DOCMAN

1. Session1: Being a leader of change
Simon Sikora, Edinburgh Napier University

2. Learning/ Intellectual Outcomes
1. Critically engage with key theories of innovation, leadership and change
management in contributing collaboratively to organisational innovation
and effectiveness
2. Critically reflect on how effective leaders foster and influence an innovative
culture within their organisations
3. Critique relevant current literature to explore the impact of leadership
approaches and their effects on innovative practice in health and social care
4. Evaluate their personal leadership style and its impact within the health and
social care environments
5. Examine the potential impact of introduction of a client-focussed change to
their working environment

3. In this session we will explore…
• Our responses to change
• A couple of models of change
• What drives and inhibits change
• Adoption of change

4. From the intro in Reppu: Activity / Scenario
‘Your line manager has informed you today that the organisation
will be bringing in a major change to how things are done, which
will have a significant impact on your clients/patients, you and
the staff in your department/office’
• In the groups where you sit, agree 10 words/emotions that
first come to mind when considering the prospect of this major
change
• Write them down on the flipchart paper

5. Words associated with ‘change’
Frightening Threatening Apathetic Resistant Fearful
Anxious Scared Uncomfortable Distrust Unwilling
Worried Concerned Apprehensive Uneasy Fretful
Nervous Exciting Positive An opportunity Cynical
(43 Health and Social Care practitioners.)
Jones and Bennett 2012

6. From the intro in Reppu: Activity / Scenario
‘Your line manager has informed you today that the organisation
will be bringing in a major change to how things are done, which
will have a significant impact on your clients/patients, you and
the staff in your department/office’
• In the groups where you sit, agree 10 words/emotions that
first come to mind when considering the prospect of this major
change
• Write them down on the flipchart paper
• Now underline the words/emotions generally considered
‘positive’

7. Words associated with ‘change’
Frightening Threatening Apathetic Resistant Fearful
Anxious Scared Uncomfortable Distrust Unwilling
Worried Concerned Apprehensive Uneasy Fretful
Nervous Exciting Positive An opportunity Cynical
(43 Health and Social Care practitioners.)
Jones and Bennett 2012

8. Some responses to change…

9. Change models…
1. Change as loss (human/psychological model)
2. Change to be managed (task/outcomes model)

10. • Holmes and
Rahe (1967):
Social
readjustment
rating scale
1. Change as loss

11. • Pioneering work on death and dying, by Elizabeth Kubler-Ross (1973 on)
frequently applied to people’s response to change:
Grief, loss and change

12. Adams, Hayes and Hopson (1976)
• The experience of change

13. People changing…
• Working through the curves takes time – there is only so much change an
individual can cope with at a time
• A series of changes - even minor ones - can build on each other
• Sometimes people don’t adjust to change – getting ‘stuck’ (eg in denial and/or
anger)
• The more traumatic an event is perceived, the longer it may take to adjust to
• Transition is easier if the change is chosen, meaningful and purposeful
• All professional and personal development is dependent on managing transition
• Successful transition engenders personal growth and hence often builds self-
esteem

14. Strategies for managing change (psychological model)
Strategy Purpose
Managing Meaning Make sure people understand the reasons for change, value it and are motivated to
succeed
Managing Direction Establish clear objectives, team and individual action plans; monitor and review
progress
Problem Solving Identify problems as they arise and mobilise the team and others to find ways forward
Manage Emotion Make sure the emotional impact of change is not ignored. This involves both negative
and positive emotions. Remember to celebrate and recognise team and individual
successes; personal growth and development
Develop Ensure people have the knowledge, skills and guidance they need to manage
transitions
Individualise Make sure you recognise and respond to individual needs
Gray, Field and Brown (2010)

15. Adopting change – ‘diffusion curve’ (Rogers, 1995)

16. ‘There is nothing more difficult to take in hand, more
perilous to conduct, or more uncertain in its success, than to
take the lead in the introduction of a new order of things.
For the reformer has enemies in all those who profit by the
old order, and only lukewarm defenders in all those who
would profit by the new order, this lukewarmness arising
partly from fear of their adversaries … and partly from the
incredulity of mankind, who do not truly believe in anything
new until they have had actual experience of it.’
Niccolo Machiavelli: The Prince (1469 – 1527)
2. Change as tasks and outcomes – to be managed

17. Managing change
A few examples of models and theories:
• Early proponent was Karl Lewin (1951) – utilising ‘force-field analysis’
• Lippett (et al) : Seven phases of change (1958) included introduction of
the concept of an ‘agent of change’ to lead
• Havelock (1973): Built on Lippett and Lewin’s work to identify a six stage
model
• Kotter and Schlesinger (1979): Around managing resistance to change

18. Force field
analysis (Lewin)

19. Kotter’s 8-step change-management model

20. Causes of resistance to change
(Kotter and Schlesinger, 1979)
Cause of resistance Rationale
Self-interest Change doesn’t necessarily bring benefits to everyone. People resist simply
because the change will have negative effects upon them
Misunderstanding and
lack of trust
It is easy for people to misunderstand the purpose of change. If there is a lack
of trust, the worst possible interpretation will be placed on the change and the
worst of motivations assumed
Differing assessments
of need or the
situation
People can simply disagree with the change on rational grounds. Change is
always contended so people can review and analyse a proposed change and
prefer a different solution or way forward
Low tolerance to
change
Some groups are less able to take on change than others. For instance, an
organisation in a resource or political crisis cannot cope readily with major
change, and if a group has been subject to relentless change initiatives, people
can be burnt out
Gray, Field and Brown (2010)

21. Creative/Defensive Cycle of
Change – a model

22. THREAT
Response
Behaviour
Emotions
EVENT/
CHANGE My
DECISION
Time!?
Hide
Do something else / Avoid
Delegate
Not doing that
Indecisive
Poor concentration
Defensive
Ineffective
Irritable
Non-approachable
Defiant
Disruptive
Obstructive
Anxious
Tense
Panic
Frustration
Exasperated
Unhappy / tearful
Helpless (Seligman)
Betrayed
Disempowered
ENERGY 

23. Opportunity/
Challenge
Response
Behaviour
Emotions
EVENT/
CHANGE My
DECISION
Embracing
Excited
Analyse
Treat as Learning
Decisive
Positive
Communicating
Energetic
Determined
Committed
Task-focussed
Forward-thinking
Visualising
Setting goals
Achieving
Enthusiasm
Proud
Elated
Excited
Feel good
Feeling of
achievement
In control
Relief
Calm
ENERGY 

24. Otázky, Kysymykset, Fragen,
Questions?

26. Session 2:
Change management /
transition in social or
health care

27. In this session we will explore…
• A specific model of change management
• How it may be applied to a given scenario
• Opportunities for application to the innovation for your
final assignment

28. Assignment 2 (2000 words)
…will require students to develop a plan around a client-focussed change,
relating to their own social or health care organisation.
This will require students to critically engage with the theoretical
background and research-based knowledge on leadership, innovation
and change management in social and health care management.
They will need to plan the change and hypothesise around its
application.
(LO / IO s 1, 2 and 3 will be demonstrated through this assessment. )

29. Lewin’s Force-field analysis (1951)
• Kurt Lewin believed that human behaviour is a dynamic balance that can
be altered by adding, removing or changing a force
• The model has been widely used in health and social care in the past
• Forces can be driving (which cause something to happen) or restraining
(which prevent something from happening)
• Strategies for change are aimed at increasing driving forces and
decreasing restraining forces or both
• ‘Strengths’ of forces (driving and opposing) may also be calculated/
estimated to enumerate the size of the challenge

30. Restraining Forces
Equilibrium
(Current state)
Driving Forces

32. Examples…

34. Lewin’s Three stage process (1951)
• ‘Unfreezing’: enabling the team to recognise the need for change and challenging and reducing
forces which support established ways of working
• ‘Movement’: new attitudes and/or behaviours are developed and the organisation moves
through various stages of implementation of the change
• ‘Refreezing’: ensuring that the change is sustained. The change is reinforced through supportive
mechanisms, such as coaching appropriate policies and organisational norms

35. Activity (30 mins)
A recent audit of care in a residential home revealed that bathroom doors
were consistently left open by staff when clients were being washed and
bathed.
How could Lewin’s model of change be applied to this situation to
enhance the dignity of clients in the home?
Jones and Bennett (2012)

36. Feedback on the activity
• What are the driving forces for the scenario?
• How could they be enhanced?
• What are the opposing forces in the scenario?
• How could they be diminished?
• What would ‘unfreezing’ look like?
• How would ‘refreezing’ be effectively achieved?
• What is the main learning from this?

37. Kysymykset, Fragen, Questions,
Otázky?

38. After lunch
•Your opportunity to start to ‘sketch out’ a change
strategy you might like to use for the innovation
suggested in your organisation

39. Session 3: Assignment 2

40. Assignment 2 (2000 words)
Assignment 2 will require students to develop a plan around a client-
focussed change, relating to their own social or health care organisation.
This will require students to critically engage with the theoretical
background and research-based knowledge on leadership, innovation
and change management in social and health care management.
They will need to plan the change and hypothesise around its
application.
(LO / IO s 1, 2 and 3 will be demonstrated through this assessment. )

41. Some thoughts…
• Use of SWOT / PESTLE/ another tool may be helpful
• The logistics of a ‘local’ change are probably easier to predict,
but it may be beneficial to fewer clients.
• Perhaps consider a ‘pilot’ site?
• Consider the perspectives of other ‘stakeholders’ in the
change and how they might react.
• Consider a ‘change agent’
• SMART Action plan?

42. Activity (30 mins) – a few trigger questions
In your groups, discuss your thoughts on what innovations you would like
to use in your individual assignments.
What has led you to chose it
What difference will it make for your clients/patients/customers?
Who are all the ‘stakeholders’?
Consider the evidence – is it strong enough to support the change?
Think about which change model(s) you’d like to use, and how it could be
led and managed (are these different?)
How will you measure success or failure?

43. Where are we?
Have you decided on what you are going to ‘change’?
Is it client-focussed?
Is there good (strong) evidence for it’s introduction – if so, what is it?
Do you have a change model / process you want to adopt?
Do you have enough understanding around the theory – if not, where can
you seek more?
Do you have an effective metric of success?

44. Further thoughts…
• Don’t lose focus on what you are being assessed on. The client–focussed
innovation is important, but the key knowledge is around leading and
managing a change using innovative approaches
• Use appendices to reduce your word-count, but only for supplemental
information
• Use the APA 6th Referencing system
• Submission will be via an electronic dropbox in Reppu by 17th December

45. Fragen, Questions, Otázky,
Kysymykset ?