1. Research implementation Lecture 4: Diagnosing for Change and strategy I – making sense of change and models of change management Carl Thompson

2. Lecture aims  To understand the concept of change in relation to research implementation  To understand some models of managing change in the context of implementation

3. What do we mean by change?  Planned change  deliberate, conscious, rational social action  Emergent change  Spontaneous, unplanned (Mintzberg, 1989)

4. So…  Identify explore and challenge assumptions underpinning decisions  Facilitation and change  Control/isolation from uncertainty x  Organisational change is not fixed or linear, but contains an important emergent element!

5. Episodic vs continuous change  Episodic  Infrequent, discontinuous, intentional. Also known as radical or 2 nd order replacing one program or strategy with another  Continuous change  Ongoing, evolving, cumulative. Also known as 1 st order or incremental change. Constant adaptation and editing of ideas – critical mass develops if enough people involved.

6. Change and scope: Developmental Change  Improvement of existing situation

7. Transitional change  Implementation of a known new state management of the interim transition state over a controlled period of time

8. Transformational change  Emergence of a new state, unknown until it takes shape, out of the remains of the chaotic death of the old state; time period hard to control (Ackerman 1997)

9. Change and Systems Thinking  Explores properties of the whole (rather than component parts)  Elements connected together to form a whole –  possesses unique properties (as a whole system)  Closed systems – autonomous and independent  Open systems – material, energy and information exchange (Checkland 1981; Senge 1990)

10. So….  System is made up of related and interdependent parts, so that any system must be viewed as a whole  Cannot view a system in isolation from its environment  Systems in equilibrium will only change if some type of energy is applied  Players within the system have views on system purpose and function, each person’s view may be different.

11. NHS Plan  Requires that the NHS becomes an organisation able to embrace continuous, emergent change  Need models for Dx the ‘organisation’ which are useful for understanding and intervening in particular circumstances

12. Models and change questions  How can we understand complexity, interdependence and fragmentation?  Why do we need to change?  Who and what can change? (next week)  How can we make change happen? (next week)

13. How can we understand complexity, interdependence and fragmentation?  Weisbord’s 6 box organisational model  7s model  5 whys  Content, context and process model  Soft systems methodology  Process modelling  Process flow  Influence diagrams

14. Why do we need to change?  SWOT

15. Weisbord’s 6 box model

16. 7S model

18. 5 whys

19. Content Context Process

20. Soft systems

22. Process mapping

23. Influence diagrams

24. Decision trees vs influence diagrams