Implementing Change: Engaging People and Changing Practice Barbara Wren C. Psychol. Consultant Lead Psychologist in Occupational Health Royal Free Hampstead NHS Trust Health and Work Centre, London, UK.

Your own Reactions To Change. Was the change one you had made or had it been imposed on you? How did you feel initially? What was your reaction? Were you surprised at your reaction? Did your feelings and reactions stay constant or did they change over time? Have you now accepted the change? Barbara Wren , Implementing Change: Engaging People and Changing Practice, Dublin,April 2008

Common Reactions To Change (1) People are less ready to accept change when it is done ‘to’ them and not ‘by’ them. Most people adversely react to change unless they know why. Different people can view the same change as negative or positive depending or their perspective. Barbara Wren , Implementing Change: Engaging People and Changing Practice, Dublin,April 2008

Common Reactions To Change (2) People’s emotional responses to change are remarkably similar irrespective of the nature of the change. People tend to focus on the threat of change rather than the opportunity to them. Barbara Wren , Implementing Change: Engaging People and Changing Practice, Dublin,April 2008

During Change People revert to previous behaviours To make it happen you need to constantly work at it People need coaching and development to change the way they do things People are uncomfortable if they do not know why change is happening Barbara Wren , Implementing Change: Engaging People and Changing Practice, Dublin,April 2008

Stages Of Emotional Transition 1. Denial 2. Resistance 4. Commitment 3. Exploration Barbara Wren , Implementing Change: Engaging People and Changing Practice, Dublin,April 2008

The Change Process Prepare Review Plan Implement Why What Communicate What went well What went less well What have we learned Agree way ahead Agree Action Plan Success Criteria Involve Team Implement Put plan in to action Monitor & Measure Communicate Barbara Wren , Implementing Change: Engaging People and Changing Practice, Dublin,April 2008

The Preparation Stage Involves: Defining what will success look like. (Well Formed Outcomes). Identifying who are the stakeholders. (Need to be engaged in the change cycle) Using analytical tools to gather more information. (e.g. Gap analysis / Force field analysis) Being clear about the resourcing issues. (What support is available?) Devising a workable solution to take the change forward to the planning stage. Barbara Wren , Implementing Change: Engaging People and Changing Practice, Dublin,April 2008

A Model For Setting ‘Well-Formed Outcomes’ State in the positive. What do you want to achieve? Be specific. When, where & with whom do you want this? What evidence would you need to know you had achieved your outcome? What will you see, hear & feel when you achieve this outcome? Barbara Wren , Implementing Change: Engaging People and Changing Practice, Dublin,April 2008

A Model For Setting ‘Well-Formed Outcomes’ What part will you play in the process? (Are you in charge of the changes you require?) Will you lose anything if you achieve this outcome? Is the outcome worth what it takes to get it? What are the consequences in your life if the goal is achieved? Barbara Wren , Implementing Change: Engaging People and Changing Practice, Dublin,April 2008

Stakeholder Analysis Who is needed to make the change happen? Whose support is needed to enable it to proceed? Who will be affected by the change? How do you remove any resistance to change to engage them in the process? Barbara Wren , Implementing Change: Engaging People and Changing Practice, Dublin,April 2008

Key People in Key Roles Individual or group who legitimises the change SPONSOR Individual or group who legitimises the change CHANGE AGENT Individual or group who is responsible for implementing the change CHANGE ADVOCATE Individual or group who wants to achieve a change but does not possess legitimisation power Barbara Wren , Implementing Change: Engaging People and Changing Practice, Dublin,April 2008

GAP ANALYSIS (1). Ask “Where do we want to be?” (This vision has been clarified by your Well-Formed Outcome). Ask “Where are we now?” Measure the gap between the present & the ideal state. Quantify it tangibly Barbara Wren , Implementing Change: Engaging People and Changing Practice, Dublin,April 2008

GAP ANALYSIS (2) Map out the key changes needed to close the gap, working back from the ideal. State these changes in clear words & figures as a focus for planning change. Barbara Wren , Implementing Change: Engaging People and Changing Practice, Dublin,April 2008

FORCEFIELD ANALYSIS Desired State Restraining Forces Current State Driving Forces Barbara Wren , Implementing Change: Engaging People and Changing Practice, Dublin,April 2008

Four Factors That Influence Behaviour Change. Systems – Forecast, Plan, Control & Report on the work. Process - Are processes simple & logical? Structure - People’s roles & responsibilities. Training - Providing hard & soft skills. Barbara Wren , Implementing Change: Engaging People and Changing Practice, Dublin,April 2008

Building a Change Action Plan From your force-field analysis note down your driving forces and restraining forces. Take the individual headings and break them down into activities required to either assist the drivers or inhibit the restrainers. Explore each item in detail, (breaking it down again if appropriate) and identify the activities that have to be done between now and implementation of the change. Barbara Wren , Implementing Change: Engaging People and Changing Practice, Dublin,April 2008

RESOURCE & SUPPORT MAPPING. What support & resources will be required for the change to take place? (Money, People, Skills, Time). Identify where these resources and support will come from. Then highlight any gaps. (Extra training? Getting people on board? Securing extra funding? Shifting priorities?) 3. Identify how (or if !!) these gaps can be addressed. Barbara Wren , Implementing Change: Engaging People and Changing Practice, Dublin,April 2008

Commitment Curve Time Degree of support for the change Internalisation 7 Degree of “This is the way we do things” support Commitment 6 for the “I like to do it this way” change Acceptance “The new rules” 5 Engagement 4 “This looks worth a try” Understanding Awareness 3 “I know the implications for me” Contact 2 “I know what it is” 1 “I’m being told about something” Time Barbara Wren , Implementing Change: Engaging People and Changing Practice, Dublin,April 2008

IMPLEMENTATION. Pilot. Adjust. Refine. Improve. Put the Change Action Plan into action Communicate progress Monitor the plan against the success criteria Control and update the plan Resilience is important. Barbara Wren , Implementing Change: Engaging People and Changing Practice, Dublin,April 2008

A B Barbara Wren , Implementing Change: Engaging People and Changing Practice, Dublin,April 2008

The Planning Phase Set a Change Action Plan with a timetable Agree criteria to measure success Assign roles to activities Involve the team in creating the output Barbara Wren , Implementing Change: Engaging People and Changing Practice, Dublin,April 2008

Thank you and Goodbye! That’s it for today! barbara.wren@royalfree.nhs.uk Barbara Wren , Implementing Change: Engaging People and Changing Practice, Dublin,April 2008