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VHA ICD-10 Webinar Series
                                  Session 2:
          Leadership & Awareness

                             Kathy M. Johnson, RHIA
                          VP Coding Quality & Compliance
                            Care Communications, Inc.




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ICD-10 Leadership & Awareness
     http://www.ahima.org/icd10/ICD-10PreparationChecklist.mht
 Year      2009/ 2010           2011              2012               2013
Phase I     Impact Assessment


Phase II                        Preparing for Implementation


 Phase
                                                                 Go Live
  III
                                                               Preparation


Phase IV                                                                       Post –
                                                                             Implementation




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ICD-10 Leadership & Awareness
  Truth:
    ICD-10
    implementation
    cannot effectively
    be planned for in
    isolation.




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Areas of Impact:                  ICD-10 Leadership &
   Everywhere!                         Awareness
   Disease             Financials     Reimbursement
Management                        Case                   Test
 Quality
            Registries         Management             Ordering
Measures    Clinical Decision   Health      Billing
                 Making         Policy    Identifying Fraudulent
 Research &
                                            Practices
   Studies          Scheduling
                                 Payment Systems and
        Registration              Claims Processing
                                                        Pharmacy
Performance Improvement &         Reporting       Encoding
      Measurements
                                                  Software


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ICD-10 Leadership & Awareness
   We are in a time that
   demands an immense
   amount of agility and
   flexibility - leaders
   must have the skill and
   insight to prepare for a
   future that is rushing
   at a faster pace than
   ever before.


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Leading Change
   “How do you manage change?
   Pretty much the same way
   you’d manage anything else of
   a turbulent, messy, chaotic
   nature, that is, you don’t really
   manage it, you grapple with it.
   It’s more a matter of leadership
   ability than management skill.”

   Fred Nickols



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“Management is about complexity,
        leadership is about change.” J.Kotter

      Management            Leadership
      Plan, budget,         Establish direction,
      organize, staff,      align people,
      control and           motivate, and inspire.
      problem solve.



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Project Management

          •   Initiating
          •   Planning
          •   Executing
          •   Controlling
          •   Closing



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It’s All About Leadership
        – Vision
        – Presence
        – Competence
        – Collaboration
        – Creativity
        – Influence



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Eight-step Process for Leading Successful Change
                Implementing
                and sustaining                8. Make it stick
                the change
                                          7. Don’t let up
       Engaging
       and enabling
                                         6. Create short-term wins
       the whole
       organization
                                    5. Enable action
                                 4. Communicate for buy-in
Creating a                 3. Get the vision right
climate for
change            2. Build guiding teams
                                             Source: The Heart of Change Field Guide –
                   1. Increase urgency                    Dan S. Cohen



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Phase 1:
            Create a Climate for Change
          • Deal with the emotional process of
            change from the beginning
          • Build the needed level of energy to get
            the change off the ground
          • Steps: Urgency, Guiding Teams, Vision



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1                         Increase Urgency
                  •       Build a case for change
                          – Performance gaps
                          – Competitive advantage
                          – Errors, failures and missed
                            opportunities
                          – Trends
                          – Determine what people in the
                            organization value


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1                  Increase Urgency continued
   • Identify behaviors that
     stop change:
          Complacency
          Immobilization
          Anger
          Pessimism
          Sabotage


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1                 Increase Urgency         continued


            •    Leaders should:
                 – Make everyone involved feel and see the
                   need for change
                 – Respect the past, acknowledge present
                   weakness and future challenges
                 – Communicate compelling stories –
                   engage stakeholders in a dialogue
                 – Ensure that all senior executives and at
                   least 75% of management are on the
                   change bus

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ICD-10 Leadership & Awareness

 Truth:
   Decisions that impact financial, team and
   project performance are made faster, with
   better information, when accomplished in
   collaboration with key stakeholders.




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2                     Build Guiding Teams

  Key Roles:
  •     “Change” sponsor
  •     Senior guiding team
  •     Field guiding teams




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2                     Build Guiding Teams

              “Right mix” of people:
                  organizational credibility
                  influence
                  expertise
                  inspires and motivates
                  decision-making authority
                  sense of urgency
                  able to remove barriers

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2                 Build the Guiding Team

             • 5 basic elements of effective teams:
                – Shared sense of purpose
                – Clear roles
                – Defined team process
                – Strong relationships
                – Effective interactions with other
                  teams and managers


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3                     Get the Vision Right

        • “Never under estimate the
          power of a good story”
        • Determine the process for
          creating and communicating
          the vision
        • Create bold visions
        • Move as fast as possible



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ICD-10 Leadership & Awareness
              Vision Statement

   ICD-10 is the primary         Regulatory mandate and
   vehicle to further position   compliance will be
   ABC Health Care System        achieved with full
   to drive efficiencies and     implementation of ICD-10
   use granular data to          by October 1, 2013.
   improve care outcomes.



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ICD-10 Leadership & Awareness
              Vision Statement
   Implementation of ICD-10    ABC Medical Center will
   will further advance our    gain quality health care
   clinical decision making    outcomes knowledge
   capabilities and business   through robust data
   models to support           capture using ICD-10 to
   effective delivery of       better serve our patient
   patient care.               community.



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ICD-10 Leadership & Awareness
              Vision Statement

  Quality Initiative:          Providing better care and
    Improve patient safety     patient services with the
    and overall care           use of ICD-10 data.
    outcomes with the use of
    ICD-10 codified data.




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ICD-10 Leadership & Awareness
             Vision Statement
• Is the statement clear and motivating – even inspiring?
• Is the vision realistic and achievable?
• Does the vision describe where the organization wants
  to go and show the future?
• Does the vision appeal to the values & long term interest
  of employees, customers & stakeholders?



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“It’s a terrible thing to look over your
   shoulder when you are trying to lead and
                find no one there.”

                    Franklin Delano Roosevelt




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Phase II:
    Engage and Enable the Organization
         • A leadership responsibility!
         • All stakeholders engaged and involved
           in the change
         • Steps: Communicate for buy-in, enable
           action, create short term wins


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Adaptation of Geoffrey Moore’s Responses to Change




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Law of Diffusion of Innovation




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ICD-10 Leadership & Awareness
            Communication Plan
Truth:
  A single memo announcing the
  transformation or even a series of speeches
  by the CEO and the executive team are never
  enough communication of a large scale
  change.


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4                Communicate for Buy-In

           • Prepare for Q&A
           • Communicate the right message at the
             right time
           • Perform an assessment of peoples’
             understanding of the vision and
             strategies


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4                Communicate for Buy-In

            •   Develop a compelling story
            •   Use metaphors and analogies
            •   Say it again, again and again
            •   Use many different forums
            •   Keep communication simple
            •   Develop a communication plan


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ICD-10 Leadership & Awareness
 • 32% of time is spent
   helping others resolve
   questions

      – 54% of the questions have
        been answered before but
        not in any type of
        accessible knowledge base

 • 81% believe it is
   important to share
   knowledge

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ICD-10 Leadership & Awareness
            Communication Plan
               Key
     Target                             Channel or
    Audience Message Create   Deliver
                                          Forum
              Points




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ICD-10 Leadership & Awareness
            Communication Plan

     Target    How             Feed
                      Issues   Back   Frequency
    Audience Impacted




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ICD-10 Leadership & Awareness
            Communication Plan
 • Board of Executives     • Registry Personnel
 • Medical Staff           • Data Analytics Staff
 • Department & Practice   • Administration
   Line Leaders            • Compliance & Risk
                             Management Staff
 • Case Management
                           • Committee Members
 • Coding Staff
                              – Revenue Cycle
 • Customers                  – Informatics
 • Codified Data Users        – Cancer Care Board

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ICD-10 Leadership & Awareness
          Communication Checklist
• Are you using the preferred senders to deliver
  communications in your organization?
• Are you answering the question "what's in it for me
  (WIIFM)"?
• Are you repeating key messages 5 to 7 times?
• Are you creating opportunities for two-way
  communication?
• Are you finding effective ways to reach your
  audience?

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ICD-10 Leadership & Awareness
           Communication Checklist
• Did you develop new communication channels?
    –   ICD-10 Webpage          –   Elevator and Stairwell Posters
    –   Screen Saver Messages   –   Use of External Presenters
    –   Lunch and Learn         –   Demonstrations
    –   Intranet Q & A Forum    –   Interview Videos
                                –   An ICD-10 Event Day
    –   Newsletter
                                –   Social Networking




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Leaders Inspiring Action

   http://www.ted.com/talks/lang/eng/simon_sinek
        _how_great_leaders_inspire_action.html




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ICD-10 Leadership & Awareness




 When written in Chinese the word “crisis” is
       composed of two characters. One
  represents danger, and the other represents
                 opportunity.
                              John F. Kennedy
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ICD-10 Leadership & Awareness



                          Ask Me
                           About
                          ICD-10




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     1.800.458.3544
ICD-10 Leadership & Awareness

                    Email:
kjohnson@care-communications.com


             Telephone:
           1-312-229-7167




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ICD-10 Leadership & Awareness

  • 1. VHA ICD-10 Webinar Series Session 2: Leadership & Awareness Kathy M. Johnson, RHIA VP Coding Quality & Compliance Care Communications, Inc. www.carecommunications. 1 com 1.800.458.3544
  • 2. ICD-10 Leadership & Awareness http://www.ahima.org/icd10/ICD-10PreparationChecklist.mht Year 2009/ 2010 2011 2012 2013 Phase I Impact Assessment Phase II Preparing for Implementation Phase Go Live III Preparation Phase IV Post – Implementation www.carecommunications. 2 com 1.800.458.3544
  • 3. ICD-10 Leadership & Awareness Truth: ICD-10 implementation cannot effectively be planned for in isolation. www.carecommunications. 3 com 1.800.458.3544
  • 4. Areas of Impact: ICD-10 Leadership & Everywhere! Awareness Disease Financials Reimbursement Management Case Test Quality Registries Management Ordering Measures Clinical Decision Health Billing Making Policy Identifying Fraudulent Research & Practices Studies Scheduling Payment Systems and Registration Claims Processing Pharmacy Performance Improvement & Reporting Encoding Measurements Software www.carecommunications. 4 com 1.800.458.3544
  • 5. ICD-10 Leadership & Awareness We are in a time that demands an immense amount of agility and flexibility - leaders must have the skill and insight to prepare for a future that is rushing at a faster pace than ever before. www.carecommunications. 5 com 1.800.458.3544
  • 6. Leading Change “How do you manage change? Pretty much the same way you’d manage anything else of a turbulent, messy, chaotic nature, that is, you don’t really manage it, you grapple with it. It’s more a matter of leadership ability than management skill.” Fred Nickols www.carecommunications. 6 com 1.800.458.3544
  • 7. “Management is about complexity, leadership is about change.” J.Kotter Management Leadership Plan, budget, Establish direction, organize, staff, align people, control and motivate, and inspire. problem solve. www.carecommunications. 7 com 1.800.458.3544
  • 8. Project Management • Initiating • Planning • Executing • Controlling • Closing www.carecommunications. 8 com 1.800.458.3544
  • 9. It’s All About Leadership – Vision – Presence – Competence – Collaboration – Creativity – Influence www.carecommunications. 9 com 1.800.458.3544
  • 10. Eight-step Process for Leading Successful Change Implementing and sustaining 8. Make it stick the change 7. Don’t let up Engaging and enabling 6. Create short-term wins the whole organization 5. Enable action 4. Communicate for buy-in Creating a 3. Get the vision right climate for change 2. Build guiding teams Source: The Heart of Change Field Guide – 1. Increase urgency Dan S. Cohen www.carecommunications. 10 com 1.800.458.3544
  • 11. Phase 1: Create a Climate for Change • Deal with the emotional process of change from the beginning • Build the needed level of energy to get the change off the ground • Steps: Urgency, Guiding Teams, Vision www.carecommunications. 11 com 1.800.458.3544
  • 12. 1 Increase Urgency • Build a case for change – Performance gaps – Competitive advantage – Errors, failures and missed opportunities – Trends – Determine what people in the organization value www.carecommunications. 12 com 1.800.458.3544
  • 13. 1 Increase Urgency continued • Identify behaviors that stop change: Complacency Immobilization Anger Pessimism Sabotage www.carecommunications. 13 com 1.800.458.3544
  • 14. 1 Increase Urgency continued • Leaders should: – Make everyone involved feel and see the need for change – Respect the past, acknowledge present weakness and future challenges – Communicate compelling stories – engage stakeholders in a dialogue – Ensure that all senior executives and at least 75% of management are on the change bus www.carecommunications. 14 com 1.800.458.3544
  • 15. ICD-10 Leadership & Awareness Truth: Decisions that impact financial, team and project performance are made faster, with better information, when accomplished in collaboration with key stakeholders. www.carecommunications. 15 com 1.800.458.3544
  • 16. 2 Build Guiding Teams Key Roles: • “Change” sponsor • Senior guiding team • Field guiding teams www.carecommunications. 16 com 1.800.458.3544
  • 17. 2 Build Guiding Teams “Right mix” of people: organizational credibility influence expertise inspires and motivates decision-making authority sense of urgency able to remove barriers www.carecommunications. 17 com 1.800.458.3544
  • 18. 2 Build the Guiding Team • 5 basic elements of effective teams: – Shared sense of purpose – Clear roles – Defined team process – Strong relationships – Effective interactions with other teams and managers www.carecommunications. 18 com 1.800.458.3544
  • 19. 3 Get the Vision Right • “Never under estimate the power of a good story” • Determine the process for creating and communicating the vision • Create bold visions • Move as fast as possible www.carecommunications. 19 com 1.800.458.3544
  • 20. ICD-10 Leadership & Awareness Vision Statement ICD-10 is the primary Regulatory mandate and vehicle to further position compliance will be ABC Health Care System achieved with full to drive efficiencies and implementation of ICD-10 use granular data to by October 1, 2013. improve care outcomes. www.carecommunications. 20 com 1.800.458.3544
  • 21. ICD-10 Leadership & Awareness Vision Statement Implementation of ICD-10 ABC Medical Center will will further advance our gain quality health care clinical decision making outcomes knowledge capabilities and business through robust data models to support capture using ICD-10 to effective delivery of better serve our patient patient care. community. www.carecommunications. 21 com 1.800.458.3544
  • 22. ICD-10 Leadership & Awareness Vision Statement Quality Initiative: Providing better care and Improve patient safety patient services with the and overall care use of ICD-10 data. outcomes with the use of ICD-10 codified data. www.carecommunications. 22 com 1.800.458.3544
  • 23. ICD-10 Leadership & Awareness Vision Statement • Is the statement clear and motivating – even inspiring? • Is the vision realistic and achievable? • Does the vision describe where the organization wants to go and show the future? • Does the vision appeal to the values & long term interest of employees, customers & stakeholders? www.carecommunications. 23 com 1.800.458.3544
  • 24. “It’s a terrible thing to look over your shoulder when you are trying to lead and find no one there.” Franklin Delano Roosevelt www.carecommunications. 24 com 1.800.458.3544
  • 25. Phase II: Engage and Enable the Organization • A leadership responsibility! • All stakeholders engaged and involved in the change • Steps: Communicate for buy-in, enable action, create short term wins www.carecommunications. 25 com 1.800.458.3544
  • 26. Adaptation of Geoffrey Moore’s Responses to Change www.carecommunications. 26 com 1.800.458.3544
  • 27. Law of Diffusion of Innovation www.carecommunications. 27 com 1.800.458.3544
  • 28. ICD-10 Leadership & Awareness Communication Plan Truth: A single memo announcing the transformation or even a series of speeches by the CEO and the executive team are never enough communication of a large scale change. www.carecommunications. 28 com 1.800.458.3544
  • 29. 4 Communicate for Buy-In • Prepare for Q&A • Communicate the right message at the right time • Perform an assessment of peoples’ understanding of the vision and strategies www.carecommunications. 29 com 1.800.458.3544
  • 30. 4 Communicate for Buy-In • Develop a compelling story • Use metaphors and analogies • Say it again, again and again • Use many different forums • Keep communication simple • Develop a communication plan www.carecommunications. 30 com 1.800.458.3544
  • 31. ICD-10 Leadership & Awareness • 32% of time is spent helping others resolve questions – 54% of the questions have been answered before but not in any type of accessible knowledge base • 81% believe it is important to share knowledge www.carecommunications. 31 com 1.800.458.3544
  • 32. ICD-10 Leadership & Awareness Communication Plan Key Target Channel or Audience Message Create Deliver Forum Points www.carecommunications. 32 com 1.800.458.3544
  • 33. ICD-10 Leadership & Awareness Communication Plan Target How Feed Issues Back Frequency Audience Impacted www.carecommunications. 33 com 1.800.458.3544
  • 34. ICD-10 Leadership & Awareness Communication Plan • Board of Executives • Registry Personnel • Medical Staff • Data Analytics Staff • Department & Practice • Administration Line Leaders • Compliance & Risk Management Staff • Case Management • Committee Members • Coding Staff – Revenue Cycle • Customers – Informatics • Codified Data Users – Cancer Care Board www.carecommunications. 34 com 1.800.458.3544
  • 35. ICD-10 Leadership & Awareness Communication Checklist • Are you using the preferred senders to deliver communications in your organization? • Are you answering the question "what's in it for me (WIIFM)"? • Are you repeating key messages 5 to 7 times? • Are you creating opportunities for two-way communication? • Are you finding effective ways to reach your audience? www.carecommunications. 35 com 1.800.458.3544
  • 36. ICD-10 Leadership & Awareness Communication Checklist • Did you develop new communication channels? – ICD-10 Webpage – Elevator and Stairwell Posters – Screen Saver Messages – Use of External Presenters – Lunch and Learn – Demonstrations – Intranet Q & A Forum – Interview Videos – An ICD-10 Event Day – Newsletter – Social Networking www.carecommunications. 36 com 1.800.458.3544
  • 37. Leaders Inspiring Action http://www.ted.com/talks/lang/eng/simon_sinek _how_great_leaders_inspire_action.html www.carecommunications. 37 com 1.800.458.3544
  • 38. ICD-10 Leadership & Awareness When written in Chinese the word “crisis” is composed of two characters. One represents danger, and the other represents opportunity. John F. Kennedy www.carecommunications. 38 com 1.800.458.3544
  • 39. ICD-10 Leadership & Awareness Ask Me About ICD-10 www.carecommunications. 39 com 1.800.458.3544
  • 40. ICD-10 Leadership & Awareness Email: kjohnson@care-communications.com Telephone: 1-312-229-7167 www.carecommunications. 40 com 1.800.458.3544