Change Management Sinead O’Connor

Imagine a healthcare world, where change……… Is the norm Is sought out & embraced by all Is safe and effective Enables teams and empowers employees Improves our patient outcomes Improves our patient experiences Where you end up is better than where you started !!

The more familiar response to change is……. Not happening! It won’t work! Don’t want to know! It’s not needed! It was a disaster the last time we tried!

All organisations need to change to survive! To stay relevant, effective & efficient To continue to improve on quality, safety, patient outcomes & experiences To attract & retain top talent

Why change management programmes fail? Not understanding or ignoring the culture “Change fatigue”- too many changes without prioritisation “Visionary” change… I don’t need a plan Communication is not engagement Change on the cheap Visionary change- someone sitting in their office Ineffective or no real senior management buy in or commitment Gaps or inconsistencies in change leader skills Fear to feedback or of failure

Other reasons….. Mission accomplished (opps…. not quite) Failure to embed the change But everything really comes down to people, who they are, how they are set up, who leads them, who influences them, who engages them, who listens to them

Step 1: Understand the culture, “how things get done around here” How it is done & who does it Change managers must address culture - what are people proud of? Unleash the power of special forces - informal leaders who are trusted & are proud of what they do. Leaders by example Myth: Changing communications, reward systems, adding more training is all that is required to move an organisation to a new place Coherent

Step 2: Create a sense of urgency. Establish the compelling need for change & identify the risks of “standing still” Start the conversation…… Understand the “translation effect” Incidents complaints, staff recruitment & retention, patient safety, not best practice, poor patient feedback or customer experience. Internal & external input Translation compeling case for change translated for all the players

Step 3: Identify & create a guiding coalition Those who get it. Those who don’t get it but want to get it Those who don’t want to get it & don’t want to get it.

Those who don’t get it, but want to get it Those who get it Those who don’t get it, but want to get it Embraces change Embraces the opportunity Can see the end game & the roadmap to get there Don’t need convincing Heart is in the right place Needs more help & support Almost always gets there Those who don’t want to get it & don’t want to get it Intractable & inflexible Do not believe their way of working is antiquated. “ If it ain’t broke; don’t fix it” Recognise that some employees, you just can’t reach Carrot & stick approach

Beware Negative Nellies & Resisters “It’s hard to overstate the impact that “Negative Nellies” can have on culture, morale, and the ultimate success of a new change management programme” Prof John Kotter, Harvard Business School,  https://www.youtube.com/watch?v=Wdroj6F3VlQ Resist to the death. Tendency to try to get them on board or win them over. Some even bring them into the key team in the hope to give them ownership. For the absolute resisters get them out of the way, distract them & move on. If the are real no’s they will undermine the project & destrroy the integrity of the same. In cases of significant change this is the only solution. Result or transformation not achieved Wasted resources- time people & money Left with reduced morale

Like sport- team selection is everything Respected leaders Relevant expertise Ability & willingness to play as part of a team Trusted Mix of members from different areas Those who get it. Those who don’t get it but want to get it Those who don’t want to get it and don’t want to get it

Step 4: Develop the plan & engage the stakeholders Talk about it (a lot) Listen to fears & anxieties & deal with them (& I mean REALLY listen!) Know the details & give them confidence in you You can have the best designed hospital, with all of the infrastructure in place, devices at the hands of every clinician and provide all of the professional development on how to do the stuff, and none of it will matter if people do not know why these things are important, and they see themselves as part of the change, not people that are being changed. Deal with them- change how it will be executed Determine the reason for change Develop a vision & strategy Vision statement- how you see the future post the change Know how it will be executed Easily explained

Rethink how you communicate

Step 5: Enable the Team Identify leaders Choose respected influencers across all workgroups Give them authority and confidence to act Visibly support them Talk about it (a lot) Without understanding why and seeing yourself as part of something bigger than yourself, we can’t expect schools to change en masse, nor will we see it happen.  And this isn’t just in schools, it is in all organizations.  It is easy to get people to do stuff, but it is a lot harder (and more important) to have people do amazing stuff. There’s a difference. And the infrastructure and environment is important, but not as important as the thinking that makes “incredible” happen. Schools will always be people powered, and they should always be our biggest investment.

Step 6: Score some early goals Quick wins that can be measured & felt Celebrate successes & talk about them (a lot) Tell the “working together” story Generate short term wins

Step 7: Run up the score Continually analyse what went right & what needs improvement Build on belief 80-20 rule Don’t settle

Step 8: Embed the change - “this is just what we do & how we do it” Keep celebrating success, keep telling stories, keep making heroes Include the change ideals & values, when hiring, inducting, training, promoting……