Response to Literature Hobnail by Crystal Arbogast Lesson #2 Hines and Garside.
The Management of Change Sandra Dawson & Pam Garside International Health Leadership Programme 2006.
-
Upload
ariel-zane -
Category
Documents
-
view
214 -
download
1
Transcript of The Management of Change Sandra Dawson & Pam Garside International Health Leadership Programme 2006.
![Page 1: The Management of Change Sandra Dawson & Pam Garside International Health Leadership Programme 2006.](https://reader035.fdocuments.in/reader035/viewer/2022070306/55179dd355034645368b59ef/html5/thumbnails/1.jpg)
The Management of Change
Sandra Dawson & Pam Garside
International Health Leadership Programme 2006
![Page 2: The Management of Change Sandra Dawson & Pam Garside International Health Leadership Programme 2006.](https://reader035.fdocuments.in/reader035/viewer/2022070306/55179dd355034645368b59ef/html5/thumbnails/2.jpg)
The session
• Dos and Don’ts of Managing Change
• Group Work and Feedback
• Leadership,Delegation,Trust and Change
![Page 3: The Management of Change Sandra Dawson & Pam Garside International Health Leadership Programme 2006.](https://reader035.fdocuments.in/reader035/viewer/2022070306/55179dd355034645368b59ef/html5/thumbnails/3.jpg)
What is meant by ‘Change?’
‘Improvement is an innocuous term.Even innovation is fairly innocuous.
Change is not.Change meansdisruption,by definition”
Tom Peters,1997 ‘Thriving on Chaos’
![Page 4: The Management of Change Sandra Dawson & Pam Garside International Health Leadership Programme 2006.](https://reader035.fdocuments.in/reader035/viewer/2022070306/55179dd355034645368b59ef/html5/thumbnails/4.jpg)
Dos and Don’ts of Managing Change
![Page 5: The Management of Change Sandra Dawson & Pam Garside International Health Leadership Programme 2006.](https://reader035.fdocuments.in/reader035/viewer/2022070306/55179dd355034645368b59ef/html5/thumbnails/5.jpg)
‘Dos’….annotated with your experiences of the reasons which led to a successful change
![Page 6: The Management of Change Sandra Dawson & Pam Garside International Health Leadership Programme 2006.](https://reader035.fdocuments.in/reader035/viewer/2022070306/55179dd355034645368b59ef/html5/thumbnails/6.jpg)
1 Have very clear goals-know why you’re doing it and tell everyone
• Have a good reason for the change which was highly sellable to the local community
• Have evidence for your proposition • Coherent strategy and roll-out plan• Goals were clear• Articulating to staff of the ‘Whys’• Clear goals,incentives timeframes• Having a pressing need and a high priority • Lack of data to support the problem identification• Background of problem not appreciated/understood• The lack of a vision to include alternative uses to community
hospitals
![Page 7: The Management of Change Sandra Dawson & Pam Garside International Health Leadership Programme 2006.](https://reader035.fdocuments.in/reader035/viewer/2022070306/55179dd355034645368b59ef/html5/thumbnails/7.jpg)
2 High level support for the change maintained throughout the process
• Ministerial and CEO Support • Strong political will • Senior team, hands on engagement• Authority is most important • Persistence• Political Support• Lack of senior manager buy-in • Change of minister at critical point• Inadequate support of senior management,lack of
alignment of management team re goals
![Page 8: The Management of Change Sandra Dawson & Pam Garside International Health Leadership Programme 2006.](https://reader035.fdocuments.in/reader035/viewer/2022070306/55179dd355034645368b59ef/html5/thumbnails/8.jpg)
3 Involve / listen to people /engage stakeholders
• Involvement of the physicians themselves in the process of development of guidelines for diabetes-this ownership was the reason for implementation
• Well consulted • It was clear to me and my own management team that the
turnaround in staff morale was due to staff’s understanding that we had listened to them and that we had valued their in put by implementing their recommendations
• Active involvement of all those which were supposed to be affected by the change
• Lack of support of stakeholders
![Page 9: The Management of Change Sandra Dawson & Pam Garside International Health Leadership Programme 2006.](https://reader035.fdocuments.in/reader035/viewer/2022070306/55179dd355034645368b59ef/html5/thumbnails/9.jpg)
4 Communicate,communicate and then communicate again
• Repeated persuasion of the senior management, with pros and cons of the change process. This was successful as I communicated the need clearly and with evidence and because the delegator was in a position of authority.Also this change was giving 6 other directors more authority
• Well communicated• Lack of reception of message
![Page 10: The Management of Change Sandra Dawson & Pam Garside International Health Leadership Programme 2006.](https://reader035.fdocuments.in/reader035/viewer/2022070306/55179dd355034645368b59ef/html5/thumbnails/10.jpg)
![Page 11: The Management of Change Sandra Dawson & Pam Garside International Health Leadership Programme 2006.](https://reader035.fdocuments.in/reader035/viewer/2022070306/55179dd355034645368b59ef/html5/thumbnails/11.jpg)
5 Champions on the Ground
• Keenness to implement at operational level
• Community champions advocating on behalf of the policy change
• The large pool of potential trainees formed a major pressure group within the Medical Association
![Page 12: The Management of Change Sandra Dawson & Pam Garside International Health Leadership Programme 2006.](https://reader035.fdocuments.in/reader035/viewer/2022070306/55179dd355034645368b59ef/html5/thumbnails/12.jpg)
6 Get the timing right and be in this for the long term
• Reforms took the ‘long haul’ approach and required huge communication and engagement
• Change of government facilitated the development of training
![Page 13: The Management of Change Sandra Dawson & Pam Garside International Health Leadership Programme 2006.](https://reader035.fdocuments.in/reader035/viewer/2022070306/55179dd355034645368b59ef/html5/thumbnails/13.jpg)
7 Resource the process properly, establish a dedicated project team
• Allocation of resources and budget for the whole change process
• A Change Fund was identified but this was offset by the financial savings
• Development Activities resourced from development partners
• Get a champion to manage the programme• Inexperienced project manager was given too
much latitude over the project
![Page 14: The Management of Change Sandra Dawson & Pam Garside International Health Leadership Programme 2006.](https://reader035.fdocuments.in/reader035/viewer/2022070306/55179dd355034645368b59ef/html5/thumbnails/14.jpg)
8 Be honest and transparent with the facts
• Transparency made the junior doctors more relaxed in dealing with authority
![Page 15: The Management of Change Sandra Dawson & Pam Garside International Health Leadership Programme 2006.](https://reader035.fdocuments.in/reader035/viewer/2022070306/55179dd355034645368b59ef/html5/thumbnails/15.jpg)
9 Remember people are thinking ‘What does this mean for me’
• Understanding their fear (the staff)
• Fears were addressed..securities provided
![Page 16: The Management of Change Sandra Dawson & Pam Garside International Health Leadership Programme 2006.](https://reader035.fdocuments.in/reader035/viewer/2022070306/55179dd355034645368b59ef/html5/thumbnails/16.jpg)
![Page 17: The Management of Change Sandra Dawson & Pam Garside International Health Leadership Programme 2006.](https://reader035.fdocuments.in/reader035/viewer/2022070306/55179dd355034645368b59ef/html5/thumbnails/17.jpg)
![Page 18: The Management of Change Sandra Dawson & Pam Garside International Health Leadership Programme 2006.](https://reader035.fdocuments.in/reader035/viewer/2022070306/55179dd355034645368b59ef/html5/thumbnails/18.jpg)
10 Remember trust and dignity are easily eroded
Build up Trust between parties who did not trust each other.How? By meeting to understand each other first and then work out details of process to create a true win/win environment for both parties
![Page 19: The Management of Change Sandra Dawson & Pam Garside International Health Leadership Programme 2006.](https://reader035.fdocuments.in/reader035/viewer/2022070306/55179dd355034645368b59ef/html5/thumbnails/19.jpg)
11 HR processes are key:Training and development /plan exits/ do ‘deals’/ succession planning.Individuals have to trust the HR process and how it will treat them.
Individualised training
![Page 20: The Management of Change Sandra Dawson & Pam Garside International Health Leadership Programme 2006.](https://reader035.fdocuments.in/reader035/viewer/2022070306/55179dd355034645368b59ef/html5/thumbnails/20.jpg)
12 Evaluate!!
Good monitoring and evaluation strategy
![Page 21: The Management of Change Sandra Dawson & Pam Garside International Health Leadership Programme 2006.](https://reader035.fdocuments.in/reader035/viewer/2022070306/55179dd355034645368b59ef/html5/thumbnails/21.jpg)
Dos that Pam and Sandra would add..
• Use line managers at every level
• Symbols are critical
• Create the team, keep the key people
![Page 22: The Management of Change Sandra Dawson & Pam Garside International Health Leadership Programme 2006.](https://reader035.fdocuments.in/reader035/viewer/2022070306/55179dd355034645368b59ef/html5/thumbnails/22.jpg)
Don’ts
• Rely on videos,publications,and large meetings• Use jargon and over-intellectualise• Give inconsistent messages• Forget key stakeholders• Over-promise and under-deliver• Think that everyone who signed up on Day 1 will
be with you on Day 60 or even day 600
![Page 23: The Management of Change Sandra Dawson & Pam Garside International Health Leadership Programme 2006.](https://reader035.fdocuments.in/reader035/viewer/2022070306/55179dd355034645368b59ef/html5/thumbnails/23.jpg)
Don’ts (2)
• Forget middle managers and unions/staff side• Lose heart half way through-be brave and take
measured risks,but to be adaptable is not necessarily weakness
• Expect the world to stay the same as you progress through the change process
• Forget the business must run day to day• Be confrontational• Have lack of alignment of goals• Underestimate resistance from stakeholders
![Page 24: The Management of Change Sandra Dawson & Pam Garside International Health Leadership Programme 2006.](https://reader035.fdocuments.in/reader035/viewer/2022070306/55179dd355034645368b59ef/html5/thumbnails/24.jpg)
Why do change programmes so often fail?
• Success rates in Fortune 500 companies estimated at 25-50%-why? – Because ’leaders’ and employees see change
differently– Change leaders fail to establish trust within
their organisation– There is insufficient communication of the
vision/goal/reasons for change
![Page 25: The Management of Change Sandra Dawson & Pam Garside International Health Leadership Programme 2006.](https://reader035.fdocuments.in/reader035/viewer/2022070306/55179dd355034645368b59ef/html5/thumbnails/25.jpg)
The Slot Machine model of change
Cherry Cherry Cherry Cherry
![Page 26: The Management of Change Sandra Dawson & Pam Garside International Health Leadership Programme 2006.](https://reader035.fdocuments.in/reader035/viewer/2022070306/55179dd355034645368b59ef/html5/thumbnails/26.jpg)
Kanter’s Law..
‘Everything can look like failure in the middle’
Prof.Rosabeth Moss Kanter,Harvard Business School
![Page 27: The Management of Change Sandra Dawson & Pam Garside International Health Leadership Programme 2006.](https://reader035.fdocuments.in/reader035/viewer/2022070306/55179dd355034645368b59ef/html5/thumbnails/27.jpg)
“Closing a hospital is like moving a graveyard-there’s not a
lot of internal support for the move”
![Page 28: The Management of Change Sandra Dawson & Pam Garside International Health Leadership Programme 2006.](https://reader035.fdocuments.in/reader035/viewer/2022070306/55179dd355034645368b59ef/html5/thumbnails/28.jpg)
Work in groups to provide feedback on
two sets of four change projects:
Set 1
Community nursing designed to reduce emergency (Kyung)
Community Ambulance Cover (Arthur)
Staff Morale improvement (Al)
Reform of PG Medical education (Dela)
![Page 29: The Management of Change Sandra Dawson & Pam Garside International Health Leadership Programme 2006.](https://reader035.fdocuments.in/reader035/viewer/2022070306/55179dd355034645368b59ef/html5/thumbnails/29.jpg)
Work in groups to provide feedback on
two sets of four change projects:
Set 2
New structure for health technical support unit (Aqila)
Cross training of nursing staff (Murray)
Roll out of anti retroviral treatment programme (Norbert)
Moving primary care out of Tygerberg hospital (Japie)
![Page 30: The Management of Change Sandra Dawson & Pam Garside International Health Leadership Programme 2006.](https://reader035.fdocuments.in/reader035/viewer/2022070306/55179dd355034645368b59ef/html5/thumbnails/30.jpg)
Work in groups to discuss each change project:
For each project• Describe it• Identify stakeholders• Summarise sources of resistance• What strategies/tactics were used, with what effect?
What other tactics might have been successful?• Lessons learnedCome back together in order to focus on what you have
learned in addition to/or in amplification of, our collective learning…..