1. Leading Change Melanie Nelson – Cerner Corporation
Vice President, Behavior Change & Adoption
Mike Allison – Cerner Corporation
Senior Director, Associate Learning
MIKE

2. Where Does Your Organization Stand?
MIKE

3. Percentage of Successful Org Change Efforts
15%
MIKE
Arthur D Little is a consulting company - At Arthur D. Little we take pride in being the oldest management consultancy in the world. We strive to be the top management consulting firm linking strategy, technology and innovation to master our clients' business complexity to deliver sustainable results.
Despite all the rhetoric, books, effort, and money thrown into change efforts, most organizational change efforts fail. Arthur D. Little and McKinsey & Co, have studied hundreds of organizations that entered into change initiatives and have found that about two-thirds fail to produce the results expected.
In recent surveys, CEOs report that up to 75% of their organizational change efforts do not yield the promised results. These change efforts fail to produce what had been hoped for and yet always produce a stream of unintended and unhelpful consequences.
- According to Arthur D. Little Study

4. Session Objectives
Provide an overview of Cerner and the challenges facing health care
Contrast adaptive and technical problems within change challenges
Describe key lessons learned to help you effectively engage change
Construct an action plan for your success
MIKE

5. Cerner Corporation
$3.6B company focused on health care & the health of communities
Just under 15,000 employees worldwide with 9,739 based in the Kansas City area – will be at 20,000 total employees by 2020
#13 Most Innovative Company in the world (Forbes)
MIKE
Introduce Cerner

6. OUR MISSION Our Mission…
To contribute to the systemic improvement of health care delivery and the health of communities
Our work combines technology and health to revolutionize global healthcare
MIKE
Time on slide: Approx. 1 min.
Who is Cerner? Provide audience the quick and direct overview of Cerner
Our mission as a company is to contribute to the systemic improvement of health care delivery and the health of communities.
In short, our work combines health, wellness and technology to change global health care for the better.

7. 10,000+ Clients in 24 Countries Our Clients MIKE Time on slide: 1 min.
So who exactly are our clients?
In short, our clients are facilities where health and care occur. So you have your more traditional clients, like hospitals and doctor’s offices, ancillary care units (home health, surgery, labs, radiology, pharmacy, cardiac) and more and more we are branching out into other areas, like employer-based health programs.

8. services Our Solutions technology Medical Software & Devices
Mobile Applications
“Smart” Hospital Rooms
services
Employer Health / Wellness
Client Support Services
Global Consulting
Population Health
MIKE
Time on slide: 3 min.
How are we making it better?
By offering a comprehensive blend of technology solutions and professional services.
Cerner engineering teams create medical software and devices, most prominently the Electronic Health Record that integrates all health data for a patient.
More and more, we’re making that technology and information accessible via mobile devices, as you can see in the pictures. From iPads to mobile phone apps, Cerner is working to make health care information available at the right time in the right place.
Consider the image of the baby at the center of the hospital room. Does anyone think we could make that experience better? Cerner is also developing technology that allows a hospital room to actually be more intuitive to support the care process. From beds, to scales, to screens that provide the patient information, we are making hospital rooms smarter so they can be a place of health and healing for the patient inside.
From a service side, we have found that as we become more experienced with health care and technology, there are a number of professional services we can provide our clients to help them focus on their main goal of keeping people well. Across the globe, Cerner provides client support in the areas of: [USE THESE AS EXAMPLES; DON’T NEED TO GO THROUGH ALL]
Employer Health/Wellness: Helping employers understand their role in creating health environments for their employees. Later, you’ll see more about how Cerner is doing this at our own offices.
Client Support Services: Cerner is an invested partner with our clients, so we do not just do implementations and move on. We provide comprehensive services that allow for ongoing support of our client systems, long after they have been implemented. (Remote hosting, revenue cycle support, device integration support, etc.)
Global Consulting: Similarly, we work alongside our clients as they design and build their system. Cerner consultants offer their system expertise to clients to ensure they are developing efficient workflows and processes as they integrate their Cerner systems.
Population Health: As more and more health data becomes automated, Cerner is able to partner with our clients to identify ways we can impact the health of large populations with similar health needs. Those can be condition similarities (groups with heart disease, cancer, diabetes, pregnancy, etc.) or geographic similarities (employee populations) or health system similarities (those who share the same provider or health system).

9. Safety Cost Quality Access to Care Evolving Business Models
Top Healthcare Organization Challenges
Safety
Population Health
Economic Uncertainty
Access to Care
A Fraying Medicaid
Cost
Evolving Business Models
Price Transparency
Health Insurance Exchanges
MIKE
Review challenges as they build on the slide.
State: “Adaptability is necessary for us (and them) to thrive in challenging times.”
For transition, state: “At Cerner Corporation, we are feeling a sense of urgency about the challenges we’re facing in healthcare. Here’s the reality….”
Patient Satisfaction
Meaningful Use
Globalization
Regulatory Compliance
Quality
New Technology

10. MIKE
Explain slide layout
Ask audience where Healthcare sits
Then click and show (slide builds)….They are always surprised.
Emphasize need to move healthcare to the right. In order to do that our organization – and others in healthcare - aspire to thrive in challenging times and rapidly adapt by:
Reading and acting on signals of change
Experimenting rapidly and frequently
Leading complex, interconnected systems of multiple stakeholders
Influencing associates and partners

11. The General Problem MIKE
Briefly explain the change management problem examples.
For transition, state, “Let’s see what’s holding us back.”

12. Activity: Obstacles to Change
Consider your change challenge
Record one obstacle on a sticky note
Share your thoughts with your table group
You have five minutes
MIKE and transition to Melanie
Facilitator provides instructions according to the slide.
Individually reflect on and select a change challenge you’re facing
Record one obstacle blocking your success on a sticky note
Share your change challenge and obstacle with your table group
Participants have three minutes
As they work, hand off the clicker to Melanie.
Melanie debriefs the activity by asking for volunteers to share 2-3 obstacles they’re facing.
For transition, state, “Let’s explore some of these underlying issues a bit further.”

13. The single biggest failure of leadership is to treat adaptive challenges like technical problems.
Groupsmith, Inc.
MELANIE
State: “Like the good stewards of technology that we are at Cerner, oftentimes we find ourselves trying to solve adaptive, or behavior problems, with tools and processes. And we find we aren’t actually solving the right problem at all.”

14. Technical Problems vs. Adaptive Challenges
Easy to identify
Often lend themselves to quick and easy solutions
Often can be solved by an authority or expert
Difficult to identify, easy to deny
Require changes in values, beliefs, roles, relationships & approaches to work
People with the problem do the work of solving it
People often resist even acknowledging the problem
MELANIE
Examples:
Technical Problem: Take medication to lower blood pressure
Adaptive Problem: Change lifestyle to eat healthy, get more exercise and lower stress
Technical Problem: Change your tires and brakes
Adaptive Problem: Change your driving habits
People are generally receptive to technical solutions

15. Activity: Adaptive vs Technical Obstacles
At your tables consider the obstacles
Categorize them as either adaptive or technical problems
Apply them to the appropriate flip chart
You have five minutes
MELANIE
State: “Now that we’ve contrasted technical and adaptive problems, let’s apply these characteristics to the sets of barriers to change you defined at your table.”
Facilitator provides instructions according to the slide.
As a table group think about the definitions and categorize the obstacles you just wrote down into two piles – one for technical problems and one for adaptive problems.
Send representatives to the flip charts to add the appropriate stacks.
Then we’ll discuss your findings.
Participants have five minutes.
Ask: “What did you find?”
Hopefully the adaptive stack is 80%. Key point is to help them discover that the majority of problems with change management is about people and their behaviors – not about the technical tools and processes. And, yet, we often spend the majority of our efforts tweaking process and tools.

16. NOT The Field of Dreams? MELANIE
State: This is not the Field of Dreams (click) – they won’t just come.

17. Activity: Why Change Efforts Fail
At your tables discuss a failed change initiative
List two reasons results were not achieved
Be prepared to share with the larger group
You have five minutes
MELANIE
Facilitator provides instructions according to the slide.
At your tables quickly discuss a failed change initiative you’ve personally experienced.
List two reasons why you were unable to achieve the outcomes you (or your organization) were seeking.
Facilitator asks for people to shout out reasons and record on flip chart.
State: “OK, so we’ve discussed that we often have a sense of urgency for our change, and we agree that most of our barriers are adaptive. We have found that many of our efforts fail – and you’ve identified a considerable list of reasons why. Now let’s get out of failure mode. Let’s set ourselves up for success!”

18. VitalSmart’s Influencer Model
MELANIE
State: “At Cerner Corporation, we’ve chosen to espouse VitalSmart’s Influencer Model as our approach to tackling behavior change challenges. It provides a tactical and organized framework that operationalizes any organizational change management philosophy, and comes with a ready set of proven techniques to help you drive the results you’re seeking.”
“Although this is a two day class, we’re going to do some Influencer speed dating. This is how it works.”

19. VitalSmart’s Influencer Model
MELANIE
State: “First we clarify the problem we’re trying to solve and define specific and measurable targets for success.”

20. VitalSmart’s Influencer Model
MELANIE
State: “Then we identify the vital behaviors or key actions we need our target audience to consistently and routinely demonstrate in order to achieve the result we seek.”

21. VitalSmart’s Influencer Model
MELANIE
State: “Next we diagnose and execute an action plan across six sources of influence to elicit the vital behaviors from our audience.”

22. VitalSmart’s Influencer Model
MELANIE
State: “The six sources of influence are based on the premise that people do things for only two reasons.”
Click and state: “Because they want to – which comprises the motivation column.”
Click and state: “And, because they can – which translates to the ability column.”

23. VitalSmart’s Influencer Model
MELANIE
State: “Likewise, people’s motivation and ability are impacted across three dimensions.”
Click and state: “Personal – when I’m in a room by myself, what will I want to do, and be able to do?”
Click and state: “Social – when I’m in a room with others, how will they motivate or enable me to act?”
Click and state: “And, finally, structural – what are the nonhuman elements in my environment that motivate or enable me?”
Hand off clicker to Mike

24. Top Ten Lessons We’ve Learned from Influencer
MIKE
State: “In deference to our friend, David Letterman, we have a Top Ten List of the key lessons we’ve learned from Influencer as we affect change at our organization and with our clients. In a slight variation to his approach, we’ll start in sequence with #1, the most important lesson, and proceed from there.”

25. Lessons We’ve Learned from Influencer - #1
Influencers lead
“I know you are taking it in the teeth, but the first guy through the wall... he always gets bloody... always. This is threatening not just a way of doing business... but in their minds, it's threatening the game. Really what it's threatening is their livelihood, their jobs. It's threatening the way they do things...”
- John Henry to Billy Beane, Moneyball
MIKE introduces, MELANIE provides color.
State: “We’ve learned that in spite of all of the challenges and barriers facing them, influencers lead. They gain leadership buy-in, effectively communicate, manage negative perceptions and reactions, and manage organizational politics. They display high emotional intelligence.
We learn from John Henry, the owner of the Boston Red Sox, in a discussion with Billy Beane, the general manager for the Oakland A’s in the movie Moneyball, that the first guy through the wall gets bloody. Leading change isn’t easy. If it were, none of us would be here talking about it – and we wouldn’t get 53 million google hits about the topic. Influencers succeed where others don’t – and they have the data to prove it.”

26. Lessons We’ve Learned from Influencer - #2
The desired future state is clear
MIKE introduces, MELANIE provides color.
State: “Before we can lead a behavior change effort, we need to define the problem we’re trying to solve. Changing for change sake will doom us. Instead, our second lesson from Influencer tells us that a clearly defined and articulated future state is essential to communicating the why behind a change.”

27. Lessons We’ve Learned from Influencer - #3
Value and outcomes are defined
MIKE introduces, MELANIE provides color.
State: “Lewis Carroll reminds us ‘If you don’t know where you’re going, any road will get you there.’” The key starting point in actually using the Influencer approach is in translating your desired future state into a measurable business value or outcome – such as financials, client satisfaction, or productivity – so you know when you’ve arrived at your future state. Make sure you are actually measuring what you want to achieve – and the change is aligned with key business initiatives.”

28. Lessons We’ve Learned from Influencer - #4
New actions are identified
MIKE introduces, MELANIE provides color.
State: “One of the challenges we face in change management, is really understanding the changes we’re seeking – the ones that will drive our results. We need to define the new actions, steps and behaviors we want our audience to demonstrate day in and day out. And then our efforts to get this new action becomes the focus of our effort. All techniques we use in our plan should be totally dedicated to driving this behavior change.”

29. Lessons We’ve Learned from Influencer - #5
People feel personally motivated
MIKE introduces, MELANIE provides color.
State: “If people don’t feel personally motivated to act in a different way, you won’t see sustained change. Our traditional technique of telling people what they should believe needs to be shoved to the wayside. Instead we need to truly understand their personal values and connect our change effort into that. The best method is through providing opportunities for people to self-discover that a new behavior or action isn’t nearly as boring, scary or hard as they thought it would be. Our change plan should include a robust communication approach that constantly clears the road of fear, uncertainty and doubt for our audience.”

30. Lessons We’ve Learned from Influencer - #6
People have the opportunity to practice
MIKE introduces, MELANIE provides color.
State: “I think many of us get thrown into change like this. Our default rationale is “if he really wanted to change, then he would”. But, indeed, we don’t often help people build the knowledge, skills and strength necessary to demonstrate that new behavior with confidence. Its crucial to allow people time to practice and receive honest, actionable feedback from a coach to course correct behaviors.”

31. Lessons We’ve Learned from Influencer - #7
The right people are engaged
MIKE introduces, MELANIE provides color.
State: “Everett Roger’s diffusion of innovation curve really helps us to understand the science supporting the Influencer lesson that its critical to get the right people engaged on your initiative. The job of the influencer isn’t to change the distribution of people across this curve – it will always happen this way. Instead, the key is to identify the early adopters in your audience who will be reasonably persuaded to join your effort AND have the social credibility with the early majority – who will follow merely because the early adopters do. Watch out, however, for the innovators. While they play an important role, they can actually damage your change effort because they aren’t socially connected – they’re actually seen by others as the crazy guy.”

32. Lessons We’ve Learned from Influencer - #8
Incentives support the change
MIKE introduces, MELANIE provides color.
State: “In today’s world we may find our existing reward and recognition structures are actually working against us – and aren’t effectively motivating people in a way that supports our change effort. Using a different tactic, that uses moderate rewards that actually reward the new behaviors will help us gain ground.”

33. Lessons We’ve Learned from Influencer - #9
Data, tools and processes drive behaviors
MIKE introduces, MELANIE provides color.
State: “Oh, how often have we made change all about the new tool. If you want to truly tackle adaptive challenges, look through a different lens. Our cool technologies, data reports and processes should enable the behavior change rather than be the focus of it.”

34. Lessons We’ve Learned from Influencer - #10
Success is celebrated
MIKE introduces, MELANIE provides color.
State: “There’s nothing more gratifying than making success public, no matter how small. These stories and testimonials fuel the engine for greater change and help accelerate the adoption curve. And, besides, why not have a little fun while you’re at it!”

35. Hope is not a plan MELANIE (Mike clicks)
State, “Hope is not a plan. Instead, we need to take deliberate action. Let’s start an action plan that you can use tomorrow to tackle your change challenges.”

36. Activity: Start Your Action Plan
Write three things you will do tomorrow
Share your thoughts with your table group
You have five minutes
MIKE
Facilitator provides instructions according to the slide.
Individually complete their quick action plan as a follow up to this session
Be prepared to share with the larger group
Participants have five minutes
Click to the next slide for participants’ reference during the activity.

37. Top Ten Lessons We’ve Learned from Influencer
Influencers lead
The desired future state is clear
Value and outcomes are defined
New actions are identified
People feel personally motivated
People have the opportunity to practice
The right people are engaged
Incentives support the change
Data, tools and processes drive behaviors
Success is celebrated
MIKE
If we have time, debrief activity from this slide by asking participants to share examples of follow-up action items with the larger group.

38. The New Science of Leading Change
To learn more…
Influencer:
The New Science of Leading Change
MIKE
Share opportunities for the audience to learn more – the book, the website, youtube videos, and the course.

39. Questions?
MIKE
What do you think?