Quality Academy – Cohort 6 April 8, 2013 UNDERSTANDING ORGANIZATIONAL EFFECTIVENESS AND CHANGE MODELS

Theory of Change ‒Theory of Profound Knowledge (Deming) ‒Rogers (Innovation / Diffusion Theory) ‒Social Movement / Large Scale Change Theory

Theory of Profound Knowledge - Deming Appreciation of a System Theory of Knowledge Psychology of Change Knowledge about Variation

Appreciation of a System A system is complex. Made up of interdependent and interrelated components of people and processes For change to occur, requires a shared understanding and commitment to the aim or purpose of the system.

Psychology of Change The system self-organizes around its Identity. –Vision –Purpose –Guiding principles –Values –History –Shared aspirations

Theory of Knowledge System improvement depends learning and developing new knowledge about the system. Involves several steps: –Forming a theory –making predictions based on past experiences –testing the theory –checking the results. Knowledge is developed from the application of theory - provides a window from which to view the situation and gives meaning to experience.

Knowledge About Variation No two things are exactly alike, not people, not processes. Variation is a natural, inevitable part of life. Goal of quality or continuous improvement is to reduce the range of variation over time, in addition to adjusting the process level to the desired level.

Dancing guy video

Roger’s: 5 Elements Affecting Adoption Characteristics of an innovation that may influence its adoption Decision-making process that occurs when individuals consider adopting a new idea or practice Characteristics of the individuals that make them more likely to adopt an innovation Consequences for the individuals or society in adopting Communication channels used during the adoption process

Social Movement / Large Scale Change Theory Large Scale Change Theory – focus at Residency Session 2 (Vancouver) Social Movement Theory …

Questions for Reflection Think about a movement or campaign that you have been involved in: 1.What were its features? 2.How would you describe it?

Social Movements “A voluntary collective of individuals committed to promoting or resisting change through coordinated activity.” - Produce a lasting and self-generating effect - Create a sense of shared identity Bibby et al, 2009

Characteristics of Social Movements Energy Mass Passion Commitment Pace and momentum Spread Longevity

Change is about releasing energy and is largely self-directing (top-led, bottom up) ‘Moving’ people Focus on what is the right thing to do, even if there are personal implications for me Insists change needs opposition - it is the friend not enemy of change People change themselves and each other - peer to peer A planned programme of change with goals and milestones (led from the top) ‘Motivating’ people Change is driven by an appeal to the ‘what’s in it for me’ Talks about ‘overcoming resistance’ Change is done ‘to’ people or ‘with’ them - leaders and followers “Planned” or “Programme” view of change “Movement” view of change vs.. Not “either/or” but “both/and”

5 Key Steps for Building a Movement Frame to connect with hearts and minds Energise and mobilise for action Organise to drive change forward Make change a personal mission Hold the gains and sustain momentum

Change as a Personal Mission Most movements are associated with a key figurehead leader; however, social movements are based upon a distributed leadership Organizational Radicals: –Those not satisfied with the status quo and who are willing to take some personal risk to achieve their goals –Work with their organization to improve, rather than work against it –Courage – “stick your neck out” –Energy, passion and impatience

Successful Organizational Radicals Conviction- and value-driven, with a strong sense of self-belief that they are personally able to change Join forces with others and work as a collective body Achieve small wins which gives a sense of hope and confidence Optimistic in the face of challenge; see opportunities but take into account obstacles Profound sense of purpose Want to “rock the boat” and stay in it Often everyday leaders – but often have a critical role in organizational change

What Makes a Good Cause? –Not too broad, not too narrow –Worthy and worthwhile –Ambitious and lofty, yet achievable –Makes more friends than enemies –Cognitive dissonance Other factors to consider … -Too narrow a set of goals, you will not draw people in -Too wide, you lose focus -People join movements that appear likely to be successful!

Question for Reflection “When have you felt most energize and passionate about the work you have been involved in?”

Campaigns – 5 Key Elements 1.Message needs to make sense and have relevance 2.Strategic theme to create forward momentum; a journey 3.Within the strategic theme, small, single issues to work on (can see how they can make a difference and take action) 4.Inclusive 5.Infrastructure

Consequences of Missing Elements ListeningStrategic Theme Single IssueSweeping people in InfrastructureFailure modes ? ■■■■ = social engineering ■ ? ■■■ = opportunism, lack of direction ■■ ? ■■ = lack of focus and impact ■■■ ? ■ = political resistance ■■■■ ? = loss of momentum, enabling organization

Interested in further reading?

So We’ve Talked About the Soft Stuff … “Companies must pay as much attention to the hard side of change management as they to the soft aspects. By rigorously focusing on four critical elements, they can stake the odds in favor of success.” Sirkin, Keenan, Jackson, 2005

Hard Factors Affecting Change Initiatives Time necessary to complete Number of people required to execute Financial results that intended actions are expected to achieve “If companies don’t pay attention to the hard issues first, transformation programs will break down before the soft elements come into play.” Sirkin, Keenan, Jackson, 2005

The Evidence – DICE Factors Outcomes (success or failure) of change programs are correlated with four hard factors: 1.Duration 2.Performance integrity or capabilities of project teams 3.Commitment of senior executives and staff affected by change 4.Additional effort employees must make to cope with the change Sirkin, Keenan, Jackson, 2005

Duration It isn’t necessarily the time it takes – –Rather it is the time between reviews that is critical for success –e.g., a long project that is reviewed frequently is more likely to be successful than a short project that isn’t Trouble rises exponentially when the time between reviews by executives exceeds 8 weeks –Complex project – every 2 weeks –Simple projects – every 6-8 weeks Milestones to report: –Major actions or achievements vs day-to-day activities –When timelines not met – ask why and take corrective action Think: Monthly Report

Integrity Capability of the team Staff time needs to be given, without a negative consequence to day-to-day job Teamwork! Team leader, clear roles, responsibilities and accountabilities Team composition

Commitment Boost commitment of two groups: –Visible backing from most influential executives (not necessarily the top titles!) –People who must deal with the new process, system or way of working Top level-commitment is vital to obtaining the commitment from the front-line Talk up the new change three times more than you need to! Organizations also underestimate their ability to build staff support –Straight talk –One-to-one

Effort If change is added on top of existing responsibilities, people will resist Calculate how much work people will have to do beyond their existing responsibilities to change to a new work process (should not exceed 10%) –BUT – sometimes a change will reduce work time! –Data – balancing measures An example: medication reconciliation - 20 minutes saved/patient of nursing time at admission - 45 minutes saved/patient of pharmacist time at discharge

DICE as a Framework Evaluate your change initiatives and shine a spotlight and intervention that improve their chance of success Subjective assessment Scores … –WIN: statistically likely to succeed –WORRY: outcomes hard to predict –WOE: project results are unpredictable or subject to failure Why use? –Track projects –Force conversation

DICE Score

Questions?