Team Planning and Delivery Event Friday 18 th September 2009.

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  • Slide 1
  • Team Planning and Delivery Event Friday 18 th September 2009
  • Slide 2
  • Networking activity Valerie Iles Which box of the Matrix do you focus on most frequently? Which box of the Matrix do you think the programme is strongest in? Planned/ deliberate SpontaneousEmergent/ crafted Thinking ahead 1 Analysing situation and designing intervention 2 Engaging players in developing a spirit and purpose 3 Finding out what really happens around here Real time 4 Project managing the implementation programme 5 Living in the moment, responding to events in the spirit of the plan 6 Noticing what is happening, the day to day decisions being taken Reflecting and learning 7 Evaluating the implementation 8 Reflecting on the dynamics 9 Putting together and telling the story
  • Slide 3
  • Aims: Articulate the vision for the programme Develop explicit values and behaviours to support this Discuss what success will look like Reflect on the operating context for the programme Carry out horizon scanning Discuss how to run an effective programme Ensure full engagement and involvement of all the team Discuss style and practical arrangements for the SMT Plan team development that supports the team to be visibly skilled in programme approach and methodology by January CLD event Reducing reliance on external support Creating the environment for the development of the faculty
  • Slide 4
  • Ground rules for team development sessions Honest Constructive Forward looking learning from the past Directive to focus resolution Supportive Objective & Reflective ability to stand back Not talk over each other What is said in the room stays in the room Agreed and committed to actions Agreed 26 th August 2009
  • Slide 5
  • A Recap Discussed achievements a sense of personal and team pride Agreed actions to deliver the programme Learning to work together as a programme team Identifying and meeting personal and team development needs
  • Slide 6
  • Approach today Maintain a positive and proactive focus Build on progress to date Continue to move forward as a team Dont get bogged down in the detail (use the parking boards if needed)
  • Slide 7
  • CLARHC Vision To continuously improve the quality of patient care by accelerating the implementation of evidence based research and innovations into practice Strap line: accelerating research into better care
  • Slide 8
  • Vision Vision is the core of leadership Vision is seeing the potential purpose in the chaos of the moment, but which could bring to birth new possibilities for a person, company or nation. Vision is seeing what life could be like when dealing with life as it is. Vision deals with those deeper human intangibles that alone give purpose to life. In the end, vision must always deal with lifes qualities not quantities William Van Dusen Wishard
  • Slide 9
  • Vision without action is hallucination. Beverly Malone
  • Slide 10
  • CLARHC Aims Improve the delivery of innovative research to provide the highest quality of patient care Devise and evaluate a systematic approach for the rapid adoption of clinically effective interventions Develop a model for the conduct and application of health research that is transferable across the NHS Develop research capacity and capability across northwest London
  • Slide 11
  • Team Values Take 5 minutes to identify values for the team Share your values Agree team values Team Behaviours Take 5 minutes to consider behaviours that support the agreed values Share and agree team behaviours
  • Slide 12
  • Senior Management Team Working together
  • Slide 13
  • Running a programme that delivers results Operating context and horizon scanning Ganesh to insert slides
  • Slide 14
  • after Rosabeth Kanter 1999 Successful 21st Century Organisations: Concepts: encourage ideas and technology driven by innovation Competence: develop skills and abilities Connections: create collaborative strategic relationships
  • Slide 15
  • The 3 As Alignment core business Agility processes Attitudes culture, leadership, management
  • Slide 16
  • Maintaining a Balance Anatomical Physiological
  • Slide 17
  • Balancing the two approaches AnatomicalPhysiologicalIn practice both are necessary Change is a step by step process Outcomes cannot be predetermined You need to set direction but be flexible Initiated top downChange come from bottom up Top down support is needed for bottom up change Objectives set in stone in advance There is no end pointObjectives need to be set and success at each milestone celebrated, in practice improvement never ends It goes wrong because of poor planning and project control It goes wrong because of people issues Planning and control are important but commitment of people is vital
  • Slide 18
  • Leading Change - 8 steps to transforming your organisation Establish a Sense of Urgency Examine market and competitive realities Identify and discuss crises, potential crises, or major opportunities Form a Powerful Guiding Coalition Assemble a group with enough power to lead the change effort Encourage the group to work as a team Create a Vision Create a vision to help direct the change effort Develop strategies for achieving that vision Communicate the Vision Use every vehicle possible to communicate the new vision and strategies Teach new behaviours by the example of the guiding coalition Empower Others to Act on the Vision Get rid of obstacles to change Change systems or structures that seriously undermine the vision Encourage risk-taking and non-traditional ideas, activities, and actions
  • Slide 19
  • Plan for and Create Short-Term Wins Plan for visible performance improvements Create those improvements Recognize and reward employees involved in the improvements Consolidate Improvements and Produce Still More Change Use increased credibility to change systems, structures, and policies that don't fit the vision Hire, promote, and develop employees who can implement the vision Reinvigorate the process with new projects, themes, and change agents Institutionalize New Approaches Articulate the connections between the new behaviours and organizational success Develop the means to ensure leadership development and succession Source: Kotter, John P. "Winning at Change" Leader to Leader. 10 (Fall 1998): 27-33.Leader to Leader Leading Change: Why transformation efforts fail Source: Kotter, John P Harvard Business Review, 2007
  • Slide 20
  • Applying this this to a healthcare context ..and a dynamic and challenging programme
  • Slide 21
  • Complicated Complex Simple Source: Brenda Zimmerman Formulae have only a limited application Raising one child gives no assurance of success with the next Expertise can help but is not sufficient Every child is unique Uncertainty of outcome remains Raising a Child z Recipe is essential z Recipes are tested to assure replicability of later efforts z No particular expertise; knowing how to cook increases success z Recipes produce standard products z Certainty of same results every time Following a Recipe A Moon Rocket z Formulae are critical and necessary z Sending one rocket increases assurance that next will be ok z High level of expertise in many specialized fields & coordination z Rockets similar in critical ways z High degree of certainty of outcome
  • Slide 22
  • Throwing a Rock or a Bird? y = x 2 b f = ma ? attractor Source: Paul Plsek, based on Richard Dawkins
  • Slide 23
  • We know: A very complex system can be (is) guided by a few simple rules Which means: Build a good enough vision provide general direction pointing, absolute boundaries and resources or permission rather than trying to plan everything in detail Simple rules (often unstated) also maintain the system at status quo Greatest leverage for innovation and change comes by modifying simple rules
  • Slide 24
  • Defined as wicked problems Instability is a necessary catalyst for change Impose general (or simple) rules to condition the system, stand back and allow solutions to emerge Be prepared to deal with paradox, contradiction and conflict Horst Rittel & Melvin Webber Dont micro-manage or over engineer
  • Slide 25
  • Remember Culture eats strategy for breakfast
  • Slide 26
  • Running a programme that delivers results
  • Slide 27
  • Making Strategy Work Planned/ deliberate SpontaneousEmergent/ crafted Thinking ahead 1 Analysing situation and designing intervention 2 Engaging players in developing a spirit and purpose 3 Finding out what really happens around here Real time 4 Project managing the implementation programme 5 Living in the moment, responding to events in the spirit of the plan 6 Noticing what is happening, the day to day decisions being taken Reflecting and learning 7 Evaluating the implementation 8 Reflecting on the dynamics 9 Putting together and telling the story Which box of the Matrix do you focus on most frequently? Which box of the Matrix do you think the programme is strongest in?
  • Slide 28
  • Change in practice: observations Row 1 often done in a spirit of blame Row 3 hardly undertaken at all Resentment at being given box 1 and expected to start in box 4 Even if rest done well, box 5 is where it goes wrong Casts of mind (often invisible, often aggressive)
  • Slide 29
  • Importance of increasing capability in rigorous, disciplined, creative use of change concepts
  • Slide 30
  • Need to move from: Box 1: Analysing a situation and designing an intervention Box 4: Implementing the plan Box 7: Evaluating the implementation
  • Slide 31
  • To: Box 1: Analysing a situation and designing an intervention Box 2: Opening up perspectives and awakening responsibilities to participate Box 3: Continuing on a journey to somewhere, yet to be determined Row 1 using all the boxes
  • Slide 32
  • Reflection and feedback Take 5 minutes to consider some of the messages and how you take forward some of the messages and concepts in your work as a team
  • Slide 33
  • A practical exercise developing the CEO letter What do you want to say? From this list what are the key priorities? In groups - Develop the detail of the priority messages Feedback and agree actions
  • Slide 34
  • Debrief How did that feel? What went well? What could have been better? What happens now?
  • Slide 35
  • A few thoughts in summary The process of transition Development as a team Personal authority and accountability (empowerment) Taking control as team how much can you reduce the fire fighting?
  • Slide 36
  • Slide 37
  • The process of team development NormingStorming Forming Performing and Adjourning and Mourning Bruce Tuckman 1965
  • Slide 38
  • Translation to Situational Leadership SellingParticipating Telling Delegating Tannenbaum and Schmidt
  • Slide 39
  • Management Style Tannenbaum and Schmidt Use of authority by Manager Freedom for Subordinates
  • Slide 40
  • Do not confuse motion with action. (aka a Rocking Horse) Alfred A Montapert Moving from chaos and stress?
  • Slide 41
  • For discussion over lunch Prioritisation and planning Communication Conflict resolution Role of the management, governance and advisory groups Are you making best use of these in decision making? How do you decide as a team who does what at a programme level? Representing other themes Communication
  • Slide 42
  • Remember this challenge? What are we trying to accomplish? What investments are we willing to make? What activities should we de-emphasise? What conflicts are we willing to resolve? What risks are we willing to take? How much disruption to the organisation are we willing to support to make the transition to a better performing system? Carol Haraden, IHI
  • Slide 43
  • Feedback and agree actions
  • Slide 44
  • Refection and review
  • Slide 45
  • Communication where are you as a team? Adapted from Seven Habits of Highly Effective People Stephen Covey
  • Slide 46
  • Familiarity Reliable Information Clear Communications Integrity Shared Values Shared Vision Trusting Relationships Change/Uncertainty/Dishonesty Conflicting Needs Pressures/Stress Complex/Poor Data Unclear Communications Lack of Time / Prior Experience Distrusting Relationships Source: Richard Lauve, MD (VHA Inc.)
  • Slide 47
  • Creating trust Extent to which I believe you care about me Extent to which I believe you are competent and capable Trust Respect Distrust Affection high low Adapted from Peter Scholtes, The Leaders Handbook
  • Slide 48
  • Circle of influence Circle of Concern Steven Covey 7 Habits of Highly Effective People
  • Slide 49
  • Circle of influence Circle of Concern Steven Covey 7 Habits of Highly Effective People Proactive Focus
  • Slide 50
  • Circle of influence Circle of Concern Steven Covey 7 Habits of Highly Effective People Reactive Focus
  • Slide 51
  • Circle of influence Circle of Concern Steven Covey 7 Habits of Highly Effective People Direct control Indirect control No Control ...give me the courage to change the things which can and ought to be changed, the serenity to accept the things which cannot be changes, and the wisdom to know the difference.
  • Slide 52
  • Becoming self sufficient What do we mean by this? (group discussion)
  • Slide 53
  • For the Project Teams and Partnership Current model Centrally driven & led Project based support Short term external resourcing Short term access to skills development Future model Locally owned & led Continuous & sustained implementation across the partnership Requires headroom & ongoing resourcing Skills development embedded
  • Slide 54
  • Developing local capability - understanding the transition Local Capability Low High Imposed structure High Low Locally developed improvement structures Passive acceptance of programme structure Local adaptation of programme structure Lack of understanding of the programme
  • Slide 55
  • Recognition of the need for change Discomfort with the status quo Developing the capability and capacity Using tools and techniques through a systematic plan Embedded sustainable improvements Moving to continuous improvement
  • Slide 56
  • Supporting the transition What is the role of the Programme Team? NW London Partnership and participating organisations? What should be the role of the CLARHC Faculty?
  • Slide 57
  • C...

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