Managing Transitions Building Support for Change

8/9/2019 Managing Transitions Building Support for Change

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Managing TransitionsManaging TransitionsHelping your People to Support ChangeHelping your People to Support Change

Demi Hafenrefer, RN , MBAHafenrefer and Associates, nc!

"""!consultdemi!net

http://www.consultdemi.net/

http://www.consultdemi.net/



Some +uestions or you toSome +uestions or you todiscussdiscuss

Ho" is your current C- programoperationali.ed'◦ $hat are your /ey measures'◦ $hat is your staf#s understanding o

-uality'◦ Ho" are they measured'◦ Are your measurements %ased on

regulatory compliance'◦

Ho" and "hen are they analy.ed'◦ $ho de0elops and implements - plans'◦ $hat are your results'$hat is your current change pro1ect'



$HAT C234D $)$HAT C234D $)

B)C2M)'B)C2M)'



The present and the The present and the

utureutureC- program isprimarily in0ol0ed inauditing

Staf ear C- audits

Structured acti0ities5acility %elongs to staf 2rgani.ational chartsStaf ma/e all decisions

or residents Tas/ oriented 1o%sNurse is the %oss

C- program is %ased onroot cause analysis thatassists in identi ying i apro%lem e*ists6 thecause6 and strengths!Staf are e*cited %yopportunities to impro0e7 no ear 7 no ailure 7only eed%ac/Spontaneous acti0ities5acility is home to res!5lattened structureResidents8 amilies ma/edecisionsCare deli0ered to res!needs & desires

Team "or/ 7 nurse is aconsultant



The present and the The present and the

utureutureStaf 9oatNighttime care includese0ery t"o hour roundsRestrict mo%ility 7 /eep

sa e Tray ser0iceAll meals at set hoursSur0eyor 1o% is todetermine compliance5ollo" 2BRA rules topass sur0eyMa/e decisions %ased on

ear o citationsResidents "ho ha0e diedare hidden & rushed out

Consistent assignmentsResidents sleeps until they"a/e up:eep me sa e 7 let memo0e

DiningStaf8residents can ma/emeals & choose "hen toeatRis/ is part o li e 7 no onehas all the ans"ers3se 2BRA to create

autonomy & independenceMa/e decisions %ased onresident need & desireAll staf8residents are gi0enopportunity to mourn thedeath o a resident



$) AR) TH) PR2B4)M;;$) AR) TH) PR2B4)M;;<$hen people "ho are actually

creating a system start to seethemsel0es as the source o their

pro%lems, they in0aria%lydisco0er ne" capacity to create

results they truly desire!=

PresenceSenge, Scharmer, Jaworski &

Flowers



Pro0er%Pro0er%

< an organi.ation is not gro"ingt is

dying=



2rgani.ational Rene"al2rgani.ational Rene"al



< n order or change "e need to connect

more"ith

23RS)4>)S & lea0e our

other

sel0es %ehind!=

Demi Hafenrefer



Transition Transition?! Passage rom one orm, state, style,

or place to another!@! A transition or change, as to a

spiritual e*istence at death! Difers rom change?! Change ocuses on outcomes 7 transition

is a process@! More people ocused

! Transition#s starting point is the ending 7ocuses not on the change %ut on the

letting go o the old reality %e ore thechange too/ place



StagesStages

4etting go o the old "ays andthe old identity people had

oing through an in %et"eentime "hen the old is gone %ut thene" is not ully operational 7<neutral .one=

Coming out o the transition andma/ing a ne" %eginning 7 this is"hen change occurs



Helping your peopleHelping your people

(ou change rst;Plan & organi.eHelp them to let go 7 manage theendings4ead them through the neutral.one4aunch the ne" %eginning



(ou Change 5irst (ou Change 5irst

4eadership4eadership<4et him that "ould mo0e the

"orld,rst

mo0e himsel =

Socrates



Become Sel A"areBecome Sel A"are

Disco0er Sel Become a real human %eing◦ Do your people /no" "ho you are'

Disco0er your "orld 0ie"$hat#s in your %rie case'

Test your integrityMatching your 0ision 8 0alues"ith that o your organi.ation



4eading Planning4eading Planning$ho are your leaders'Ho" do they lead'$hat %eha0iors & attitudes "ill needto change'$ho "ill lose "hat under the ne"system'

Tal/ to them 7 in0ol0e staf at all le0els Teach your leaders a%out transition

>isit other organi.ations$ho are your champions'$here is your commitment &moti0ation'



Case StudyCase StudyNe" Heights Reha%! 5acility decided to

9atten its organi.ational structure %yde0eloping sel led processimpro0ement teams6 sel scheduling6 &renamed all positions! Policy andProcedure manuals "ere updated6 staftrained6 & the program implementedone month ago! The purpose o thischange "as to implement other personcentered measures! (ou ha0e %eenhired to assist "ith this implementation!



$hat "ill you do'$hat "ill you do')*plain the changes in postedmemos

et to /no" employees & gureout ho" %eha0iors & attitudes "illafect the change

Analy.e "ho "ill loose "hat

Redo the compensation pac/age

Sell the changeChange the en0ironment

Create a slogan & a logo

Train teams in con9ict resolution& ho" to %e team mem%ers

this system does not seem %e"or/ing %e ready to change it andimplement another!

Bring in a moti0ational spea/er

Pro0ide them "ith in o on pros &cons o ne" system

Plan ceremonies and cele%rations

Tal/ to indi0iduals a%out thetransition and "hat it does topeople

De0elop teams 7 plan social e0ents

Re"rite 1o% descriptions

>isit other organi.ations "ho ha0edone something similar

Brea/ the change into smallerstages

Pull the %est people together as amodel team to sho" e0eryone elseho" to do it

Change indi0idual targets to teamtargets & gi0e %onuses

Appoint a change managerDesign temporary systems

Create a disciplining system

et rid o the indi0idual sa%otagers

Set up a hot line



Help them to let goHelp them to let go Team meetings 7 gi0e in ormation

◦ <(ou can#t +uarter%ac/ rom the stands= 7 Nancy5o*

4osses◦ Accept the importance o losses◦ )*pect o0erreaction◦ Ac/no"ledge losses◦ )*pect grie0ingCompensate or lossesDe ne "hat is o0er and "hat is not

Treat the past "ith respect4et them ta/e a piece o the old "ith themSho" ho" endings ensures continuity o "hatreally matters 7 e*pect the %est



4eading them through the4eading them through the<Neutral Eone=<Neutral Eone=

<$hen "e#re learning something ne","e can eel a"/"ard, incompetent,

and e0en oolish! t#s easy tocon0ince oursel0es that it#s reallynot so important a ter all to

incorporate the ne" 7 so "e gi0eup!=

PresenceSenge, Scharmer, Jaworski & Flowers



Pro%lemsPro%lems

An*iety increases and moti0ationallsncreased a%senteeism 7

decreased producti0ity2ld pro%lems get "orseMi*ed signals and messagesPeople %ecome polari.edSa%otage



$hat "ill you do'$hat "ill you do't has %een t"o months since thechange at Ne" Heights6 a%senteeismis up6 a num%er o errors ha0eoccurred in care and ser0ices6 some othe old "ays ha0e crept %ac/ in6groups are starting to orm &managers are maintaining their old

ties6 communication is declining6 thene" system is ailing and teams "antto go %ac/ to the old organi.ationalstructure!



$hat "ill you do'$hat "ill you do')*plain the changes in postedmemos

et to /no" employees & gureout ho" %eha0iors & attitudes"ill afect the change

Analy.e "ho "ill loose "hatRedo the compensation pac/age

Sell the change

Change the en0ironment

Create a slogan & a logo

Train teams in con9ict resolution& ho" to %e team mem%ers

this system does not seem %e"or/ing %e ready to change itand implement another!

Bring in a moti0ational spea/er

Pro0ide them "ith in o on pros &cons o ne" system

Plan ceremonies & cele%rations

Tal/ to indi0iduals a%out thetransition and "hat it does topeople

De0elop teams 7 plan social e0ents

Re"rite 1o% descriptions

>isit other organi.ations "ho ha0edone something similar

Brea/ the change into smallerstages

Pull the %est people together as amodel team to sho" e0eryone elseho" to do it

Change indi0idual targets to teamtargets & gi0e %onuses

Appoint a change manager

Design temporary systems

Create a disciplining system

et rid o the indi0idual sa%otagers

Set up a hot line



SolutionsSolutionsnter0entions 7 nter0ene at these

pointsF◦ Beha0ior◦ Gusti cation or the %eha0ior◦

Cultural communications◦ Hiring 7 mem%ers "ho < t= the ne" culture◦ 2rgani.ational culture as a "hole◦ Remo0e those "ho de0iate rom the cultureNormali.e 7 Create slogansCreate temporary systemsStrengthen intragroup connectionsConsider a transition monitoring team



SolutionsSolutions

)ncourage %rainstorming osolutions, e*perimentationSuspend your normal "ays othin/ing



The Ne" Beginning The Ne" Beginning

<Gust %ecause e0erything isdiferent

doesn#t mean thatanything has changed;=

rene Peter American

$riter



)*ercise)*ercise?! Rearrange yoursel0es in groups

according to your %irth datemonth!

@! Rearrange yoursel0es accordingto your %irthdates



The Ne" Beginning The Ne" Beginning

Remem%er not all are going throughthese stages simultaneouslyRe%uild and maintain trustClari y and communicate the purpose3nderstand that "ith C- change is anormal processCreate a Plan 7 Rein orce the ne"◦ Be consistent◦ )nsure +uic/ successes◦ Sym%oli.e the Ne" dentity◦ Cele%rate



Assessing yourAssessing yourorgani.ation#s readiness ororgani.ation#s readiness orchangechange$here are you today'

◦ Ho" do indi0iduals interact'◦ Ho" are tas/s accomplished'roup norms myths, rumors, storiesI

◦ Standards o %eha0iorStated 0alues and ormal philosophies◦ n "hat "ays does the organi.ation support

these'

Rules or getting along20erall climate calm, learning,supporti0e, ear %ased, disorgani.ation,someone is out to get usI



Assessing yourAssessing yourorgani.ation#s readiness ororgani.ation#s readiness orchangechange)m%edded s/ills

◦ Ho" to groups interrelate◦ Special competencies◦ Su%cultures' 4eaders "ithin these

su%cultures'Arti acts dress, urnishings,architectural, assigned par/ing, locationo oJcesI◦

Does the o0erall en0ironment supportperson centered care'$ho are the heroes8mentors◦ $ho do staf loo/ up to other than residents'



2ther resources2ther resources

Bridges, $! @KK I! Managing TransitionsF Ma/ing the Most o Change!Cam%ridge, MAF Da Capo Press!Dana, B! @KKLI! De0eloping a -uality

Management System @nd

editionI AHCA5o*, N! @KK I! The Gourney o a 4i etimeF4eadership Path"ays to Culture Changein 4ong Term Care! )den Alternati0e!

Senge, P! M! et al @KK I! PresenceF An)*ploration o Pro ound Change inPeople, 2rgani.ations, and Society!Random HouseF N(!



THAN: (23; THAN: (23;

Managing Transitions Building Support for Change

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