hfma 8 essential steps to manage succesful change

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8 Essential Steps to Managing Successful Change 24 th January 2012 Yorkshire & Humber Branch Annual Conference “The New Improved NHS ”

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Presentation delivered to HFMA Healthcare Financial Management Association Conference 24th January 2013

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Page 1: Hfma 8 essential steps to manage succesful change

8 Essential Steps to Managing Successful Change

24th January 2012

Yorkshire & Humber Branch

Annual Conference“The New Improved NHS ”

Page 2: Hfma 8 essential steps to manage succesful change

What is change management?Change management is a structured approach

to transitioning individuals, teams and organisations from a current state to a desired

future state

Page 3: Hfma 8 essential steps to manage succesful change
Page 4: Hfma 8 essential steps to manage succesful change

Change quotes…

Page 5: Hfma 8 essential steps to manage succesful change

Why change?No change is without a purpose

Environment- internal or external factors

• Systems• Processes• Culture• Things could be better• Mergers• Acquisitions • Continuous Improvement• Take Over

• Competition• Innovation• Upgrades• New Strategy• Outsourcing• Economy • New Technology• Restructuring

Page 6: Hfma 8 essential steps to manage succesful change

"If you are doing business today the same way as you did business yesterday, the chances are that you won’t be doing business tomorrow"

Peter F Drucker

Page 7: Hfma 8 essential steps to manage succesful change

Changes over the years

Nobody can go back and start a new beginning but anyone can start today and make a new ending

Page 8: Hfma 8 essential steps to manage succesful change

A changing perspective

Page 9: Hfma 8 essential steps to manage succesful change

A changing perspective

Page 10: Hfma 8 essential steps to manage succesful change

Change processBased on Kurt Lewin’s model

Undesired situation

Desired situation

Chaos Unpredictability

No controlConfusion

Loss-AttachmentFear

ShockAnger

Page 11: Hfma 8 essential steps to manage succesful change

Bargaining

Shock

Denial

Anger

Stability

Depression

Testing/Acceptance/letting

go

Understanding

Present Reality

Transition Phase

Preferred Future

Don’t see the reasons why

Can’t be happening, no need, it’ll run out of steam, it’ll go away

Start outing emotions, frustrated, hurt, blame.

Try to defer it, attempt to moderate the change

They don’t care, why should I?Withdrawn from job, lack of engagement, quiet, introverted, full scale of change has sunk in

Test our understanding of how it relates to us, put out feelers, maybe I can cope!

Ok This is where I’m at and what I’m doing now

People’s reaction to change - 8 step process.

Information/Communication

Emotional Support

Guidance/Direction

Page 12: Hfma 8 essential steps to manage succesful change

Bargaining

Shock

Denial

Anger

Stability

Depression

Testing/Acceptance/letting go

Understanding

Present Reality

Transition Phase

Preferred Future

Don’t see the reasons why

Can’t be happening, No need, it’ll run out of steam, it’ll go away

Start outing emotions, frustrated, hurt, blame.

Try to defer it, attempt to moderate the change

Withdrawn from job, lack of engagement, quiet, introverted, full scale of change has sunk in

Test our understanding of how it relates to us, put out feelers, maybe I can cope!

Ok This is where I’m at an what I’m doing now

Don’t compromise, stand firm!

Let them express their feelings, listen, be empathetic, explain, communicate, communicate, communicate!

Expect the shock! Explain and sell the benefits.•Communicate!•Communicate!•Communicate!

Accept people will be withdrawn and not contribute very much. Give them space to go through this period.

Give them time and let them know what they mean to you, reinforce their value, train, coach, be there for them.

If led positively you can build on this and lead them into the future.

People’s reaction to change - 8 step process.

Page 13: Hfma 8 essential steps to manage succesful change

5 Phases of change

Page 14: Hfma 8 essential steps to manage succesful change

5 Phases of change

Page 15: Hfma 8 essential steps to manage succesful change

Universal facts about changeWho do you know that really looks forward to change?

Page 16: Hfma 8 essential steps to manage succesful change

Universal facts about change

The chains of habit are too weak to be felt until they are too strong to be broken’.

Samuel Johnson

Page 17: Hfma 8 essential steps to manage succesful change

Universal facts about change

• Different people react differently to change• Change often involves a loss and people go

through a loss curve• Success or failure of change depends on co-

operation of people implementing the change

Page 18: Hfma 8 essential steps to manage succesful change

Universal facts about change

• They key question everyone has on their mind about change is….?

• A small number of people and groups are almost always pivotal to a smooth and effective change process

• Your leadership is the absolute key to its success or not

• Effective communication and support are vital

Page 19: Hfma 8 essential steps to manage succesful change

Questions we must ask before change

• What do we need to achieve?• Why? How? When?• Who will be affected?• How will they react?• How do we support them?• Have we the resources to manage

the change?

Page 20: Hfma 8 essential steps to manage succesful change

Questions we must ask before change

• How do we communicate the change and get buy in?

• How do we deal with resistance?• What part of the change do we

need help with?• How do we know what success is

and how will we measure it?• After the change, what next?

Page 21: Hfma 8 essential steps to manage succesful change

How do we introduce change?

1

•Build trust- be open and honest

2

•Build a compelling, logical case for organisational change

3

•Match actions and words

4

•Involve the people affected

5

•Communicate a sense of confidence

6

•Repeat you main messages

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8 steps to effective change

Page 23: Hfma 8 essential steps to manage succesful change

8 steps to effective change

Page 24: Hfma 8 essential steps to manage succesful change

Pre-requisites for change

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Communicate for change!

• Communicate only what you know to be true (don’t speculate)

• Be sure senior management approves what you are communicating

• Communicate what you know as soon as you know.

• Communicate from their perspective- put yourself in their shoes

Page 26: Hfma 8 essential steps to manage succesful change

Communicate for change!

• Communicate using multiple mediums ( 1-1, small groups, large groups, written, focus groups, discussions etc.)

• Be prepared to answer questions.• Really listen• The more resistance, the more you

need to communicate.

Page 27: Hfma 8 essential steps to manage succesful change

Barriers and resistance to change

FearAngerHabitsNegative thinkingAttitudeCultureSubjectivityPeople EmotionsPoor planning

The normal reaction to change is resistance

1. Parochial self interest2. Misunderstanding3. Low tolerance to change4. Genuine disagreement

Page 28: Hfma 8 essential steps to manage succesful change

Factors for failure

• Lack of pro-active leadership or strategy

• Lack of consistent leadership• Poor communication• Intensive or brash approach• Lack of recognition and reward• Apathy

Page 29: Hfma 8 essential steps to manage succesful change

Factors for failure

• Staff kept in the dark• Lack of time, capacity, budget• Short term approach- stressed out out

staff• Lack of staff buy-in• Lack of initiative to do something

different

These factors then lead to the ‘tread-mill effect’, setting up a vicious circle

Page 30: Hfma 8 essential steps to manage succesful change

Absolute don'ts of change management

Don’t just think that change will happen

automatically- it needs work

Do not do a management high up

selling alone. You need to sell change to all your staff and

stakeholders

Don’t try and do it on your own, you need

supporters!

Don’t ignore rationale concerns, address

them and find solutions

Don’t start any change

management without a business

case and a planDon’t ignore

communication and support. You need both for change to

stick.

Page 31: Hfma 8 essential steps to manage succesful change

Change management summary

Change is difficult because of emotions

People will react differently but

typically follow the same pattern

Page 32: Hfma 8 essential steps to manage succesful change

Change management summary

Accept that fear , denial, anger,

resistance is normal

Good information and communication is essential. People are good at dealing with change if they

know what is changing

Page 33: Hfma 8 essential steps to manage succesful change

Change management summary

Focus on removing fear, most other

behaviours seem to stem from this

Carefully look for the opportunities, they

will be there

Page 34: Hfma 8 essential steps to manage succesful change
Page 35: Hfma 8 essential steps to manage succesful change

8 Essential Steps to Managing Successful Change

24th January 2012

Yorkshire & Humber BranchAnnual Conference

“The New Improved NHS ”