Download - Unleashing energy for change

Transcript
Page 1: Unleashing energy for change

@helenbevan #Quality2013

Unleashing energy for change

Helen Bevan@helenbevan@NHSIQ#Quality2013

Page 2: Unleashing energy for change

@helenbevan@helenbevan #Quality2013 @helenbevan #Quality2013

Most large scale change fails to achieve its objectives

Source: McKinsey Performance Transformation Survey, 3000 respondents to global, multi-industry survey

Page 3: Unleashing energy for change

@helenbevan #Quality2013

What happens to large scale change efforts in reality?

In order of frequency:1. the effort effectively “runs out of energy” and

simply fades away2. the change hits a plateau at some level and no

longer attracts new supporters3. the change becomes reasonably well

established; several levels across the system have changed to accommodate or support it in a sustainable way.

Source: Leading Large Scale Change: a practical guide (2011), NHS Institute

Page 4: Unleashing energy for change

© NHS Institute for Innovation and Improvement, 2011@helenbevan #Quality2013

Anatomy of change Physiology of change

Definition The shape and processes of the system; detailed analysis;

how the components fit together.

The vitality and life-giving forces that enable the system and its people to

develop, grow and change.

FocusProcesses and structures

to deliver health and healthcare

Energy/fuel for change

Leadership activities

measurement and evidence

improving clinical systems reducing waste and

variation in healthcare processes

redesigning pathways

creating a higher purpose and deeper meaning for the change process

building commitment to change connecting with values creating hope and optimism about

the future calling to actionSource: Crump and Bevan

Page 5: Unleashing energy for change

© NHS Institute for Innovation and Improvement, 2011@helenbevan #Quality2013

Anatomy of change Physiology of change

Definition The shape and processes of the system; detailed

analysis; how the components fit together

Focus Processes and structures to deliver health /healthcare

Leadership activities

measurement and evidence

improving clinical systems

reducing waste and variation in healthcare processes

redesigning pathways

Page 6: Unleashing energy for change

© NHS Institute for Innovation and Improvement, 2011@helenbevan #Quality2013

Anatomy of change Physiology of change

Definition The shape and processes of the system; detailed

analysis; how the components fit together

The vitality and life-giving forces that enable the system and its people to develop, grow and

change

Focus Processes and structures to deliver health /healthcare

Energy as a fuel for change

Leadership activities

measurement and evidence

improving clinical systems

reducing waste and variation in healthcare processes

redesigning pathways

creating a higher purpose and deeper meaning for the change process

building commitment to change connecting with values creating hope and optimism

about the future calling to action

Source: Crump and Bevan

Page 7: Unleashing energy for change

@helenbevan #Quality2013

Intrinsic motivators •connecting to shared purpose

•engaging, mobilising and calling to action

•motivational leadership

build energy and

creativity

Page 8: Unleashing energy for change

@helenbevan #Quality2013

Intrinsic motivators •connecting to shared purpose

•engaging, mobilising and calling to action

•motivational leadership

build energy and

creativity create focus & momentum for delivery

Drivers of extrinsic motivation

Page 9: Unleashing energy for change

@helenbevan #Quality2013

Drivers of extrinsic motivation

create focus & momentum for delivery

Intrinsic motivators •connecting to shared purpose

•engaging, mobilising and calling to action

•motivational leadership

build energy and

creativity

•System drivers & incentives•Payment by results•Performance management•Measurement for accountability

Page 10: Unleashing energy for change

@helenbevan #Quality2013

Internal motivators

•connecting to shared purpose

•engaging, mobilising and calling to action

•motivational leadership

build energy and creativity

Drivers of extrinsicmotivation

•System drivers & incentives•Performance management•Measurement for accountabilitycreate & focus

momentum for delivery

Page 11: Unleashing energy for change

Transformation is not a matter of intent.........it is a matter of alignmentPeter Fuda

Page 12: Unleashing energy for change

@helenbevan

NHS Change Model

www.changemodel.nhs.uk

Page 13: Unleashing energy for change

@helenbevan@helenbevan #Quality2013

0123456789

10Our shared purpose

Spread of innovation

Improvementmethodology

Rigorous delivery

Transparentmeasurement

System drivers

Engagement tomobilise

Leadership for change

What's our prognosis for this asthma pathway project?

Page 14: Unleashing energy for change

@helenbevan

NHS Change Model

www.changemodel.nhs.uk

Page 15: Unleashing energy for change

@helenbevan #Quality2013

Does fear motivate people to change?

Page 16: Unleashing energy for change

@helenbevan #Quality2013

burning platformversus

burning ambition@PeterFuda

Page 17: Unleashing energy for change

@helenbevan #Quality2013

Show Peter Fuda film here

Page 18: Unleashing energy for change

@helenbevan #Quality2013

Lessons for transformational change

1. In order to sustain transformational change we need to move from a burning platform (fear based urgency) to a burning ambition (shared purpose for a better future)

2. We need to articulate personal reasons for change as well as organisational reasons

3. If the fire (the compelling reason) goes out, all other factors are redundant

@PeterFuda

Page 19: Unleashing energy for change

@helenbevan #Quality2013

Task

Talk to the person next to you• What is “my burning ambition” for my service,

my community and /or my patients?• Try to make it personal: tell others why this

ambition connects with your personal motivations

Page 20: Unleashing energy for change

@helenbevan@helenbevan #Quality2013

You get the best efforts from others not by lighting a fire

beneath them but by building

Source: Bob Nelson

Page 21: Unleashing energy for change

@helenbevan@helenbevan #Quality2013

Page 22: Unleashing energy for change

@helenbevan@helenbevan #Quality2013

Show “energy for change” film here

Page 23: Unleashing energy for change

@helenbevan@helenbevan #Quality2013

the capacity and drive of a team, organisation or system to act and make the

difference necessary to

achieve its goals

Psychological

Physical

Spiritual

Social Intellectual

Energy for change is:

Page 24: Unleashing energy for change

@helenbevan@helenbevan #Quality2013

The five energies for change

Page 25: Unleashing energy for change

@helenbevan@helenbevan #Quality2013

High and low ends of each energy domain

Low High

Social isolated solidarity

Spiritual uncommitted higher purpose

Psychological risky safe

Physical fatigue vitality

Intellectual Illogical reason

Page 26: Unleashing energy for change

@helenbevan@helenbevan #Quality2013

The SSPPI Energy Index – Part IThis questionnaire enables teams to measure their energy for change.  Please agree the nature of the change context with your team before answering the following statements. Then answer all statements with your particular change context in mind.

1 = Strongly disagree 2 = Disagree 3 = Neutral 4 = Agree 5 = Strongly AgreeI am energised by the momentum of change____I have gained insight into the case for change____I feel a sense of solidarity with those I work with ____I am weary of change____I am able to keep expressing hope for the change when presented with setbacks_____The reasoning for the change is not compelling___I don’t feel appreciated by others at work_____ I will be blamed if I try something new and it fails____I feel isolated from others____I feel depleted of energy when others express doubt about the change_____The case for change has stimulated my creativity_____I feel disconnected from others____I am committed to our common vision for the future____I feel safe enough to do things differently____I am driven by shared values____I am experiencing change fatigue____The change does not fit with my sense of purpose_____I am not driven by a shared purpose for change_____I think there is no rational argument for change____The case for change is interesting to me_____I feel that we are getting things done to achieve the change_____I feel the change may conflict with my values___I feel personally engaged in the change___Clear thinking and analysis underpins the change___I feel fearful about the change___I sense openness about the potential to change___

Page 27: Unleashing energy for change

@helenbevan

Social energy is the energy of personal engagement, relationships and connections between people.  It reflects a “sense of us” and is therefore a collective concept that captures a situation where people are drawn into an improvement or change because they feel a connection to it as part of the collective group.

My social energy is ____The social energy of those I work with is____The importance of social energy to me is____

Psychological energy is the energy of courage, trust and feeling safe to do things differently. It involves feeling supported to make a change as well as belief in self and the team, organisation or system, and trust in leadership and direction.

My psychological energy is ____The psychological energy of those I work with is____The importance of psychological energy to me is____

Physical energy is the energy of action, getting things done and making progress. It is the flexible, responsive drive to make things happen, with vitality and kinetic force (motion)

My physical energy is ____The physical energy of those I work with is ____The importance of physical energy to me is____

Intellectual energy is the energy of curiosity, analysis, thinking and cognition. It involves gaining insight, a thirst for new knowledge as well as planning and supporting processes, evaluation, and arguing a case on the basis of logic and evidence.

My intellectual energy is ____The intellectual energy of those I work with is____The importance of intellectual energy to me is____

Complete these statements on a scale of 1 = low - 5 = high

Spiritual energy is the energy of commitment to a common vision for the future, driven by shared values and a higher purpose. It involves giving people the confidence to move towards a different future that is more compelling than the status quo, by finding the deep meaning in what they do.

My spiritual energy is ____The spiritual energy of those I work with is____The importance of spiritual energy to me is____

The SSPPI Energy Index – V2, Part 2

Page 28: Unleashing energy for change

@helenbevan@helenbevan #Quality2013

• Are particular energy domains more dominant than others for our team at the moment?

• Is this the optimal energy profile to help us achieve our improvement goals?

Energy for change profile

Page 29: Unleashing energy for change

@helenbevan@helenbevan #Quality2013

• Are particular energy domains more dominant than others for our team at the moment?

• Is this the optimal energy profile to help us achieve our improvement goals?

Energy for change profile

Page 30: Unleashing energy for change

@helenbevan

Team 1: what’s your assessment of their energy for change?

Page 31: Unleashing energy for change

@helenbevan

Team 1: what’s your assessment of their energy for change?

This energy profile is characterised by an environment that has harnessed people’s interest and momentum for change, but which has failed to engage people fully. This imbalance results in their feeling some uncertainty regarding how they can contribute fully to the change, and therefore a sense of risk and lack of hope for the future. We can build energy by building team solidarity and developing shared purpose

Page 32: Unleashing energy for change

@helenbevan

Team 2: what’s your assessment of their energy for change?

Page 33: Unleashing energy for change

@helenbevan

Team 2: what’s your assessment of their energy for change?

This energy profile shows strong connections between people, a true sense of solidarity, which gives them enough hope for the future, but this energy is undirected, because the rational argument and shared purpose has not been agreed. We can build energy by agreeing shared goals for change and using systematic approaches to thinking through and planning the change

Page 34: Unleashing energy for change

@helenbevan

Resources for building and aligning energyTitle and source S S P P IQuality and Service Improvement Tools – NHS X X X X X

Energy Project tips – The Energy Project X X X X

Emotional Resilience Toolkit – DH/Business in the Community

X X X X

IHI Improvement Map – Institute for Healthcare Improvement

X X X X

P3M Resource Centre – NHS Connecting for Health

X X X X

i-resilience assessment – RobertsonCooper X X X X

Appreciative Inquiry – Appreciative Inquiry Commons

X X X

Good Day at Work network – RobertsonCooper X X X

Juice Intelligent Energy resource centre – Juice Int. Energy

X X X

Leadership tips: change management toolkit – Johns Hopkins

X X X

Action Learning Sets – Action Learning network X X X

Living our Local Values - NHS Institute for Innovation and Improvement

X X X

Thomas-Kilmann Inventory conflict mode instrument

X X

Sustainability Model – NHS Institute for Innovation and Improvement

X X

Benefits Realisation – NHS X X

Myers-Briggs Personality Types – M&B Foundation

X X

Belbin Team Roles – Belbin Associates X X

Productive Series – NHS Institute for Innovation and Improvement

X X X X X

Building Improvement Capability – NHS Institute for Innovation and Improvement

X X

Organising for Quality and Value – NHS Institute for Innovation and Improvement

X X

Call to Action –NHS Institute for Innovation and Improvement

X X

350 Workshops – Marshall Ganz / New Organizing Institute

X X

Staff engagement resource – DH / NHS Employers

X X

Engagement to mobilise – NHS Change Model X X

Strength Development Inventory - SDI X X

Change Management Toolkit – Local Government Programme X

Managing your energy levels – Bupa X

Our shared purpose – NHS Change Model X

Leadership Framework 360o assessment – NHS Ld Ac X

McKinsey 7S Framework – McKinsey & Co X

Creating a Culture of Innovation – NHS Institute for Innovation and Improvement X

Focus On Series – NHS Institute for Innovation and Improvement X

Physical Activity toolkit – SWYPFT (NHS FT)

Page 35: Unleashing energy for change

@helenbevan #qs13@helenbevan #Quality2013

“Money incentives do not create energy for change; the energy comes from connection to meaningful goals”

Ann-Charlott Norman, Talking about improvements: discursive patterns and their conditions for learning,

Clinical Microsystem Festival, Jönköping March 2012

Page 36: Unleashing energy for change

@helenbevan@helenbevan #Quality2013

[Shared] purpose goes way deeper than vision and mission; it goes right into your gut

and taps some part of your primal self. I believe that if you can bring people with similar primal-purposes together and get them all marching in the same direction,

amazing things can be achieved.Seth Carguilo

Page 37: Unleashing energy for change

@helenbevan #qs13@helenbevan #Quality2013

Avoiding “de facto” purpose• What leaders pay attention to matters to staff, and consequently

staff pay attention to that too• Shared purpose can easily be displaced by a “de facto” purpose:

hitting a target reducing costs reducing length of stay eliminating waste completing activities within a timescale complying with an inspection regime

• If purpose isn’t explicit and shared, then it is very easy for something else to become a de facto purpose in the minds of the workforce

Source: Delivering Public Services That Work: The Vanguard Method in the Public Sector

Page 38: Unleashing energy for change

@helenbevan #qs13@helenbevan #Quality2013

Page 39: Unleashing energy for change

@helenbevan #qs13@helenbevan #Quality2013

Purpose

Obfuscation O-

meter

Page 40: Unleashing energy for change

@helenbevan #qs13@helenbevan #Quality2013

Police

Page 41: Unleashing energy for change

@helenbevan #qs13@helenbevan #Quality2013

Education

Page 42: Unleashing energy for change

@helenbevan #qs13@helenbevan #Quality2013

Healthcare

Page 43: Unleashing energy for change

@helenbevan

What focus for our improvement projects?

Source: 100 improvement projects on national improvement leadership programme October 2012

Page 44: Unleashing energy for change

@helenbevan #qs13@helenbevan #Quality2013

....the last era of management was about how much performance we could extract from people .....the next is all about how much humanity we can inspireDov Seidman