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Leadership in Changing Times Bud Nicola, MD, MHSA and Susan Allan, MD, JD, MPH.

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1 Leadership in Changing Times Bud Nicola, MD, MHSA and Susan Allan, MD, JD, MPH

2 Learning Objectives By the end of this class, students will be able to: Identify strengths and potential pitfalls of different social and leadership styles. Describe various styles and preferences for dealing with conflict, and when they are most effective. Plan and organize meetings to effectively advance an agenda for organizational change. Develop a policy brief or use a similar process to engage others and achieve alignment on new policies or programs. Describe three key factors in effective communication as a leader. Describe the importance of cultural competency in being an effective leader.

3 Leadership In Changing Times Monday, August 4 Who You Are 8:30 Summer Institute Welcome Room 316 9:00 Course Introduction and Culture chest (Bud and Susan) 10:00 Break 10:15 Lifelong Learning (Susan) 11:50 Reflection 12:00 Lunch 1:00 Social Styles and Leadership Styles (Bud) 2:50 Reflection 3:00 Break 3:15 Personal Mastery 4:20 Reflection 4:30 Self assessments

4 Leadership In Changing Times Tuesday, August 5Working with Conflict and Change 8:30 Introduction to change management; dealing with conflict (Bud) 9:50 Getting things done through meetings (Bud) 10:00 Break 10:15 Continue with morning topics (Dr. Lawrence Loh, Fraser Health Authority) 11:50 Reflection 12:00 Lunch 1:00 Talking to leaders - Preparation for leaders conversation (Susan) 2:00 Panel leader discussion, Muriel DeLaVergne-Brown, Mark Szalwinski 3:15 Break 3:30 Health Leaders Forum Join us for a complimentary networking reception immediately following the panel.

5 Leadership In Changing Times Wednesday, August 6Working with Others 8:30 Communications and influence (Hilary Karasz) 10:00 Break 10:15 Policy briefs (Susan) 12:00 Dialogue on Racial Equity and Health, Scott Winn 1:30 Racial, ethnic, gender, and generational aspects of leadership (Susan) 3:00 Break 3:15 Working with others 4:50 Reflection; review Toolkit Presentation webinar

6 Leadership In Changing Times Thursday, August 7Bringing it all together: Integrating and Launching 8:30 Leadership example (Dr. Ed Walker, University of Washington) 10:00 Break 10:10 Group Photo 10:15 Debriefing and next steps (Susan and Bud) 12:00 End of Summer Institute

7 Culture Chest

8 What is Leadership?

9 Defining Leadership Leadership: the process of inspiring others to work hard to accomplish important tasks 9

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11 Susan Allan, MD, JD, MPH Lifelong Learning 11

12 “Why Leadership Development Fails To Produce Good Leaders” from “ Psychology Today,” Ray B Williams “Most leadership development initiatives focus on competencies, skill development and techniques, which is some ways is like rearranging the deck chairs on a sinking ship. Good leaders need to become masters of themselves before they can attempt to be masters of anything else.” http://www.psychologytoday.com/blog/wired-success/201310/why-leadership-development-fails-produce-good-leaders

13 “Leadership development initiatives need to focus on the following core areas to really make a difference …” Self-awareness. Emotional self-mastery. A deep understanding of the dynamics of human behavior on an individual basis. Ongoing engagement…”any substantial behavioral or attitudinal change requires continuity and a long-term commitment to be successful” An individual personal stake in self-development. Choosing people who know how to mentor, coach and develop leaders. Incorporate mindfulness practices into leadership development. Good leaders are reflective and often introspective. http://www.psychologytoday.com/blog/wired-success/201310/why-leadership-development-fails-produce-good-leaders

14 The #1 Reason Leadership Development Fails from “Forbes,” Mike Myatt “Training” vs “Development” Training – orients to known systems, practices 1)Assumes that the “right way” to do things is known Development - nuanced, contextual, collaborative, fluid. http://www.forbes.com/sites/mikemyatt/2012/12/19/the-1-reason-leadership-development-fails/

15 Training Blends to a norm Tests patience Focuses on the present Focuses on efficiency Development Occurs beyond the norm Tests courage Focuses on the future Focuses on effectiveness http://www.forbes.com/sites/mikemyatt/2012/12/19/the-1-reason-leadership-development-fails

16 Development is transformational. - focuses on growth. - catalyzes innovation. - focuses on solutions. - explores the unknowns. - moves people beyond their comfort zones. - is infinite. http://www.forbes.com/sites/mikemyatt/2012/12/19/the-1-reason-leadership-development-fails

17 Bud Nicola, MD, MHSA Personal Styles and Leadership Styles 17

18 Session Objectives Leadership begins with who you are Discover your social style preference See how strengths, overdone, become weaknesses Learn to recognize preferences of others See the value of diversity in accomplishing organizational work See the dangers of group think Learn to “borrow” other styles Slides courtesy of Dr. Ed Walker 18

19 The MBTI Four Preferences What is our energy source? 1)Extraversion vs. Introversion How do we take in information? 1)Sensing vs. Intuition How do we make decisions? 1)Thinking vs. Feeling What is our orientation to the world? 1)Judging vs. Perceiving 19

20 Extraverted Characteristics (E) Act first, think/reflect later Feel deprived when cutoff from interaction with the outside world Usually open to and motivated by outside world of people and things Enjoy wide variety and change in people relationships Introverted Characteristics (I) Think/reflect first, then Act Regularly require an amount of "private time" to recharge batteries Motivated internally, mind is sometimes so active it is "closed" to outside world Prefer one-to-one communication and relationships 20

21 Sensing Characteristics (S) Mentally live in the Now Using common sense and creating practical solutions is automatic-instinctual Memory recall is rich in detail of facts and past events Best improvise from past experience Like clear and concrete information; dislike guessing when facts are "fuzzy" Intuitive Characteristics (N) Mentally live in the Future Using imagination and creating/inventing new possibilities is Memory recall emphasizes patterns, contexts, and connections Best improvise from theoretical understanding Comfortable with ambiguous, fuzzy data and with guessing its meaning. 21

22 Thinking Characteristics (T) Instinctively search for facts and logic in a decision situation Naturally notices tasks and work to be accomplished. Easily able to provide an objective and critical analysis Accept conflict as a natural, normal part of relationships with people. Feeling Characteristics (F) Instinctively employ feelings and impact on people in decision situations Naturally sensitive to people needs and reactions Naturally seek consensus and popular opinions Unsettled by conflict; have almost a toxic reaction to disharmony. 22

23 Judging Characteristics (J) Plan many of the details in advance before moving into action. Focus on task-related action. Work best and avoid stress when keep ahead of deadlines. Use targets, dates and standard routines to manage life and commitments. Perceiving Characteristics (P) Comfortable moving into action without a plan; plan on-the-go. Like to multitask, have variety. Naturally tolerant of time pressure; work best close to the deadlines. Avoid commitments which interfere with flexibility, freedom and variety 23

24 Discussion What do you think your preference is? 24

25 25

26 26

27 Wait – that’s 16 different combinations! 27 Isn’t there a simpler way to do this? http://www.youtube.com/watch?v=wRBx8IkV-kQ

28 Assertiveness Asks Tells Less Assertiveness More Assertiveness

29 Verbal Behavioral Clues Factor Pace of speech Quantity of speech Volume of speech Less Assertive Slower Fewer statements Softer More Assertive Faster More statements Louder

30 Non-Verbal Behavioral Clues Factor Use of hands Body posture Eye contact Less Assertive Relaxed or cupped Leans back while talking Indirect contact while speaking More Assertive Pointing at others Leans forward to make a point Direct contact while speaking

31 Responsiveness Less Responsiveness More Responsiveness Controls emotions More feeling displayed

32 Verbal Behavioral Clues Factor Emotion in voice Subjects of speech Description Less Responsive Monotone Tasks Facts/Data More Responsive Inflections People Opinion or stories

33 Non-Verbal Behavioral Clues Factor Use of hands Body posture Eye contact Less Responsive Closed Rigid Controlled More Responsive Open palms Casual Animated

34 34 More Responsive Less Responsive Merrill and Reid A Four Box Solution More AssertiveLess Assertive EXPRESSIVE AMIABLE DRIVER ANALYTIC

35 Hey, don’t try to box me in… I’m more than a label! No best or worst style – advantages and disadvantages to each Strengths, pushed far enough, become liabilities No pure styles – but one is usually preferred Behavior style does not explain the whole person, just perception 75% of the world is not like you – better learn to adapt! 35

36 Driver – Extroverted Thinking Action oriented Decisive A problem solver Direct Assertive Demanding A risk taker Forceful Adventuresome Competitive Self-reliant Independent Determined An agitator Results oriented 36

37 Driver Style – the Doer 37 + Tends to be perceived as - Growth action Stress action Strong willed Independent Practical Decisive Efficient Pushy Severe Tough Dominating Harsh LISTENING AUTOCRATIC POWER

38 Recognizing Drivers Swift reaction time Maximum effort to control Minimum concern for caution in relationships Present time frame Direct action Tendency to reject inaction Need for control/results/achievement 38

39 Expressive – Extroverted Feeling Verbal Motivating Enthusiastic Gregarious Convincing Emotional Impulsive Generous Influential Charming Confident Inspiring Dramatic Optimistic Animated 39

40 Expressive Style – the Intuitor 40 + Tends to be perceived as - Growth action Stress action Ambitious Stimulating Enthusiastic Dramatic Friendly Manipulative Excitable Undisciplined Reacting Egotistical CHECKING PERSONAL ATTACK

41 Recognizing Expressives Rapid reaction time Maximum effort to involve Minimum concern for routine Future time frame Impulsive action Tendency to reject isolation Need for excitement/personal approach/acceptance 41

42 Amiable – Introverted Feeling Patient Loyal Sympathetic A team person Relaxed Mature Organized Questioning Supportive Stable Considerate Empathetic Persevering Trusting Congenial 42

43 Amiable Style – the Feeler 43 + Tends to be perceived as - Growth action Stress action Supportive Respectful Willing Dependable Agreeable Conforming Unsure Pliable Dependent Awkward INITIATION COMPLIANCE

44 Recognizing Amiables Unhurried reaction time Maximum effort to relate Minimum concern for effecting change Present time frame Supportive action Tendency to reject conflict Need for cooperation/personal security/acceptance 44

45 Analytic – Introverted Thinking Diplomatic Accurate Conscientious A fact finder Systematic Logical Conventional Analytical Sensitive Controlled Orderly Precise Disciplined Deliberate Cautious 45

46 Analytic Style – the Analyzer 46 + Tends to be perceived as - Growth action Stress action Industrious Persistent Serious Exacting Orderly Critical Indecisive Stuffy Picky Moralistic DECLARATION AVOIDANCE

47 Recognizing Analytics Slow reaction time Maximum effort to organize Minimum concern for relationships Historical time frame Cautious action Tendency to reject involvement Need for accuracy/being right/achievement 47

48 If You’re Still Not Sure... Driver : · Objective-focused · Know what they want and how to get there! · Communicates quickly, gets to the point · Sometimes tactless and brusque · Can be an "ends justify the means" type of person · Hardworking, high energy · Does not shy away from conflict Expressive : · Natural salesmen or story-tellers · Warm and enthusiastic · Good motivators, communicators · Can be competitive · Can tend to exaggerate, leave out facts and details · Sometimes would rather talk about things than do them! Amiable : · Kind-hearted people who avoid conflict · Can blend into any situation well · Can appear uncertain · Has difficulty with firm decisions · Often loves art, music and poetry · Highly sensitive · Can be quiet and soft-spoken Analytical : · Highly detail oriented people · Can have a difficult time making decisions without ALL the facts · Make great accountants and engineers · Tend to be highly critical people · Can tend to be pessimistic in nature · Very perceptive 48

49 49 StyleIntentNeedPaceFocus DriverGet job doneControlFastTask AmiableGet alongHarmonySlowPeople AnalyzerGet job done right AccuracySlowTask ExpressiveBe heardAttentionFastPeople Adapted from Merrill and Reid Comparison of Styles

50 Merrill-ReidDriverExpressiveAmiableAnalytical Enneagram Adventurer Achiever Helper Romantic Peacemaker Observer Asserter Perfectionist HippocratesCholericSanguinePhlegmaticMelancholy Western Astrology FireAirWaterEarth AnimalsBearMonkeyDolphinOwl Children's Literature RabbitTiggerPoohEeyore Charlie Brown LucySnoopy Charlie Brown Linus Who Moved My Cheese? SniffScurryHawHem Common “Four-Box” Characterizations 50

51 Interacting Effectively With Other Styles Start by knowing yourself Observe the behavior patterns of others Learn how they see and interact with world Avoid judgments, evaluations, and analyzing “why” someone behaves a certain way Tentatively classify a style and adapt to that style http://www.youtube.com/watch?v=nJ0GxUI4RxY 51

52 How does the group look? Place yourself in the room Driver/Analytic/Amiable/Expressive

53 53 More Responsive Less Responsive Merrill and Reid A Four Box Solution More AssertiveLess Assertive EXPRESSIVE AMIABLE DRIVER ANALYTIC

54 54 More Responsive Less Responsive Merrill and Reid What Is Your Own Style? More AssertiveLess Assertive EXPRESSIVE AMIABLE DRIVER ANALYTIC My ideal My real

55 Learn to Be Flexible! Be adaptable and skillful You can only control your half of the interaction You can improve effectiveness by temporarily modifying your preferences Learn to “borrow” the other three styles when needed 55

56 56 EXPRESSIVE ANALYTICDRIVER AMIABLE DECREASE FEELING Contain feelings Express facts Use facts INCREASE FEELING Control less Express more/Be open to feelings Trust intuition/ Give more value to opinion INCREASE ASSERTIVENESS Tell more Ask less Take control REDUCE ASSERTIVENESS Ask more Tell less Share control Flexibility and Role Shifting

57 Other Examples CACTUS 1549 http://www.youtube.com/watch?v=tE_5eiYn0D0 57

58 Group Tasks Describe your personality style 1)Which preferences do you have? 2)Which is the hardest style for you to move into and maintain if needed? 3)Where are your strengths and blind spots? 4)What do you need to watch for during group participation? Pick a recent meeting where you now see that these styles were operating? How would you act differently? 58

59 Early definitions included the following: 1 Power & Motive 2 King, Chief, Commander 3 Personality Driven – Self-Assertive What is Leadership?

60 Group Process Perspective – Leader is center of group and embodies will Personality Perspective – Special traits and characteristics to motivate others Act or Behavior Perspective – Things leaders do to bring about change in a group Power Relationship Perspective – Leaders have power to wield change over others Instrument of Goal Perspective – Help others with vision, role modeling, attention Skill Perspective – Knowledge & skills that make leaders effective In actuality, 65 different definitions & counting! 65

61 Process: Transactional event between leader and follower Influence: Concerned with how the leaders effect followers Groups: Context in where the leadership takes place Goals: Directing a group of individuals toward accomplishing some task or goal. “Leadership is a process whereby an individual influences a group of individuals to achieve a common goal. “ -- Northouse Defined: Process + Influence + Group Context + Goal Attainment

62 Management vs. Leadership Management Planning & Budgeting –Agendas –Time Tables –Resources Organizing –Provide structure –Job Placements –Rules & Procedures Problem-Solving –Develop Incentives –Generate Solutions –Take Corrective Actions Leadership Establishing Direction –Vision –Big Picture –Set Strategies Aligning People –Communicate goals –Seek commitment –Build Teams Motivating –Inspire and Energize –Empower Subordinates –Satisfy unmet needs

63 Leader or Manager External Leadership Theories: Situational, Contingency, Leader- Member Exchange, Transactional, Emotional-Intelligence Based, Transformational, Charismatic, Servant Internal Leadership Theories: Leading from the Inside Out, Principle-Center Leadership “Leaders do the right things while managers do things right.” - Warren Bennis “Many managers mistakenly assume that leadership style is a function of personality rather than strategic choice.” - Daniel Goleman, Leadership That Gets Results

64 Are you up for the challenge?

65 What is your LEADERSHIP STYLE?

66 Negative “Do what I tell you” Demands immediate compliance In a crisis, to kick start a turnaround, or with a problem employee Use with caution; long term use damages morale Coercive Leadership Style From Goleman’s Six Styles of Leadership Overall impact Leader’s modus operandi Style in a phrase When this style works best Disadvantages

67 Most strongly positive “Come with me” Mobilizes people toward a vision When change requires new vision; when clear direction is needed Although powerful, does not work in every situation Authoritative Leadership Style From Goleman’s Six Styles of Leadership Overall impact Leader’s modus operandi Style in a phrase When this style works best Disadvantages

68 Positive “People come first” Creates harmony and builds emotional bonds To heal rifts in a team or motivate people during stressful circumstances Exclusive use may encourage poor performance and lead to group failure Affiliative Leadership Style From Goleman’s Six Styles of Leadership Overall impact Leader’s modus operandi Style in a phrase When this style works best Disadvantages

69 Positive “What do you think?” Forges consensus through participation To build buy-in or consensus, or get input from valuable employees Leaders may use style to put off making decisions and create confusion and conflict Democratic Leadership Style From Goleman’s Six Styles of Leadership Overall impact Leader’s modus operandi Style in a phrase When this style works best Disadvantages

70 Negative “Do as I do, now” Sets high standards of performance To get quick results from a highly motivated and competent team May destroy “climate” and cause loss of initiative and commitment Pacesetting Leadership Style From Goleman’s Six Styles of Leadership Overall impact Leader’s modus operandi Style in a phrase When this style works best Disadvantages

71 Positive “Try this” Develops people for the future To help employee improve performance or develop long- term strengths Less effective when employees are resistant to learning or changing Coaching Leadership Style From Goleman’s Six Styles of Leadership Overall impact Leader’s modus operandi Style in a phrase When this style works best Disadvantages

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74 Break Break Time

75 Bud Nicola, MD, MHSA Introduction to Change Management 75

76 Tao Sheng Kwan-Gett, MD, MPH Director, Northwest Center for Public Health Practice Senior Lecturer, University of Washington School of Public Health Innovation

77 What is innovation? in·no·va·tion noun \ ˌ i-nə- ˈ vā- shən\ \ : a new idea, device, or method : the act or process of introducing new ideas, devices, or methods Merriam Webster Dictionary

78 Innovation is Driven by “Eureka” Moments: Myth or Reality? Reality: Innovation builds upon the hard work of the past. Public health example: The best public health interventions are evidence-based.

79 We Know History - Innovation is About the Future: Myth or Reality? Reality: History can provide important insights that can help us be more effective in the present. Public health example: Can we draw upon the experience of past applications of an intervention?

80 Good Ideas Are Rare: Myth or Reality? Reality: Good ideas are common, it’s the conviction to take the risk to invest in them that’s rare. Public health example: For innovations to have impact, we have to think about systems and sustainability.

81 There Is a Method to Innovation: Myth or Reality? Reality: You can’t hit a home run every time. Many factors are out of your control. You can do everything right and still fail. Public health example: We can’t expect every intervention to have a demonstrable impact, so consider approaching problems with a portfolio of interventions.

82 We Love New Ideas: Myth or Reality? Reality: New ideas often are not appreciated in their time. Public health example: We will need to combine advocacy with innovation to implement new ideas for community health.

83

84 Five Myths of Innovation Source: http://sloanreview.mit.edu/article/the-5-myths-of-innovationhttp://sloanreview.mit.edu/article/the-5-myths-of-innovation

85 Bud Nicola, MD, MHSA Leadership and Organization Change

86 Force Field Analysis POSITIVEPOSITIVE NEGATIVENEGATIVE

87

88 Why Change Efforts Fail Allow too much complacency Don’t create a sufficiently powerful guiding coalition Underestimate the power of a purpose Under communicate the purpose Permit obstacles to block the purpose Don’t create short-term wins Declare victory too soon Don’t anchor changes in culture

89 Consequences of Errors New strategies are not fully implemented Reorganizations don’t achieve expected results Work redesign takes too long and costs too much Reductions in numbers of employees do not reduce costs in the long run Quality improvement efforts do not deliver expected results Organizational goals not accomplished

90 The Eight Stage Change Process Why a process? Why eight steps?

91 The Eight Stage Process 1.Establishing a sense of urgency 2.Creating the guiding coalition 3.Developing a purpose (vision) and strategy 4.Communicating the purpose 5.Empowering the change process 6.Generating short-term wins 7.Consolidating gains and producing more change 8.Anchoring change in the culture

92 Work on an Example Choose a change that is planned or is something you have thought about doing. Describe it in one sentence [3 minutes] As each stage is described, write down your plans for handling that change.

93 Leader and Manager Roles in Change Leader Set a direction Align people Motivate and inspire Manager Plan and budget Organize and staff Control and problem solve

94 What Change Are You Planning? 3 minutes: Write down a change that you are planning on. This can be something currently announced or in the planning stages or a thought in the back of your mind. As we go through the stages write down your thoughts about how you will achieve that step.

95 1. Establishing a Sense of Urgency Examine the organizational and political realities of the current situation Identify and discuss immediate opportunities and crises, or probable long term opportunities and crises

96 How do you raise the urgency level? Allow systems problems to create crisis instead of continuing band-aid solutions Set productivity targets very high Hold middle managers for total organizational performance Make performance data highly visible Connect employee with unhappy clients, suppliers, board members Stop happy talk-admit problems

97 2. Creating the Guiding Coalition Organize a group with influence sufficient to lead the change process Form a change management team

98 Key Characteristics of Coalition Members Position power in sufficient numbers Expertise to create informed, intelligent decisions Credibility and reputations to be taken seriously Leadership of high quality and sufficient numbers Beware of egos, snakes and reluctant players

99 Building the Coalition Find the right people Create trust Develop a common goal

100 3. Developing a Purpose and Strategy Purpose (Vision) –Directives –Management led –Collaborative Strategies –Experience –Experts –Pilot projects –Trial and error

101 Why a Purpose? Sets general direction of change and simplifies many detail decisions Motivates people to take action toward a shared end, even if actions are painful Helps coordinate actions Eliminates unnecessary activities

102 Characteristics of an Effective Purpose Imaginable Desirable Feasible Focused Flexible Communicable

103 The Elevator Speech “If you cannot describe your vision or purpose to someone in 40 seconds and get their interest, you have more work to do in this phase of the transformation process”

104 4. Communicating the Purpose Use every possible method and medium to communicate the purpose and strategies Modeling and demonstrating new procedures and behaviors

105 Keys to Effective Communication Keep it simple and jargon free Use metaphors, analogies, and examples Use multiple forums Repetition, repetition, repetition Lead by example Explain apparent inconsistencies Listen, listen, listen

106 Examples Version #1: Through a process of debureaucratization, we will empower our frontline employees to better serve idiosyncratic customer requirements.

107 Examples Version #2: We are going to throw out the rule books and give employees more authority to do the right thing for our clients.

108 5. Empowering the Change Process “Removing Barriers That Box Employees” Formal structures make it difficult to act A lack of needed skills undermines action Personnel and information systems make it difficult to act Bosses discourage actions aimed at implementing change

109 Empowering Employees for Action Removing obstacles Changing systems that interfere with implementing change activities Encouraging risk taking and experimentation Broad based delegation of authority Building rapid feedback systems

110 Empowering People to Make Changes Communicate a sensible vision to employees Remove or change incompatible structures Provide needed training Align information and personnel systems Confront and engage supervisors who block change

111 6. Generating Short-Term Wins Why Are They Important? Prove that sacrifices are worth the effort Reward change agents with recognition Help fine-tune purpose and strategies Under mine cynics and self-serving resisters Keep leaders and managers on board Build momentum

112 How Do You Create Short-Term Wins? Plan for highly visible performance improvements Organize and implement changes with high probability of success Create visibility for leaders and staff associated with successful changes Use incentives

113 7. Consolidating Gains and Producing More Change Use early successes to build credibility for additional changes Hire and promote successful change agents Create energy through new projects and staff

114 A View of Stage 7 More change not less More help More leadership from senior management More project management from front line managers Reduction of unnecessary interdependencies

115 8. Anchoring Change in a Culture What does it mean? How to do it?

116 Assessment and Measurement Focus on outcomes Measure for information not “evaluation” Understand that change takes time Stages of progress lead to the final goal Recognize and reward progress Make assessment and measurement as important as the process and outcome

117 Compare your example with your neighbor

118 The Twenty-First Century Organization Structure 1)Non-bureaucratic, with fewer rules and employees 2)Limited to fewer organizational levels 3)Organized with management leading and employees managing 4)Reduction in silos and internal interdependences

119 21 Century Organization Systems Dependent on information systems providing more data than in the past Widely distributed information Widely distributed management training Client centered systems dominate

120 21th Century Organizations Culture Externally oriented Empowering Quick to make decisions Open and candid More risk tolerant Permeable boundaries Change defined

121 Mechanistic or Organic? MechanisticOrganic 1. Task definitionNarrow, TechnicalBroad, general 2. Individual to org purposeVague, indirectClear, direct 3. Task flexibilitySpecificGeneral 4. Hierarchy controlHighLow 5. CommunicationTop downLateral 6. Decision styleAuthoritarianDemocratic 7. Loyalty emphasisHighLow

122 References Kotter, John P, Leading Change, Harvard Business School Press, Boston, 1996. Rogers, Richard, Communication and Diffusion of Innovation, Senge, Peter, et al., The Dance of Change, Currency Doubleday, New York, 1999.

123 Bud Nicola, MD, MHSA Dealing with Conflict 123

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127 Neal Dempsey – On an Endurance Mindset Neal Dempsey video

128 Bud Nicola, MD, MHSA http://tobytripp.github.io/meeting-ticker/ Meetings Bloody Meetings, or Getting Things Done Through Meetings

129 Meetings Bloody Meetings Small Group: Discuss the worst meeting you have ever attended. What were the characteristics? What about the meeting made it ineffective? As a group, list the characteristics of a bad meeting.

130 Meetings Bloody Meetings Small Group: Discuss the best meeting you have ever attended. What were the characteristics? What about the meeting made it effective? As a group, list the characteristics of an excellent meeting.

131 To Improve Meetings - PREPARE 1.List topics to be covered. 2.Define meeting goals. 3.Describe the deliverable as a whole and for each topic. 4.Put the topics in logical sequence. 5.Decide process for each deliverable. 6.Decide lead for each topic. 7.Decide who needs to be present. 8.Determine what info needs to be available.

132 How to Hold an Effective Meeting...

133 Boring meetings suck

134 Chairing a meeting https://www.youtube.com/watch?v=oPhKhTI0Lss

135 Meetings Effective meetings Boring meetings suck Chairing a meeting https://www.youtube.com/watch?v=oPhKhTI0Lss Meeting meter http://tobytripp.github.io/meeting-ticker/

136 Susan Allan, MD, JD, MPH Talking to Leaders 136

137 Hilary Karasz, PhD, MA Communications and influence 137

138 Break Break Time

139 Susan Allan, MD, JD, MPH Policy Briefs 139

140 Policy Briefs What, Why, When, and How Susan Allan, MD, JD, MPH

141 Objectives Describe the key components of a policy brief Identify situations in which a policy brief would be helpful Describe the benefits of using a policy brief process and format Be able to apply policy brief principles to leadership challenges

142 It’s About Communication “Elsas and other researchers say they believe that aspartame can do more damage over a long period of time than federal health officials.” —Morning Call, Allentown, PA

143 What Is a Policy Brief? A short and concise document that presents facts, policy options, and recommendations to policy makers or other influential audience Key features Action oriented Audience oriented

144 Purpose… Synthesizes information Presents findings and recommendations in a format that easily understood Increases the chances that policymakers will read, consider, and apply evidence when making policy decisions

145 Another Way to Describe a Policy Brief A concise summary of 1)A particular issue 2)Recommendations Target audience 1)Policy makers or others who make or influence policy

146 It’s About Communication "This is the first time there has been institutional support," said Martin Levinson, the director of the drug prevention program in District 30 in Queens. "For the morale of the drug workers, it is a shot in the arm.” —New York Times

147 Other Benefits of Developing a Policy Brief Clear thinking Clear communication Common understanding

148 Clear Thinking Structure an analysis of an issue or proposal Test clarity of recommendation or desired action

149 Clear Thinking – Common Faults Recommendation or proposal is missing or mushy Problems and issues not clearly linked to recommendation Prematurely wedded to your own selection of the evidence, analysis, or recommendations

150 Clear Communication Flexible resource for oral presentations, PowerPoints, editorials, etc. Ensure that the argument is oriented to audience Highlight the most important or most compelling points Obtain and incorporate critical review and suggestions from others

151 Clear Communication – Common Faults –Using jargon, acronyms, etc. –Burying the main points in too much detail –Losing the interest of the audience before getting to the main point!

152 Common Understanding Explicit agreement about the information and proposal Common or coordinated action Common talking points –Key points, facts –Clear and consistent description of proposed action or recommendation

153 Common Understanding – Common Faults –Supporters sound like they are making different proposals –Team members discover or air differences of interpretation or approach midway into the process – or in public settings –Being unwilling to rethink the evidence, analysis, or recommendations

154 Target a Specific Audience Most common audience: the decision-maker Other audiences for broad support Journalists, leaders of CBOs, community activists Leadership or administrators in other government agencies

155 We Don’t Always Say What We Mean! “Childbirth is big step to parenthood.” “Disciplining Children: Concrete Helps”

156 Structure of Policy Brief – Simple is Best Issue: one sentence summary Recommendation: one or two sentences Background: several paragraphs to more than half a page Discussion: several paragraphs to more than half a page Conclusion or Summary: several sentences to one paragraph

157 Structure of Policy Brief Length: Maximum one page front and back Title or Subject: Carefully craft to be clear and engaging Format: Your organization may have preferred formats

158 Process: Suggestions

159 Defining the Problem or Issue “The task force said it looked at hunger as a social problem in which some people cannot obtain adequate amounts of food.” —Sonja Hillgren, Boston Globe

160 Statement of Proposal or Recommendation Test for clarity and effectiveness Confirm that this is supported by the evidence and analysis Make recommendations realistic. Policymakers will be more interested in recommendations that they can implement, that are politically, economically, socially, and technically feasible Refining may be an iterative process

161 Who Is the Audience? Whose agreement, authority or resources are needed? Answer the questions: –Why is the topic important to this audience? –Why should they care?

162 Building the Policy Brief Structure the text in a logical manner Keep the paragraphs short and restricted to a single idea Reduce detail to only what reader needs to know Explain how policy changes improve the situation Consider advantages and disadvantages of each serious option Provide concrete facts or examples to support assertions Use more headings and subheadings Re-read each paragraph and ask yourself “so what?”

163 Ways to Write a Policy Brief Start at beginning Start at end Combination of two

164 Start at the Beginning First, write the introduction Then, work out the structure Write the body Put the supporting material together: the cases, boxes, tables, graphics, photos, etc. Write the recommendations Rearrange the text so the recommendations come at the beginning 1 2 3 4 5 6

165 Write the recommendations Work out the structure, body, and supporting material Write the introduction Rearrange the text Start at the End 1 2 3 4

166 Rats! A Public Health Policy Brief Story

167 Problem Poor rat control by the county, creating health risk Six county depts with partial responsibility, depending on where the rat was seen

168 Proposed Action Create and fund centralized rat control program in the health department

169 Evidence Anecdotes by staff and a couple of commercial property owners Knowledge from PH history that rats are unhealthy Common sense conviction that this is a poor approach

170 Department Director's Initial Response Where is the evidence that this is creating public health problems in our community? Where is the evidence that this is any kind of problem for the county? "I don't want to be known as the rat department!"

171 Next Step: Reassess Approach Find creative way to collect evidence 1)The county has excessive and uncontrolled rats 2)This is causing current and significant problems Consider how to redefine the problem in terms that are meaningful to director and county board

172 Talking About Rats…. “Do not sweep an area where there have been rodents with a broom.” —Recommendation from guidelines issued by a past public health official for rodent control

173 New Evidence Maps: number of rat reports or sightings on or near restaurant and grocery store properties Number of complaints received by several departments Anecdotal complaints from vocal citizens Enlarged photos of rat presence and rat damage in high income neighborhoods, new high-rise condos, and high profile shopping mall

174 Policy Brief Reframed OldNew ProblemPoor rat control by the county, creating health risk Six county depts with partial responsibility Uncoordinated system for rat control, resulting in property damage and community dissatisfaction Proposed action Create and fund centralized rat control program in the health department EvidenceAnecdotes by staff and a couple of commercial property owners Knowledge from PH history that rats are unhealthy Common sense conviction that this is a poor approach Strong and vivid Relevant to director’s values and priorities

175 Results Department director convinced 1)Need was real 2)Good for department image Director arranged for presentation to county board County board approved centralized program for rat control (funding for three staff) Other departments appreciated removal of burden A commendation for pro-active work!

176 Common Problems with Public Health Policy Writing Jargon Too much detail Assuming that “the facts will speak for themselves” Burying the key point Unclear about the recommendation or proposed action 1)Discussion focuses excessively on the problem and little about the possible solutions

177 Any Questions?

178 Susan Allan, MD, JD, MPH Racial, Ethnic, Gender, and Generational Aspects of Leadership 178

179 Susan and Bud Debrief and Next Steps 179


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