Pam Crouch shares her experiences working as a change manager for the first time.

1. The greatest challenge for the
change agent is to dare to dream in
the reality of the role

2. Role exploration
 Why me as the agent of change?
 What was the role and what makes up cancer at STV?
 Change part 1 – driven by innocent enthusiasm
 Change part 2 – driven by system and role awareness
 Role development for improving sustainability of both
self and service

3. Why me as an agent of
change?
 Family influence
 Sunday school
 Family cancer
 Occupational influence
 Insider but with sales experience
 Nurse – control and fix everything

4. What was the role and what
made up the service?
 Health system influences
 Disconnect in funding
 Cultural silos and competition
 Hospital drivers and barriers
 Cancer business drivers (5 & 20)
 Separate systems and independent operation
 Conflicting primary task – activity V disease focus
 Job description
 Leant authority
 the “anything else we want” clause

5. Change part 1 – driven by
innocent enthusiasm
 First year - Redesign service and implementation
 Strategic planning and governance
 Research / grants / education
 Second year – Reward and recognition
 Costing models
 Data management
 Third year – Business planning
 Strategic alliances and modelling of CC
 Fourth year – Commenced personal studies to
understand the change process - masters in
Organisation Dynamics
 Design and development of cancer centre

6. Change part 2 – driven by
system and role awareness
 Fifth year – Commenced personal role development work
 New governance model
 Change is now the STV reality
 Approval to construct cancer centre
 Development of patient case manger role
 Development of integrated data and communication
processes
 Sixth year – construction to be completed
 Staff to be relocated into new roles with new facilities
 Cancer departments as well as teams to be integrated

7. What changed?
 Change provoke system changes and individual unrest
 Differing agendas and identified the needed to
manage clinician buy in to maintain satisfaction of
multidisciplinary service delivery model
 I felt responsible for the uncertainty aroused in
everyone

8. Role development to the rescue
Systems Psychodynamic Role analysis
(Newton and Long) helped me identify
how I was holding my role in my mind

9. Role awareness
 Began the work of joining the dots between the reality
of the situation and the fantasy of my role
 Authority relations
 Role given V role taken - Impact of resentment and envy
 The concept of boundary management
 I must be flexible in the role I take up and it must be
customised to the system, people and situation.
 Awareness and acceptance that change is difficult and
anxiety provoking and the role of the agent is to
recognise and manage this and facilitate containment
not necessarily lead the project.

10. Personal insights
 Capacity to continue with a commitment to valuing the
power of influence and the role of followership
 An understanding that real power in the system is
accepting the influence of role awareness and
managment.
 Found the grace to accept the role of followership to
support others to take up their roles to the best of their
ability to manage the uncertainty of the change
process and therefore grow with the service changes.

11. Nelson Mandela
Our deepest fear is not that we are inadequate.
Our deepest fear is that we are powerful beyond measure.
It is our light, not our darkness, that most frightens us.
We ask ourselves, who am I to be brilliant, gorgeous, talented,
And fabulous? Actually, who are you not to be?
You are a child of God...Your playing small doesn't serve the
world. There's nothing enlightened about shrinking so that other
people won't feel insecure around you. We are all meant to
shine, as children do. We are born to make manifest the glory of
God that is within us. It's not just in some of us, it's in everyone.
And as we let our own light shine, we unconsciously give other
people permission to do the same.
As we are liberated from our own fear, our presence
Automatically liberates others.
Thanks and good luck. Drop past for a coffee and a chat anytime.
You all know where to find me. cheers