Presentation delivered to HFMA Healthcare Financial Management Association Conference 24th January 2013

1. Yorkshire & Humber Branch
Annual Conference
“The New Improved NHS ”
8 Essential Steps to Managing
Successful Change
24th January 2012

2. What is change management?
Change management is a structured approach
to transitioning individuals, teams and
organisations from a current state to a desired
future state

4. Change quotes…

5. Why change?
No change is without a purpose
Environment- internal or external factors
• Systems • Competition
• Processes • Innovation
• Culture • Upgrades
• Things could be better • New Strategy
• Mergers • Outsourcing
• Acquisitions • Economy
• Continuous Improvement • New Technology
• Take Over • Restructuring

6. "If you are doing business today the same way
as you did business yesterday, the chances are
that you won’t be doing business tomorrow"
Peter F Drucker

7. Changes over the years
Nobody can go back and start a new beginning but anyone
can start today and make a new ending

8. A changing perspective

9. A changing perspective

10. Change process
Based on Kurt Lewin’s model
Undesired Chaos Desired
situation Unpredictability situation
No control
Confusion
Loss-Attachment
Fear
Shock
Anger

11. People’s reaction to change - 8 step process.
Information/Communication Guidance/Direction
Stability Emotional Support Understanding
Shock Ok This is where I’m at and what
Don’t see the reasons why
I’m doing now
Can’t be happening, no need, it’ll run
Denial out of steam, it’ll go away
Start outing emotions, frustrated,
Anger hurt, blame.
Testing/Acceptance/
Bargaining letting go
Test our understanding
Try to defer it, attempt to
of how it relates to us,
moderate the change
put out feelers, maybe I
can cope!
Depression
They don’t care, why should I?
Present Withdrawn from job, lack of Preferred
engagement, quiet, introverted,
Reality full scale of change has sunk in Future
Transition Phase

12. People’s reaction to change - 8 step process.
If led positively you can build
Let them express their feelings, listen, be on this and lead them into the
empathetic, explain, communicate, future.
Stability communicate, communicate! Understanding
Shock
Don’t see the reasons why
Expect the shock! Ok This is where I’m at an what
Explain and sell Can’t be happening, No need, it’ll run I’m doing now
the benefits. Denial out of steam, it’ll go away
•Communicate!
•Communicate! Start outing
•Communicate! Anger emotions, frustrated, hurt, blame.
Don’t compromise, stand Testing/Acceptance/
firm!
Bargaining letting go
Try to defer it, attempt to
Accept people will moderate the change Test our understanding
be withdrawn and of how it relates to us,
Give them time and let put out feelers, maybe I
not contribute very
them know what they
much. Give them Depression mean to you, reinforce
can cope!
space to go through
Withdrawn from job, lack of their value, train, coach,
this period.
engagement, quiet, be there for them.
Preferred
Present introverted, full scale of
change has sunk in
Future
Reality
Transition Phase

13. 5 Phases of change

14. 5 Phases of change

15. Universal facts about change
Who do you know that really looks forward to change?

16. Universal facts about change
The chains of habit are
too weak to be felt until
they are too strong to be
broken’.
Samuel Johnson

17. Universal facts about change
• Different people react differently to change
• Change often involves a loss and people go
through a loss curve
• Success or failure of change depends on co-
operation of people implementing the change

18. Universal facts about change
• They key question everyone has on their mind
about change is….?
• A small number of people and groups are
almost always pivotal to a smooth and
effective change process
• Your leadership is the absolute key to its
success or not
• Effective communication and support are vital

19. Questions we must ask before change
• What do we need to achieve?
• Why? How? When?
• Who will be affected?
• How will they react?
• How do we support them?
• Have we the resources to manage
the change?

20. Questions we must ask before change
• How do we communicate the
change and get buy in?
• How do we deal with resistance?
• What part of the change do we
need help with?
• How do we know what success is
and how will we measure it?
• After the change, what next?

21. How do we introduce change?
• Build trust- be open and honest
1
• Build a compelling, logical case for organisational change
2
• Match actions and words
3
• Involve the people affected
4
• Communicate a sense of confidence
5
• Repeat you main messages
6

22. 8 steps to effective change

23. 8 steps to effective change

24. Pre-requisites for change

25. Communicate for change!
• Communicate only what you know to be true
(don’t speculate)
• Be sure senior management approves what
you are communicating
• Communicate what you know as
soon as you know.
• Communicate from their perspective-
put yourself in their shoes

26. Communicate for change!
• Communicate using multiple
mediums ( 1-1, small groups, large
groups, written, focus groups,
discussions etc.)
• Be prepared to answer questions.
• Really listen
• The more resistance, the more you
need to communicate.

27. Barriers and resistance to change
The normal reaction to change is resistance
Fear
Anger 1. Parochial self interest
Habits 2. Misunderstanding
Negative thinking 3. Low tolerance to change
Attitude 4. Genuine disagreement
Culture
Subjectivity
People
Emotions
Poor planning

28. Factors for failure
• Lack of pro-active leadership or
strategy
• Lack of consistent leadership
• Poor communication
• Intensive or brash approach
• Lack of recognition and reward
• Apathy

29. Factors for failure
• Staff kept in the dark
• Lack of time, capacity, budget
• Short term approach- stressed out out
staff
• Lack of staff buy-in
• Lack of initiative to do something
different
These factors then lead to the ‘tread-
mill effect’, setting up a vicious circle

30. Absolute don'ts of change
management
Don’t just think that Don’t start any
change will happen change
automatically- it management
needs work without a business
case and a plan
Don’t ignore
communication and
support. You need
Do not do a
Don’t try and do it on both for change to
management high up
your own, you need stick.
selling alone. You
supporters!
need to sell change
to all your staff and
stakeholders
Don’t ignore rationale
concerns, address
them and find
solutions

31. Change management summary
People will react
Change is difficult differently but
because of emotions typically follow the
same pattern

32. Change management summary
Good information
Accept that fear , and communication
denial, anger, is essential. People
resistance is normal are good at dealing
with change if they
know what is
changing

33. Change management summary
Focus on removing Carefully look for the
fear, most other opportunities, they
behaviours seem to will be there
stem from this

35. Yorkshire & Humber Branch
Annual Conference
“The New Improved NHS ”
8 Essential Steps to Managing
Successful Change
24th January 2012