranking

• facilitator moderation

choosing good goals

considerations

• feasibility

• impact

• high priorities v. low hanging

fruit

• stretch goals

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group activity #2

identifying and writing good goals & objectives

1.use the SWOT analysis from the morning session to identify

the inter-agency goals/objectives

HINT: the broader mission of the change team (see last

paragraph of the case study) is what they would like to

accomplish. Your group will write how they will get there.

2. individually identify 1-3 goals for the process improvement

plan

3.go around the table and share your goals with your group

(one member needs to record each of these goals)

4.vote on the goals you view as the highest priority by placing

your initials next to the goal

5.write the group’s top priority goals in the process improvement

planning worksheet and identify which Strengths,

Weaknesses, Opportunities or Threats each goal pertains to

identifying goals & objectives

What were your top priority goals?

How did you prioritize these goals?

Why did you chose those areas to

focus on?

debrief: group discussion

implementing

changes &

managing high

performance teams

communication, conflict management & and overcoming obstacles

Part 5

{coming up

communication

strategies

conflict

management

implementation

obstacles

part I: communication

strategies

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communication

strategies

regular meetings

milestone

celebrations

email

face to face,

when possible

tele-

conferencing

agendas & minutes

policies & memos

training

webinars

communication tasks

facilitator & change

team leader

• email reminders

• sending agendas

• meeting meetings

• calling team members for status

updates

• engaging key stakeholders

(frontline, management, etc.)

• trainings

• permissions & buy-in from

executive sponsors

managing conflict

• addressing instead of avoiding

conflict

• identifying conflicting goals,

values, priorities

• finding common ground

• using facilitator to mediate part II: implementation

obstacles

implementation obstacles

common obstacles

• turnover

• team conflict

• team member absences/non-

participation

• leadership changes

• flagging motivation

• lag time/start-and-stop progress

• external forces (state/local budgets,

organizational-level changes)

planning for

sustainment

assessing progressing and sustaining momentum

Part 6

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{coming up

key terms

tasks of facilitator

& team members

assessing

progress

strategies for

sustainment

facilitator exit

part I: key terms

sustainment

The continued use of an

innovation in practice; when

innovations or changes have

become institutionalized.

(Aarons, Hurlburt, & McCue Horwitz, 2011)

key terms

implementation

summary

A document created by the

change team and facilitator

which summarizes the extent

to which process improvement

goals were implemented.

(Aarons, Hurlburt, & McCue Horwitz, 2011)

key terms

sustainability plan

A document created by the

change team and facilitator

which identifies those actions

needed to assure that changes

are sustained.

(Aarons, Hurlburt, & McCue Horwitz, 2011)

key terms

facilitator exit

The point at which a

facilitator will withdraw from

the project, and the team will

enter the sustainability phase

of the change process which

is marked by the development

of an Implementation

Summary to characterize

changes, and a Sustainability

Plan.

(Aarons, Hurlburt, & McCue Horwitz, 2011)

key terms

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part II: facilitator and

change team tasks

facilitator tasks

• attend final in-person meeting

• assist with implementation

summary

• provide material and information for

sustainability plan

team tasks

• develop implementation

summary

• develop sustainability plan

• plan for final in-person meeting

sustainment tasks

part III: assessing

progress and outcomes

how will you know the change you

are looking to see is taking place?

• need for a baseline measurement

• methods of measuring change

• piloting the change

• adjusting the change

seeing the change

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part IV: strategies for

sustainability

sustainability planning

• Should the existing team remain in place

or should a new team be formed to

address future issues?

• Should the changes developed and

implemented by the team be sustained

and institutionalized? If yes, what

procedures need to be in place to sustain

the changes?

sustainability

strategies for sustainability

1. building resources

• institutionalizing the change

• potential funding sources (e.g. grant funding, supplemental budget

requests arguing for cost-effectiveness, cost-offset, etc.)

2. generating buy-in from team members

affected by the change

3. spreading the change/practice through

the agency or system

4. regular communication about change

processes

5. share evidence of change benefits

part V: facilitator exit

facilitator exit practices

• member awareness and involvement

• addressing concerns

• expressing appreciation

• summarize outcomes

• assistance with final reports

Facilitator Exit

facilitator exit

What do you plan to use from this

presentation?

How would you use this in your

agency?

What are your next steps?

debrief: next steps

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contact info:

Adrienne.Lindsey@asu.edu

web-based training to be released fall 2014!

feedback? interest in consultation?