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This presentation examines a number of strategies to enable successful change to take place.
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Managing Change – Choosing A Strategy
David StonehouseSenior LecturerTel: 01695 657003E-mail: [email protected]
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Change Tools
■ Rosabeth Moss Kanter
■ SWOT Analysis■ The Change
Equation■ Process mapping■ RAID Model
■ PDSA Cycle■ Seven Steps For
Improvement■ Gannt Charts■ Responsibility
Matrix■ Prince
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Ten Commandments For Executing Change
(Kanter et al, 1992)1. Analyse the organisation & its need for change2. Create a shared vision & a common direction3. Separate from the past4. Create a sense of urgency5. Support a strong leader role6. Line up political sponsorship7. Craft an implementation plan8. Develop enabling structures9. Communicate, involve people & be honest10. Reinforce & institutionalise change.
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SWOT Analysis (Mullins, 2010)
Strengths Weaknesses
Opportunities Threats
■ Analyse the problem
■ Identify priorities for action
■ Consider internal and external factors
■ Consider the consequences of actions
The Change Equation
Dissatis-faction
Vision CapacityFirstSteps
ResistanceX X X >
•Dissatisfaction: with the present situation
•Vision: an understanding of what the change(s) would look like
•Capacity: Sufficient resources to make the change happen
•First Steps: an appreciation of how the change is to be implemented
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Process MappingWhat is a process?“A series of connected steps or actions which
achieve an outcome.”It has:■ Start and end point. (this is the scope)■ A purpose or aim.■ Rules governing the standard or quality of inputs
throughout the process.■ Can be simple & short, or complex & long.
Think about all the different steps you do from getting up out of bed to going out the
door to work.WAKE UP DRINK EXIT FOR
COLLEGEWALK DOG
PREPARE LUNCH
CLEAN TEETH
EAT GET DRESSED
GET KIDS DRESSED
WATCH T.V.
WASH/ SHOWER
GET KIDS UP
GET KIDS FOOD
TALK TO PARTNER
LISTEN TO RADIO
TOILET
A Process Map of this could look something like this
WAKE UP TOILETWASH/
SHOWER
GET DRESSEDGET KIDS UP
GET KIDS DRESSED
GET KIDS
FOOD
CLEAN TEETH
EAT DRINK
PREPARE LUNCHEXIT HOUSE
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How to Process Map?
■ Get representatives of all people involved, staff patients, families, external groups.
■ Need support.
■ Plan 2 events
- 1st Process mapping
- 2nd Action planning
■ Use Post-it notes in different colours and flip charts.
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RAID Model
■ Review:
■ Agree:
■ Implement:
■ Demonstrate:
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REVIEW
■ Teams gain the patients and families views of the service to capture the quality of services delivered and to hear their suggestions for improvement.
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AGREE
■ Results of this listening exercise are triangulated with a staff listening exercise and aligned to influence the strategic direction of the organisation. Patients are fed back the findings
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IMPLEMENT
■ Teams work with patients to implement changes in practice, i.e Patients/carers are involved in audit, process mapping, training, influencing committees, on interview panels.
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DEMONSTRATE■ Demonstrate the improvements to
both patients and staff/organisation.■ Does it make a difference? ■ Will benefits continue? ■ Identifying lessons ■ Spreading the message ■ Sharing the learning
What are we trying toaccomplish?
Model for improvement
project aims
PDSA CYCLE
What are we trying toaccomplish?
How will we know that achange is an improvement?
Model for improvement
project aims
global
measurements
PDSA CYCLE
What are we trying toaccomplish?
How will we know that achange is an improvement?What changes can we make
that will result in the improvements that we seek ?
Model for improvement
project aims
global
measurements
change principles
PDSA CYCLE
What are we trying toaccomplish?
How will we know that achange is an improvement?What changes can we make
that will result in the improvements that we seek ?
Model for improvement
Plan
project aims
global
measurements
change principles
PDSA CYCLE
What are we trying toaccomplish?
How will we know that achange is an improvement?What changes can we make
that will result in the improvements that we seek ?
Model for improvement
Plan
Do
project aims
global
measurements
change principles
PDSA CYCLE
What are we trying toaccomplish?
How will we know that achange is an improvement?What changes can we make
that will result in the improvements that we seek ?
Model for improvement
Plan
Study Do
project aims
global
measurements
change principles
PDSA CYCLE
What are we trying toaccomplish?
How will we know that achange is an improvement?What changes can we make
that will result in the improvements that we seek ?
Model for improvement
Act Plan
Study Do
project aims
global
measurements
change principles
PDSA CYCLE(NHS Institute For Innovation
And Improvement, 2007)
Seven Steps For Improvement
Step 1.
Define the aim for the project:- the group of patients/staff.- your targets.
Step 2.
Consider how you are going to know if a change is an improvement:
-what measures are you going to use
-how are you going to report progress to interested parties
Seven Steps For Improvement
Step 3.
Involve everyone in mapping / analysing the process:- to really understand the problems for all parties- to start to measure & create the baselines for your improvements.
Step 4.
Investigate all the changes that are likely to make an improvement in line with the aims set:
- talk to other areas, organisations.
Seven Steps For Improvement
Step 5.
Test out the change ideas to see if they actually do make improvements:- consider the knock on effects that making one change will have to that process & other parts of the system or different systems.
Step 6.
Implement the changes that you have identified that will make improvements.
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Seven Steps For Improvement
Step 7.
Review changes to ensure improvement
&
Celebrate success
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Gantt Charts
■ Are a visual scheduling tool
■ Show dependencies between tasks, personnel, and other resources
■ Helps track progress towards completion.
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Gantt Charts
• List all tasks and milestones along the vertical axis
• List time frame along the horizontal axis.
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Responsibility Matrix
■ Creates accountability by assigning each task to a person.
Task Bob John Betty Albert
Activity 1. X
Activity 2. X X
Activity 3. X
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PRINCE2
PRINCE stands for:
Projects
IN
Controlled
Environments
Used extensively by the U.K. government
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PRINCE2
■ Process based approach to project management.
■ Project is divided into manageable stages.
■ Project plans are focused on delivering results.
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References Burnes, B. (2000) Managing Change: A Strategic Approach To
Organisational
Dynamics. Third Edition. Essex: Pearson Education Ltd.
Kanter, R.M. (2009) ‘Managing The Human Side Of Change.’ In: Price, D. (ed) The Principles And Practice Of Change. Hampshire: Palgrave MacMillan. Pp 175-183.
Kanter, R.M; Kanter, R.M; Stein and Jick (1992) The Challenge of Organizational Change. New York: Free Press.
Marquis, B. L. & Huston, C. J. (2009) Leadership Roles and
Management Functions in Nursing. Sixth Edition. Philadelphia:
Lippincott Williams & Wilkins.
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References Mullins, L.J. (2010) Management and Organisational Behaviour.
Ninth Edition. London:Financial Times Prentice Hall.
NHS Institute For Innovation And Improvement (2007) Process Mapping, Analysis And Redesign: General Improvement Skills. Nottingham: NHS.
Smith, A. & Langston, A. (1999) Managing Staff in Early Years Settings. London: Routledge.
Stonehouse, D. (2011) ‘Management and Leadership For Support Workers.’ British Journal of Healthcare Assistants. October. Vol 05. No 10.