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Navigation: A Guide to Implementing Person-Centred Care September 20125. What can people directlyaffected by the changestell you about theNavigationimplementation plan:A fulldescriptionA descriptionof where itaffects theirowndepartment oractivityA general ideaNothing6. Intended outcomes of thechange have been:Specified indetailOutlined ingeneral termsPoorly definedNot defined7. Work procedures followingthe introduction ofNavigation are seen asneeding:Major changeSignificantalterationMinorimprovementNo change8. The problems addressedthrough Navigation werefirst raised by:The staffdirectlyinvolvedManagersOutside bodies:CPAC,provincialcancerorganizationsThe change isnot seen asaddressingimportant andrelevant serviceproblems9. The next stage of change isviewed by staff as:Crucial to theorganization’sfutureGenerallybeneficial tothe organizationBeneficial onlyto part of theorganizationUnimportant10. Top management supportfor Navigation is:Enthusiastic Limited Minimal Unclear11. The management team has:Committedsignificantresources tothe changesAssigned tokenadditionalresources tothe changesExpects thechange to beimplementedfrom existingresourcesNot plannedthe resourcesthat areneeded12. The management performanceappraisal andreview process is:An importantpart of managementdevelopmentA helpfulproblemsolvingprocessRoutineAn obstacle toimprovement13. The change deals withissues of relevance to thepractice environment:Directly Partly Only indirectly Not at all14. Navigation and relatedchanges:Make jobsmorerewardingMake jobseasier andmore satisfyingHave littleimpact onpeople's workMake jobsharder15. Navigation and relatedchange istechnically:Similar toothers alreadyunderwaySimilar toothers undertakenin therecent pastNovelTechnicallyunclear72
Navigation: A Guide to Implementing Person-Centred Care September 2012Readiness for Change Checklist:Some Problems and SolutionsTrack Record of Changes (Questions 1-3)The potential problems are:• Past changes have met with resistance• Past changes were poorly understood• Employees are thought to be too cautious• Recently introduced changes have had limited or little successThe solutions are:• Keep everyone informed by making information available, explaining plans clearlyand allowing access to management for questions and clarification.• Ensure that change is solid realistically by making a practical case for it. Explainchange in terms which the employee will see as relevant and acceptable. Showhow change fits service needs and plans. Spend time and effort on presentations.• Prepare carefully by making a full organizational diagnosis by spending time withpeople and groups, and building trust, understanding and support.• Start small and build up a successful track record. Implement changes in clearphases.• Plan for success by starting with things that can give a quick and positive pay-off.Publicise early successes. Provide positive feedback to those involved in successes.Expectations of Change (Questions 4-6)The potential problems are:• Different people hold different ideas about the change• People do not know what to expect• Objectives are not clearly definedThe solutions are:• Clarify benefits of changes by emphasising benefits to those involved, that is, tothe service.• Choose messages and messengers carefully and communicate often.• Reinforce that the guidelines are evidence-based and that much of the value of theguideline pertains to improving patient and family experience with cancer(i.e., every patient will be screened and assessed for distress and all interventionswill lead to the best possible outcome).73
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