Post on 29-Mar-2015
transcript
Leading and Changing
School of Management, RMIT
Tuesday 9 December 2003
Assoc. Prof. Janet A Secatore
Director of Nursing
The Alfred
Change - a constant - lack of certainty
Complexity - always in crisis
Leadership - to manage / cope with change
Goals
Introduce (re-acquaint) you to ideas and authors
Encourage you to think, reflect, learn
Change
If change is happenning all the time, why
aren’t we very good at it?
Paradigms
establish boundaries
identify behaviours for success
Set of Rules & Regulations that
Characteristics of Paradigms
CommonUsefulReverse common senseMore than oneParadigm ParalysisParadigm FlexibilityCan choose to change paradigm
Change and Paradigms
Changes in societal paradigms
Changes in healthcare paradigms
Complexity
SimpleFollowing a Recipe
Recipe is essential Recipes are tested to
assure replicability of later efforts
No particular expertise; knowing how to cook increases success
Recipes produce standard products
Certainty of same results every time
ComplicatedA Moon Rocket
Formulae are critical and necessary
Sending one rocket increases assurance that next will be ok
High level of expertise in many specialised fields & coordination
Rockets similar in critical ways
High degree of certainty of outcome
ComplexRaising a Child
Formulae have only a limited application
Raising one child gives no assurace of success with the next
Expertise can help but is not sufficient
Every child is unique
Uncertainty of outcome remains
Plsek 2003
Complex Adaptive System
Collection of parts Share an environment or space Parts can act independently Parts are interconnected Action by any part affects the whole
Examples : immune system, insect colony, flock,
stock market, just about any collection of humans
Plsek 2003
Complex systems can be described by the following elements…
Structure (concrete attributes)
Process (sequence of events)
Pattern (phenomena, behaviours)
Plsek 2003
Medication Administration System
Structure
Pharmacy
Nursing Units
Elevators
Committees
Info systems
Individual roles
Etc.
Process
Ordering
Transcribing
Entering
Dispensing
Etc.
Pattern
Prescribing practices
Types of errors
Feelings & values
Supportive behaviour
Blaming
Fear
# of errors reported
Etc.
Plsek 2003
Organisational Change Efforts
Much change in structureClassic improvement work focuses on
processPatterns are more difficult and are often left
largely untouchedSuccessful transformation requires
integration and change in structure, process, and pattern
Plsek 2003
Five Key Patterns in Organisational Culture
Key patterns that need rethinking in health care organisations include:
the nature of relationships how decisions are made how power is defined, acquired, and used how conflict is handled how learning is supported
Plsek 2003
Leadership
Change our thinking, not structures
(Morgan)
Organisations are overmanaged and underled
(Kotter)
Leadership is “influencing others”
Neutral
Leadership
Positively influencing others
Giving people a reason to follow
Vision Precedes Success
Have to know what you want to be,
not just want to want to do
(De Pree)
Management or Leadership Role
Tool
A means to an end
What do you want to achieve?
Leadership
“Capacity to translate intention into
reality and sustain it.”
“Influence and organise meaning for
members of an organisation”
(Bennis)
Leadership
“Define mission.”
“Create a human community held together
by a work bond for a common purpose.”
(Drucker)
Leadership
“Capacity to hold a shared picture of the
future we seek to create.”
(Senge)
Leadership
“The first responsibility of a leader is
to define reality. The last is to say thank-you.
In between the leader is a servant.”
(De Pree)
Leadership
Leadership is that “influential increment
over and above mechanical compliance
with the routine directives of the
organisation.”
(Katz and Kahn, 1978)
“… to make the agony of decision
making so intense that one can only
escape by thinking.”
(Fred Friendly, 1993)