lynne gallacher senior vice president, organizational excellence solutions

Lynne GallacherSenior Vice President, Organizational Excellence [email protected] 905-761-8000 ext. 266

Canadian Hospital Pharmacy Leadership Conference

June 7-9, 2013

Leading Change

Context

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• A Model for Change• My Observations

• Challenges/Barriers

• Success Strategies to Overcome Challenges/Barriers

Leading Change

Kotter’s 8 Reasons Why Change Fails

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• Not Establishing a Great Enough Sense of Urgency#1

• Not Creating a Powerful Enough Guiding Coalition#2

• Lacking a Vision#3

• Under-communicating the Vision by a Factor of Ten#4

• Not Removing Obstacles to the New Vision#5

• Not Systematically Planning for and Creating Short-Term Wins#6

• Declaring Victory Too Soon#7

• Not Anchoring Changes in the Corporation’s Culture#8

Source: Kotter, John P. “Leading Change: Why Transformation Efforts Fail.” Harvard Business Review (Jan 2007); p. 99

Leading Change

Kotter’s 8 Reasons Why Change Fails

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• Not Establishing a Great Enough Sense of Urgency#1

• Not Creating a Powerful Enough Guiding Coalition#2

• Lacking a Vision#3

• Under-communicating the Vision by a Factor of Ten#4

• Not Removing Obstacles to the New Vision#5

• Not Systematically Planning for and Creating Short-Term Wins#6

• Declaring Victory Too Soon#7

• Not Anchoring Changes in the Corporation’s Culture#8

Source: Kotter, John P. “Leading Change: Why Transformation Efforts Fail.” Harvard Business Review (Jan 2007); p. 99

Leading Change 5

Establish a Sense of Urgency


Form a Powerful Guiding Coalition


Create a VisionCreate a Vision

Communicate the Vision

Communicate the Vision

Empower Others to Act on the Vision


Plan for and Create Short-term Wins


Consolidate Improvements and Produce Even More Change


Institutionalize New Approaches


Kotter’s 8 Steps to Guiding Successful Change

Source: Kotter, John P. (1996) Leading Change. p.21

Leading Change 6

Culture of

complacency

No major crisis “Status quo is

working” mindset The human

challenge: converting intention to action

#1 Establish a Sense of Urgency Establish a Sense of Urgency

BarriersBarriers Success StrategiesSuccess Strategies

Identify the need for change

Challenge the feasibility of maintaining the status quo

Reinforce the consequences of status quo / change

Leading Change 7

Lack of executive “active” sponsorship

Lack of dedicated project teams

Lack of broad-scale involvement and buy-in(VP staff)

#2 Form a Powerful Guiding Coalition Form a Powerful Guiding Coalition


Influence CEO / VP championship with aligned goals

Commit focused resources to plan/implement

Ensure broad “powerful” participation (VP, staff, physicians, patients)

Leading Change 8

No clear purpose Unclear desired

outcomes Inability to make

choices Confusing Plans

and Programs with Vision

#3 Create a Vision Create a Vision


Create a concise articulation of your desired future state

Define measures of success / KPIs

Leading Change 9

False perception that communication is an “event”

Messaging doesn’t connect with hearts and minds

Leader words and actions are misaligned

#4 Communicate the Vision Communicate the Vision


Brand it Use all existing

communication channels

Communicate … over and over

Focus on the “why” and “WIIFM”

Live it – “Walk the talk” and “Walk around”

Leading Change 10

Assumptions that obstacles are too great to overcome

Influential resistors Systems/structure/

process misalignment

#5 Empower Others/Remove Obstacles Empower Others/Remove Obstacles


Anticipate real barriers (people, systems, structures)

Proactively address barriers

Equip/educate on new roles/behaviours

Engage broad stakeholders in solutioning

Leading Change 11

Lack of momentum No tangible

evidence of improvement

#6 Plan and Create Short-term Wins Plan and Create Short-term Wins


Plan short-term goals (12-24 months)

Action / achieve them Show demonstrable

progress / improvement

Celebrate / acknowledge successes

Leading Change 12

Unclear expectations

Distractions Lack of momentum No tangible

evidence of improvement

#8 Institutionalize New Approaches Institutionalize New Approaches


Create “system” that defines/measures expectations SOPs Management /

communication routines

Accountability systems

Explicitly link results to change in behaviour

Don’t stop until it’s in the organizational “DNA”

Leading Change

So What?

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1. What is the need for change in your hospital?

2. What’s standing in the way of making that change a reality?

3. What can you do to lead the change you want?


Best Practices for Leading and Facilitating Change

June 9, 2013

Leading Change 15






Communicate the VisionCommunicate the Vision









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88 Steps to Guiding Successful Change


Leading Change 16






Communicate the VisionCommunicate the Vision









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88 Steps to Guiding Successful Change


Proposal Title

What Great Change Leaders Do

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1. Self-Manage 2. Support and Empower Team Members to Act3. Communicate their Vision for Change … over

and over4. Build Broad Organizational Support

Leading Change

“Leading others through change starts with leading oneself.”

Art Horn

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Leading Change

How many words per minute do we…

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Think?450 words/minute

Speak?150 words/minute

Leading Change 20

Judges & Evaluates

Tends to be

Negative

Self-talk

Leading Change 21

I take

Actionsbased on my beliefs,

conclusions and emotions

I’m presented with a

Situation

I interpret the situation based on my

BeliefsI draw

Conclusions(judgments, generalizations, assumptions)

based on my beliefs

I express

Emotion based on my conclusions

The Cause and Effect of Self-talk

Based on work by Chris Argyris, popularized by Peter Senge (2006) in The Fifth Discipline: The Art and Practice of the Learning Organization.

Leading Change

Personal Reflection:

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Thinking of a current or pending change in your organization, how is your Self-talk impacting your actions (or lack of action)?

Self-talk

Leading Change

Managing Self-talk

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STOP

CHOOSE

CHALLENGE

Leading Change

Personal Reflection:

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STOP: Thinking of the current or pending change in your organization:

CHALLENGE: What assumptions are driving your negative Self-talk ?What if the assumption were not true?How could you view the situation differently?

CHOOSE: What different course of action could/should you take?

Self-talk

Proposal Title


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Leading Change

“All of the great leaders have had one characteristic in common: it was the willingness to confront unequivocally the major anxiety of their people in

their time. This, and not much else, is the essence of leadership.”

John Kenneth Galbraith

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Leading Change 27

Relatedness – sense of safety with others (friend or foe) –

Fairness – perception of fair exchanges between

people –

Motivations and Barriers to Change - SCARF

Status – relative importance to others –

Certainty – being able to predict the future –

Autonomy – sense of control over events –

Source: Rock, D. (2008) SCARF: a brain-based model for collaborating with and influencing others. NeuroLeadership Journal, 2008 (1), pp. 1-9.

Leading Change

Typical Human Reactions to Change

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Deflector

Victim

Personalizer

Naïve Optimist

Agent

“Not Me”

“Poor Me”

“It’s Me”

“No Problem”

“Here’s What I’m Going to

Do”

Leading Change

Empathy

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Our ability to identify with the perspectives and feelings of others,

•When we demonstrate genuine Empathy, it lowers others’ natural defensiveness and related Self-talk, and causes them to feel “truly heard.” •As a result, they are more open to sharing information, which allows both parties to become aligned in their views.

Source: Rogers, Carl R. (1952) Gateway to Communication; Harvard Business ReviewHorn, Art. (2010) The Gifts of Leadership: Team Building Through Empathy and Focus.

“The main barrier to communication is our

tendency to evaluate, to approve or disapprove

of, what another person is saying.”

Dr. Carl R. Rogers

“The main barrier to communication is our

tendency to evaluate, to approve or disapprove

of, what another person is saying.”

Dr. Carl R. Rogers

Leading Change

The Irony of Influence

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Self-talk

Judge

Sense of Self

Difficult to Empathize

People Don’t Listen

Not as Likely to Influence

Leading Change

Purpose

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An inclination towards consistently setting goals, aligning goals with other parties, and actively striving to ensure goals are achieved.

•Defining goals increases the likelihood of achieving them•The effect of aligned goals can be very powerful! •Establishing aligned goals can allow us to communicate:

o “I understand your goal. To prove to you that I do, let me demonstrate to you exactly how your goal aligns with mine.”

Source: Horn, Art. (2010) The Gifts of Leadership: Team Building Through Empathy and Focus.

Leading Change

The Balancing Act

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How well do you balance Empathy and Purpose in your team

interactions?

Leading Change

Supporting your Team through Change

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• Show genuine interest

• Observe• Assess their

tolerance for change

• Ask questions

• Understand their motivations

• Demonstrate understanding

• Validate

• Align goals• Communica

te the need for change

• Reframe their perspective

• Communicate the WIIFM – “what’s in it for them”

• Move them to “agency” and action

Proposal Title


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Leading Change

“My own definition of leadership is this: The capacity and the will to rally men and women to a common purpose and the character which inspires confidence.”

General Montgomery

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Leading Change

CHANGE Influential Messaging Framework

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Leading Change

CHANGE Example

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Connect

History

Ambition

• I want to connect with you to give you more context about the smoking-cessation counseling initiative.

• I’ll reinforce why this transformation really does make sense for our hospital

• And, why I’m personally excited by what it means for our patients, and for our pharmacy team

• I also want to answer your questions so you are 100% clear and aligned

• We first started discussing this initiative over a year ago, in response to the CSHP 2015 Quality Initiative

• Since then, we’ve made great strides in developing our strategy and counseling approach, and the pilot program has gone very well – we’ve proven to ourselves that this will work!

• It’s time now to roll it out to 100% of our hospitalized patients who smoke

• I’m excited about our Vision for this program – to provide smoking-cessation counseling to 100% of our hospitalized patients who smoke

• We all know the health risks associated with smoking, and the long-term benefits of quitting – with this program we will provide the information, tools and support necessary to help our patients better understand the risks, and hopefully choose to quit so patient outcomes improve

Leading Change

CHANGE Example

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Need

Getting in the Way

Encourage

• Our patients who smoke need our help – some aren’t aware of all of the health risks, and most don’t know there are tools and supports that will make quitting much easier

• In our hospital, we don’t currently have a program in place to provide that help, either through the pharmacy or other health care providers

• We’re committed to CSHP 2015, and it’s time to live up to those commitments• I know this program is something above and beyond what we’re currently doing – it will take time and energy to implement, and we’re busy as it is

• Good news is there are other initiatives, like our new automated unit dose system, that are taking a few things off of our plates, and will make room for this

• It’s also a change in terms of the scope of our duties, that requires others to give us access to 100% of our smoking patients – over time, we’ll get everybody on board• So, as we roll this program out, I ask that you:

• Support each other in managing through the ups and downs• Be open-minded by challenging some of your own assumptions

about our role in the hospital, and in patient care• Share what’s on your mind openly. I want to hear your

perspective and ideas• Join me in believing in and pursuing our Vision for smoking-

cessation counseling• Together, I know we can make a huge impact on our patients lives!

Proposal Title


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Leading Change

“The key to successful leadership today is influence, not authority.”

Kenneth Blanchard

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Leading Change

Building Broad Organizational Support

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• WHO is influential?

• WHAT is their disposition?

• HOW can I influence them?

Leading Change

Identifying CluesIdentifying Clues

• Direct access to funding• Releases funds• Veto power

• Gatekeeper• Gives go/no go

recommendation

• Impacted by decision• Gives advice• Can’t say “yes”; maybe “no”

• Provides guidance re: organization, players and proposal

Decision Influencers

Decision Influencers

• Balancing the budget• Impact on patient care• Average case costing

• Expertise matched to specific requirements

• Track record in managing similar projects/initiatives efficiently

• Success with a proposal

FocusFocus

WHO? – DIG (Decision Influence Group)

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Approver

Recommender

Advisor

Coach

Leading Change

WHAT? – Motivations and Disposition

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•WHAT are their Motivations (Business & Personal)?o What do they crave? o What do they fear?

•WHAT is their Disposition toward you/the project?o Advocate, Neutral, Adversary

•WHAT is their Influence Level in your hospital?o High, Med, Low

Leading Change

HOW? - Influence Strategy

AdvocateAdversary DISPOSITION

Low

High

INFLUENCE

DevelopDevelop LeverageLeverage

SupportSupportMonitorMonitor

Leading Change

Leverage•Ask for coaching •Influence others - the “Develops”Develop•Establish and maintain contact•Address issues, perceptions, objections•Align project benefits with their motivationsSupport•Expose their ideas to more influential stakeholders (Leverage and Develop)•Promote themMonitor•Neutralize objections proactively leveraging more influential stakeholders•Remain open to opportunities to build bridges

HOW? - Influencing your DIGDevelop Leverage

Monitor Support

Proposal Title


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What will you do differently to be a Great Change Leader?


Canadian Hospital Pharmacy Leadership Conference

June 7-9, 2013

lynne gallacher senior vice president, organizational excellence solutions

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