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Canadian Hospital Pharmacy Leadership Conference. June 7-9, 2013. Lynne Gallacher Senior Vice President, Organizational Excellence Solutions HORN [email protected] 905-761-8000 ext. 266. Context. A Model for Change My Observations Challenges/Barriers - PowerPoint PPT Presentation
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Lynne GallacherSenior Vice President, Organizational Excellence [email protected] 905-761-8000 ext. 266
Canadian Hospital Pharmacy Leadership Conference
June 7-9, 2013
Leading Change
Context
2
• A Model for Change• My Observations
• Challenges/Barriers
• Success Strategies to Overcome Challenges/Barriers
Leading Change
Kotter’s 8 Reasons Why Change Fails
3
• Not Establishing a Great Enough Sense of Urgency#1
• Not Creating a Powerful Enough Guiding Coalition#2
• Lacking a Vision#3
• Under-communicating the Vision by a Factor of Ten#4
• Not Removing Obstacles to the New Vision#5
• Not Systematically Planning for and Creating Short-Term Wins#6
• Declaring Victory Too Soon#7
• Not Anchoring Changes in the Corporation’s Culture#8
Source: Kotter, John P. “Leading Change: Why Transformation Efforts Fail.” Harvard Business Review (Jan 2007); p. 99
Leading Change
Kotter’s 8 Reasons Why Change Fails
4
• Not Establishing a Great Enough Sense of Urgency#1
• Not Creating a Powerful Enough Guiding Coalition#2
• Lacking a Vision#3
• Under-communicating the Vision by a Factor of Ten#4
• Not Removing Obstacles to the New Vision#5
• Not Systematically Planning for and Creating Short-Term Wins#6
• Declaring Victory Too Soon#7
• Not Anchoring Changes in the Corporation’s Culture#8
Source: Kotter, John P. “Leading Change: Why Transformation Efforts Fail.” Harvard Business Review (Jan 2007); p. 99
Leading Change 5
Establish a Sense of Urgency
Establish a Sense of Urgency
Form a Powerful Guiding Coalition
Form a Powerful Guiding Coalition
Create a VisionCreate a Vision
Communicate the Vision
Communicate the Vision
Empower Others to Act on the Vision
Empower Others to Act on the Vision
Plan for and Create Short-term Wins
Plan for and Create Short-term Wins
Consolidate Improvements and Produce Even More Change
Consolidate Improvements and Produce Even More Change
Institutionalize New Approaches
Institutionalize New Approaches
Kotter’s 8 Steps to Guiding Successful Change
Source: Kotter, John P. (1996) Leading Change. p.21
Leading Change 6
Culture of
complacency
No major crisis “Status quo is
working” mindset The human
challenge: converting intention to action
#1 Establish a Sense of Urgency Establish a Sense of Urgency
BarriersBarriers Success StrategiesSuccess Strategies
Identify the need for change
Challenge the feasibility of maintaining the status quo
Reinforce the consequences of status quo / change
Leading Change 7
Lack of executive “active” sponsorship
Lack of dedicated project teams
Lack of broad-scale involvement and buy-in(VP staff)
#2 Form a Powerful Guiding Coalition Form a Powerful Guiding Coalition
BarriersBarriers Success StrategiesSuccess Strategies
Influence CEO / VP championship with aligned goals
Commit focused resources to plan/implement
Ensure broad “powerful” participation (VP, staff, physicians, patients)
Leading Change 8
No clear purpose Unclear desired
outcomes Inability to make
choices Confusing Plans
and Programs with Vision
#3 Create a Vision Create a Vision
BarriersBarriers Success StrategiesSuccess Strategies
Create a concise articulation of your desired future state
Define measures of success / KPIs
Leading Change 9
False perception that communication is an “event”
Messaging doesn’t connect with hearts and minds
Leader words and actions are misaligned
#4 Communicate the Vision Communicate the Vision
BarriersBarriers Success StrategiesSuccess Strategies
Brand it Use all existing
communication channels
Communicate … over and over
Focus on the “why” and “WIIFM”
Live it – “Walk the talk” and “Walk around”
Leading Change 10
Assumptions that obstacles are too great to overcome
Influential resistors Systems/structure/
process misalignment
#5 Empower Others/Remove Obstacles Empower Others/Remove Obstacles
BarriersBarriers Success StrategiesSuccess Strategies
Anticipate real barriers (people, systems, structures)
Proactively address barriers
Equip/educate on new roles/behaviours
Engage broad stakeholders in solutioning
Leading Change 11
Lack of momentum No tangible
evidence of improvement
#6 Plan and Create Short-term Wins Plan and Create Short-term Wins
BarriersBarriers Success StrategiesSuccess Strategies
Plan short-term goals (12-24 months)
Action / achieve them Show demonstrable
progress / improvement
Celebrate / acknowledge successes
Leading Change 12
Unclear expectations
Distractions Lack of momentum No tangible
evidence of improvement
#8 Institutionalize New Approaches Institutionalize New Approaches
BarriersBarriers Success StrategiesSuccess Strategies
Create “system” that defines/measures expectations SOPs Management /
communication routines
Accountability systems
Explicitly link results to change in behaviour
Don’t stop until it’s in the organizational “DNA”
Leading Change
So What?
13
1. What is the need for change in your hospital?
2. What’s standing in the way of making that change a reality?
3. What can you do to lead the change you want?
Lynne GallacherSenior Vice President, Organizational Excellence [email protected] 905-761-8000 ext. 266
Best Practices for Leading and Facilitating Change
June 9, 2013
Leading Change 15
Establish a Sense of Urgency
Establish a Sense of Urgency
Form a Powerful Guiding Coalition
Form a Powerful Guiding Coalition
Create a VisionCreate a Vision
Communicate the VisionCommunicate the Vision
Empower Others to Act on the Vision
Empower Others to Act on the Vision
Plan for and Create Short-term Wins
Plan for and Create Short-term Wins
Consolidate Improvements and Produce Even More Change
Consolidate Improvements and Produce Even More Change
Institutionalize New Approaches
Institutionalize New Approaches
1
2
3
4
5
6
7
88 Steps to Guiding Successful Change
Source: Kotter, John P. (1996) Leading Change. p.21
Leading Change 16
Establish a Sense of Urgency
Establish a Sense of Urgency
Form a Powerful Guiding Coalition
Form a Powerful Guiding Coalition
Create a VisionCreate a Vision
Communicate the VisionCommunicate the Vision
Empower Others to Act on the Vision
Empower Others to Act on the Vision
Plan for and Create Short-term Wins
Plan for and Create Short-term Wins
Consolidate Improvements and Produce Even More Change
Consolidate Improvements and Produce Even More Change
Institutionalize New Approaches
Institutionalize New Approaches
1
2
3
4
5
6
7
88 Steps to Guiding Successful Change
Source: Kotter, John P. (1996) Leading Change. p.21
Proposal Title
What Great Change Leaders Do
17
1. Self-Manage 2. Support and Empower Team Members to Act3. Communicate their Vision for Change … over
and over4. Build Broad Organizational Support
Leading Change
“Leading others through change starts with leading oneself.”
Art Horn
18
Leading Change
How many words per minute do we…
19
Think?450 words/minute
Speak?150 words/minute
Leading Change 20
Judges & Evaluates
Tends to be
Negative
Self-talk
Leading Change 21
I take
Actionsbased on my beliefs,
conclusions and emotions
I’m presented with a
Situation
I interpret the situation based on my
BeliefsI draw
Conclusions(judgments, generalizations, assumptions)
based on my beliefs
I express
Emotion based on my conclusions
The Cause and Effect of Self-talk
Based on work by Chris Argyris, popularized by Peter Senge (2006) in The Fifth Discipline: The Art and Practice of the Learning Organization.
Leading Change
Personal Reflection:
22
Thinking of a current or pending change in your organization, how is your Self-talk impacting your actions (or lack of action)?
Self-talk
Leading Change
Managing Self-talk
23
STOP
CHOOSE
CHALLENGE
Leading Change
Personal Reflection:
24
STOP: Thinking of the current or pending change in your organization:
CHALLENGE: What assumptions are driving your negative Self-talk ?What if the assumption were not true?How could you view the situation differently?
CHOOSE: What different course of action could/should you take?
Self-talk
Proposal Title
What Great Change Leaders Do
25
1. Self-Manage 2. Support and Empower Team Members to Act3. Communicate their Vision for Change … over
and over4. Build Broad Organizational Support
Leading Change
“All of the great leaders have had one characteristic in common: it was the willingness to confront unequivocally the major anxiety of their people in
their time. This, and not much else, is the essence of leadership.”
John Kenneth Galbraith
26
Leading Change 27
Relatedness – sense of safety with others (friend or foe) –
Fairness – perception of fair exchanges between
people –
Motivations and Barriers to Change - SCARF
Status – relative importance to others –
Certainty – being able to predict the future –
Autonomy – sense of control over events –
Source: Rock, D. (2008) SCARF: a brain-based model for collaborating with and influencing others. NeuroLeadership Journal, 2008 (1), pp. 1-9.
Leading Change
Typical Human Reactions to Change
28
Deflector
Victim
Personalizer
Naïve Optimist
Agent
“Not Me”
“Poor Me”
“It’s Me”
“No Problem”
“Here’s What I’m Going to
Do”
Leading Change
Empathy
29
Our ability to identify with the perspectives and feelings of others,
•When we demonstrate genuine Empathy, it lowers others’ natural defensiveness and related Self-talk, and causes them to feel “truly heard.” •As a result, they are more open to sharing information, which allows both parties to become aligned in their views.
Source: Rogers, Carl R. (1952) Gateway to Communication; Harvard Business ReviewHorn, Art. (2010) The Gifts of Leadership: Team Building Through Empathy and Focus.
“The main barrier to communication is our
tendency to evaluate, to approve or disapprove
of, what another person is saying.”
Dr. Carl R. Rogers
“The main barrier to communication is our
tendency to evaluate, to approve or disapprove
of, what another person is saying.”
Dr. Carl R. Rogers
Leading Change
The Irony of Influence
30
Self-talk
Judge
Sense of Self
Difficult to Empathize
People Don’t Listen
Not as Likely to Influence
Leading Change
Purpose
31
An inclination towards consistently setting goals, aligning goals with other parties, and actively striving to ensure goals are achieved.
•Defining goals increases the likelihood of achieving them•The effect of aligned goals can be very powerful! •Establishing aligned goals can allow us to communicate:
o “I understand your goal. To prove to you that I do, let me demonstrate to you exactly how your goal aligns with mine.”
Source: Horn, Art. (2010) The Gifts of Leadership: Team Building Through Empathy and Focus.
Leading Change
The Balancing Act
32
How well do you balance Empathy and Purpose in your team
interactions?
Leading Change
Supporting your Team through Change
33
• Show genuine interest
• Observe• Assess their
tolerance for change
• Ask questions
• Understand their motivations
• Demonstrate understanding
• Validate
• Align goals• Communica
te the need for change
• Reframe their perspective
• Communicate the WIIFM – “what’s in it for them”
• Move them to “agency” and action
Proposal Title
What Great Change Leaders Do
34
1. Self-Manage 2. Support and Empower Team Members to Act3. Communicate their Vision for Change … over
and over4. Build Broad Organizational Support
Leading Change
“My own definition of leadership is this: The capacity and the will to rally men and women to a common purpose and the character which inspires confidence.”
General Montgomery
35
Leading Change
CHANGE Influential Messaging Framework
36
Leading Change
CHANGE Example
37
Connect
History
Ambition
• I want to connect with you to give you more context about the smoking-cessation counseling initiative.
• I’ll reinforce why this transformation really does make sense for our hospital
• And, why I’m personally excited by what it means for our patients, and for our pharmacy team
• I also want to answer your questions so you are 100% clear and aligned
• We first started discussing this initiative over a year ago, in response to the CSHP 2015 Quality Initiative
• Since then, we’ve made great strides in developing our strategy and counseling approach, and the pilot program has gone very well – we’ve proven to ourselves that this will work!
• It’s time now to roll it out to 100% of our hospitalized patients who smoke
• I’m excited about our Vision for this program – to provide smoking-cessation counseling to 100% of our hospitalized patients who smoke
• We all know the health risks associated with smoking, and the long-term benefits of quitting – with this program we will provide the information, tools and support necessary to help our patients better understand the risks, and hopefully choose to quit so patient outcomes improve
Leading Change
CHANGE Example
38
Need
Getting in the Way
Encourage
• Our patients who smoke need our help – some aren’t aware of all of the health risks, and most don’t know there are tools and supports that will make quitting much easier
• In our hospital, we don’t currently have a program in place to provide that help, either through the pharmacy or other health care providers
• We’re committed to CSHP 2015, and it’s time to live up to those commitments• I know this program is something above and beyond what we’re currently doing – it will take time and energy to implement, and we’re busy as it is
• Good news is there are other initiatives, like our new automated unit dose system, that are taking a few things off of our plates, and will make room for this
• It’s also a change in terms of the scope of our duties, that requires others to give us access to 100% of our smoking patients – over time, we’ll get everybody on board• So, as we roll this program out, I ask that you:
• Support each other in managing through the ups and downs• Be open-minded by challenging some of your own assumptions
about our role in the hospital, and in patient care• Share what’s on your mind openly. I want to hear your
perspective and ideas• Join me in believing in and pursuing our Vision for smoking-
cessation counseling• Together, I know we can make a huge impact on our patients lives!
Proposal Title
What Great Change Leaders Do
39
1. Self-Manage 2. Support and Empower Team Members to Act3. Communicate their Vision for Change … over
and over4. Build Broad Organizational Support
Leading Change
“The key to successful leadership today is influence, not authority.”
Kenneth Blanchard
40
Leading Change
Building Broad Organizational Support
41
• WHO is influential?
• WHAT is their disposition?
• HOW can I influence them?
Leading Change
Identifying CluesIdentifying Clues
• Direct access to funding• Releases funds• Veto power
• Gatekeeper• Gives go/no go
recommendation
• Impacted by decision• Gives advice• Can’t say “yes”; maybe “no”
• Provides guidance re: organization, players and proposal
Decision Influencers
Decision Influencers
• Balancing the budget• Impact on patient care• Average case costing
• Expertise matched to specific requirements
• Track record in managing similar projects/initiatives efficiently
• Success with a proposal
FocusFocus
WHO? – DIG (Decision Influence Group)
42
Approver
Recommender
Advisor
Coach
Leading Change
WHAT? – Motivations and Disposition
43
•WHAT are their Motivations (Business & Personal)?o What do they crave? o What do they fear?
•WHAT is their Disposition toward you/the project?o Advocate, Neutral, Adversary
•WHAT is their Influence Level in your hospital?o High, Med, Low
Leading Change
HOW? - Influence Strategy
AdvocateAdversary DISPOSITION
Low
High
INFLUENCE
DevelopDevelop LeverageLeverage
SupportSupportMonitorMonitor
Leading Change
Leverage•Ask for coaching •Influence others - the “Develops”Develop•Establish and maintain contact•Address issues, perceptions, objections•Align project benefits with their motivationsSupport•Expose their ideas to more influential stakeholders (Leverage and Develop)•Promote themMonitor•Neutralize objections proactively leveraging more influential stakeholders•Remain open to opportunities to build bridges
HOW? - Influencing your DIGDevelop Leverage
Monitor Support
Proposal Title
What Great Change Leaders Do
46
1. Self-Manage 2. Support and Empower Team Members to Act3. Communicate their Vision for Change … over
and over4. Build Broad Organizational Support
What will you do differently to be a Great Change Leader?
Lynne GallacherSenior Vice President, Organizational Excellence [email protected] 905-761-8000 ext. 266
Canadian Hospital Pharmacy Leadership Conference
June 7-9, 2013