1. 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

2. Reducing Colonic Anastomotic Leakage

3. 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!

4. 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

5. 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

6. Kotter: transformation is a process not an event

7. 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

8. 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

9. 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

10. 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

11. 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

12. 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)

13. 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

14. 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

15. Execution
Lag measures
Lead measures

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

18. Thank You