People Matter

Material adapted from

Core Skills 2

Human Dimensions of Change

Janet Harris

Service Improvement Manager

Session Aims• Understand why the Human Dimensions of Change are

important

• Consider what needs to change

• Understand how complex adaptive change techniques will support service transformation and the different approaches needed

• Have a better understanding of why people resist change and ways to respond to resistance

• Understand how to use the Force Field Analysis Tool

‘People responsible for planning and implementing change often forget that while the first task of change management is to understand the destination and how to get there, the first task of transition management is to convince people to leave home.’

William Bridges

Why is it important to manage the human dimensions of change?• Change in Healthcare = people changing

• Estimated 80% of change projects failure = failure to manage the people issues

• Need to understand the ways people react to change

– minimise the risks of failure

– maximises skills and talents of the team

What Needs to Change?

• People need to understand what needs to change

• Audiology now part of 18 Week Target

• What needs done?

• How are we responding?

• What type of change are we going through?

Complex Adaptive Systems

• Health and social care systems meet the classification of a complex adaptive system.

• BUT….complex systems have systems within systems – and some of these might be simple

Complex Adaptive Systems

•Collection of partsCollection of parts•Share an environment or spaceShare an environment or space•Parts can act independentlyParts can act independently•Parts are interconnectedParts are interconnected•Action by any part affects the wholeAction by any part affects the whole

Examples: immune system, insect colony, flock,stock market, just about any collection of humans

Audiology, ENT Services

Stacey Agreement and Certainty Matrix

A method to select the appropriate management actions in a CAS

Close toCertainty

Far fromCertainty

Clo

se t

o

Ag

reem

en

tFa

r fr

om

A

gre

em

en

t Stacey Matrix

Anarchy

Simple

So what do we already know about change?

• Change happens to us all ..whether we like it or

not!

And it works best when………...• It is owned by the people working in the system

• We consider the impact of change on people

Exercise in Pairs

How Does that Make You Feel?

Transition CurveProgress through curve depends on:

– Personality type– How much feel in control of change– How much other change is going on in life– Past experience

Change is situational: new site, new boss, new team roles, new policy.

Transition is the psychological process people go through to come to terms with new situations.

Change is different from transition

Change is external, transition is internal.Adapted from William Bridges, Managing Transitions

Change and learning

Comfort ZoneComfort ZoneNo learningNo learningNo changeNo change

Panic Zone

•people close uppeople close up

•they freezethey freeze

•they don’t learnthey don’t learn

Change and learning

Discomfort Zone

•uncertainty uncertainty •learninglearning

PanicZone

Comfort ZoneComfort Zone

Leaving the comfort zone

‘To leave the comfort of the status quo, most individuals need to believe that the change is truly imperative and that there is a more attractive alternative’

Silversin/Kornacki

Resistance is Inevitable

• Resistance in inevitable in any change process

• Don’t struggle

• Embrace it as a positive force of change

Why might resistance be positive?

•Not all change is good – might stop you walking over cliff edge

•Even if change good – elements of approach may need refining

•Shows people care

•Psychological importance – buys time for individuals to acclimatise (Klein)

Why do people resist change?

• Poor Leadership– Failure to make case for change

– Behaviour of leaders contradicts proposed change

– Failure to communicate effectively with those expected to make changes

– Mixed signals re priorities

• Organisational/Environmental Issues

– Organisational structures work against change

– Too much change

– Time & energy to implement change detracts from another priority

Why do people resist change?

• Skills Issues– Don’t know how to effectively implement change

– Don’t know how to stop doing what currently do

– Don’t know how to do replacement activities

• Group/Psychological Issues– Threat to power/influence/autonomy

– Investment in status quo

– Group issues

– Personality

– Amount of change in personal life

a) People are less likely to resist when actively involved in change decisions (Lawrence, 2001)

b) Understand why people resist – and remember it may be for good reasons

c) Focus on reducing resistance rather than forcing the drivers

d) Resistance is better than no response

Methods for responding to resistance

How Do We Reduce Resistance?• Education and communication - including

asking people why they are resisting• Participation and Involvement – including

piloting changes with willing team• Facilitation and Support – including training• Negotiation and Agreement – including use of

incentives for changeNot recommended• Manipulation and co-optation• Explicit and implicit co-ercion(Taken from Kotter and Schlesinger, 2008)

Lewin’s Force Field Analysis

Lewin’s Force Field Analysis

Exercise

• Identify the Goal

• Identify the current situation

• Identify what things are driving audiology services to meet the 18 week target?

• Identify the human elements that may be restraining audiology services from achieving the 18 week target?

Dig Deeper

• Identify causes of each of the restraining forces identified

• Where are the priorities?

• Are there any common themes?

• What solutions can you propose?

• Go back to your organisation and prove or disprove driving or restraining forces

“..Success is the ability to go from one failure to another

with no loss of enthusiasm”.

Winston S Churchill

Summary of DaySeven Key Messages

• Work out the type of change – simple/complex• People need to know – why change?• People need to have sense of what changing to• Involve Involve Involve • We are all different – so need to use a variety of

methods• Resistance can be positive and helpful • Listen…seek first to understand and then to be

understood