Leading change is not as easy as it sounds. This slide pack gives an overview of a presentation I gave to a group of front line manager at a regional hospital in Red Deer Alberta. Enjoy! Marlies
8. Most change programmes fail to
deliver their objectives
Source: McKinsey Performance Transformation Survey, 3000 respondents to
global, multi-industry survey
70%
25%
5%
Gets anywhere near
achieving the
change and
delivering the
benefits
9. Source: McKinsey Performance Transformation Survey, 3000 respondents to
global, multi-industry survey
70%
25%
5% Delivers and
sustains the change
Most change programmes fail to
deliver their objectives
10. What do you think the % is in
healthcare?
What are you working on right now
that is about change?
14. @HelenBevan #QS2015
Anatomical
approach
Improving clinical
systems
Seeking to reduce
harm and reduce risk
Redesigning pathways
Standardising
Measuring
Physiological
approach
The vitality and life-giving forces
that enable the system and its
people to develop, grow &
change
creating higher purpose
and deeper meaning
Leading through values
building commitment
creating hope and
optimism about the future
calling to action
15. @HelenBevan #QS2015
Anatomical
approach
Improving clinical
systems
Seeking to reduce
harm and reduce risk
Redesigning pathways
Standardising
Measuring
Physiological
approach
The vitality and life-giving forces
that enable the system and its
people to develop, grow &
change
creating higher purpose
and deeper meaning
Leading through values
building commitment
creating hope and
optimism about the future
calling to action
It’s all
about
energy!
16. Leading change in a new era
Dominant approach Emerging direction
Most healthcare
transformation
efforts are driven
from this side
17.
18. @HelenBevan #QS2015
The reality
“What the leader cares about (and typically bases at
least 80% of his or her message to others on) does
not tap into roughly 80% of the workforce’s primary
motivators for putting extra energy into the change
programme”
Scott Keller and Carolyn Aiken (2009)
The Inconvenient Truth about Change Management
Source of image: swedenbourg-openlearning.org.uk
19. @HelenBevan #QS2015
Leaders ask their staff to be ready for change,
but do not engage enough in
sensemaking........
Sensemaking is not done via marketing...or
slogans but by emotional connection with
employees
Ron Weil
32. People who are highly connected
have twice as much power to
influence change as people with
hierarchical power
Leandro Herrero
http://t.co/Du6zCbrDBC
39. Research from the sales industry:
How many NOs should we be seeking to get?
• 2% of sales are made on the first contact
• 3% of sales are made on the second contact
• 5% of sales are made on the third contact
• 10% of sales are made on the fourth contact
• 80% of sales are made on the fifth to twelfth contact
Source: http://www.slideshare.net/bryandaly/go-for-no
50. Effective framing:
what do we need to do?
1. Tell a story
2. Make it personal
3. Be authentic
4. Create a sense of “us” (and be clear who the “us”
is)
5. Build in a call for urgent action
Source of image: woccdoc.org
51.
52.
53.
54. Which do you like better?
1. Our infection rates are higher than they should be.
We have new clinical guidelines. Let’s work
together to implement them!
2. You are the one at the bedside. You know what
works and what doesn’t. How can we tackle our
infection rates?
3. Remember Mrs. Smith. She fully recovered from C-
diff that she picked up on our unit. Just like you, I
want to protect more of the chronic elderly. What
do you think we can do?
55. What motivates people?
• Impact on Society (building community)
• Impact on Customer (patients and families)
• Impact on Organization
• Impact on Team (work environment)
• Impact on me (development or bonus)
56. What are the traits of
“inspirational”
leaders?
-chat-
63. Marlies van Dijk
Provincial Implementation Lead, Innovation
Quality and Healthcare Improvement
Alberta Health Services
marlies.vandijk@albertahealthservices.ca
@tweetvandijk
@HCRcentral
@ChangeDayAB
64.
65. “Throw your own pebble - a simple commitment to
make an act of improvement however small - into the
pond of your world and those you care for. And know
that its effects will join with those of others who do the
same, the rings of change extending far and wide.
Imagine what we could do.”
Jon Popowich
opinion profoundly at odds with what is generally accepted.
Yet, what happens to radicals??????????
Let’s think about Heretics….Heresy is any provocative belief or theory that is strongly at variance with established beliefs or customs. A heretic is a proponent of such claims or beliefs.[1]
The end results for people who challenge established ideas/conventions isn’t always pretty!
Ignaz Philipp Semmelweis[Note 1] (July 1, 1818 – August 13, 1865)
a Hungarian physician known as an early pioneer of antiseptic procedures.
Described as the "savior of mothers", Semmelweis discovered that the incidence of puerperal fever could be drastically cut by the use of hand disinfection in obstetrical clinics. Puerperal fever was common in mid-19th-century hospitals and often fatal, with mortality at 10%–35%. Semmelweis proposed the practice of washing with chlorinated lime solutions in 1847 while working in Vienna General Hospital's First Obstetrical Clinic, where doctors' wards had three times the mortality of midwives' wards.[3] He published a book of his findings in Etiology, Concept and Prophylaxis of Childbed Fever.
Despite various publications of results where hand-washing reduced mortality to below 1%, Semmelweis's observations conflicted with the established scientific and medical opinions of the time and his ideas were rejected by the medical community.
Some doctors were offended at the suggestion that they should wash their hands and Semmelweis could offer no acceptable scientific explanation for his findings. Semmelweis's practice earned widespread acceptance only years after his death, when Louis Pasteur confirmed the germ theory and Joseph Lister, acting on the French microbiologist's research, practiced and operated, using hygienic methods, with great success.
In 1865, Semmelweis was committed to an asylum, where he died at age 47 after being beaten by the guards, only 14 days after he was committed.
On December 1, 1955, in Montgomery, Alabama, Parks refused to obey bus driver James F. Blake's order that she give up her seat in the colored section to a white passenger, after the white section was filled. Parks was not the first person to resist bus segregation. Others had taken similar steps, including Irene Morgan in 1946, Sarah Louise Keys in 1955, and the members of the Browder v. Gayle lawsuit (Claudette Colvin, Aurelia Browder, Susie McDonald, and Mary Louise Smith) were arrested months before Parks. NAACP organizers believed that Parks was the best candidate for seeing through a court challenge after her arrest for civil disobedience in violating Alabama segregation laws though eventually her case became bogged down in the state courts.[2][3]
Parks' act of defiance and the Montgomery Bus Boycott became important symbols of the modern Civil Rights Movement. She became an international icon of resistance to racial segregation. She organized and collaborated with civil rights leaders, including Edgar Nixon, president of the local chapter of the NAACP; and Martin Luther King, Jr., a new minister in town who gained national prominence in the civil rights movement.
Steve Jobs challenged things to be different
Had a vision for a different world
Can we imagine a world right now with out our iPads, iMacs, iPhones, Apple TV?
“The ones who are crazy enough to think that they can change the world are the ones who do” - Jack Kerouac
I was at a national organization in Canada and I challenged internal policies and was not towing the party line.
I ended up voicing my concerns in an e-mail and I was reported to the CEO. Which led to a “letter on my file” – not sure if you
have heard of that – I hadn’t … I was deeply offended – but pinned it on my office wall to show people that this was a feather
In my cap vs. a punishment.
I knew I had to leave.
How do you form teams
New ventures – build a great team vs. perfecting an idea. Success is dependent on the quality of the idea – but deeply dependent of the ability of the team to execute.
What if you have no control over the team?
E’s become great relationship and engagement manager. To understand the ability of good team members. Those can be used to leverage the sense of co-ownership
See the sense of co-ownership.
They have ability to pull others along with them.
Live in a state of “manage discomfort’ – there might be an unease as they are entrepeneurs – or even to find space to be entrepreneurial
Act entrepreurial outside of their job description. “capable of squeezing through the smallest of opportunity to build evidence that my idea is good”
Official job title “change agent” – operate off the org chart – seek out places in nook and crannies in the organzation -then develop truth of the value of their idea
Octopus – she says I can squeeze through the smallest opportunity to get my idea out there – or it would get killed
Another guy: project manager – he showed value through other side projects and through a community of practice. Although his company thought he should do that through his day job
Day it is broken out – one hour meetings not condusive to entrepreneurial thinking.
Meeting culture – what can happen and not happen. Entrepreneurs get bigger blocks of time to do creative work
Hour long meetings – not contusive to entrepreneurial behaviour. They look for ways to structure their days differently – larger blocs of time.
An organization can have strong or weak entrepreneurial cultures
Ppt “what and how” – story telling – powerful to mobilize others to act. Through stories. Through a new outcome or new reality.
Notice that there is meager support to how to develop good story telling. Entrepreuners know this skill – through trial and error.
Two practices 1) recognize what the language gap is between stakeholders – ie,., trying telling stories about new idea at several levels – really needed to understand the concept the idea – she thought everyone was on the same page but she was missing the mark. 2)technique: progressive disclosure (from interaction and design field)– essence: sequencing information and action across several groups of people. Start with small disclosure and reveal more and more. Ie,. Progressively disclosed more in his story – and added on that as people were caught up. New idea later broadly socialized to get resources.
Important element piece
How do you learn to become an entreprenuer inside.
Build 2 knowledge
Domain knowledge: expertise in their industry in their product or field
Organizational knowledge: “the know how” how an organization works. Tacid experiential experience on how an org works. Reading the landscape. Thinking like an anthrapologist – being able to learn about the history but respond to information coming in.
A process of de- education. Unlearning prior behaviours that does not serve an E. If you a disengaged employee you are building habits that don’t serve you as an E. De educate yourself on perfectionism – does not serve you well if you are a E. Holding on to an idea to tightly. Working towards performance evaluation. Executing ideas of others. Build into habits – and other E muscles will atrophy.
Those will atrophy other E muscles – you need to de-learning curve. Unlearn of things so you can build different habits.
Experimentation
Wired for experimentation but the orgs they work for are not. Not surprising. Experimentation is hard to operationalize and support.
Following rules and operating procedures – they do not see it as killing experimentation.
Experimentation = google 20% of the time. First steps for experimentation is overcoming self doubt – getting challenged all the time can be tiring. Trick is figuring out what idea is a good one and which one is not.
E are good at creative conflict as a way to experiment. Creative Conflict: Opposition to help shape opportunities – different from opposition that is resistant to change.
Example: VP Brings early ideas to them – reiterate shape ideas
E sees both success and failure as a learning opportunity. Uncomfortable if they sit on a success too long. They know someone will come along and challenge it.
How can we link ideas for change/improvements….
Poll.
Our infection rates are higher than they should be. We have new clinical guidelines. Let’s work together to implement them!
You are the one at the bedside. You know what works and what doesn’t. How can we tackle our infection rates?
Remember Mrs. Smith. She fully recovered from C-diff that she picked up on our unit. Just like you, I want to protect more of the chronic elderly. What do you think we can do?
Pick 1,2,3 or none.
There is an exciting movement that is happening in Alberta and we are thrilled to be a part of it.
It’s called Change Day!
Do you have great ideas but not sure you can implement them? Our healthcare system is not perfect and this is your chance to be part of making it better.
Change Day is a movement where you can pledge to improve your own health or the healthcare system.
This is the time to unleash all of your ideas and creativity, make a pledge, and become a change day hero. Can you imagine what an impact we could have if every employee in AHS made a pledge?
Change Day is a worldwide movement that started in the UK and has spread to countries across the globe with huge involvement from healthcare providers and the public.
Change Day AB is sponsored by the Health Quality Network which represents a diverse group of health organizations.
The announcement is happening on Monday at the Quality Summit in Edmonton.
The website will be live on Monday o start collecting pledges. Check out the video
What will happen?
You can make a pledge at any time. On April 4, 2016 we will unite as Change Day heroes, tally the pledges, have a bash and celebrate!
Pledges are personal commitments to change. Check out the website to see what other people are pledging.
The kick-off is today at the Quality Summit in Edmonton with 400 people.
Check out the twitter feed at #ChangeDayAB
Pledge here
www.ChangeDayAB.ca