human dimensions of change and team working

Human Dimensions of Change

and Team Working

Hannah Wall

National Improvement Lead

Aims of this session

• To understand the importance of team working to create successful improvements

• To recognise that managing change for individuals and within teams is a fundamental part of service improvement

• To recognise individual styles within teams and how those styles respond to change

• To offer tools to help in the acceptance of new ways of working

• To understand the role of improvement leader

Teams in endoscopy

• Scheduling/ booking

• Decon

• Procedure room

• Whole unit

Good team work is essential everyday for:

safety, efficiency, productivity and morale.

You just can’t get it done alone…

Successful improvement teams

• Share the work load

• Generate new ideas

• Conduct PDSA and testing

• Embed for sustainability

Working with a team during

improvement

All improvement requires change, but not all change is improvement.

Anonymous

A round man cannot be expected to fit into a square hole right away. He must have time to modify his shape.

Mark Twain

Diffusion of Innovations

We have all been laggards

• iPhone 7?• Self-service scans at the checkout?• Hybrid cars?• eBay?• Flat screen TV?• Analogue vs digital?

Transition CurveC

om

pe

ten

ce

/ C

on

fid

en

ce

/Se

lf e

ste

em

Time

1. Shock

3. Denial

5. Bargaining

8. Acceptance

7. Testing

Source – Based on Kubler-Ross 1969, Adam,

Hayes and Hopson, 1976 and Virginia Satir (1991)

4. Anger

6. Depression

2. Hysteria

Mobilise Move Sustain

Transition CurveC

om

pete

nce/

Confidence/S

elf e

ste

em

Time

1. Shock

3. Denial

5. Bargaining

8. Acceptance

7. Testing

4. Anger

6. Depression

2. Hysteria

Mobilise Move Sustain

Minimise shock

Full and early

communication

of intentions,

possibilities and

overall change of

direction

Discuss implications with

individuals and

teams

Pay attention to

people’s needs

and concerns

Practice patience

Listenempathise, support

Don’t suppress

conflict or different

views of emotions

Remember people

aren’t necessarily

attacking you

personally

Encourage

Paint a vision

Foster

communication

Create goals and

opportunities

Coach

Delegate

Discuss

Reflect

Celebrate

success

Prepare to start again!

Source – Based on Kubler-Ross 1969, Adam,

Hayes and Hopson, 1976 and Virginia Satir (1991)

We are all different

• Amiable

• Driver

• Analyst

• Expressive

Merrill D.W. and Reid R.H.(1999)

Personal Styles and Effective Performance:

make your style work for you

Analyst: the Technical Specialist

• Accurate

• Conscientious

• Serious

• Persistent

• Organised

• Deliberate

• Cautious

The Expressive: Social Specialist

• Verbal

• Inspiring

• Ambitious

• Enthusiastic

• Energetic

• Confident

• Friendly

• Influential

Amiable: The Relationship Specialist

• Patient

• Respectful

• Willing

• Agreeable

• Dependable

• Concerned

• Relaxed

• Organised

• Mature

• Empathetic

Driver: Command Specialist

• Decisive

• Independent

• Practical

• Determined

• Efficient

• Assertive

• A risk taker

• Direct

• Problem solver

Which type are you?

Analyst Amiable Expressive Driver

Analytical Patient Verbal Action-orientated

Controlled Loyal Motivating Decisive

Orderly Sympathetic Enthusiastic Problem solver

Precise Team person Gregarious Direct

Disciplined Relaxed Convincing Assertive

Deliberate Mature Impulsive Demanding

Cautious Supportive Generous Risk-taker

Diplomatic Stable Influential Forceful

Accurate Considerate Charming Competitive

Conscientious Empathetic Confident Independent

Fact finder Persevering Inspiring Determined

Systematic Trusting Dramatic Results-orientated

Logical Congenial Optimistic

Conventional Animated

How do you feel about change?

How do you behave under stress?

The Analyst

The Analyst:

Technical Specialist

May be perceived

positively as

May be perceived

negatively as

How to work better

with analysts

• accurate • critical • tell how first

• conscientious • picky • list pros & cons

• serious • moralistic • be accurate & logical

• persistent • stuffy • provide evidence

• organised • stubborn • provide deadlines

• deliberate • indecisive • give them time

• cautious • don’t rush or surprise

The Amiable

The Amiable: Relationship Specialist

May be perceived

positively as

May be perceived

negatively as

How to work better

with amiables

• patient • hesitant • tell why & who first

• respectful • ‘wishy-washy’ • ask instead of telling

• willing • pliant • draw out their opinions

• agreeable • conforming • chat about their life

• dependable • dependent • define expectations

• concerned • unsure • strive for harmony

• relaxed • laid back

• organised

• mature

• empathetic

The Expressive

The Expressive: Social Specialist

May be perceived

positively as

May be perceived

negatively as

How to work better

with expressives

• verbal • a talker • tell who first

• inspiring • overly dramatic • be enthusiastic

• ambitious • impulsive • allow for fun

• enthusiastic • undisciplined • support their creativity & intuition

• energetic • excitable • talk about people & goals

• confident • egotistical • value feelings & opinions

• friendly • flaky • keep fast paced

• influential • manipulating • be flexible

The Driver

The Driver: Command Specialist

May be perceived

positively as

May be perceived

negatively as

How to work better

with drivers

• decisive • pushy • tell what & when first

• independent • one man show • keep fast paced

• practical • tough • don’t waste time

• determined • demanding • be business like

• efficient • dominating • give some freedom

• assertive • an agitator • talk results

• risk-taker • cuts corners • find shortcuts

• direct • insensitive

• a problem solver

Analytical•not enough information

•making a wrong decision

•being forced to decide

Driver•loss of control

•failure

•lack of purpose

Amiable•damaged relationships

•confrontations

•not being recognised

for efforts

Expressive•being ignored

•being asked for detail

•being linked with failure

Merrill D, Reid R (1991) Personal Styles and Effective Performance, CRC Press, London

Fears about change

Case study

An Improvement Leader (driver) was keen to bring about a change to reduce waiting times for patients. However, she initially failed to realise her list of pros and cons was not sufficient to convince her ‘amiable’ colleague. Her colleague needed to feel convinced that it was a real improvement from the patients’ point of view.

How can we take this forward?

• Recognise different types within your teams

• Understand individuals must see the ‘what’s in it for me?’

• Consider the strengths of each type and how they will

respond when faced with change

• Which types are similar and which clash

• Remember everyone will go through the transition curve at

a different speed

• Fears should be dealt with and expectations should be

managed realistically

Diffusion of Innovations

• Work with people initially who want to get involved

• Rather than repeating the argument for change modify your approach to those who fall in the latter half of the curve

• If you engage 20% of a population, the rest will follow

Improvement tools (1)

1. Verbal communication

- 1:1s

- Team meetings

- Daily ‘huddle’ – highly inclusive 15 min meeting every morning led by different people every day

2. Encourage and act upon staff feedback

- Create opportunities for people to express their views e.g. anonymous opinion board in a less used area with frequent responses or a staff survey

Improvement tools (2)

Improvement tools (3)

3. Visual management

- Show publically how the unit is performing and praise achievements

Leading Improvement

http://www.changemodel.nhs.uk/pg/groups/12195

Leading Improvement

Leading improvement – basically it’s all about the leader

having a mind set change from one of fire fighting to one of

continuous improvement

Quote from NHS Institute

Changing leadership styles

Thank you

QUESTIONS

hannah.wall@improvement.nhs.uk

07920845437