harnessing organizational energy for transformational change by helen bevan 6 june 2016

@HelenBevan #NHLC2016

Dr Helen Bevan, OBEChief Transformation Officer

@HelenBevan#NHLC2016 Source of image: ivysea.com

Harnessing organizational

energy for transformational

change

Tomorrow belongs to those who can hear it coming

David Bowie

Change is changing

After World War 2, it took Japanese companies three

decades to seize leadership roles in car making and electronics from their global competitors

Source: P Choudray

In contrast, Uber, a little over five years old, competes

around the worldSource: P Choudray

Kinthi Sturtevant, IBM 13th

annual Change Management Conference

June 2015

We rarely see two, three or four year change projects anymore. Now it’s 30-60-90 day change

projects

Source: Bromford P (2015), ”What’s the difference between a test and a pilot?”

Acceleration of connectedness

Change is changing

100,000

1.8 million Twitter impressions a monthReaching nearly 2000,000 individual accounts50,000+ Twitter followers across all main accounts

See contact details at the end

How does the NHS improvement community prefer to communicate?

Hierarchical power

Change is changing

Hierarchical power

Change is changing

Hierarchical power

Change from the edge

Future health and care leaders will need to be leaders at the edge!

http://www.slideshare.net/Openpolicymaking/policy-lab-slide-share-introduction-final

Why go to the edge?

“ Leading from the edge brings us into contact with a far wider range

of relationships, and in turn, this increases our potential for diversity in terms of thought, experience and background. Diversity leads to more

disruptive thinking, faster change and better outcomes

Aylet Baron

Jeremy Heimens TED talk “What new power looks like” https://www.youtube.com/watch?v=j-S03JfgHEA

old power new power

Currency

Held by a few

Pushed down

Commanded

Closed

Transaction

Current

Made by many

Pulled in

Shared

Relationship

The Network Secrets of Great Change AgentsJulie Battilana &Tiziana Casciaro

As a change agent, my centrality in the informal network is more important

than my position in the formal hierarchy

People who are highly connected have twice as much power to

influence change as people with hierarchical power

Leandro Herrerohttp://t.co/Du6zCbrDBC

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: http://www.nhsiq.nhs.uk/8530.aspx

Typically, around any change effort, there is an initial spike of tangible energy, and change, but when leadership loses interest, the momentum

of change slows down drastically.”Tara Paluck

Anatomicalapproach

Physiologicalapproach

Anatomicalapproach

Improving clinical systems

Seeking to reduce harm and reduce risk

Redesigning pathways Standardising Measuring

The shape and structure of the system; structures and processes to deliver health and healthcare

Anatomicalapproach

The shape and structure of the system; structures and

processes to deliver health and healthcare

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

people to develop, grow & change

creating higher purpose and deeper meaning

Leading through values building commitment creating hope and

optimism about the future calling to action

Anatomicalapproach

The shape and structure of the system; structures and

processes to deliver health and healthcare

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

people to develop, grow & change

creating higher purpose and deeper meaning

Leading through values building commitment creating hope and

optimism about the future calling to action

It’s all about

energy!

The reality“What the leader cares about (and typically bases at

least 80% of his or her message to others on) does not tap into roughly 80% of the workforce’s primary motivators for putting extra energy into the change

programme”Scott Keller and Carolyn Aiken (2009)

The Inconvenient Truth about Change Management

Source of image: swedenbourg-openlearning.org.uk

Intrinsic motivationPeople engage in the activity for the pleasure and satisfaction of doing it

Invokes many positive behaviours

Extrinsic motivationPeople engage in the activity for the rewards or avoiding punishmentAny external influence is referred to as extrinsic motivation

Images: pixgood.com

The power of extrinsic drivers

Three types of levers for large scale change

‘Prod mechanisms’ targets

performance management

price & payment incentives regulation

competition

‘Proactive support’

relies on building ‘intrinsic motivation’ in

staff to make the right changes to

improve

‘People focused’ education and training

national contractsprofessional regulation

clinical quality standards

Type one:

Type two: Type three:

Source: Health Foundation report Constructive comfort: accelerating change in the NHS 2015

competition

improve

clinical quality standards

Type one:

competition

improve

Clinical quality

Type one:

competition

improve

Clinical quality

Type one:

Less than 10%of the

potential for improvement

at system level can be

delivered through type one change

#SHCR @School4Radicals@HelenBevan #NHLC2016

Bruch and Vogel researchOrganisations with HIGH productive energy scored higher on: overall performance - 14% higher productivity – 17% efficiency – 14% customer satisfaction – 6% customer loyalty – 12%

#SHCR @School4Radicals

Energy for change

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

achieve its goals

http://www.institute.nhs.uk/tools/energy_for_change/energy_for_change_.html

Psychological

Physical

Spiritual

Social Intellectual

Energy for change

Social energy

Energy of personal engagement, relationships and

connections between people

It’s where people feel a sense of “us and us” rather than “us and them”

Spiritual energy

Energy of commitment to a common vision for the future, driven by shared

values and a higher purposeGives people the confidence to move towards a

different future that is more compelling than the status quo

Psychological energy

Energy of courage, resilience and feeling safe to do things differently

Involves feeling supported to make a change and trust in leadership and direction

Physical energy

Energy of action, getting things done and making progress

The flexible, responsive drive to make things happen

Intellectual energy

Energy of analysis, planning and thinking

Involves gaining insight as well as planning and supporting processes, evaluation, and arguing a

case on the basis of logic/ evidence

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

Some questions

Which group likely to have higher spiritual energy scores (clinicians/non clinicians?)

Nearer to CEO, higher or lower energy scores?

@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 profileSocial

Spiritual

PsychologicalPhysical

Intellectual

Social

Spiritual

Intellectual

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

Social

Spiritual

Intellectual

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

#SHCR @School4Radicals@HelenBevan

Where is your team?

Social

Spiritual

Intellectual

Is your change process a cathedral or a bazaar?

http://www.unterstein.net/su/docs/CathBaz.pdf

We have a lot of cathedrals

Source: Sewell (2015) : Stop training our project managers to be process junkies

Resistant behaviour is a good indicator of missing relevance

Harald Schirmerhttp://de.slideshare.net/haraldschirmer/strategies-for-corporate-change-the-new-role-of-hr-driving-social-adoption-and-change-in-the-enterprise

Source of image: driverlayer.com

‘‘

There has never been a time in the history of healthcare when this advice has been more

pertinent

“Leadership is not about making clever decisions and doing bigger deals.

It is about helping release the positive energy that exists naturally within

people”Henry Mintzberg

The Change Challenge

Tapping the collective brilliance of the NHS

14,000 contributions identified 10 barriers to change:

Confusing strategies

Over controlling leadership

Perverse incentivesStifling innovation

Poor workforce planning

One way communication

Inhibiting environment

Undervaluing staff

Poor project management

Playing it safe

@HelenBevan #HACWEnergisingForChange

Leaders ask their staff to be ready for change, but do not engage enough in sensemaking........

Sensemaking is not done via marketing...or slogans but by emotional connection with employees

Ron Weil

14,000 contributions identified 11 building blocks for change:

Inspiring & supportive leadershipCollaborative working

Thought diversityAutonomy & trust

Smart use of resources

Flexibility & adaptability

Long term thinking

Nurturing our people

Fostering an open culture

A call to action

Source: Health Service Journal, Nursing Times, NHS Improving Quality, “Change Challenge” March 2015

Challenging the status quo

Two kinds of people at work

Feel connected to a higher purpose

Controlled & coordinated through shared goals & values

Collaborate Embrace change Work to who they are

The contributors The compliant

• Feel disconnected from purpose• Controlled & coordinated

through performance management & standardised procedures

• Hold back• Resist change• Work to a role specification

Adapted from The Emotional Economy http://emotionaleconomy.com.au/papers-articles/why-the-winners-in-business-are-taking-the-time-to-build-a-positive-kind-social-culture/

Two kinds of people at work

Feel connected to a higher purpose

Controlled & coordinated through shared goals & values

Collaborate Embrace change Work to who they are

The contributors The compliant

• Feel disconnected from purpose• Controlled & coordinated

through performance management & standardised procedures

• Hold back• Resist change• Work to a role specification

Gallup global research:

• Only 13% of the workforce are

engaged (contributors)

• Contributors create six times the value

to an organisation compared to the

complianthttp://www.gallup.com/poll/165269/worldwide-empl

oyees-engaged-work.aspx

‘Avedis Donabedian

Ultimately, the secret of quality is love.…… If you have love, you can then work backward to monitor and improve the system

Project Aristotle: http://qz.com/625870/after-years-of-intensive-analysis-google-discovers-the-key-to-good-teamwork-is-being-nice/

Tactic for leaders:Out-love everyone else

Source of image: Bradley Burgess

....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

@helenbevan@HelenBevan #NHLC2016

1. Follow us on Twitter

@HelenBevan @NHSIQ

2. Subscribe to

3. Get materials from The School for Health and Care Radicals: www.theedge.nhsiq.nhs.uk/school

Learn more about the Horizons team: http://theedge.nhsiq.nhs.uk/horizons

TheEdge.nhsiq.nhs.uk

Ways to connect!

@School4Radicals@TheEdgeNHS

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