Background Statement

A medical institution is a very complicated enterprise. There are many interconnected activities and pieces, which must all be in place at the right time, for delivery of best care for patients and efficient operations to ensure institutions do not suffer loss.

The Aga Khan University Hospital (EST 1958) is a reputable medical institution in Kenya, offering a wide range of services to patients from Kenya and other countries in East Africa. In its efforts to deliver the best care to patients and operate efficiently, the hospital has invested heavily in human resources and equipment, such as the PET Scan.

The hospital retains a staff base of around 3,000 people deployed to various departments. It operates over 50 outpatient clinics within Kenya and beyond. It is the teaching hospital of the Aga Khan University, a not-for-profit academic institution with presence in six countries across three continents.

Statement of the Problem

Technology is widely accepted as a panacea to many challenges that hinder the growth and development of institutions, globally. According to a 2022 study published on Statista, over 64% of business leaders identified big data/ analytics as one of the main technological factors that will earn them competitive advantage.

Recognizing the potential of technology to further improve its operations, the hospital decided to invest in an Electronic Health Records (EHR) system over a decade ago. An EHR system is an electronic version of a patient’s medical history, maintained by the provider over time and may include all of the clinical and administrative data related to a patient’s medical care. The EHR contains information about a patient’s medical history, diagnoses, medications, treatment plans, immunization dates, allergies, radiology images, laboratory and test results, vital signs, personal statistics such as age and weight, and billing information.

Through a team of multidisciplinary experts, the institution immediately embarked on a journey to identify the most effective system that would address the institution’s current and emerging needs. 

After thorough evaluation, the team settled on a system that would aptly meet the needs of the hospital. It also recognized the need for research, through the Aga Khan University, with a view to advancing medical knowledge and as a basis to develop interventions and solutions suited to Low- and Middle-Income Countries. These regions, have to a large extent been given a wide berth in medical research and interventions.

The system does not come as a plug-and-play. It requires a great deal of customization to conform to an institutions current and emerging needs. The process required planning, training and documentation of processes, tasks which are not routinely done within an institutional setting.

Research

To develop an effective communication strategy for the digital transformation project, the hospital conducted research on its internal and external audiences. The research that informed the strategy heavily hinged on the following insights.

1. Audiences need to be disaggregated. In the short and medium term, the focus would be on internal audiences as they would be the ones involved and affected by the planning process. External audiences would only be targeted once the system was operational and had gone through the stabilization process.
2. Most internal audiences were clinicians who spend most of their working days with patients in clinical settings such as wards, diagnostic laboratories of the pharmacy.
3. Change often faces resistance. However, this is more likely if the main push for change comes from the leadership.
4. The work to prepare the system for use was an ongoing process. It was best for communication to mirror this approach and highlight the most important milestones.
5. There was need to create avenues for feedback and/ or seek clarification, to ensure that no one was left behind in the digital transformation project.

Strategy

Based on the above-mentioned insights, Communications embarked on developing a befitting change management communication strategy. With many factors at play, the team learnt early in the game that this was going to be a dynamic strategy. The insights gave the following imperatives, that informed our strategic approach. 

1. Phase One of the communication strategy would only target staff. This is to ensure their support and full participation in all preparatory work regarding the system. External audiences would only be informed and engaged once the system is fully operational and stable.
2. Corporate communication is often done through emails, memos, and other print communication. To ensure maximum uptake of the communication, we would use video as the primary approach. The multimedia elements are more attractive, appeal to multiple senses in communication and would go further to stimulate conversations among colleagues regarding the system.
3. We created local heroes and made them the first-line influencers of the digital transformation. These heroes were representatives of different departments who would discuss and share various aspects of their work in the project, on video. These videos were professionally done and would be shared with colleagues monthly.
4. Drip Communication, providing “bite-size” information on a regular basis, was deemed a befitting way to sustain audience attention. The sustained approach was intended to keep colleagues regularly updated, informed, and engaged, while demonstrating momentum in the development of the digital transformation project.
5. Colleagues were given an opportunity to share their feedback through weekly team meetings and a dedicated email address. In addition, the team organized townhall events specifically to share information, receive feedback and discuss any sticky issues. These events were hybrid, allowing in person or virtual attendance, particularly considering the university’s wide geographical footprint. 

Objectives

The communication was designed to meet and address the following objectives:

1. Create awareness about the digital transformation project among +15,000 colleagues in Kenya, Uganda, Tanzania, Pakistan, Afghanistan, and United Kingdom.
2. Illustrate the benefits of the digital transformation project on clinical outcomes, operational efficiency, and research aspirations. 
3. Mitigate potential apathy to the digital transformation project. Apathy would have derailed the project and its impact.
4. To profile and celebrate colleagues who put in a lot of effort to develop the system and illustrate their distinct and collective roles.
5. Communicate, subtly, about the new roles that arose from the project and its implementation.
6. To offer a platform for feedback and input from the entire staff base. 
7. Offer events support and amplify the same using the institution’s channels.

Planning

To bring the strategy to life, there were some critical ingredients to success. Here are the preliminary activities that took place before the strategy was put into effect.

1. Strategy Cascade: The strategy was shared with colleagues during meetings with a view to securing their buy-in, support and concurrence.
2. Content Plan: In addition to the strategy, there was need to develop a plan that guides what to communicate at which phase of the campaign. This however remained dynamic, to accommodate unforeseen happenings.
3. Onboarding of Suppliers: Some of the executional aspects of the campaign relied on external suppliers.:
   • Video and photography
   • Design
   • Others

Audiences: The audiences for the initial phase of the communication were internal. 

Communication Channels:

• Newsletter (Monthly)
• Posters and notices (Ongoing process)
• Video & Photography (On-a-need basis)
• Townhall Sessions (Two before go-live and two after)
• PowerPoint Template (Once)
• Banners (On a need basis)
• Wearables -branded polo shirts (Once then on a need basis (replenishment))
• Branded gifts/ treats (Once -at go-live)
• Certificates/ Tokens of Appreciation (Once/ On a need basis)

Other Collateral:

• PowerPoint Template for the Project
• Banners
• Backdrops
• Branded T-Shirts 
• Lanyards 

Theoretical Background: Diffusion of Innovation Theory

Proposed by Everett Rogers in 1962, the Diffusion of Innovation theory explains how an idea or product is diffused and received amongst audiences. It proffers that there are five categories of adopters to the innovation. These are: Innovators, Early Adopters, Early Majority, Late Majority, and Laggards. 

The strategy employed in the digital transformation project at AKU aimed to ensure that change project is well understood and received positively by all internal audiences. As such, drip feeding, was intended to ensure that there is equal understanding of the project and its impact.

Conclusion and Closing

The project went live in November 2022, ushering in the stabilization phase of the project. During this period, teams worked together to ensure that all operations within an institution were seamless. Upon the conclusion of this phase, the institution will embark on optimization, which aims to make the system more effective by adding more projects. This will be a long term and incremental activity. 

As such, change management communication remains a continuous activity that connects technological advancements and human elements. This will be an infinite undertaking. 

Reference: https://www.statista.com/statistics/1224853/tech-helping-organizations-realize-business-goals-worldwide/