unleashing energy for change
DESCRIPTION
Unleashing energy for change Presented by Helen Bevan on 16 April to an audience of Norweigan healthcare studentsTRANSCRIPT
@helenbevan #Quality2013
Unleashing energy for change
Helen Bevan@helenbevan@NHSIQ#Quality2013
@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
@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
© 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
© 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
© 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
@helenbevan #Quality2013
Intrinsic motivators •connecting to shared purpose
•engaging, mobilising and calling to action
•motivational leadership
build energy and
creativity
@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
@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
@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
Transformation is not a matter of intent.........it is a matter of alignmentPeter Fuda
@helenbevan
NHS Change Model
www.changemodel.nhs.uk
@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?
@helenbevan
NHS Change Model
www.changemodel.nhs.uk
@helenbevan #Quality2013
Does fear motivate people to change?
@helenbevan #Quality2013
burning platformversus
burning ambition@PeterFuda
@helenbevan #Quality2013
Show Peter Fuda film here
@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
@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
@helenbevan@helenbevan #Quality2013
You get the best efforts from others not by lighting a fire
beneath them but by building
Source: Bob Nelson
@helenbevan@helenbevan #Quality2013
@helenbevan@helenbevan #Quality2013
Show “energy for change” film here
@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:
@helenbevan@helenbevan #Quality2013
The five energies 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
@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___
@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
@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
@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
@helenbevan
Team 1: what’s your assessment of their 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
@helenbevan
Team 2: what’s your assessment of their 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
@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)
@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
@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
@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
@helenbevan #qs13@helenbevan #Quality2013
@helenbevan #qs13@helenbevan #Quality2013
Purpose
Obfuscation O-
meter
@helenbevan #qs13@helenbevan #Quality2013
Police
@helenbevan #qs13@helenbevan #Quality2013
Education
@helenbevan #qs13@helenbevan #Quality2013
Healthcare
@helenbevan
What focus for our improvement projects?
Source: 100 improvement projects on national improvement leadership programme October 2012
@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