change management #2 of 3 nature of change who and what can change? see also organisational...

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Change Management #2 of 3 Change Management #2 of 3 Nature of change Nature of change Who and What can Change? Who and What can Change? See also See also organisational cultural analysis and change How can we make change happen? How can we make change happen? Securing individual and group level change Securing individual and group level change See also See also Managing the human dimensions of change Managing the human dimensions of change

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Change Management #2 of 3Change Management #2 of 3Change Management #2 of 3Change Management #2 of 3

Nature of changeNature of changeWho and What can Change?Who and What can Change?

See also See also organisational cultural analysis and changeHow can we make change happen?How can we make change happen?

Securing individual and group level changeSecuring individual and group level changeSee also See also Managing the human dimensions of changeManaging the human dimensions of change

2

How Can we understand the complexity, interdependence and fragmentation

PESTELI/STEP* 6 Box Organisational Model (Weisbord, 1976) Organisational Model (Burke-Litwin, 1992) 7S Organisational Model (Peters & Waterman, 1980) Content context & Process Model (Pettigrew & Whipp, 1991) Soft Systems Methodology Process Mapping and Redesign

See also cultural analysis (below)

Why do we need to change

SWOT Analysis Self Assessment

against quality frameworks eg Clinical Gov’, ISO9000, EFQM, Baldridge, NSF

Who and What can change

Force Field Analysis

Stakeholder analysis

Readiness and capability – also (WIFM)

Cultural analysis

See also models of

organisation (above)

How can we make the change

happen? Organisational

Development (OD) Organisational

Learning Action Research Project management

– service improvement teams

TQM, EFQM, CG Parallel Learning

Structures – group level change

Individual ChangeIles & Southerland, 2001,

p.23

Requires Effective

Leadership!!

* External,(Environmental)

analysis

Other models both external and internal

analysis

3

Lewin (1947, 1951) – Force Field Analysis

Force field analysis (Lewin, 1951) is a diagnostic technique which has been applied to ways of looking at the variables involved in determining whether organisational change will occur.

It is based on the concept of ‘forces’, a term which refers to the perceptions of people in the organisation about a particular factor and its influence. Driving forces are those forces affecting a situation and

which are attempting to push it in particular direction. These forces tend to initiate change or keep it going.

Restraining forces are forces acting to restrain or decrease the driving forces. A state of equilibrium is reached when the sum of the driving forces equals the

Who and What Can ChangeWho and What Can Change

Iles & Southerland, 2001, p. 43-44

As long as the driving forces equal the restraining forces, the status quo is maintained. If disequilibrium is created with one of

the forces gaining strength over the other, a change may occur. To facilitate a change, strategies need to be developed to reduce the

restraining forces and strengthen the driving forces

As long as the driving forces equal the restraining forces, the status quo is maintained. If disequilibrium is created with one of

the forces gaining strength over the other, a change may occur. To facilitate a change, strategies need to be developed to reduce the

restraining forces and strengthen the driving forces

4

Lewin (1947, 1951) – Force Field Analysis

Lewin formulated three fundamental assertions about force fields and change. Increasing the driving forces results in an increase

in the resisting forces; the current equilibrium does not change but is maintained under increased tension.

Reducing resisting forces is preferable because it allows movement towards the desired state, without increasing tension.

Group norms are an important force in resisting and shaping organisational change.

Who and What Can ChangeWho and What Can Change

Iles & Southerland, 2001, p. 43-44

USE: Once change priorities have been agreed, using methods from the last twoclusters, a force field analysis can be used to identify actions that would

enhance their successful implementation.

USE: Once change priorities have been agreed, using methods from the last twoclusters, a force field analysis can be used to identify actions that would

enhance their successful implementation.

5

Lewin (1947, 1951) – Force Field Analysis

Wh

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Wh

at C

an C

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Wh

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Wh

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ge

Iles & Southerland, 2001, p. 43-44

6

Lewin (1947, 1951) – Force Field Analysis

For the model to be of use, the forces need to be identified perceptively, rigorously and objectively, and the means identified of addressing the resisting forces need to be creative.

Many practising managers will be able to reflect on occasions in their own experience when they have aimed to increase the driving forces, rather than reduce the resisting ones, and have increased the resistance and the tension as a result.

Other change management authors have developed models and tools which analyse forces. (Kanter, 1983; Beckhard and Harris, 1987; Nadler)

Who and What Can ChangeWho and What Can Change

7

Stakeholder Analysis and WIFM

In pairs undertake a a Force Field

Analysis in relation to your proposed

service improvement.

One person play the role of the consultant for 10 mins and then

swap roles

8

Sources and Potency of Forces (Beckhard & Harris, 1987)

In their book Organisational Transitions: Managing Complex Change (1987) Beckhard and Harris describe and illustrate two techniques for analysing relevant sources of energy.

They analyse respectively the ‘sources and potency of forces for change’, and the ‘readiness and capability’ of individuals and groups to enact change.

First, the nature of the change demanded must be specified, using tools and techniques associated with environmental and organisational analysis.

Then all the forces for change, both inside the organisation and external to it, are listed along one axis of a grid.

On the other axis the potency of the forces is indicated, as high, medium or low.

Who and What Can ChangeWho and What Can Change

Iles & Southerland, 2001, p. 45

Special Note: Probably not as easy to use as WIFM stakeholder analysis!! – also; need to be very clear in relation to the performance gap – ie the ‘nature of change demanded’

Special Note: Probably not as easy to use as WIFM stakeholder analysis!! – also; need to be very clear in relation to the performance gap – ie the ‘nature of change demanded’

9

Sources and Potency of Forces (Beckhard & Harris, 1987)

Who and What Can ChangeWho and What Can Change

Iles & Southerland, 2001, p. 45

Nature of the change Demanded:

Owners Legislature Employees Trade Unions Social Values

Po

tency o

f Fo

rces

High

Medium

Low

10

Readiness and Capability(Beckhard & Harris, 1987)

Early on in the change process, managers need to identify which specific groups and individuals will be required to support the change if the change is to be successful. (See Stakeholder Analysis)

When they have done so they can determine the readiness and capability of these individuals and groups to enact the roles required of them in the change process. Understanding the readiness involves analysing attitudes:

willingness, motives and aims. Capability is determined by whether they have the power, the

influence and the authority to allocate resources, and the appropriate information and skills.

Beckhard and Harris (1987, p.63) have developed a Readiness–Capability Assessment Chart which enables the user to list individuals or groups who are critical to the change effort, and to rank them (high, medium, or low) each according to their readiness and capability with respect to change.

Who and What Can ChangeWho and What Can Change

Iles & Southerland, 2001, p. 45

Special Note: Again probably not as easy to use as WIFM stakeholder analysis!! – also; need to be very clear in relation to

the performance gap – ie the ‘nature of change demanded’

Special Note: Again probably not as easy to use as WIFM stakeholder analysis!! – also; need to be very clear in relation to

the performance gap – ie the ‘nature of change demanded’

11

Readiness and Capability(Beckhard & Harris, 1987)

Who and What Can ChangeWho and What Can Change

Iles & Southerland, 2001, p. 46

Stakeholder (Key

individuals or groups)

Readiness Capability Actions required to

increase capability

and/or Readiness

__________ __________ __________

etcPsychological commitment to change,

willingness, confidence,

security etc.

Psychological commitment to change,

willingness, confidence,

security etc.

Technical capacity for

change – knowledge, skills etc.,

Technical capacity for

change – knowledge, skills etc.,

Need to rate as low, medium or high

Need to rate as low, medium or high

12

Commitment, enrolment and Compliance (Senge, 1990)

Where a change must be implemented from the outside, ie when it has not been defined as necessary by the people involved, then it is unlikely to succeed (yield the full results of which people have ambitions) unless some of those involved are in favour of it.

Several observers (Rogers, 1983) have suggested however that not everyone needs to support a change, and that not everybody needs to support it to the same extent.

Senge in The Fifth Discipline (1990) talks of the difference between commitment, enrolment and compliance,

suggesting that while it is more pleasant (and reassuring) to have considerable commitment, it is not necessary for everyone to be as fully signed-up as this.

There exist a number of positions along a continuum, along which players may position themselves in response to proposed action and change

Who and What Can ChangeWho and What Can Change

Iles & Southerland, 2001, p. 45

Special Note: Again probably not as easy to use as WIFM stakeholder analysis!! – also; need to be very clear in relation to

the performance gap – ie the ‘nature of change demanded’

Special Note: Again probably not as easy to use as WIFM stakeholder analysis!! – also; need to be very clear in relation to

the performance gap – ie the ‘nature of change demanded’

13

Commitment, enrolment and Compliance (Senge, 1990)

Iles & Southerland, 2001, p. 46

DISPOSITION Players Response to Change

Commitment Want change to happen and will work to make it happen. Willing to create whatever structures, systems and frameworks are necessary

for it to work.

Enrolment Want change to happen and will devote time and energy to making it happen within given frameworks.

Act within the spirit of the frameworks.

Genuine Compliance

See the virtue in what is proposed, do what is asked of them and think proactively about what is needed.

Act within the letter of the frameworks.

Formal Compliance

Can describe the benefits of what is proposed and are not hostile to them. They do what they are asked but no more. Stick to the letter of the framework.

Grudging Compliance

Do not accept that there are benefits to what is proposed and do not go along with it.

They do enough of what is asked of them not to jeopardise position. They voice opposition and hopes for failure. Interpret the letter of the framework.

Non-Compliance Do not accept that there are benefits and have nothing to lose by opposing the proposition.

Will not do what is asked of them. Work outside framework.

Apathy Neither in support of nor in opposition to the proposal, just serving time. Don’t care about framework.

14

Commitment, enrolment and Compliance (Senge, 1990)

Who and What Can ChangeWho and What Can Change

Iles & Southerland, 2001, p. 45

Stakeholder (Key individuals or

groups)

Disposition Actions required to increase

commitment and/or minimise the effects

of apathy __________ __________ __________

etc

Need to assess on a continuum

of:Commitment – Apathy (See

previous slide)

Need to assess on a continuum

of:Commitment – Apathy (See

previous slide)

15

Sources of Potency or Levels of Commitment!

In pairs undertake an additionally

stakeholder analysis which includes an

analysis of sources of potency or levels

of commitment!

One person play the role of the consultant for 10 mins and then

swap roles

OPTIONAL Activity

16

Innovation Research (Rogers, 1983, 1995)

Innovation research refers to a body of literature that contains many models and approaches.

Some of the specific areas within it provide insights that are particularly relevant to managers.

Originating in the marketing literature of the 1960s, innovation research has developed into a significant area in its own right (Rogers, 1983; Stocking, 1992).

Research into the diffusion of innovations suggests that the propensity of individuals to change and implement new ideas, products or processes differs.

The adoption process, from an individual perspective,

Securing Individual & Group Level ChangeSecuring Individual & Group Level Change

Iles & Southerland, 2001, p.56-57

17

Innovation Research (Rogers, 1983, 1995)

The adoption process, from an individual perspective, has been depicted as a five-stage process, starting with:

establishing an awareness of the innovation in potential adopters and proceeding through:

persuasion, or arousal of interest

mental evaluation of the innovation

trial to implementation (Rogers, 1983;

Van de Ven, 1993).

Securing Individual & Group Level ChangeSecuring Individual & Group Level Change

Iles & Southerland, 2001, p.56-57

18

Innovation Research (Rogers, 1983, 1995)

Innovation research (Rogers, 1983) provides insights for change management in three ways.

First, it identifies properties of innovations (in this case organisational changes) that are likely to meet with success. These are:

relative advantage, the degree to which it is perceived to be better than existing technology

compatibility, the perceived ‘fit’ of the innovation with existing structures, procedures and values

complexity, the degree of difficulty involved in learning about and implementing the innovation

trialability, the extent to which an innovation can be tried by potential adopters without major investment of time or resources

observability, the degree to which outcomes resulting from the adoption of an innovation are visible.

Armed with this knowledge, managers can optimise and tailor their change programmes in order to maximise chances of success.

Securing Individual & Group Level ChangeSecuring Individual & Group Level Change

Iles & Southerland, 2001, p.56-57

19

Innovation Research (Rogers, 1983, 1995)

In health, Stocking (1985) provides a more specific list about the key factors in the adoption of innovations or change. It includes: the presence of identifiable

enthusiasts for innovation or change

conducive power relationships (i.e. lack of conflict with national policies or professional opinion)

adaptability to local conditions a general perception that the innovation meets current needs

minimal requirements for extra resources.

Securing Individual & Group Level ChangeSecuring Individual & Group Level Change

Iles & Southerland, 2001, p.56-57

20

Innovation Research (Rogers, 1983, 1995)

In health, Stocking (1985) provides a more specific list about the key factors in the adoption of innovations or change. It includes: the presence of identifiable

enthusiasts for innovation or change

conducive power relationships (i.e. lack of conflict with national policies or professional opinion)

adaptability to local conditions a general perception that the innovation meets current needs

minimal requirements for extra resources.

Securing Individual & Group Level ChangeSecuring Individual & Group Level Change

More recent work in this field has been concerned to explore the social andcultural factors in promoting or hindering change (Pettigrew et al., 1992;

Dawson et al., 1999).

More recent work in this field has been concerned to explore the social andcultural factors in promoting or hindering change (Pettigrew et al., 1992;

Dawson et al., 1999).

Iles & Southerland, 2001, p.56-57

21

Innovation Research (Rogers, 1983, 1995)

The second insight concerns the important role that organisational context plays in the adoption of innovation and change.

Three environmental features have been linked with the propensity to innovate: rapid change and heterogeneity

in an organisation’s operating environment

effective external communication networks

presence of boundary-spanning individuals (Slappendel, 1996).

Securing Individual & Group Level ChangeSecuring Individual & Group Level Change

Iles & Southerland, 2001, p.56-57

These environmental/organisational features are key contributing process to organisation organisational learning (Dixon, 1999; Pedler et

al, 191; Senge 1990)

These environmental/organisational features are key contributing process to organisation organisational learning (Dixon, 1999; Pedler et

al, 191; Senge 1990)

22

Innovation Research (Rogers, 1983, 1995)

The third insight that innovation research provides for change managers is that individuals have different attitudes to change per se.

It categorises people in terms of their propensity to change, ranging from: innovators

(venturesome) to early adopters

(respectable) to early majority

(deliberate) to late majority

(sceptical) to laggards (traditional).

Securing Individual & Group Level ChangeSecuring Individual & Group Level Change

Iles & Southerland, 2001, p.56-57

23

Reactions to change Rogers (1983, 1995)

24

Innovators Those who will leap with enthusiasm at your proposals they will strongly support it and will expect others to be active in pursuing them.

Early Adopters

These are people who will be rapidly persuaded, especially by early success. They are likely to want to adapt your proposals to their own circumstances.

Early Majority Are those who will want to see tangible outcomes to your proposals – they will not be convinced merely by the idea or principle.

Late Majority Those who will follow the lead of a powerful person if they show signs of agreement and support for your ideas. The commitment is centred on political calculation.

Resistors (Laggards)

Predictable, these people’s interest will need considerable evidence – the more vivid and directly observable the better – before they can be mobilised away from present methods and preferences. As a group, this category may be relatively risk adverse.

Rogers (1983, 1995) Reactions to change

25

Innovation Research (Rogers, 1983, 1995)

In addition to these attitudes, an individual’s reactions are greatly influenced by contextual factors involved.

The extent to which people are more or less resistant, indifferent, or likely to lend support to change is affected by how they perceive the change affecting them. Reasons for resisting change include: loss of control too much uncertainty surprise confusion loss of face concerns about competence in

a new context increased workload change fatigue the view that costs outweigh

benefits past resentments real threats. (Kanter et al.,

1992; Dawson, 1996)

Securing Individual & Group Level ChangeSecuring Individual & Group Level Change

Iles & Southerland, 2001, p.56-57

Managers need to take affirmative

action to minimise these effects!

26

The pattern observed in 3,500 successful innovations

7

How to influence each group?

5 Change the rules!

4 Prove it

3 Show them a working example

2 Mention it

1 No need

Time

Upta

ke o

f new

id

ea

Everett Rogers 1983

1.Innovators

2.Early adopters

3.Early majority

4.Late majority

5.’Laggards’

Innovation Research (Rogers, 1983, 1995)

Securing Individual & Group Level ChangeSecuring Individual & Group Level Change

25% usually ensure adoption

of and innovation!

27

Time

Time

ResistorsFloatersAdvocates

No of People

Innovators

Early Adopters

Early Majority

LateMajority Resitors

No of People

Rogers (1983) Reactions to change

28

Time

Time

ResistorsFloatersAdvocates

No of People

Innovators

Early Adopters

Early Majority

LateMajority Resitors

No of People

Rogers (1983, 1995) Reactions to change

16% 16%

68%

29

(Lewin, 1951) Change Model

Driving Forces (Positive/Supportive) Restraining Forces (Negative/Opposing)

10 8 6 4 2 0 2 4 6 8 10

Current State

Future State

Length of the arrow indicates the strength of the force!

Securing Individual & Group Level ChangeSecuring Individual & Group Level Change

30

Lewin (1947, 1951) – Force Field Analysis

Iles & Southerland, 2001, p. 43-44

Sec

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ng

In

div

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Gro

up

Lev

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han

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Sec

uri

ng

In

div

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al &

Gro

up

Lev

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31

Lewin (1951) formulated three fundamental assertions about force fields and change:1. Increasing the driving forces results in an

increase in the resisting forces; the current equilibrium does not change but is maintained under increased tension.

2. Reducing resisting forces is preferable because it allows movement towards the desired state, without increasing tension.

3. Group norms are an important force in resisting and shaping organizational change.

(Lewin, 1951) Change ModelSecuring Individual & Group Level ChangeSecuring Individual & Group Level Change

32

Once change priorities have been agreed, a Force Field Analysis can be used to identify actions that would enhance their successful implementation.

Lewin (1951) suggests that there are three phases in the change process.

Unfreezing

Moving

Re-freezing

(Lewin, 1951) Change ModelSecuring Individual & Group Level ChangeSecuring Individual & Group Level Change

33

Unfreezing

Moving

Re-freezing

Strong exciting Vision, Providing Information on a Better Way of doing things – creating dissatisfaction with the current state, Identify the need for a solution – sell

the benefits, model a positive outlook!

Develop an incremental plan, with contingencies, design easy wins, create a safe first set, recognise the importance of

education, listen to concerns empathetically, reward/reinforce small steps in the right

direction!

Continually reinforce new behaviours, ensure these are embedded in the artefacts of

culture eg guidelines, policies, job descriptions etc., ensure clear responsibility

for monitoring key processes using SPC!

(Lewin, 1951) Change ModelSecuring Individual & Group Level ChangeSecuring Individual & Group Level Change

34

(Lewin, 1951) Change Model

Unfreezing (Vision, Support, Positive Outlook & Modelling) This can be done by providing information or

examples of new ways of doing things or getting the job done or by raising everyone's awareness that the goal or goals of the organisation are not being met in some way and that a change is necessary to get back on track.

It is necessary to make those involved in the process feel secure and at ease with the proposed change or changes to reduce threats to the safety and security of those involved and reduce resistance to the proposed change.

During unfreezing, the process of developing an awareness to a need or problem is started and change is seen as the only solution.

Securing Individual & Group Level ChangeSecuring Individual & Group Level Change

35

(Lewin, 1951) Change Model

Unfreezing (Vision, Support, Positive Outlook & Modelling)

The change agent needs to increase pressures toward the change and reduce threats associated with changing. According to Lewin, this is done through three mechanisms.

• Disconfirmation: occurs when the change agent introduces evidence that a need is not being met. This can be done through meeting with the staff in small groups to discuss inadequacies or problems.

• Inducing guilt or anxiety: can be accomplished by introducing a period of uncomfortableness about the way things are and how they are not meeting an important goal or value.

• Creation of psychological safety: the third mechanism is important to provide sufficient security to minimise risk involved with the change. The change agent can provide time for discussion, involvement, education, supervision and approval to small advances toward the intended change.

Securing Individual & Group Level ChangeSecuring Individual & Group Level Change

Tow

ard

s S

afe

U

ncerta

inty

!!Tow

ard

s S

afe

U

ncerta

inty

!!

36

(Lewin, 1951) Change Model

Moving or Changing (Planning, Overcoming Resistance, Implementation, Open Communication & Support) This is the actual change or implementation

phase of the change process. During the moving stage, the driving forces have overcome the restraining forces and the change moves ahead

A new way of behaving or working is established as information and feedback is used to encourage group involvement and allow the participants to discuss and assimilate the change into their practice.

The change is planned in detail and then implementation begins. Time must be allowed for support, group discussion, evaluation, and feedback to deal with resistance as it occurs. Open communication is important.

Securing Individual & Group Level ChangeSecuring Individual & Group Level Change

37

(Lewin, 1951) Change Model

Refreezing (Embedding the change into the artefacts values, beliefs and behaviours of the client system as the basis of cultural regeneration/reinvention) During Refreezing, the change has been implemented and

needs to be stabilised. The organisation (client system) must return to its normal

level of functioning and the change consolidated into the regular operations of the organisation.

The change becomes integrated into the whole organisation as part of its routine functioning.

The change agent must provide guidance and support to ensure that the change will be maintained.

The change agent needs to reduce participation in the functioning of the change and delegate responsibility for the continuance of the change.

The integration of the change allows the change process to end and the participants (client system) to take on the responsibility for the continuance of operations.

Refreezing takes place as the group has moved to a new equilibrium of the driving and restraining forces with the change functioning in place.

Securing Individual & Group Level ChangeSecuring Individual & Group Level Change

38

Model of Change (Beckhard & Harris, 1987)

Describe a five stage model of change: Determine the need for change. Define the desired future state Describe the present state. Assess the present in terms of the future to determine

the work to be done. Manage the transition.

Enabling Conditions and the Change Equation: D x V x C x F > Resistance

• D dissatisfaction: with the present situation • V vision: an understanding of what the change(s) would look

like• C capacity: sufficient resources to make the change happen • F first steps: an appreciation of how the change is to be

implemented (Adapted from Beckhard & Harris, 1987)

If any of the elements on the left-hand side of the equation are zero, there will be insufficient impetus to overcome the resistance to change!!

Securing Individual & Group Level ChangeSecuring Individual & Group Level Change

39

Change Equation (Beckhard & Harris, 1987)

D x V x C x F > Resistance

D x V x C x F > Resistance D dissatisfaction: with the present situation V vision: an understanding of what the

change(s) would look like C capacity: sufficient resources to make the

change happen F first steps: an appreciation of how the

change is to be implemented (Adapted from Beckhard & Harris, 1987)

If any of the elements on the left-hand side of the equation are zero, there will be insufficient impetus to overcome the resistance to change!!

Securing Individual & Group Level ChangeSecuring Individual & Group Level Change

40

Change Equation (Beckhard & Harris, 1987)

D x V x C x F > Resistance

Dissatisfaction – Key Questions…. How satisfied is the person/group with the current

state of things? Is any dissatisfaction shared with their colleagues? How is the dissatisfaction understood and

experienced? How can we utilise information eg control charts,

from the Analyse phase to increase dissatisfaction with the current state without de-motivating key stakeholders?

“The … thing … that was astounding was mapping. We all thought we knew how the system worked but none of us had a clue. Many times an hour my mouth was just falling open because I didn’t realise what a mess it was.” Lead Clinician Cancer Services Collaborative

“The … thing … that was astounding was mapping. We all thought we knew how the system worked but none of us had a clue. Many times an hour my mouth was just falling open because I didn’t realise what a mess it was.” Lead Clinician Cancer Services Collaborative

Securing Individual & Group Level ChangeSecuring Individual & Group Level Change

41

Change Equation (Beckhard & Harris, 1987)

D x V x C x F > Resistance

Creating shared Dissatisfaction with the status-quo: Rea (1993) provides some practical advice on leading change in relation to Beckhard & Harris’s (1987) model. Look at your stakeholder scan:

This is achieved partly through the strength of the vision Create opportunities for learning about what other

organisations in your health sector do – by visiting these. Ensure that stakeholders are encouraged to access relevant

contemporaneous research in order to inform best practice. Create opportunities for patient/client involvement in

developing services eg through patient stories etc. Ensure evidence of poor performance from surveys and audits is

disseminated to all stakeholders within the client system. Provide immediate direct evidence of the cost benefits of existing

process.

Securing Individual & Group Level ChangeSecuring Individual & Group Level Change

42

Change Equation (Beckhard & Harris, 1987)

D x V x C x F > Resistance

Vision – Key Questions…. what do the key stakeholders want want for their patients,

themselves and their colleagues? what are their values and beliefs, goals and desires? what could the new system look like – can you provide

examples of where your proposed solution has provided positive benefits – how can you create an exciting future – is your plan sound - can you answer the question How?

“One of the reasons we got involved was because we care about the way that we deliver the service to patients … we were interested in ways of trying to improve … you think, there must be a better way of doing things.” Lead Clinician Cancer Services Collaborative

“One of the reasons we got involved was because we care about the way that we deliver the service to patients … we were interested in ways of trying to improve … you think, there must be a better way of doing things.” Lead Clinician Cancer Services Collaborative

Securing Individual & Group Level ChangeSecuring Individual & Group Level Change

43

Change Equation (Beckhard & Harris, 1987)

D x V x C x F > Resistance

Creating shared Visions of a better state: Rea (1993) provides some practical advice on leading change in relation to Beckhard & Harris’s (1987) model. Look at your stakeholder scan:

How precisely might you create dialogue with the different interests? Which interests might prefer closer direction? Which might prefer virtually

autonomous decision-making? (Remember that history is important) What factors might damage the efforts to achieve shared discussion? What would the vision need to look like; Detailed? Flexible? Highly

Measured? Would your change issue be more effectively achieved by one vision or many,

as formulated by various interests? What do we do about potentially contradictory visions between stakeholders?

Securing Individual & Group Level ChangeSecuring Individual & Group Level Change

44

Change Equation (Beckhard & Harris, 1987)

D x V x C x F > Resistance

Yukl (1998) argues that and effective visioning must: Provide a simple but exciting picture of a desirable but attainable

future, which is highly discrepant from the present state. Involve and/or attend to the needs of as many stakeholders as

possible. Be based on core ideologies and values of the organisation. Include a plan for implementation. Be flexible enough for regular review.

Securing Individual & Group Level ChangeSecuring Individual & Group Level Change

"A vision should be simple and idealistic, a picture of a desirable future, not a complex plan with quantitative objectives and detailed action steps. The vision should appeal to the values, hopes and ideals of organisation members and other stakeholders whose support is needed. The vision should emphasis distant ideological objectives rather than immediate

tangible benefits. The vision should be challenging but realistic. To be meaningful and credible, it should not be a wishful fantasy, but rather an

attainable future about what is important for the organisation, how it should related to the environment, and how people should be treated."

(Yukl G, 1998, pp.443)

"A vision should be simple and idealistic, a picture of a desirable future, not a complex plan with quantitative objectives and detailed action steps. The vision should appeal to the values, hopes and ideals of organisation members and other stakeholders whose support is needed. The vision should emphasis distant ideological objectives rather than immediate

tangible benefits. The vision should be challenging but realistic. To be meaningful and credible, it should not be a wishful fantasy, but rather an

attainable future about what is important for the organisation, how it should related to the environment, and how people should be treated."

(Yukl G, 1998, pp.443)

45

Change Equation (Beckhard & Harris, 1987)

D x V x C x F > Resistance

Capacity – Key Questions…. What resources are needed to achieve the change? don’t

forget resources such as energy and capability How can the resources be generated or shared? How can we use existing resources in a different way? What are the consequences of not changing?

First Step – Key Questions…. What first steps could people undertake which everyone

agrees would be moving in the right direction? How can you create a safe first step – safe uncertainty?

(Consider, training, vision, levels of supervision, incremental steps, building on what already works – ie do not through the baby out with the bath water).

Securing Individual & Group Level ChangeSecuring Individual & Group Level Change

46

Change Equation (Beckhard & Harris, 1987)

D x V x C x F > Resistance

Creating Safe Fist Step with appropriate Support Rea (1993) provides some practical advice on leading change in relation to Beckhard & Harris’s (1987) model. Look at your stakeholder scan in order to:

Involve stakeholders in developing a plan for implementation:• try to include as many contingencies as possible• create short term wins!

Determine appropriate levels of supervision during the change process for all stakeholders within the client system.

Provide access to education and learning opportunities according to individual need.

Recognise that individuals within the client system will internalise and commit to the change within very different time scales.

Role model appropriate behaviours yourself - recognise and reward these behaviours in others.

Match mature/competent individuals with those who are less so. Be accessible and encourage discussion. Celebrate each and every success

Securing Individual & Group Level ChangeSecuring Individual & Group Level Change

47

Lippitt White & Westley (1958), Model

This model expands Lewin's (1951) theory to a seven-step change process and concentrates on the role of the leader or change agent in the change process.

It emphasises the role of planning and problem solving in the process and adds the dimension of the interpersonal aspects of the helping relationship by the change agent in the change process.

The Seven Steps are: The development of a need for change, including problem awareness and a desire for change. Establishment of a change relationship between the change agent and the client system and

their mutual decision to work together on the change. Clarification or diagnosis of a client system's problem; a collaborative effort to diagnose the

difficulties. Examination of alternative means of action and goals, and the establishment of goals and

intentions of action. Transformation of intentions into actual change efforts, in which the active work of changing

takes place and success, is measured by how well plans are transformed into achievements. Generalisation and stabilisation of the change. The process of institutionalisation occurs. Achieving a terminal relationship to prevent the client system from becoming too dependent on

the change agent.

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48

Rogers (1983) Infusion of Innovations

Model

This model explains change as a result of the introduction of an innovation(s).

Innovation(s) are an idea, practice, or material artefact perceived to be new.

Diffusion is the process by which an innovation is communicated through certain channels over time among the members of a social system; it is a type of communication concerned with new ideas.

The five steps in this model are as follows: Knowledge-Awareness or Knowledge is presented to the group,

showing that the innovation is available. Persuasion-Interest arousal, excitement with the innovation its

utility to the client system is explained. Decision - the decision to use and evaluate the innovation is made. Implementation - the innovation is trialled occurs. Confirmation decision to adopt or reject the innovation is made by

the group.

Securing Individual & Group Level ChangeSecuring Individual & Group Level Change

“Roger’s also considers the role of the change agent as important and delineates the responsibilities of the change agent role: to develop a need for change, establish an

information -exchange relationship, diagnose the problem, create an intent to change in the client, translate the intent into action, stabilise the adoption and prevent discontinuance, and

achieve a terminal relationship.” (White K, 1998, p.185)

“Roger’s also considers the role of the change agent as important and delineates the responsibilities of the change agent role: to develop a need for change, establish an

information -exchange relationship, diagnose the problem, create an intent to change in the client, translate the intent into action, stabilise the adoption and prevent discontinuance, and

achieve a terminal relationship.” (White K, 1998, p.185)

49

Havelock’s (1973) Model

Havelock (1973) expanded the work of Rogers and Lewin and described a six-step process that discusses how successful innovation takes place and how change agents can organise their work so a successful innovation will take place.

Havelock's work focused on innovation in the educational process and emphasised planning and the use of a participatory approach for the group involved.

Havelock's theory suggests four ways that a change agent can facilitate the change: as a catalyst, solution giver, process helper, and resource linker.

Summary of the 6 Stages: Build a relationship Diagnose a problem Acquire resources Choose a solution Gain Acceptance Stabilisation and Termination

Securing Individual & Group Level ChangeSecuring Individual & Group Level Change

These are key Leadership

Roles

50

Havelock’s (1973) Model

The need to build a good relationship between the change agent and the client (or client system).

The relationship between the people involved in the change must be carefully developed for success to be achieved.

An assessment of the client, his or her norms, the leaders, the gatekeepers, and the larger environment should be completed.

The change agent needs to diagnose the problem and make a systematic attempt to understand it.

The diagnosis should include details about the symptoms, history, and causes. The change agent should help the client to articulate his or her needs as problem statements.

Identify and acquire relevant resources that will help in reaching the solution to the defined problem.

Resources are needed for diagnosis, awareness, and evaluation before trial, for trial, evaluation after trial, installation and maintenance.

Choose a solution to accomplish the change after generating a range of possibilities that follow looking at the implications, testing the feasibility of the alternative solutions, and adapting the preferred one to the needs and circumstances of the client system.

Move the solution toward acceptance and adoption. Finally, there is the need to stabilise the innovation so that the client system can maintain the

change on its own. Thus, a gradual termination of the change agent relationship is accomplished.

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51

Comparison of Major Theories of Planned Change

Nursing Process

Lewin (1951) Lippitt et al (1958)

Rogers (1983) Havelock (1973)

Identification of problem

Unfreezing Developing need for change

Knowledge

Assessment Unfreezing Establish change relationship

Build a relationship

Diagnosis Unfreezing Clarify diagnosis Persuasion Diagnose a problem

Goal Setting Moving/Changing

Establish goals and intentions for action

Decision Acquire resources

Planning and Implementation

Moving/Changing

Examine alternatives

Choose a solution

Implementation Moving/Changing/Refreezing

Transform intentions into actual change

Implementation Gain acceptance

Evaluation Refreezing Generalise and stabilise change; achieve terminal relationship

Confirmation Stabilisation

52

Kotter J P, 1980, 1995 n-stage model

Establish a sense of urgency Examine the organisation's operating environment for change factors

and competitive realities Identify and discuss crises, or major opportunities

Form a powerful enough guiding coalition Assemble a group with enough power to lead the change effort Encourage the group to work better as a team

Create a vision Use every vehicle possible to communicate the new vision and

strategies Teach new behaviours by the example of the guiding coalition

Empower others to act on vision Get rid of obstacles to change Change system structures that seriously undermine the vision Encourage risk taking and non-traditional ideas, activities and actions

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53

Kotter J P, 1980, 1995 n-stage model

Plan for and create short-term wins Plan for visible performance improvements Create those improvements Recognise and reward employees involved in the improvements

Consolidate improvements and produce still more changes Use increased credibility to change systems, structures, and

policies that don't fit the vision Hire, promote and develop employees, who can implement the

vision Reinvigorate the process with new projects, themes, and change

agents Institutionalise new approaches ie stabilise the change

Articulate the connections between the new behaviours and corporate success

Develop the means to ensure leadership development and succession

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Kotter & Schlesinger (1985) Methods for dealing with

resistance to change?

Securing Individual & Group Level ChangeSecuring Individual & Group Level Change

ApproachCommonly

used in situations

Advantages Drawbacks

Education + Communication

Where there is a lack of information or inaccurate information and analysis

Once persuaded, people will often help with the implementation of the change

Can be very time-consuming if lots of people are involved

Participation + Involvement

Where the initiators do not have all the information they need to design the change and where others have considerable power to resist

People who participate will be committed to implementing change, and any relevant information they have will be integrated into the change plan

Can be very time consuming if participators design and inappropriate change

…/CTD

55

Kotter & Schlesinger (1985) Methods for dealing with

resistance to change?

Securing Individual & Group Level ChangeSecuring Individual & Group Level Change

…/CTD

ApproachCommonly

used in situations

Advantages Drawbacks

Facilitation + Support

Where people are resisting because of adjustment problems

No other approach works as well with adjustment problems

Can be time consuming, expensive and still fail

Negotiation + Agreement

Where someone or some group will clearly lose out in a change, and where that group has considerable power to resist

Sometimes it is a relatively easy way to avoid major resistance

Can be too expensive in many cases if it alerts others to negotiate for compliance

56

Kotter & Schlesinger (1985) Methods for dealing with

resistance to change?

Securing Individual & Group Level ChangeSecuring Individual & Group Level Change

ApproachCommonly

used in situations

Advantages Drawbacks

Manipulation + Cooptation

Where other tactics will not work, or are too expensive

It can be a relatively quick and inexpensive solution to resistance problems

Can lead to future problems if people feel manipulated

Explicit + Implicit Coercion

Where speed is essential, and the change initiators posses considerable power

It is speedy, and can overcome any kind of resistance.

Can be risky if it leaves people mad at the initiators

57

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