1. Practical Exercise Symptoms of Pressure (1) Review the symptoms of pressure given Which have you noticed among staff in your organisation? Development of National Coding Standards within the Czech DRG System

2. Practical Exercise Symptoms of Pressure (2) Review the approaches to minimising pressure Which are relevant to you? How will you implement them in your work? Development of National Coding Standards within the Czech DRG System

3. Understanding Change Positive versus negative Input / feelings of control Others’ attitudes Amount of compulsion Development of National Coding Standards within the Czech DRG System

4. Psychological Reactions to Change Denial / disbelief Anger Depression Performance Development of National Coding Standards within the Czech DRG System

5. Practical Exercise Change Reflect on a change you want –Describe –Measurable objectives –Inform / involve others –Difficulties –Resource / cost implications –Benefits –Selling points –Maintain motivation –Critical success factors –Key people Development of National Coding Standards within the Czech DRG System

6. Five Step Model of Change Liz Clarke Research external & internal market Anticipate resistance Develop a shared vision Mobilise commitment Prepare a change plan / implementation Development of National Coding Standards within the Czech DRG System

7. Research External and Internal Market Questionnaires / surveys Round table discussions Staff meetings Team briefings –Why change is needed –Scope of change –Interests being surveyed –Methodology Development of National Coding Standards within the Czech DRG System

8. Research Internal and External Market – Data Protection Briefing paper on data protection Need for fairness and transparency Ask for ideas and approaches Ask about barriers and how overcome Summarise responses 3 / 4 options Development of National Coding Standards within the Czech DRG System

9. Anticipate Resistance Those who currently benefit Those worried about not coping –Active resistance –Passive resistance Development of National Coding Standards within the Czech DRG System

10. Reducing Resistance Communicate plans & reasons Involve staff / stakeholders in planning Manage implementation –Follow up with clarification –Query problems –Find solutions –Check progress Development of National Coding Standards within the Czech DRG System

11. Develop a Shared Vision Developing the vision Acceptance of the vision Consult and involve Action must match principles Development of National Coding Standards within the Czech DRG System

12. Mobilise Commitment Identify and develop supporters Key influencers Pilot initiative –Builds confidence –Resolves problems –More manageable –Build experience –No major commitment of resources Development of National Coding Standards within the Czech DRG System

13. Prepare a Change Plan Communication of changes Change leadership When – order and timing Visible demonstration of change Monitoring Reinforced by senior management Development of National Coding Standards within the Czech DRG System

14. Practical Exercise Planning Change Plan a change associated with Coding Answer the questions on the Planning Form Development of National Coding Standards within the Czech DRG System