Change Project 911: Unable to sustain a change

Mat Roosa, LCSW-R
NIATx Coach

“It’s easy to quit drinking. I’ve done it a thousand times.”   W.C. Fields

Change is easy. Sustaining change is not so easy. This is true for personal changes like quitting smoking, exercising more, driving slower, or keeping the house more organized. It is also true for workplace systems changes, such as implementing new policies and procedures. Too often, despite our best intention, we end up like Sisyphus, doing our best to roll the change up the hill, only to see it slide back down.  

The NIATx rapid-cycle PDSA change model emphasizes making changes that you can measure and implement quickly. Sometimes, change teams think of the process as a quick sprint to change. But sustaining a change (sustainment) is more like a long-distance run. So here are a few things you can do to pace yourself to sustain your change project gains. 

Create a sustain plan

Sustainment rarely happens without a clear sustainment plan. Just as inpatient hospital care should include discharge planning at admission, change projects should start sustainment planning at the beginning of the change. Build the sustainment conversation into the change project planning, and use the elements below to ensure sustainment success. 

Keep meeting

NIATx change teams meet frequently when developing and implementing a change project. Too often, these teams disband prematurely at the end of the change implementation. Schedule ongoing—but less frequent—change team meetings to monitor the successful change. 

Track the data

Many successful change sustainment teams develop a data dashboard for tracking key change metrics. Periodic review of the data helps decision-makers take action when the data reflects a drift from the new practice. Teams can set parameters that will trigger actions: If metric x drops below level Y, we will do Z, etc.

Engage new staff

Staff turnover poses a primary challenge to sustainment. Initial implementors leave, often replaced by staff who have no knowledge or investment in the new practice. Offset this issue and sustain the new practice by building it into your organization’s policy and procedures and new staff training. In addition, learning the history story of successful change projects helps new staff to appreciate the work that has come before them and will motivate them to sustain the improvements.

Assign a Sustain Leader

A key role in the NIATx model is the Change Leader. Teams are also encouraged to assign a data coordinator, who gathers and presents the change project data. The Sustain Leader plays another key role for Change Teams. Assigning a  Sustain Leader responsible for creating a sustainment plan is the clearest path to making sustaining the change a priority for your team.

Focus on ROI

Change teams feel frustrated when they see the progress of a successful change project fading—or worse, reverting to the old way. Backsliding leaves the team right back where they started, with little to show for their efforts. Instead, motivate teams to sustain successful gains by celebrating progress. Announcing the successful change and honoring the change team's effort in an office newsletter or other communication can also motivate the team to sustain the improvement.

Recognize the challenge of turning the new into the norm

Most people and teams are better at starting new things than they are at sustaining new things. Humans evolved to notice risk and make rapid decisions to increase safety. Appreciating this innate wiring can help us feel greater empathy for ourselves and our team members as we work to monitor changes and enhance sustainment. 

Using the strategies above can help you to succeed in turning new changes into norms of practice. However, continuous quality improvement is not just about the implementation of change. CQI also requires an ongoing effort to sustain the changes you have already made. 

About Change Project 911

Change Project 911 is a monthly blog post series covering common change project barriers and how to address them. Has your change project hit a snag that you’re not sure to tackle? Share your issue in the comments section below, or email Change Project 911 at matroosa@gmail.comWe’ll offer solutions from our team of change project experts!

About our Guest Blogger

                                                 

Mat Roosa was a founding member of NIATx and has been a NIATx coach for a wide range of projects. He works as a consultant in quality improvement, organizational development and planning, and implementing evidence-based practices. His experience includes direct clinical practice in mental health and substance use services, teaching at the undergraduate and graduate levels, and human service agency administration. You can reach Mat (Change Project SOS) at matroosa@gmail.com.

Change Project 911: No Time for a Change Project: Finding Time vs. Making Choices

Mat Roosa, LCSW-R
NIATx Coach

“The change seems like a good idea, but we just don’t have the time to do it. Let’s come back to this next year when we have more resources."

No time for a change project:
Finding time vs. making choices

Why do so many good change ideas end up at the bottom of the pile? Why do most teams struggle to find the time, energy, and people to implement change projects? Many teams are convinced that they cannot control the urgent needs, staffing and fiscal resource demands, and other obstacles that get in the way of change implementation.  This might be because they are asking the wrong question.

 

Instead of asking, “Do we have the time to take on this new project?” teams and leaders should be asking, “Which projects should we choose?”.

 

While we may be short on time, we can choose how we’ll spend it. The four steps below can help you choose which project to pursue. Apply these strategies to both current and potential projects periodically to ensure that you create time for the critical projects and let go of the rest.  

1. Consider the return on investment of a potential change project before implementing the change.
2. Prioritize a manageable number of activities for action to ensure that you have the resources to complete the change project successfully.
3. Cultivate urgency within your team to foster focus and action.
4. Use tested practices to unite the team and sustain action to implement the project.

ROI: Understanding pros and cons and the value of the change

In keeping with a motivational Interviewing model, we are all ambivalent about most of our decisions. This includes decisions to invest in change projects. It can be helpful to use a decision balance exercise with your team regarding the pros and cons of moving forward with the change project. How valuable will this change project be for our team?

Priority: If everything is a priority, then nothing is a priority.

Once you have determined a strong ROI for completing a change, then you need to find a way to make it happen. Most of us have too many priorities and struggle to move them forward in a timely fashion. There are only so many projects that you and your team can complete successfully, and that number is probably smaller than you think it is. To succeed with a change implementation, we need to decide what we want to do. We also need to decide what needs to come off our list to ensure that the priority projects are completed.  

Urgency: the burning platform

Most of us, most of the time, have a bias toward the status quo. Unless there is a convincing reason to change, we tend to favor options that we know over those less familiar. Known things are more comfortable, even when they are not useful, or even dangerous. New and unknown things are stressful, even when they are likely to provide us with great benefits.

Change requires a felt sense of urgency. Many have used the story of the burning platform to understand the importance of urgency. Imagine that you are on a platform in the ocean, a mile from the shore. You are told that you need to jump into the water and swim to shore. You will likely hesitate and consider all the risks related to this swim. Will you be hurt jumping off the high platform? Can you swim that far? Is there a current? Are their sharks in the water? Etc.

Now imagine that the platform is on fire, and flames are spreading toward the edge where you stand. You may pause briefly, but then you will jump and do your best to swim toward the shore. 

The challenge of urgency is that most of us do not experience the clear danger of a burning platform. The need for change is rarely as obvious as when the window of opportunity to make beneficial changes has closed. Leaders need to understand the risks of inaction and the rewards for action and communicate these in a way that cultivates urgency for the team. Leaders should never “light a fire” to get their team to jump, but they need to be able to point to the obvious risks of inaction.  

Tested Practices: Do what works to find the time. 

Once you have found a project with a high ROI, and have cultivated urgency for this new priority, you are ready to implement the change. Effective team implementation requires that you:  

• Collaborate with the team to harness the energy and skills of a diverse group. 
• Delegate elements of the project to ensure team engagement and to spread responsibility so that the project is more manageable. 
• Use existing infrastructures such as staff meetings and supervisory processes to steer the change project. This prevents the need to find additional time to work on the project. 

There is always time for the most valuable priorities. Hopefully these ideas will help you define priority changes and then take action to get them done.

Planning a change project in 2022? 

A key role in the NIATx model is the Change Leader. Teams are also encouraged to assign a data coordinator, who gathers and presents the change project data. The Sustain Leader plays another key role for Change Teams. Assigning a  Sustain Leader responsible for creating a sustainment plan is the clearest path to making sustaining the change a priority for your team.

Join an upcoming NIATx Change Leader Academy! View the complete 2022 NIATx Change Leader Academy Training Schedule.

About Change Project 911

Change Project 911 is a monthly blog post series covering common change project barriers and how to address them. Has your change project hit a snag that you’re not sure to tackle? Share your issue in the comments section below, or email Change Project 911 at matroosa@gmail.comWe’ll offer solutions from our team of change project experts!

About our Guest Blogger

                                                 

Mat Roosa was a founding member of NIATx and has been a NIATx coach for a wide range of projects. He works as a consultant in quality improvement, organizational development and planning, and implementing evidence-based practices. His experience includes direct clinical practice in mental health and substance use services, teaching at the undergraduate and graduate levels, and human service agency administration. You can reach Mat (Change Project SOS) at matroosa@gmail.com.

 

Three Ways to Sustain Change with NIATx

 By Mat Roosa, LCSW-R, NIATx Coach

The NIATx model is designed to help teams identify and implement a process improvement. While adopting a change is a significant accomplishment, the true test lies in maintaining that change and its positive outcomes over the long term: sustaining the change.

Sustainability refers to the ability to stick with the new way of doing things and continue reaping the benefits that prompted the change initially. It involves integrating the new methods into the organizational culture, ensuring stability amidst future changes, and fostering adaptability to unforeseen circumstances.

Despite its importance, sustaining change is no easy feat. Many change efforts fail to be sustained beyond the initial six months. To counter this trend, proactive planning and diligent effort are essential. Sustainability planning should commence early in the change project, aligning with the principles of continuous improvement.

Here's a trio of strategies that change teams can use to guarantee lasting improvements:

1. Appoint a Sustain Leader familiar with the change and its rationale.

It is difficult to think about the future when you are in the midst of trying something new. One of the best ways to develop a change project with sustainment in mind is to assign a member of the change team to the role of sustain leader. This individual will support the key efforts to sustain the change, including developing policies and procedures and maintaining ongoing measurement, both discussed below. When the rest of the team turns their attention to new priorities, the sustain leader will keep the change effort on course.

 

2.    Document the change in policy and procedure manuals, ensuring simplicity and clarity.

A clear indication that a successful change is at risk of not being sustained is to hear the Change Leader saying, “Don’t forget to continue to…”. Such reminders are never needed for activities that are well-established as standard operating procedures. Adjustments to documentation processes, including adding required elements and checklists, make the new practice a required element that cannot be skipped. Maintaining an up-to-date policies and procedures manual to actively guide practice will ensure that the new practice becomes the norm.

 

3.    Establish data collection methods to monitor progress continuously.

One of the best ways to sustain a change is to keep measuring it. We tend to pay attention to the things that we measure. When change projects achieve the desired goal, there is a tendency to stop measuring and move on to new priorities. When measurement is continued weekly, or at least monthly, the team can take preventive action when the numbers start to slip.

This data monitoring can trigger the reactivation of the change team. Ongoing measurement also points to the need for manageable measures that are easy to maintain and review. Complex data measures that require a high level of energy to maintain are less likely to be sustained.

By embracing sustainability from the outset, organizations can pave the way for enduring positive change and continuous improvement in their operations.

 

Ready to launch a NIATx Change Project? Join our next NIATx Virtual Change Leader Academy in May 2024!   

Embracing Change: How to Infuse Technical Assistance with NIATx Process Improvement Principles

By: Kristina Spannbauer, Communications Specialist for the Great Lakes ATTC, MHTTC, & PTTC

One of the greatest aspects of NIATx process improvement is the adaptability of this model. Over the past several years, the Great Lakes ATTC, MHTTC, and PTTC have developed hybrid training series integrating NIATx principles with other in-demand technical assistance (TA) and intensive technical assistance (ITA) offered by our centers. Some of the special focus topics featured in these series are the National Culturally and Linguistically Appropriate Services (CLAS) Standards, suicide prevention, school-based mental health, recruitment and retention, telehealth services, and supporting the COVID-19 workforce. Behavioral healthcare and prevention professionals from our region who have participated in these hybrid courses consistently report greater success in implementing and applying the skills learned during training thanks to the inclusion of NIATx principles.  

In the spirit of embracing change, I sat down with Alfredo Cerrato, Scott Gatzke, and Mat Roosa–three of the Great Lakes ATTC, MHTTC, and PTTC's subject matter experts and most experienced trainers–to better understand their considerations, planning processes, and experiences when it comes to "infusing" our TA and ITA content with NIATx principles and the Change Leader Academy (CLA) curriculum. 

What considerations and adaptations were required when integrating the NIATx model for process improvement with other technical assistance and training courses?

Mat: Since NIATx has a process focus, it naturally pairs with a wide array of content to help people improve how they do what they do. As we've worked to include NIATx with our other trainings, we've found that it's easier to market content than it is to market process. For instance, people tend to be more interested in learning evidence-based practices than they are in learning process improvement strategies, but we've also discovered that the combination of content and process draws people in. Folks are eager to learn process tools that help them implement evidence-based practices at both an individual and organizational level.

Scott: I agree. As we've continued to develop and host hybrid courses, it's become apparent that participants are quicker to engage with the content when they are learning process improvement strategies in relation to applicable, real-life practices they will use in their work.

Alfredo: I approached the process from a cultural perspective. As we've worked to integrate NIATx with our other technical assistance offerings, it's extremely important that we always prioritize culture and culturally appropriate service delivery. When developing the CLAS Standards Change Leader Academy, we were dedicated to maintaining the integrity of the original CLAS Matters! training, as well as to making abstract concepts more concrete through the application of scientific methods and academic vocabulary.

What benefits and/or challenges did you experience when integrating NIATx with other trainings?

Mat: We found that conducting hybrid courses with two trainers–one who focuses on the "content" and one who focuses on the "process"–has been really beneficial. For example, Alfredo knows NIATx and he's also our expert trainer for CLAS Standards. He and I function as co-trainers in the CLAS Standards Change Leader Academy with Alfredo taking the lead on CLAS content while I primarily teach the process improvement aspects of the series.

Alfredo: We've learned a lot while developing and facilitating the CLAS CLA. One of my main takeaways is that for this specific co-training approach to be effective, subject matter experts (SMEs) in any field must also understand the NIATx principles and be able to apply process improvement tools in their particular field(s). Likewise, the NIATx trainer must be able to speak the language of the SMEs when explaining concepts or providing examples.

As a trainer, what has been your most memorable experience(s) when facilitating these trainings?

Scott: Hearing the stories of how the NIATx tools (i.e., walk-through, flowcharting, nominal group technique, and PDSA cycles) empower the change leaders attending the training to better understand their customers, connect with leadership and staff in their organization, and make an actual improvement to their processes is very rewarding.

Alfredo: In the CLAS Standards Change Leader Academy, I am particularly impacted by how people connect the historical dots and open up to the possibility of change. I also notice that they become more aware of how current culture is changing their worldview and how past worldviews have shaped their culture.

Mat: I always love it when people are willing to be open and acknowledge that they are struggling to implement... they understand that knowing the material is not enough to get the job done. I also love seeing people who typically may not have much power in their system or organization become empowered with the NIATx process. It's inspiring to watch them gain confidence and respect from their peers and create a significant impact on the quality of services being offered. Those are typically my favorite moments.

What advice would you give to those interested in learning more about NIATx or how to apply NIATx to their work?

Alfredo: Culture is intrinsic and vital to every person. In that sense, cultural considerations trump those of process improvement, but it's important to remember that every process can be bettered or refined by first considering culture. If not considered, the process improvement effort will likely fail. However, we must also acknowledge that process is needed to understand and affect cultural change. Without an understanding of process and process improvement, negative culture will be organically perpetuated. Both concepts need one another to facilitate better outcomes.

Scott: When you really need to improve something, help your change team stay laser focused on the narrow, specific aim you have identified for your change project. Everyone’s world is full of competing needs and urgent issues, which often leads to “scope creep” for many change projects (e.g., adding multiple deliverables or goals for the project). As soon as the aim of the project becomes unclear for the team, the change project will, at best, flounder or it will become completely disbanded. As a change leader, keep the aim of your project front-and-center for your executive sponsor and change team. Only work on the activities which move toward achieving the change project aim.

Mat: My advice is quite simple: 1) attend a NIATx Change Leader Academy; 2) use the NIATx tools; 3) practice them over and over; 4) work as a team; and 5) find ways to understand that EVERYTHING is a process, and every process can be improved.

I would like to sincerely thank Alfredo, Scott, and Mat for sharing their expertise and wisdom in this blog post. On behalf of the Great Lakes ATTC, MHTTC, and PTTC, we also thank our many contributing subject matter experts, content creators, regional and national partners, and of course, the dedicated workforces of the Great Lakes region who keep our team focused on innovation, positive change, and serving our communities.  

About Our Subject Matter Experts:

Alfredo Cerrato is the Senior Cultural and Workforce Development Officer for the Great Lakes ATTC, MHTTC, and PTTC. He is also a nationally certified trainer on Culture: An Integral Part of Mental Health Services for Hispanic and Latino Populations by the National Hispanic and Latino Mental Health Technology Transfer Center in Puerto Rico and a national trainer on cultural topics for the National Association for Alcoholism and Drug Abuse Counselors (NAADAC). Mr. Cerrato has 25 years of international relations experience and specializes in cross-cultural communications, conflict resolution, and process improvement.

Scott Gatzke is Director of Dissemination for the Great Lakes ATTC, MHTTC, and PTTC. He is a NIATx trainer and coach with over 25 years of experience in process design and quality improvement in manufacturing, healthcare, and non-profit organizations.

Mat Roosa is a founding member of NIATx and has been a NIATx coach for a wide range of projects. He works as a consultant and trainer in the areas of quality improvement, organizational development, and planning, evidence-based practice implementation. Mat’s experience also includes direct clinical practice in mental health and substance use services, teaching at the undergraduate and graduate levels, and human services agency administration.

 

Great Lakes ATTC: Process Improvement Focus Helps Organizations Implement Evidence-Based Practices

Todd Molfenter, Ph.D.

Director, Great Lakes ATTC

The mission of the ATTC Network includes “accelerating the adoption and implementation of evidence-based and promising addiction treatment and recovery-oriented practices and services.”

At the Great Lakes ATTC, we’re applying our background in implementation science and process improvement to help accelerate the adoption and implementation of EPBs in our region and beyond.

Implementing EPBs can be challenging for organizations of any size. Emerging research from implementation science tells us that successful EPB implementation needs:

1. more than training alone,
2. coaching and feedback; and
3. standardized improvement model.

See related article, Water into Sand: OUD Pharmacotherapy and Implementation Science: Why Training on Evidence-Based Practices is Never Enough

The NIATx Model

A fundamental tool in the Great Lakes ATTC’s effort to accelerate EPB implementation is the NIATx model, developed in 2003 as a demonstration project supported by the Robert Wood Johnson Foundation and SAMHSA. A seminal article written by McCarty et al. in 2007 described the impact of the NIATx model on access and retention in addiction treatment settings. Since then, more than 50 peer-reviewed articles have documented the use of the NIATx model in adopting evidence-based practices in addiction treatment, mental health, HIV treatment, child welfare, criminal justice, and other human services settings.

The NIATx Change Leader Academy

To teach the NIATx model, we offer the NIATx Change Leader Academy (CLA): a one-day, face-to-face workshop followed by three months of peer networking and support from a NIATx coach. The CLA teaches organizations how to use the NIATx model of process improvement to lead change projects that focus on improving systems or implementing EBPs.

Based on customer feedback (and applying NIATx Principle #1: Understand and Involve the Customer), we continue to refine this training session to make it focused, team-based, and interactive. Participants leave the skill-building workshop with tools they can use to start a change project as soon as they get back to the office.

Available in our region and beyond

During our first year as the Great Lakes ATTC, we conducted NIATx CLAs in each state in our region. These events were a great way to build relationships with our stakeholders and to introduce more behavioral health providers to the NIATx model.

Organizations in our region are using the NIATx approach for a wide range of change projects, including implementation of medication-assisted treatment for opioid use disorder and Screening, Brief Intervention, and Referral to Treatment. NIATx tools are helping to build Recovery-Oriented Systems of Care in Ohio, Indiana, Illinois, and soon, we hope, in other states in our region. Organizations can use the NIATx approach to implement other EPBs, such as those listed in SAMHSA’s Evidence-Based Practices Resource Center.

Photo: NIATx Change Leader Academy, MARRCH, April 3, 2019

The NIATx model also provides a framework for making changes to administrative processes. In Minnesota, a recent NIATx CLA marked the launch of a strategic initiative by the Minnesota Associations of Resources for Recovery and Chemical Health (MARRCH): a statewide Change Leader Learning Community that will help Minnesota providers adapt to policy changes coming to the state.

Read the related news story: NIATx Change Leader Academy Launches Minnesota Learning Collaborative

We offer the NIATx CLA regularly in the states throughout our region; check the Great Lakes ATTC calendar for info on upcoming offerings. And if you are interested in hosting a NIATx CLA in our region, give us a call!

NIATx in New Places: Bringing the NIATx Change Leader Academy to HealtheKnowledge

By Maureen Fitzgerald, communications manager, Great Lakes ATTC, MHTTC, and PTTC, and Scott Gatzke, director of dissemination, Great Lakes ATTC, MHTTC, and PTTC

NIATx began as a demonstration project in which 39 substance use treatment organizations tested process improvement tools borrowed from industry and manufacturing to improve treatment access and retention.

The success of the NIATx approach surpassed expectations. Grantees reported impressive improvements in show rates, continuation, and even the financial bottom line of their organizations. NIATx director Dave Gustafson and his team realized they needed a plan to disseminate the model and meet the growing demand for NIATx training. A key part of the dissemination plan was to host an annual national conference.

Scott Gatzke, senior NIATx trainer and director of dissemination, joined the NIATx team in 2006 to make that plan a reality. “The Summit was also an event to celebrate the success of NIATx change teams and share best practices,” he adds.

“What set the NIATx model apart and what really motivated change teams who attended the event was the impact of making small changes that quickly yielded great results,” says Scott. “The annual Summit tapped into that energy with built-in peer networking. We also made a point to select speakers from outside the field to inspire new ideas and creative thinking.”

Each year of the Summit (2007–2013), Scott used the NIATx approach to improve the planning and execution of the event. “We analyzed attendee feedback for improvement suggestions, designed PDSA cycles for the processes needing improvement, and tested them through walk-throughs focusing on the customer experience.”

Disseminating the NIATx model
NIATX Change Leader Academy: Rapid Cycle Change for Teams

Scott was also one of the team members who helped develop and refine the NIATx Change Leader Academy (CLA). “The CLA was created to meet the growing demand for NIATx training and make the approach available to any organization looking for as easy-to-use model for making improvements,” says Scott. “Since launching in 2006, the CLA has trained hundreds of change leaders in practically every state in the country.”

The CLA also demonstrates how NIATx has expanded to reach new groups outside the original audience of substance use treatment providers. “CLAs in recent years have helped change teams in diverse areas such as culturally and linguistically appropriate services, workforce development, and suicide prevention programs in schools.”

As NIATx has expanded to new areas, the CLA has also adapted in response to customer needs. “We shortened the original two-day in-person training to one day to reduce travel time,” says Scott. “When COVID-19 hit, we developed a virtual CLA, and our newest version is now available on-demand as an online course through HealtheKnowledge: NIATx Change Leader Academy: Rapid-Cycle Change for Teams.”

Todd Molfenter, Director of the Great Lakes ATTC, MHTTC, and PTTC, created content for the course.

“We’re excited to offer training on the NIATx model in a self-paced online learning environment,” adds Scott. “The course lays out the core elements of the NIATx model using the case example of a probation department trying to improve treatment show rates for juveniles coming out of detention—reinforcing the concept that while NIATx was designed originally for substance use treatment field, the approach can work in any setting.”

The HealtheKnowledge course consists of four 15–30-minute interactive modules that give learners the tools to sketch out a change project. "They'll also learn how to apply the tools separately from a change project."

The course will also be the first component of an expanded online offering that NIATx coach Mat Roosa is now developing. “The working title for this course is NIATx CLA 4.0,” says Scott. “It will combine the core HealtheKnowledge course with a series of short videos, quizzes, and a step-by-step change project worksheet.”

Scott Gatzke is a senior trainer/coach of the NIATx process improvement model and director of dissemination for the Great Lakes ATTC, MHTTC, and PTTC. Scott is also the collaborative learning manager for the Behavioral Health Excellence-Technical Assistance Center. Scott has more than 15 years of experience coordinating state-wide and national conferences, trainings, and learning collaboratives for behavioral health and social service professionals and educators.

Keeping it Simple: The NIATx Process Improvement Model Revisited

October 4, 2016

Scott Gatzke
NIATx Coach

Director, ElderTree Dissemination

The late Peter Drucker, an influential business thought leader and educator, once stated:

Almost all quality improvement comes via simplification of design and processes.

Recently, I was reminded of the simple elegance of NIATx model.
A friend came to me and asked what I would do if faced with the following problem:

His organization struggled to make timely improvements to their operations. When a change was finally implemented, it often reverted back to the old process after a few months.

Having guided change teams for years in organizations both large and small, I was all too familiar with the challenge he presented. 

NIATx Principle #2: Fix Key Problems (And Help the CEO Sleep at Night)

Mat Roosa, LCSW-R
NIATx Coach



The NIATx model is driven by five principles that research has shown to be the hallmarks of successful improvement projects. These five principles emerged from an analysis of decades’ worth of research that gathered data from 640 organizations in 13 industries, examining 80 factors on why certain projects fail while others succeed.

Principle 1, Understand and Involve the Customer, is the single most important action a change team can take to set up a project for success. In fact, the NIATx research analysis showed that this one principle has a greater impact on success than the other four combined. (See related blog post: Why Understanding and Involving the Customer Matters in Behavioral Health.)

Lose sight of your customer (your client), and you lose sight of success.

Principle 2: Fix Key Problems (And Help the CEO Sleep at Night) switches the focus to leadership. If a change project is to be successful, it needs the full support of the agency’s leadership. The way to ensure that support is by addressing the problems that truly matter to the CEO.

Kim Linwood of Milwaukee learned the NIATx principles at
NIATx Change Leader Academy in Madison, WI, June 2019.

Change Project Pitfall: Lack of executive sponsorship
Often when change leaders are completing the NIATx project charter, they come to the “executive sponsor” box, and simply fill in the name of their supervisor.

Many are fond of saying that “team” is more of a verb than a noun. It is the act of “teaming” that creates results. The executive sponsor role in relation to the change team reflects this same truth. That is why we need to ask a critical follow-up question: Who is the Executive Sponsor, and what are they doing to ensure the success of the change project?

If everything is a priority…
We all know the second half of this statement: then nothing is a priority.

Executive Sponsors create and maintain priorities. One of the most powerful functions of the Executive Sponsor can be expressed in the following contrasting statements from two Executive Sponsors:

• ES #1: “This change project is important, but make sure you keep doing everything else that we are already working on.”
• ES #2: “This change project is important, so I am going to reassign a couple of tasks to make sure that you have the time you need for the change project to succeed.”

Strong Executive Sponsors like #2 approve the new project for takeoff, and they clear the runway to make sure that the project can pick up the speed it needs to lift off. It is critical to have the ES at the table during the formative stages of the project development to ensure adequate engagement and support. When an ES is reluctant to come to the table beyond a simple approval of the project, the Change Leader can help by reminding the ES of their critical role:

• We need you to role model support for the change project.
• We need you to dedicate resources to this effort.
• We need you to remove the obstacles to our success.
• We need you to encourage our team.

Change projects with weak executive sponsorship often fail to get off the ground. Change projects with strong executive sponsorship can soar.

About our Guest Blogger 
Mat Roosa was a founding member of NIATx and has been a NIATx coach for a wide range of projects. He works as a consultant in the areas of quality improvement, organizational development and planning, evidence-based practice implementation, and also serves as a local government planner in behavioral health in New York State. His experience includes direct clinical practice in mental health and substance use services, teaching at the undergraduate and graduate levels, and human service agency administration. 
You can reach Mat at: matroosa@gmail.com