Change management fundamentals presentation

www.nelacademy.nhs.uk
0191 371 3634
Change
Management
Fundamentals
Dr David Yarrow
david.yarrow@time-for-change.co.uk
0191 289 3855

Please find someone you don’t know and
talk to them for the next few minutes:
1. Introduce yourselves!
2. Take it in turns (2 minutes each) to talk describe
something you’re enthusiastic about, and explain
why you’re so enthusiastic about it.
This could be anything – a hobby/leisure activity, something
you’ve done once and wish you could do again, the best
meal you’ve ever had, the best decision you’ve ever made, a
great piece of technology, best holiday, your great job….

This ‘handout’ contains a selection of
the slides used in this workshop.
After the workshop we will send e-
mail you a link from which you can
download an electronic copy of all of
the slides.

Please think about these key questions as we get
ready to start:
• If I asked you to describe one thing that you’re really
enthusiastic about, what would it be?
This could be anything – a hobby/leisure activity, something
you’ve done once and wish you could do again, the best meal
you’ve ever had, the best decision you’ve ever made, a great
piece of technology, best holiday, your great job…. (you’ll be
asked to talk about this early in the workshop!)
• Why is ‘change’ and ‘change management’ important for
you/for all of us in the NHS?
Change Management Fundamentals

Aim of today
…to help you to strengthen
understanding of generic change
principles and to be confident in
applying them in your day to day
work…

References & signposting
North East Leadership Academy: http://www.nelacademy.nhs.uk
Watch out for other NELA workshops on subjects related to ‘change management’, e.g.
‘Leading Complex Change’, ‘Polarity Management’, ‘Tipping Point Workshop’,
‘Innovation and Creativity’, ‘Facilitation Skills’.
The NHS Change Model: http://www.changemodel.nhs.uk
School for Health & Care Radicals:
https://changeday.nhs.uk/healthcareradicals
Bridges, W. (2003). Managing Transitions: Making the Most of Change. 2nd edition. London:
Nicholas Brealey Publishing
Cheung-Judge, M. & Holbeche, L. (2011). Organization Development: A practitioner’s
guide for OD and HR. London: Kogan Page
Gladwell M. (2001). The Tipping Point: How little things make a big difference. London:
Abacus
Johnson, B. (1992). Polarity Management: Identifying and Managing Unsolvable Problems.
Amherst, MA: HRD Press
Kotter, J.P. (1996). Leading Change. Boston, MA: Harvard Busines School Press.
Lewin, K. (1951) Field theory in social science: selected theoretical papers. D. Cartwright
(ed.), New York, Harper & Row.
Merrill, D.W. & Reid, R.H. (1999). Personal Styles and Effective Performance. Boca
Raton, FL: CRC Press
Piderit A.K. (2000). Rethinking resistance and recognizing ambivalence ; a multidimensional
view of attitudes towards an organizational change, Academy of Management Review,
www.findarticles.com
Rogers, E. M. (2003). Diffusion of Innovations.
Shapiro, A. (2010). Creating Contagious Commitment: Applying the Tipping Point to
Organizational Change (2nd edition). Hillsborough, NC: Strategy Perspective

Learning outcomes
• be aware of nature & stages of change and their
implications
• understand responses to change and how they vary
for different people
• be familiar with ‘soft vs. hard’and ‘either/or vs.
polarity management’ approaches to change
management
• explore appropriateness of push/pull change
strategies
• understand established & newer approaches to
change management
• gain useful insights & practical ideas for effective
change management

Why does change matter?
Why is ‘change’… and
change management’…
so important to us?

“Every behaviour is motivated by need. Change –
any change – may be perceived as disruptive and
potentially dangerous as the status quo becomes
unstable.”
Mackenzie, Maureen (Associate Professor of Management, Dowling College, NY) (2008). Senior
Leadership's Role in the Change Process. www.dowling.edu/faculty/Mackenzie/docs/change.pdf
Maureen Mackenzie

Let’s think about ‘change’
• Write a list of words that you associate with
the feelings you experience when you are
going through CHANGE.
• Share these lists within your group, and
produce a flip chart that summarises the
group’s view of what it feels like to go
through CHANGE.

Let’s think a bit more about ‘change’
• Now… thinking about some significant
change(s) you have been through, can you
describe your experience of change as a
PROCESS? As a series of steps or
stages?
• As a group, try to agree on how you would
described the stages of this process, and
capture this on a flip chart.

Let’s think about ‘managing change’
• Discuss within your group your experiences
of trying to:
– lead a change initiative of some kind
– support a change that someone else is
leading
– influence other people to change their views
– influence other people to change their
behaviours
– If you wish to, draw upon some examples
from outside working life as well as
examples from ‘work’ settings.
• As a group, produce a flip chart that
summarises the group’s experiences of
INFLUENCING OTHERS TO CHANGE.

‘First of all’, he said, if you can learn a simple trick, Scout, you’ll
get along a lot better with all kinds of folks. You never really
understand a person until you consider things from his point of
view -’
‘Sir?’
‘-until you climb into his skin and walk around in it.’
Harper Lee To kill a mocking bird page 35
Atticus stood up and walked to the end of the porch.
When he completed his examination of the wistaria
vine he strolled back to me.

Change is… something we all know
quite a lot about

What does the literature tell us
about barriers to change?
• It always takes longer than you think
• Exaggerated expectations
• Scepticism
• Impatience
• At least 70 % of change efforts fail to
bring about the desired results!

Delivering change feels complex ‘cos it is!
• Our people are intelligent
• Passionate about their work
• Trained to be analytical
• Diverse professional backgrounds
• Faced with challenge, complexity and pressure
• Human
• Stretched

What do we have to do to influence change?

Predictable? Variable
Challenging Manageable?
Modellable
Diverse
Constant
Change is…
Change Management Fundamentals

Main Heading here
Change management fundamentals
• There’s a lot of “change” about…
– In life
– At work
– In the NHS
• …and there probably always will be
Constant
Diverse

Main Heading here
• People can be ‘good at change’… but we can
also be quite attached to the way things are
• Observing the ways in which people respond to
change ‘situations’, there are patterns, but…
– The same person will probably react differently to two
different change ‘situations’, and…
– Two people will probably react differently to the same
change ‘situation’
Challenging
Predictable?

Main Heading here
• A change ‘situation’ may be viewed as:
– Opportunity
– Threat
– Major issue
– Irrelevance
– Something I have to make happen
– Something that others are imposing (trying to impose) on me
– Both something that’s imposed on me and something that I have to
make happen
Variable

Main Heading here
• There are lots (and lots!) of
models/frameworks/theories about change and
change management
– None of them are 100% ‘right’ or 100% ‘universal’
– But many of them can be useful
• There are thousands of people working on
‘change’ in healthcare, lots of help/advice
available, lots of great resources.
Modellable
Manageable?

Lewin
Bridges:
transitions
Gladwell:
Tipping Point
Rogers:
Diffusion Shapiro: creating
contagious commitment
Merrill & Reid:
personal styles
Some ‘change models’
NHS
Change
Model
Johnson:
polarity
management

We have tools – but no magic bullets!

Things they say about change
PlannedEmergent
TransactionalTransformational
Extrinsic motivationIntrinsic motivation
PushPull
Hard systemsSoft systems

As a group:
• What are your thoughts about these five
‘categorisations’ of change?
• I’ll ask each group to focus on one categorisation in
particular, and lead discussion on it in a few minutes…
but also think about the others
• Is there a dominant fit in your organisation, in terms of
where ‘change’ is positioned within these categories?
Are there sub cultures within the organisation? Different
types of changes?
• What works well/not so well in your experience?

• major, strategic changes
• driven by need to align shape &
functioning of organisation with
its strategic intent
• and/or by demands of the
external environment
• profound, transformative
change requires a formal
change model – orchestrated
approach addressing both
mechanics of the change and
human/cultural aspects.
“Some changes are more severe and challenging than others in their
effects on the organisation and on employees. Managing change
requires you to recognise the type of change you face, then it is easier
to decide how to tackle it.” Mee-Yan Cheung-Judge & Linda Holbeche
Sources: Cheung-Judge,M & Holbeche,L (2011). Organization Development: A practitioner’s guide for OD and HR. London: Kogan Page.
Pellettiere, V. (2006). “Organization Self Assessment to Determine the Readiness and Risk for a Planned Change”. Organization
Development Journal, 24(4), pp. 38-43).
• smaller-scale changes
• fundamental nature of the
organisation remains unchanged
• relatively simple changes with
reasonably predictable outcomes
• e.g. changes to processes,
structure, systems
• tends to be aimed at achieving
establishd goald in new, better
ways

“The challenge many strategic leaders face [when
attempting transformational change] is that it is NOT
enough to change strategies, structures and systems,
unless the thinking that produced those strategies,
structures and systems also changes.”
Mee-Yan Cheung-Judge & Linda Holbeche

The ‘planned’ approach
• change is a step by step
process
• typically initiated top down
• objectives set in advance
• emphasis on thorough
planning and project control
PlannedEmergent
The ‘emergent’ approach
• outcomes cannot be
predetermined
• there is no end point
• change comes typically
'bottom up‘
• change can be seen
as‘managed learning’

Either/or…. or both/and ?
Are both the planned and emergent
approaches necessary?
• plans needed to set direction…. but need to be
flexible
• top down support is needed for bottom up change
• objectives need to be set and the team should be
congratulated when each objective is achieved…..
but improvement never ends
• correct use of improvement tools and techniques
should be planned and monitored….. but gaining
the commitment of people is vital

Extrinsic motivationIntrinsic motivation
• focus on achieving outcomes
• motivation comes from
outside the individual
• e.g. targets, performance
management, rewards, threat
of punishment
• competition is in an extrinsic
motivator
• motivation that is driven by
interest or enjoyment in the
task itself
• exists within the individual
rather than relying on
external pressures or
desire for reward
• people engage willingly,
enjoy the intrinsic rewards
of the activity

• Need for people to realise the
costs & risks of maintaining
status quo v risk & uncertainty of
making the change
• Push people by creating
discomfort in the system e.g.
educate people about consequences of
not changing, remove buffers and
expose people to the consequences of
not changing.
• Assumption that intrinsic
motivation is not sufficient to
bring about change
“Pull” change strategies
connect a change to things
people care about and desire
– “change attractors” e.g.
• benefits for patients &
carers
• positive outcomes for the
individual
• - advantages for their
immediate (e.g.
team/department) and
wider (e.g.
organisation/profession)
environment
PullPush

Formal
organisation
Informal
organisation
Goals, strategy,
structure, systems
& procedures etc.
Values, attitudes & beliefs,
behaviours, informal groupings,
power, politics & conflict handing
styles.
Beware – only
the tip
of the iceberg!

• All models are
imperfect
• All forecasts are
wrong
• But some models can
be useful
• They can help us to
get a better grasp of
complex realities
• Provide some useful
insights
• Help to unfog the
fog…. a little or a lot
What do we know about ‘models’?
Models of change

Models of change
• We all use
‘models’ all the
time….. often
implicitly • ‘Mental
models’…. that
are running in our
heads

Kurt Lewin’s ideas about change
Unfreeze
Move
Refreeze
Kurt Lewin (1940s)

Force Field Analysis
DrivingForces
ResistingForcesCurrent
situation
Desired
situation

As a group:
• Try-out a “Force-field analysis” of a specific change
• You could use a generic example like “deciding whether
to move house” or deciding whether to change jobs”…
• …or, agree on another specific change that you can all
relate to
• Step 1: generate ideas for DRIVING FORCES and
RESISTING FORCES
• Step 2: Draw the Force-field analysis on flipchart paper
• Step 3: Assign values (e.g. from 1 to 10) to each force
• Step 4: Conclude… is this change going to happen? If
you want it to happen, how might you go about
increasing it’s chances of success?
• If time allows, reflect on Lewin’s ideas – do they ‘work’
for you? Are they helpful as you try to better
understand and manage change?

‘Unfreezing’ seen as 3 processes
1. Disconfirmation – dissatisfaction or
frustration generated by data that
‘disconfirm’ our expectations or hopes
…but on its own, this isn’t enough…we tend to
deny or ignore the information. Need to
accept the info and connect it to something
we care about. The disconfirmation must
arouse ‘survival anxiety’… if I don’t
change, I’ll fail to meet my needs or fail to
achieve some goals…

2. Induction of ‘survival anxiety’ or guilt – but this
tends to be resisted by our defensive reactions,
manifesting as ‘learning anxiety’
If I allow myself to enter a learning or change
process…admit to self & others that something is
wrong… I’ll lose my effectiveness, self-esteem,
even my identity.
Learning anxiety is the fundamental restraining force
which can go up in direct proportion to the amount
of disconfirmation… hence the need to create
some form of ‘psychological safety’….

3. Creating psychological safety – which helps to
reduce learning anxiety, allowing me to feel the
survival anxiety and thus be genuinely motivated to
learn and change
Examples of change agents helping to‘create
psychological safety’:
• Working in groups
• Creating parallel systems that allow relief from day-to-day work
pressures
• Providing practice fields where errors can be embraced rather
than feared
• Providing positive visions
• Breaking learning into manageable steps
• Providing coaching

Main Heading here
“It isn’t the changes that do you in, it’s the
transitions. They aren’t the same thing. Change is
situational: the move to a new site, the retirement of
the [boss], the revisions to the pension plan…
..Transition, on the other hand, is psychological; it is
a three-phase process that people go through as
they internalise and come to terms with the details of
the new situation that the change brings about…”
William Bridges
“The three phases of transition”

• Bridges talks about three stages:
–The ending
–The neutral zone
–The beginning
William Bridges (1995). Managing transitions:
making the most of change (2nd edition)

The 3 stages of Transition
• The Ending:
we acknowledge that there are things we need to let
go of, and we recognise that we have lost
something
• The Neutral Zone:
the old way has finished but the new way isn't here
yet, everything is in flux and it feels like no one
knows what they should be doing, things are
confusing and disorderly
• The Beginning:
the new way feels comfortable, right and the only
way
William Bridges’ model of change

William Bridges
“The three phases of transition”
Time ?
The phases are not separate stages with clear boundaries….

• The difference between individuals is the speed at
which we go through that transition, affected by a
variety of factors:
– past experience
– personal preferred style
– degree of involvement in recognising the problem and
developing possible solutions
– the extent to which someone was pushed towards a change
rather than moving towards it voluntarily.
• Change leaders help people recognise the process
and the stages of a transition as something that is
natural.
For every change, we go through a transition…
William Bridges’ model of change

John Kotter – the eight-stage process of creating major change

1. Establishing a sense of urgency Examining the environment & ‘business’ realities
Identifying and discussing crises, potential crises, or major opportunities
2. Creating the guiding coalition Putting together a group with enough power to lead the change
Getting the group to work together like a team
3. Developing a vision and strategy Creating a vision to help direct the change effort
Developing strategies for achieving that vision
4. Communicating the change vision Using every vehicle possible to constantly communicate the new vision &
strategies
Having the guiding coalition role model the behaviour expected of employees
5. Empowering broad-based action Getting rid of obstacles
Changing systems or structures that undermine the change vision
Encouraging risk taking and non-traditional ideas, activities & actions
6. Generating short-term wins Planning for visible improvements in performance, or “wins”
Creating those wins
Visibly recognising and rewarding people who made the wins possible
7. Consolidating gains & producing
more change
Using increased credibility to change all systems, structures and policies that
don’t fit together and don’t fit the transformation vision
Recruiting, promoting & developing people who can implement the change vision
Reinvigorating the process with new projects, themes and change agents
8. Anchoring new approaches in the
culture
Creating better performance through customer- and results-oriented behaviour,
more and better leadership, and more effective management
Articulating the connections between new behaviours & organisational success
Developing means to ensure leadership development & succession
John Kotter – the eight-stage process of creating major change

John Kotter – Leading Change
• Allowing too much
complacency
• Failing to create a
sufficiently powerful
guiding coalition
• Underestimating the
power of vision
• Undercommunicating the
vision by a factor of 10 (or
100 or even 1,000)
• Permitting obstacles to
block the new vision
• Failing to create short
term wins
• Declaring victory too soon
• Neglecting to anchor
changes firmly in the
corporate culture
Eight common errors in organisational change efforts:

John Kotter – Leading Change
• Permitting obstacles to block the new vision
• Failing to create short term wins
• Declaring victory too soon
• Neglecting to anchor changes firmly in the
corporate culture
• Allowing too much complacency
• Failing to create a sufficiently powerful
guiding coalition
• Underestimating the power of vision
• Undercommunicating the vision by a factor
of 10 (or 100 or even 1,000)
Common errors
• New strategies aren’t implemented well
• Changes don’t deliver expected improvements
• Implementation takes too long and costs too much
Consequences

As a group:
• Reflect on the models of William Bridges and/or John
Kotter
• Do they make sense to you?
• Will they be useful as you seek to cope with change
and to manage changes?

Communication is key
Change
sponsor
Opinion
leader

How do ideas and practices spread?

How are ideas and practices spread?

Change as a social process
“I don’t know how it started either. All I know is that it’s part
of our corporate culture”

Group work: spreading good ideas
• Sometimes good ideas (and good
practices) seem to ‘spread’ quickly
and effectively, other times they
don’t…
• List the factors that you believe are
important in determining how quickly
and successfully ‘spread’ of a good
idea will occur

Sources: UK GSM networks - subscriber data http://www.prattfamily.demon.co.uk/mikep/subscrib2.htm
Mobile Operators Association http://www.mobilemastinfo.com/stats-and-facts/

In 2013, the percentage of UK adults using a mobile phone was 94%.
“There are now 82.7 million mobile subscriptions in the UK.”

Smartphone – “a mobile telephone with computer features
that may enable it to interact with computerised systems,
send e-mails, and access the web.”

Sources: Dedlu, H (2013). When will the US reach smartphone saturation? www.asymco.com
OFCOM (2010). The Communications Market 2010: UK. Online at http://www.ofcom.org.uk
OFCOM (2013). The Communications Market 2013: UK. Online at http://stakeholders.ofcom.org.uk

How readily do good ideas spread?

www.keytime.com
http://gigliwood.com/abcd/abcd.html
Dvorak keyboard

In Windows XP
Control Panel/Classic view/Regional & languages/Details
Add/Keyboard layout/IME choose “Dvorak”
Apply/OK

In about 1930, Dr. August Dvorak, undertook a study of efficiency in the office.
He almost immediately discovered the awful history of the QWERTY keyboard.
Christopher Sholes, the inventor of the typewriter (ca. 1870), invented the QWERTY
layout by trial and error. In his early typewriter, the type slugs hit the bottom of the
platen and then fell back down. Because Sholes didn't think of putting return springs
on the type slugs, he had trouble getting any speed out of the machine because the
type slugs would jam. So he moved the characters around in a way that made the
most common combinations hard to type, in order to SLOW THE TYPIST DOWN so
that jams would not occur.
In practical terms, then, Sholes anti-engineered the keyboard. Dvorak found that
the QWERTY arrangement is actually considerably worse than a random
arrangement!

Rogers’ hybrid corn study: the diffusion of innovation

2.5% 13.5% 34% 34% 16%
% adopting the
idea
time
to adopt
(Rogers 2003)
How ideas and practices spread
‘Innovators’
‘Early adopters’
‘Early majority’
‘Late majority’
‘Laggards’

Time
%adoption
TimeTime
%adoption%adoption
…spread is a social process
– it is about communication,
observation, persuasion,
evaluation, adoption or
rejection…
1. Awareness
2. Interest
3. Evaluation
4. Trial
5. Adoption
Relative advantage
Compatibility
Complexity
Trialability
Communicability

Rogers’ theory: The Diffusion of Innovations
1. Awareness
2. Interest
3. Evaluation
4. Trial
5. Adoption
Everett Rogers (1962, 2003). The Diffusion of Innovations
(Also known as: “how ideas & practices spread”)

Rogers & Shoemaker (1971)
Determinants of successful planned change can be
seen as people’s subjective evaluation of:
• Relative advantage
– delivers an advantage relative to the status quo
• Compatibility
– compatible with existing values, past experiences &
needs; and able to be adapted to local circumstances
• Complexity
– relatively easy to understand and use
• Divisibility (trialability)
– able to be tried without great cost or effort
• Communicability (observability)
– the outcomes can be clearly seen by others

Case study: mobile phones/smart phones
• Review the spread of mobile phones or
smart phones in terms of:
– relative advantage
– compatibility
– complexity
– trialability
– observability
•Is there an aspect of change that you’ll be
trying to encourage, in your organisation? Can
you think about it in terms of these factors?

• Review the spread of mobile phones in
terms of:
– relative advantage (time management,
freedom to move, emergencies, status
symbol, small size, low cost)
– compatibility (familiarity with phones)
– complexity (operates like a traditional
phone)
– trialability (borrow or pay as you talk)
– observability (highly visible)
Case study: mobile phones

Why might people not want to change?
THE RESISTANCE !

As a group
• Consider the idea of ‘resistance’ to
change, and your experiences of it
• Do you ever ‘resist’ changes yourself?
If so, why? Would you regard yourself
as a ‘resistor’?
• What strategies do you currently deploy
to deal with resistance?

“Health and care radicals” talking about
“resistance to change”
• “Resistance isn’t negativity, but a chance to change
our perception, engage and trouble-shoot”
• “Sometimes having to listen and explain for those
who need more convincing really pays off!”
• “Apathy kills changes, not resistance. Anyone
interested enough to enagge is a potential advocate”
• “I firmly believe weall want to see a better care
system – great core purpose, no-one is resistant to
this”

‘The Tipping Point’
Malcolm Gladwell (2000). The Tipping Point
Change is a social process… how does it
happen? Who can help to make it happen?

“The Tipping Point is the biography of an idea… that the best way to
understand the emergence of fashion trends, the ebb & flow of crime
waves, the transformation of unknown books into bestsellers, or the rise
of teenage smoking, or the phenomena of word of mouth, or any number
of the other mysterious changes that mark everyday life is to think of
them as epidemics….
…Ideas and products and messages and behaviours spread just like
viruses do”
Ideas spread like viruses

Contagiousness
3 characteristics of epidemics
Little causes can
have big effects
Change happens not gradually, but at
one dramatic moment
Time
%adoption
TimeTime
%adoption%adoption

People who can be influential
CONNECTORS
MAVENS
SALESMEN

“Creating Contagious Commitment: Applying
the Tipping Point to Organisational Change”

Results plotted in
solid lines
%Advocates (Green)
%Apathetics (Red)
The Tipping Point Workshop

“A problem to solve or a
polarity to manage?”

“Where all think alike, no-
one thinks very much”

7 levers of change in organisations

Have some of your existing views about ‘managing
change’ and/or ‘coping with change’ been reinforced?
Reflect upon what you have heard and
discussed today
Have any of your existing views been challenged or refined?
Are there some lessons you can take away and use?
Is there anything you might do differently in future?

Using change models & tools in practice
• Right tool, right job ?
• Right style, right situation?
• Right approach, right time?
• Realistic expectations?
• Push/pull… intrinsic/extrinsic?
The best change tools match the requirements of the
group and its context with the change strategy

Final thoughts/questions and evaluations

Change management fundamentals presentation

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