NHSP – Achieving our Goals IMPLEMENTATION WORKSHOP Whangarei 28 September 2012 Kevin Hartung Change Specialist, licensed by Changefirst plc, (“People-Centred

NHSP – Achieving our Goals

IMPLEMENTATION WORKSHOPWhangarei28 September 2012

Kevin HartungChange Specialist, licensed by Changefirst plc, (“People-Centred Implementation©”)

Slide 2 © Changefirst Ltd, all rights reserved 2006

Definition of major change

Major change takes place when people shift their values, aspirations or behaviours

In organisations, major change usually also means:

n cost of change failing is high n change requires high commitment from peoplen significant shifts in strategies, processes, practices and systems


Why talk about change?

USA research: “70 – 75% of major organisational change efforts fail to meet the expectations of key stakeholders” Centre for Effective Performance, 2008

UK research: “15% of transformation programmes were successful20% failed to achieve objectives but regarded as satisfactory under the circumstances65% were unsuccessful”ProjectSmart, UK government report, Jonathan Palmer 2000 - 2008

“£58 billion wasted in IT systems related change in UK each year” Professor Chris Clegg (University of Sheffield, Dept. Workplace Psychology, 2005)


Reasons for change failure

Research reveals a common pattern –

the predominant and re-occurring reasons all relate to people

n Underestimating how challenging the change will be for peoplen Poor leadershipn Inability to deal with resistancen Misalignment of the change with behavioural normsn Too much change for people to absorb

For example, “When implementing large IT projects the major reason for failure is an ‘organisational mindset’ which is to focus on getting the hardware/software installed and ignores the bigger need to actually change the way people work”. Changefirst, 2005.


Implementation versus Installation

Time

Benefit realisation

Implementatio

n

Installation Installation

People-Centred Implementation


Quality of Implementation

Quality of Solution

H

LHQuality of

Implementation


Why personal change is so difficult

Transition State

Disruption of thinking, feeling and behaving Future way

of working

The way people work

now

Current State

FutureState

Perceived loss of control


Reactions to change

Optimism

Testing

Acceptance

Adapting

Time

Shock

Denial Anger

Bargaining

Current State

FutureState

Elizabeth Kubler-Ross, as amended by Changefirst


Resistance is often caused by people’s unwillingness or inability to change

Willingness to change

Ability to change

35%

35%15%

15%

People’s disposition when faced with major change and how to address them:

Source: Siebel Systems: Report on CRM Implementation, 2005

Sideline/Remove?

Use

Convert

Educate & train

Want to,

but can’t

Can, but won’t

H - HighL - LowA - AbilityW - Will


Building Commitment

10

Awareness

Desire

Knowledge

Ability

Reinforcement Desired / Future State

Current State

The Commitment

Ladder

Real commitment

Current State

Desired or Future StateEarly

optimism

Shock

Denial

Anger

Bargaining

Adapting

Testing

Acceptance


Four major benefits of managing change

Future Way of Working

The way people

work nowReduce time to ROI

Reduce loss in performance Improve sustainability

Increase success ratesFuture Way of

Working


Some social context

1. From the ridiculous....

Most Read (story on the Herald website Monday 24 /9/12)1Hospital removes eel from man's bum2Honeymooners' parents touched by Kiwi generosity3Police use waka to save Mangere bridge jumper4McCaw will take sabbatical5Kiwi on death row in China

Man's predicament the talk of the hospital.An eel like this had an adventure. Photo / Supplied A man sought emergency treatment at hospital in Auckland this week with an eel stuck up his bottom.The unnamed individual presented himself at the A&E department at Auckland City Hospital to explain his embarrassing problem. http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=10835890

http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=10835890






http://www.nzherald.co.nz/sport/news/article.cfm?c_id=4&objectid=10835963

http://www.nzherald.co.nz/sport/news/article.cfm?c_id=4&objectid=10835963





Some social context

2. ...to the concerned....

New Zealand Herald 23.09.12

Bernard Hickey from interest.co.nz 40 comments Sickly storm brews over healthcare, pension costs5:30 AM Sunday Sep 23, 2012 “Public healthcare costs are projected to rise from 6.9 per cent of GDP in 2010 to 11.1 per cent of GDP in 2060. What will our health system look like in 2060 if we change none of the entitlements or the way they're paid for? Will we be able to afford "free" public hospital care? Will we be able to subsidise doctor's visits and prescription drugs? Will we increase taxes to keep services? Or will we limit the availability of less "discretionary" healthcare and encourage people to take out more insurance.... These questions are deeply uncomfortable ones, but they cannot be ignored for long.”

http://www.nzherald.co.nz/hospitals/news/article.cfm?c_id=500846&objectid=10835854




Some social context3. ...to the front line....

Comment 1/40

02:08 PM Sunday, 23 Sep 2012

“ I am a Pharmacist in a large mall in Christchurch. For all those people who say Bernard is a doom and gloom merchant, while sometimes you may have a point, he is right on the mark here.

The only thing is though, it won't be 2060 that the health system is stuffed, it will be at least 30 years earlier. The wave of older people coming through who consume millions of health dollars through hospital stays, medicines and other associated health services will keep rising.

Unfortunately they are only half the problem. The other half will be the Diabetes timebomb about to go off in the next 5 to 10 years. The obesity problems I see in people getting medicines is scary...

It isn't just the beneficiaries who are causing the issues, it is the well off families who are too time poor to provide good nutritious meals for themselves and eat out regularly. It starts with the treatment for the diabetes and eventually spirals years later with eye, circulation, feet problems.

These people in the next 20 years will suck the health dollars dry. This may sound like doom and gloom but it is a reality from the front line. People don't like being told they are a problem, but they need to wake up and see it.”


Our challenge

Our mission is to deliver the changes that result in the optimal healthcare system for Northland moving forward.

Our challenge is to reach the hearts and minds of Northlanders, to overcome resistance and build commitment to the proposed changes amongst:

n Leadership in all healthcare service organisationsn Healthcare professionals across Northlandn Healthcare service staff and managers across Northlandn The people of Northland

How can we ensure a greater chance of success with this significant challenge?


People Centred Implementation - Six Critical Success Factors for successful change

Effective Change

Leadership

PowerfulEngagement

Processes

Shared Change Purpose

Strong Personal

Connection

Sustained Personal

Performance

Committed Local

Sponsors

Create and share a powerful case for

change in the organisation

Develop strong change leadership for the initiative

Build and deliver plans to engage

people in the change

Build understanding and commitment

of middle and front-line managers

Create commitment and behaviour changing actions for

front-line people

Support people as they learn

to adapt

Organisational level – US

Local level – YOUR PEOPLE AND PATIENTS


Each CSF is made up of a number of risks

Shared Change Purpose

Future State Imperative Solution Visibility

Effective Change

Leadership

Leadership Behaviour Confidence in Change Agents Informal Influence

PowerfulEngagement

Processes

Involvement Training and Education Rewards and Incentives Communication

Committed Local

Sponsors

Local Role Modelling Local Manager’s Support

Strong Personal

Connection

Personal Imperative Solution Viability Being successful

Sustained Personal

Performance

Future Security Financial Impact

Work relationships Level of Responsibility

Learning Curve

Organisational Level

Local Level


Doing it better ourselves – localising the changes required to implement the NHSP

1. Understand what needs to be done from a NHS Plan perspective The Outcomes Framework, the Implementation Roadmap, identified priorities Today’s workshop sessions

2. Understand what needs to be done from a People perspective Consider the 6 CSFs and associated risks

3. Prepare effective implementation plans Tasks and project plan to deliver the changes - the WHAT People Plan to over come resistance and build commitment – the HOW Build the People Plan to address priority risks, integrate with Project Plan

4. Lead the way All leaders and managers actively and positively sponsoring the changes

5. Governance Appropriate monitoring and consequence management at both central (DHB) and local levels Strong programme management office support


Headline implementation process

Todayn Develop critical next steps for priority Headline Actions (Kim)n Template document provided to Kevin/Michelle

Immediate follow-up stepsn Your feedback/recommendations formalised, reviewed by NHSP OGn Go / Develop further / Defer instruction to Lead GM & proposed teams

Thereaftern Formal project plans prepared (with support as requested / available)n Implementation scheduling by NHSP OG if requiredn Any implementation support / resources authorised by NHSP OGn Accountable team/individuals implement agreed plan, managing both task and people impact n NHSP Project Co-ordinator provided with copy of plan, then monitors implementation, co-ordinates

resources and support, provides progress reports to GM PMPPH and NHSP OG


To close - the change process

Effective ChangeLeadership

Powerful Engagement Processes

Shared ChangePurpose

Committed LocalSponsors

Strong PersonalConnection

Sustained PersonalPerformance

ORGANISATIONAL

LOCALCurrentState

Future State

Resistance Commitment

Documents

NHSP – Achieving our Goals IMPLEMENTATION WORKSHOP Whangarei 28 September 2012 Kevin Hartung Change Specialist, licensed by Changefirst plc, (“People-Centred