leading through change and disruption

2019 Annual ConferenceLeadership Boot Camp

LEADING THROUGH CHANGE AND DISRUPTION

Jackie Gaines, Senior Director National Speaker, Author

2© 2017 Huron Consulting Group Inc. and Affiliates. All Rights Reserved.

THE WAY WE WERE…


3©2018 Huron Consulting Group Inc. and affiliates. All rights reserved.

This Photo by Unknown Author is licensed under CC BY


SESSION OBJECTIVES

1Discuss the impact of change in healthcare today

3Identify the eight sequential steps in managing change

2Offer useful tips in how leaders can manage through change

4Review the importance of self-reflection as a critical element of leadership success



How we respond determines ourdestiny


Our usual response



Change Can

Sometimes Blur Our Focus on the Most Important

Things


Change in Healthcare

• The most challenging aspect of business is leading and managing change

• Change is constant in a dynamic environment

• The only certainty is continuing uncertainty

• Competitive advantages do not last

• Leaders must:• Be open to change• Create/identify need for urgent action• Become change agents in stimulating,

implementing and supporting change in the organization



“The biggest and most profound challenge we’ve had

to deal with- and the one that’s requiring the biggestadjustments inside organizations- is our industry’smove from episodic change to continuous change.”

~Quint Studer

A Culture of High Performance


So, What’s Changing for Your Organization…Your Role as a Leader?



So what has not changed in health care?

Passion is lived out in each of us, our work and our commitment to the communities we serve.

The desire to do purposeful, worthwhile work, and make a difference- our core values (the glue in our sneakers).


Building a Culture of Quality ALWAYS• Continuous readiness versus spot

readiness• Transparency makes everyone an

“oversight” body• Organizations must maintain a

“culture of always”




Drivers of Change and Disruption Today

• MACRA/NCQA/Federal Mandates/Medical Home

• Consumer decision making; consumer mobility

• Medicaid Managed Care• Value-based purchasing (Added

Value Versus Volume)• Rapid growth• Executive Level Turnover• Engaged employees and

physicians• Generational variance (employees,

providers and patients)• And more…

Know your internal and external drivers of change!



Our Future Viability

We must transform, grow and optimize our resources to remain viable through all the disruptions we may face.

We must own our future!


External Drivers of Change



External Drivers of Change

Reimbursement Models, MACRA

Patient Choice

& Access

Nursing Shortage

Competition for Talent and Patients


What Internal Pressures Will Impact Your Organization Over the Next Year?



What Internal Pressures Will Impact Your Organization Over the Next Year?• Proficient and engaged staff• Change and managing that change• Rapid growth and construction projects• To have a cohesive and quality medical staff• Loss of key leaders (retirement)• Generational differences• Implementation of the next generation of Electronic Health Records• The addition or reduction of new service lines

We must transform, grow and optimize our resources to remain viable through all the disruptions we may face.

We must own our future!


What Will You Individually Adjust in Response?



We are in a Marathon Not a Sprint!

• Leaders and Providers will require different skills, different muscles, different tools to effectively run the distance

• Today, training must be for continuous change (proactive and not reactive)

• We must train to achieve organizational goals, fill the gap where there are weaknesses and be prepared to mentor others to sustain excellence

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Moving From Sprinter to Marathon Runner Requires New Skills:

Leadership Development is Mission Critical!

We have to consistently develop the skills leaders need to be successful to remain ahead of our competitors.

Training isn’t a one time deal because health care is always changing; we have to be lifelong learners to provide the safest care for patients and a healthy work environment for employees.

We must train to achieve organizational goals, fill the gap where there are weaknesses and be prepared to mentor others to sustain excellence.



But, We Don’t Like Change…Even For The Right Reasons!

New can be distracting and take us out of our comfort zone.


“Grandma, help me tie my shoe…please!”



What are Common Reactions to Change?

• Confusion• Anxiety• Procrastination (Gradual Change)• Frustration• False Starts• Anger• Denial/Refusal to Participate• Excitement• Other?


What Influences Our Reaction to Change? Positive or Negative



Maximize Your Ability To Influence Change

Leadership

Self-Check


Understand Leadership POWER

The ability to get others to do what you want them to do.


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Traits Often Shared by Effective Leaders

Drive High energy, displays initiative and is tenacious.

Self-confidence Trust themselves and their abilities.

Creativity Original in their thinking.

Critical ThinkerAble to integrate and interpret information.

.

Industry knowledge Know their industry and its technical foundations.

Motivation Enjoy influencing others to achieve shared goals.

Flexibility Adapts to fit the needs of followers and demands of situations.

Honesty and integrity Trustworthy and dependable


Eliminate the We/They Culture“We must be on the same team to be successful”

You are not “fighting” leadership for them. YOU are a part of leadership

Assess Your Present Level of Personal Empowerment. (Be honest.) Look in the mirror.

It’s All about Effective Communication!

Employ active, empathetic listening



EMPOWER SELF AND OTHERS“Smart leaders surround themselves with smart team members”


Personal Empowerment

• Assess your present level of personal empowerment. (Be honest.) Look in the mirror

• Determine whether your performance falls below, meets, or exceeds organizational expectations.

• If your performance is below expectations, assess your level of commitment. (Are you willing to exceed the expectations of leadership?



• By empowering others, leaders tap unlimited resources available to them by allowing others to grow.

• When assessing capabilities, consider the following based on the individual’s capabilities and seriousness of the consequences from the individual’s action/inaction :

• Willingness to accept empowerment

• Training

• Judgment

• Experience

•

Empower Others

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The Spiral of TrustBy Trusting

You Encourage

• Participation

• Consensus

• Confidence

Your Subordinate shows

• Initiative

• Dedication

• Openness

It results in

• Accomplishment

• Pride

• Communication

And Leads to:

Confirmation of Trust



Be the Change

You Want to See

Others!


The Engagement

Model



Choose Your Words Carefully


Table Exercise: Discuss how you currently empower your staff to achieve team results. What tactics assist you in that process?

Leading Practices• Rounding for Outcomes (care, inclusion, personal

interest in their ideas) • Huddles (setting clear daily expectations, managing

up success)• Reward and Recognition (pride in what right looks

like)• Inclusion in Goal Setting/90 Day Action

Plans/Execution (alignment, enhanced commitment and ownership)



I want this weight off now!!!!

Why do diets fail?

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Leading ChangeTable Exercise:

Think of a time you tried to implement a change with your staff/team and failed. What got in the way?

• Why is it so hard?

• Why do so many transformation efforts fail?


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Anchoring Change in Culture

Culture comes last, not first

Depends on results

Requires a lot of talk- Over Communicate !!!

May involve turnover

Makes decisions on succession crucial


It’s All About Communication



Effective Communication

• Empathy and understanding are the two most important aspects of communication

• Respond to emotions, but don’t react

• “I can see you’re upset. Let’s talk about what’s upsetting you.”

• Actively listening alone can sometimes satisfy the concerned party

• Do not interrupt• Nod and make eye contact• Acknowledge• Reflect the content• Do not make excuses!


Listening

• “Listening, whether done by individuals or by companies and government, is a signal of respect. When people don’t feel listened to, they don’t feel respected. And when they don’t feel respected, they feel anger and resentment. This resentment is exacerbated if people think you’re pretending to listen but aren’t.”

• Hugo Powell



The Suggested Sequence

WHY

WHAT

HOW


Let’s Take a Break!


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Lessons learned:

Change Management is a Methodical Process

Kotter, John P. 1995. Leading Change: Why Transformation Efforts Fail. Harvard Business Review. 73(2): 59-67.

• Change process goes through a series of phases

• Critical mistakes in any of the phases can have devastating impacts

• A few errors can spell the difference between success and failure


Valley of Despair

Uninformed Optimism

Immobilizationand Denial

Bargaining

Despair

Informed Pessimism Face The New Reality

Hopeful Optimism

Discovering the Devil in the Details

Informed Optimism

Structure aroundthe New Reality

Leverage the New Reality

Anger

Adapted by Keith McFarland. Author, The Breakthrough Company (2008) and Bounce (2009)


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Effective Change Processes Involves Eight Sequential Steps:


1. Establishing a Sense of Urgency2. Creating a Guiding Coalition3. Developing a Vision & Strategy4. Communicating the Change Vision5. Empowering Broad-based Action6. Generating Short-term Wins7. Consolidating Gains & Producing more Change8. Anchoring New Approaches in Culture


“The biggest obstacle in achieving high performance is not achieving the needed urgency for change.”

Kotter, John P (2008) A Sense of Urgency. United States: Harvard Business Review Press.


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1. Establish a sense of urgency

• Change typically begins with someone noticing a vulnerability in the organization. They kick into action

• They try to communicate that sense of urgency to others

Tip:

Make the anxiety of not changing greater than the anxiety of changing.

Communicate consequences in inaction



Bad results are a blessing and a curse

• Never waste the opportunities offered by a good crisis.

• Think about times of positive organizational change from a crisis? How did you communicate a sense of urgency?

• Example: Hurricane Hits Your Community


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2. Form a powerful guiding coalition

• Change efforts often start with just 1-2 people

• Ripple the impact to include more and more who believe the changes are necessary. (stakeholders)

• Gather a large enough initial core of believers (3-5 people)

• This initial group should be relatively powerful (formal and informal…not always the usual suspects)

• They help bring others on board with the new ideas.


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3. Create a vision

• A picture of the future that is relatively easy to communicate and appealing to the stakeholders

What will be better? How will I fit?

• Clarify the direction in which an organization needs to move



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leading through change and disruption

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