Health Care Conference Aruba How do we achieve, retain, and monitor an adaptive integrated health care system? Toolkit For Change Health Care Conference Aruba June 4th, 2017 Gert Kuijt

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Plan Of Attack And be LUCKY! Think BIG Find a CHAMPION Get all the STAKEHOLDERS in the same room Don’t listen to what they say, MEASURE WHAT THEY DO Play to WIN And be LUCKY!

Stance (1) Explore Exploit The world welcomes new ideas The world can change Anything is possible WHAT THE WORLD COULD LOOK LIKE Exploit Nothing is new under the sun You are a small cog in a giant machine It’s all about reliability and consistency WHAT THE WORLD DOES LOOK LIKE Roger Martin, The Design of Business

Stance (2) POSSIBILITY based ABDUCTIVE thinking Invention New knowledge Intuition, feeling, hypotheses about the future Long term Uneven, scattered, false starts, and significant leaps High risk, potentially high return Failure to consolidate / exploit returns PROOF based ANALYTICAL thinking Administration Systematic honing / refining current knowledge Analysis, reasoning, data from the past, mastery Short term Measured, careful, incremental steps Minimal risk, predictable but small rewards Exhaustion and obsolescence Roger Martin, The Design of Business

Kotter: transformation is a process not an event

Step 1: Create A Sense Of Urgency Look for potential opportunities Convince 75% of the people that the status quo is more dangerous than the unknown! Underestimating the difficulty of driving people from their comfort zones Becoming paralyzed by risks

Step 2: Form A Powerful Guiding Coalition Assemble a group with shared commitment and enough power to lead the change Encourage them to work as a team outside of the normal hierarchy No prior experience with team work at the top Not relegating team leadership to a senior manager

Step 3: Create A Vision Create a vision to direct the change effort Develop strategies for realizing that vision Presenting a vision that is too complicated to be communicated in five minutes

Step 4: Communicate The Vision Use every vehicle possible to communicate the new vision and strategies for achieving it Teach new behaviors by the example of the guiding coalition Under-communicating the vision Behaving in ways antithetical to the vision

Step 5: Empower Others To Act On The Vision Remove or alter systems or structures undermining the vision Encourage risk taking and nontraditional ideas, activities, and actions Failing to remove powerful individuals who resist the change effort

Step 6: Plan For And Create Short Term Successes Define and engineer visible performance improvements Recognize and reward employees contributing to those improvements Leaving short-term successes up to chance Failing to score successes early enough (12-24 months into the change effort)

Step 7: Consolidate Improvements And Produce More Change Use increased credibility from early wins to change systems, structures, and policies undermining the vision Hire, promote, and develop employees who can implement the vision Reinvigorate the change process with new projects and change agents Declaring victory too soon—with the first performance improvement Allowing resistors to convince “troops” that the war has been won

Step 8: Institutionalize New Approaches Articulate connections between new behaviors and success Create leadership development and succession plans consistent with the new approach Not creating new social norms and shared values consistent with changes Promoting people into leadership positions who don’t personify the new approaches

Execution Lag measures Lead measures

Conclusions Every situation is different Set big goals Find the right tools Set lead measures Do not ignore the elephant in the room

Thank You gerrit@avantgardehealth.com gkuijt@gmail.com