e-Medicine Business models Week 6

Dealing with Resistance to As-Is Modeling

To avoid stirring up unnecessary angst, we'll point out that when you get this far, there is seldom resistance to spending a reasonable amount of time on as-is modeling. You've already demonstrated how much can be accomplished in a short period of time by following well-defined methods and so have usually earned the faith of the sponsor and participants. Still, reluctance could arise that needs to be addressed appropriately. Once the modeling goes smoothly, you'll have a useful product.

As-Is Process Modeling Issues:

Unfortunately, modeling the as-is process doesn't always sail along smoothly. During the session, certain problems commonly arise and there are strategies for dealing with them. Issues and approaches are arranged under five topics:

The 5 topics of As-is process modeling issues:

1. Misapplying workflow modeling
2. Modeling different versions of the same process
3. Inability to model a particular situation
4. Facilitation issues
5. Dealing with disagreement

Phases in Process Modeling Methodology:

As you have learned, there are three phases in the process modeling methodology.

The first phase is to

establish process context, scope, and goals.

The second phase is to:

understand the current as-is process.

And the third phase is to

design the new to-be process.

We are going to focus on the third phase. To design the new or to-be process, you need to assess the as-is process, devise potential improvements, select changes, define characteristics for the to-be process, and design the new workflow.:

During phase three, it's time to transition to rethink and redesign the new to-be business process. We accomplish this task through: 1. Conducting the final as-is process assessment (the primary focus of this unit presentation)
2. Design the to-be business process (the focus of the next unit)

Final As-Is Process Assessment:

Our immediate concern is to consolidate our understanding of the factors impacting current process performance and at the same time identify ideas that might address those factors. We will resist the common urge to leap straight into modeling the to-be process workflow, and instead spend some time to conduct a holistic assessment - enabler by enabler - of the as-is process. With final as-is process assessment we are taking a step into the design of the to-be process. Conducting Final Assessment is part understanding the as-is process and part designing the to-be process - they're inseparable.

Preparing for the Final As-Is Process Assessment:

In addition to the core team, we involve the content experts who participated in the as-is workflow modeling. Everyone has built up a lot of knowledge and impressions, probably much of it is undocumented, and we want to capture it in the form of an assessment as soon as possible. Most importantly, Process team and the leadership must participate. As usual, this is best done in a facilitated session.

There are seven key steps in conducting the final as-is process assessment. They are:

1. Confirm stakeholder assessment and process goals from initial assessment.
2. capture first impressions of process strengths and weaknesses.
3. identify leverage points
4. assess by each enabler in turn, generating process improvement ideas.
5. assess individual steps, which is optional.
6. consolidate improvement ideas
7. decide on an approach.

The first step is to confirm the initial assessment and goals. This is done by looking at your initial assessment, and asking:

Would the process case for action be any different now based on what was learned while doing the mapping? Ask this question for each stakeholder.
Would the process vision be any different now based on what you learned while doing the mapping?
Then, make changes as necessary, bearing in mind that you might have to reconvene some of the earlier participants if they aren't currently involved, to confirm the changes with them.

The second step is to capture first impressions.

At this point, participants will probably have some strong ideas about the process. Open the floor, or a blank sheet of flipchart paper, and brainstorm for first impressions, including significant problems, features to keep, and possible improvements. Let participants spell out the ideas, so they can focus on the enabler-based assessment. Strictly control the session, avoid minor details.

The third step is to identify leverage points.

Ask the question: "What's really important in the process?" Looking for leverage points can help you find out. A leverage point is a part of the process that has a disproportionate impact on overall performance. They occur at the process front end and the likely root causes of the most significant problems.

The forth step is assessment by enablers.

A "Process Enabler" is one of the aspects of a process that "enables" it to perform properly. If an enabler is absent or inappropriate, it is a "disabler." Finding both enablers and disablers is important.

The six enablers are:

1. process workflow design
2. information systems
3. motivation and measurement
4. human resources
5. policies and rules
6. facilities design

Business process is supported by the six enablers.

Above all, effectively constraining the process are the organization's mission, strategy, goals, and objectives; the process' goals, objectives, and differentiator; and the organizational environment. Look at each enabler in turn, record the group suggestions on how that enabler manifests itself in the process, whether positively or negatively. When improvement ideas emerge, record them on an ideas sheet. Make sure to keep these suggestions, even if they appear dubious at first. For each meaningful change document the issue, impact, improvement idea, and expected benefit

The fifth step is optional and used to assess individual steps

Assessing individual steps in detail is optional - it can be overwhelming - and performed only for critical /complicated processes.
Ask the questions:
1. Is this step necessary?
2. Does it yield a useful result?
3. Would a "reasonable" customer pay?
4. Does the most appropriate performer handle it?

The sixth step is to:

consolidate improvement ideas. In addition to documenting the assessment, you'll want to organize the list of process improvement ideas that were generated along with the assessment.

the seventh step is to decide on an approach.

Before going any further, take some time to decide if you need to; go further that is. The future of the process is not necessarily that it will be redesigned. There are five possible courses of action:

5 possible approaches for course of action on deciding an approach from the seventh step:

1. Drop/abandon: This process is not necessary, or the benefit will never justify the cost.
2. outsource: It would be a more effective use of resources to have a supplier carry out the process
3. Leave as-is: The process is fine; the issues were elsewhere, for instance, no one follows the process or training is needed.
4. improve: The basic structure of the process is okay but specific improvements are possible.
5. redesign: The process should be fully redesigned.