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Welcome to
Human Dimensions of Change
By end of today you will:• Understand why the Human Dimensions
of Change are important
• Have an overall framework for managing change
• Understand the difference between simple and complex change – and the different approaches needed
By end of today you will:• Have developed your understanding of
how to work effectively with different personality types when leading change
• Have a better understanding of why people resist change and ways to respond to resistance
• Understand the most common reasons why change projects fail
By end of today you will not:
• Be an expert in change management – can’t do that in a day
• Have lots of easy answers –real life change is often complex and messy
• Have all your learning needs met all the time – the group is too diverse for that.
Course Approach
• Some theory - its important and helps give you confidence in your approach but….
• Not theory for theory’s sake – has to help you with real life.
• You bring the case studies – various exercises where you will look at how theory applies in your situation
Aims of Session One
• To understand why the Human Dimensions of Change are important
• To provide a framework for effective change management
• To understand the difference between simple and complex change – and the different approaches needed
Why is it important to manage the human dimensions of change?
• Change in Healthcare = people changing
• Estimated 80% of change projects failure = failure to manage the people issues
• Need to understand the ways people react to change
– minimise the risks of failure
– maximises skills and talents of the team
Exercise in Pairs
Transition Curve
Progress through curve depends on:– Personality type– How much feel in control of change– How much other change is going on in life– Past experience
STEP ONETHE CASE FOR CHANGE
‘People responsible for planning and implementing change often forget that while the first task of change management is to understand the destination and how to get there, the first task of transition management is to convince people to leave home.’
William Bridges
Why change? – how to generate dissatisfaction with status quo
• Patient Stories
• Pathway Mapping
• Use of data
• Visiting other services…seeing what is possible
Remember
and
Change and learning
Comfort ZoneComfort ZoneNo learningNo learningNo changeNo change
Panic Zone
•people close uppeople close up
•they freezethey freeze
•they don’t learnthey don’t learn
Change and learning
Discomfort Zone
•uncertainty uncertainty •learninglearning
PanicZone
Comfort ZoneComfort Zone
STEP TWOVISION FOR THE FUTURE
Leaving the comfort zone
‘To leave the comfort of the status quo, most individuals need to believe that the change is truly imperative and that there is a more attractive alternative’
Silversin/Kornacki
What to Change To?
Effectiveness of a Decision=
Quality of Decision x
Commitment to Implement
No Involvement = No Commitment
What to Change To?
• Ideally, involve those impacted in the change in developing a vision for the future:– Miracle Question– Value Stream Mapping– Option Development and Appraisal– Visits to other services
STEP THREE
PLAN TO GET BETWEEN PRESENT AND FUTURE
If, overnight, I was to remove all cats from the World - what would be different
a) Today?
b) In Six Months?
c) In Two Years?
Complex Adaptive Systems
•Collection of partsCollection of parts
•Share an environment or spaceShare an environment or space
•Parts can act independentlyParts can act independently
•Parts are interconnectedParts are interconnected
•Action by any part affects the wholeAction by any part affects the whole
Examples: immune system, insect colony, flock,stock market, just about any collection of
humans
Complex Adaptive Systems
Deterministic Systems (Machine Metaphor)
the system is predictable, if you understand the rules you can predict the behaviour
Complex Systems (Environment Metaphor)
the sum is bigger than the parts – cannot predict behaviour of whole system by understanding the
individual parts
What type of system are you trying to change – simple or complex?
Complex Adaptive Systems
• Health and social care systems meet the classification of a complex adaptive system.
• BUT….complex systems have systems within systems – and some of these might be simple
Traditional Mgt Theory
• Based on the metaphor of the organisation as a machine
• Theories or rules apply to the system and result in a particular outcome
• Mismatch between theories and practice
• CAS Theory is an explanation of why
Simple Following 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
Complicated A Moon Rocket
Formulae are critical and
necessary Sending one rocket
increases assurance that next will be okay
High level of expertise and
many specialised fields and co-ordination
Rockets similar in critical
ways High degree of certainty of
outcome
Complex Raising a Child
Formulae have only a
limited application Raising one child gives
no assurance of success with the next
Expertise can help but is
not sufficient Every child is unique Uncertainty of outcome
remains
Source: Zimmerman
Complex Adaptive SystemsWhat do we know and how does it help
us?
We know:Cannot predict effect of the change by the size of the input. Small inputs can result in large changes, large inputs can result in no change
Which means:– Promotes an experiential approach to change -
try lots of different things on the margins (PDSA)– Allows us freedom from thinking we must
work/plan it all out in advance.
Complex Adaptive SystemsWhat do we know and how does it help
us?We know:
Ability to predict in detail what will happen as a result of any given change in system rapidly deteriorates with time
Which means:
– Don’t spend lots of time on detailed plans
– Keep a close eye for unintended consequences
Complex Adaptive SystemsUnpredictable in Detail
Complex Adaptive SystemsWhat do we know and how does it help
us?We know:They have distributed control rather than one command centre
Which means:– Recognises can’t control everything by issuing
orders from the top– Solutions to issues are distributed throughout the
organisation and not confined to the top– Need to find ways to ‘attract’ the system to change
rather than ‘directing’.
Throwing a Rock or a Bird?
y = x2 – b
f = ma?
“attractor”
Source: Paul Plsek, based on Richard Dawkins
Complex Adaptive SystemsWhat do we know and how does it help
us?We know:
Much of the power for creativity and innovation lies not with individuals but within relationships among parts of complex system
Which means:
– place more emphasis on micro (people and interactions) than macro such as strategy
– generative relationships - just putting different people in the same room can result in change
Generative Relationships
“Occur when interactions among parts of a complex system produce valuable, new, and unpredictable capabilities that are not inherent in any of the parts acting alone.”
David Lane and Robert Maxfield
Complex Adaptive SystemsWhat do we know and how does it help
us?
We know:
They are history dependent - shaped and influenced by where they have been
Which means:
– Explains why good practice in one area doesn’t always work in another
– But doesn’t mean we have nothing to learn from elsewhere!
Complex Adaptive SystemsWhat do we know and how does it help
us?We know:For a CAS to be sustainable there must be diversity – key to innovation and long term viability.
Which means:– Need to value our differences - our long term success
depends on the differences– Must be prepared to ask the difficult questions - face
the taboos– But must also manage the distress to keep it at
productive levels.
Complex Adaptive SystemsWhat do we know and how does it help
us?We know:A very complex system can be (is) guided by a few simple rules
Which means:– Build a good enough vision – provide general direction
pointing, absolute boundaries and resources or permission rather than trying to plan everything in detail
– Simple rules (often unstated) also maintain the system at status quo
– Greatest leverage for innovation and change comes by modifying simple rules
Good Enough Vision andMinimum Specifications
• Hunterdon Medical Center (USA)
• Need: Community health initiatives
• Approach: Nursing committee
• Observation: After 6 months, committee had not yet gotten out of the hospital!
Good Enough Vision andMinimum Specifications
• Instead... Simple rules
– A nurse can schedule up to half-day per week to work on community health initiative
– Don’t do anything illegal
– Remain within the project budget (all expenditures publicly posted)
SummaryEffective Approaches in Complex
Situations
1) Give the change problem back to those involved to generate solutions
2) Constructive open dialogues (seek first to understand, then to be understood!)
3) Experiment – small scale change – PDSA4) Simple rules5) BOTH/AND not EITHER/OR6) Role of management is
facilitating/enabling rather than directing
Giving up the Myths
1) Myth of Autonomy – everything you do depends on others, you cannot do it alone
2) Myth of Control – can’t control everything, need to win hearts and minds
3) Myth of Omniscience – you don’t have all the answers as manager/leader
Often the toughest battle is not letting go of myths yourself but getting your staff to let go of them
Applying the Theory
Important to identify when an issue is complex and when it is simple – needs
different techniquesBut
Remember a change initiative may consist of both simple and complex
parts
Stacey Agreement and Certainty Matrix
A method to select the appropriate management actions in a CAS
Close toCertainty
Far fromCertainty
Clo
se t
o
Ag
reem
en
tFa
r fr
om
A
gre
em
en
t Stacey Matrix
Anarchy
Simple
Simple Zone• Know where you want to get to, have clarity
on steps need to take to get there and agreement that it needs to happen
• Traditional management theory works well here – project management approach, which splits out tasks and assigns them to individuals to implement
• Key role of management is ‘directing’ the process to ensure project plan implemented
Complex Zone• Not clear if you make a change what the
impact will be and no agreement whether to do it
• Key to working in this area is peoples beliefs and ways of thinking
• Focus on involving people in identifying issues and solutions, experimenting, constructive dialogue and simple rules
• Key role of management is ‘enabling and facilitating’ rather than ‘directing’
Close toCertainty
Far fromCertainty
Clo
se t
o
Ag
ree
me
nt
Fa
r fr
om
A
gre
eme
nt
Examples
Anarchy
Priority actions to improve treatment of depression
Implementation of advocacy services in line with mental health act
In the zone of complexity…
Simple
Experiment
Constructivedialogue
Structure, processand pattern mapping
Simplerules
Complexity – Where does your change fit?
Pairs Exercise•Think about a change you are currently involved in and discuss how this fits into the Stacey Matrix•Remember, different aspects of the change may fit into different parts of the Matrix•Does the change management approach being used fit with the type of change – and if not what needs to change?
Summary of Key Steps
Story so far…Step One Make the case for change (Plan)Step Two Vision for the future (Plan)Step Three Plan to get from A to B and do it (Do).
But also needStep Four Review and embed if working - do
something else if not delivering benefits (Study/Act)
Formula for Change
D x V x F > RDissatisfaction
with current state
Vision for the Future
First concrete steps towards
the future
Organisational Resistance
Beckhard & Gleicher
In this session we’ve…
• Looked at why the Human Dimensions of Change are important
• Provided a framework for effective change management
• Looked at the difference between simple and complex change
• Given you a tool for working out what type of change you are facing and looked at the different approaches needed
The Road to Transformation?Source: Gareth Morgan
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are needed to see this picture.