@helenbevan burning ambition – meeting the challenges adass/scie seminar leading through...
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@helenbevan
Burning ambition – meeting the challenges
ADASS/SCIE seminar Leading through turbulence
11 January 2013
Helen Bevan@helenbevan #NHSchange
@helenbevan
How to turbocharge healthcare improvement Energy, more than any other factor, makes the difference between improvement activities that are sustained for the long term and those that fizzle out. Energy fuels high performance. In this workshop, Helen Bevan will show you powerful methods to unleash the latent energy for change from within your organisation to increase the pace and scale of improvement.
Session Objectives• Learn why energy is a critical topic in leading improvement.• Liberate the natural energy and vitality of the workforce and service users
for the cause of high quality care.• Take home a set of useful models and frameworks for understanding,
analysing and building energy for change.
@helenbevan
Most large scale change fails to achieve its objectives
Source: McKinsey Performance Transformation Survey, 3000 respondents to global, multi-industry survey
@helenbevan
What happens to large scale change efforts in reality?
In order of frequency:1. the effort effectively “runs out of energy” and
simply fades away2. the change hits a plateau at some level and no
longer attracts new supporters3. the change becomes reasonably well established;
several levels across the system have changed to accommodate or support it in a sustainable way
Source: Leading Large Scale Change: a practical guide (2011), NHS Institute
@helenbevan
Anatomy of change Physiology of change
Definition The shape and processes of the system; detailed analysis;
how the components fit together.
The vitality and life-giving forces that enable the system and its people to
develop, grow and change.
FocusProcesses and structures
to deliver health and healthcare
Energy/fuel for change
Leadership activities
measurement and evidence
improving clinical systems reducing waste and
variation in healthcare processes
redesigning pathways
creating a higher purpose and deeper meaning for the change process
building commitment to change connecting with values creating hope and optimism about
the future calling to actionSource: Crump and Bevan
@helenbevan
Anatomy of change Physiology of change
Definition The shape and processes of the system; detailed analysis;
how the components fit together.
The vitality and life-giving forces that enable the system and its people to
develop, grow and change.
FocusProcesses and structures
to deliver health and healthcare
Energy/fuel for change
Leadership activities
measurement and evidence
improving clinical systems reducing waste and
variation in healthcare processes
redesigning pathways
creating a higher purpose and deeper meaning for the change process
building commitment to change connecting with values creating hope and optimism about
the future calling to actionSource: Crump and Bevan
@helenbevan
Anatomy of change Physiology of change
Definition The shape and processes of the system; detailed analysis;
how the components fit together.
The vitality and life-giving forces that enable the system and its people to
develop, grow and change.
FocusProcesses and structures
to deliver health and healthcare
Energy/fuel for change
Leadership activities
measurement and evidence
improving clinical systems reducing waste and
variation in healthcare processes
redesigning pathways
creating a higher purpose and deeper meaning for the change process
building commitment to change connecting with values creating hope and optimism about
the future calling to action
Source: Crump and Bevan
@helenbevan
Intrinsic motivators
build energy and creativity
@helenbevan
Intrinsic motivators •connecting to shared purpose
•engaging, mobilising and calling to action
•motivational leadership
build energy and creativity
@helenbevan
Intrinsic motivators •connecting to shared purpose
•engaging, mobilising and calling to action
•motivational leadership
build energy and creativity create focus &
momentum for delivery
Drivers of extrinsic motivation
@helenbevan
Drivers of extrinsic motivation
create focus & momentum for delivery
Intrinsic motivators •connecting to shared purpose
•engaging, mobilising and calling to action
•motivational leadership
build energy and creativity
•System drivers & incentives•Payment by results•Performance management•Measurement for accountability
@helenbevan
Internal motivators
•connecting to shared purpose
•engaging, mobilising and calling to action
•motivational leadership
build energy and creativity
Drivers of extrinsicmotivation
•System drivers & incentives•Performance management•Measurement for accountability
create & focus momentum for delivery
@helenbevan
Transformation is not a matter of intent.........
it is a matter of alignmentPeter Fuda
@helenbevan
NHS Change Model
www.changemodel.nhs.uk
@helenbevan
NHS Change Model
www.changemodel.nhs.uk
Why is energy for change important?
@helenbevan
burning platformversus
burning ambition@PeterFuda
@helenbevan
@helenbevan
Lessons for transformational change1. In order to sustain
transformational change, we as leaders need to move from a burning platform (fear based urgency) to a burning ambition (shared purpose for a better future)
2. We as leaders need to articulate personal reasons for change as well as organisational reasons
3. If the fire (the energy) goes out, all other factors are redundant
@PeterFuda
@helenbevan
You get the best efforts from others not by lighting a fire
beneath them but by building
Source: Bob Nelson
@helenbevan
@helenbevan
the capacity and drive of a team, organisation or system to act and make the
difference necessary to
achieve its goals
Psychological
Physical
Spiritual
Social Intellectual
Energy for change is:
@helenbevan
The five energies
@helenbevan
High and low ends of each energy domain
Low High
Social isolated solidarity
Spiritual uncommitted higher purpose
Psychological risky safe
Physical fatigue vitality
Intellectual Illogical reason
@helenbevan
Key conclusions from our work so far
• Psychological energy is central• Dispersed leadership model• Explanation not judgement• Making explicit the issues that
remain hidden/unarticulated and that really impact on team performance and achievement of improvement goals
Psychological
Physical
Spiritual
Social Intellectual
@helenbevan
Social energy
Deplete d by
Apathy
Isolation
Disconnection
Lack of connection
Emotional awareness
Authenticity
Engagement
Empathy
Autonomy
Enhanced by
Social energy is the energy of personal engagement, relationships and connections between people
Psychological
Physical
Spiritual
social Intellectual
@helenbevan
Spiritual energyDepleted by
Coercion
Ignoring spirit in a crisis
Disbelief in purpose
Conflicts with values
Purpose
Clarity of vision
Co -invention
Integrity
Passion
Commitment
Enhanced by
Spiritual energy is the energy of commitment to a common vision for the future, driven by shared values and a higher
purpose
Psychological
Physical
Spiritual
Emotional Intellectual
@helenbevan
Psychological energy
Depleted by
Fear Setbacks Apathy
Lack of trust Weariness
Awareness Confidence Safe, secure environment
Purpose Role-models Motivation
Enhanced by
Psychological energy is the energy of courage, trust and feeling safe to do things differently
Physical
Psychological
Physical
Spiritual
Emotional Intellectual
@helenbevan
Physical energy
Healthy, supportive work
environment Appropriate
workload Regular renewal
Enhanced by
Stress through overwork Apathy
Disconnection
Depleted by
Physical energy is the energy of action, getting things done and making progress
Psychological
Physical
Spiritual
Emotional Intellectual
@helenbevan
Intellectual energy
Depleted by
Distractions Displacement
activity Lack of discipline
Being overworked
Creativity Focus & alertness
Learning Purpose
Challenge
Enhanced by
Intellectual energy is the energy of curiosity, analysis, thinking and cognition
Psychological
Physical
Spiritual
Emotional Intellectual
@helenbevan
The energy for change index
• The energy of any team or organisation – its capacity and drive to act and make the difference necessary to achieve its goals – determines its agility for change
• We have developed an online tool which is simple and rewarding as it provides an immediate insight into one’s own personal energy for change
• It is the first of a two-stage process for teams to identify areas that need a shift in focus in order to get wider engagement in change and faster action towards achieving it
• It is a powerful tool for organisations and teams undergoing perpetual change
@helenbevan
Facilitated questions - examples
• Are particular energy domains more dominant than others for our team at the moment?
• Is this the optimal energy profile to help us achieve our change goals?
• What would the optimal energy profile look like for our team?
Physical
Psychological
SpiritualSocial
Intellectual
Energy for change profile
@helenbevan
The SSPPI Energy Index1 = Strongly disagree 2 = Disagree 3 = Neutral 4 = Agree 5 = Strongly Agree
I am energised by the momentum of change____I have gained insight into the case for change____I feel a sense of solidarity with those around me ____I am weary of change____It feels risky to try out new approaches____Prioritising various activities at work is tricky for me____I believe I make a difference as part of this group____I will be blamed if I try something new and it fails____I feel isolated from others____I trust in our direction of travel____The argument for change enables me to prioritise activities at work____I feel disconnected from others____I am committed to our common vision for the future____I feel safe enough to do things differently____I am driven by shared values____I am experiencing change fatigue____The current state is more attractive to me than the future picture____I feel that my values are compromised at work____I think there is no rational argument for change____I cannot make a difference as part of this group____I believe there is a healthy pace to change____
Those around me are energised by the momentum of change____Those around me have gained insight into the case for change____Those around me feel a sense of solidarity with each other____Those around me are weary of change____Those around me feel its risky to try out new approaches____Prioritising various activities at work is tricky for those around me____Those around me believe they make a difference as part of this group____Those around me will be blamed if they try something new and it fails____Those around me feel isolated from others____Those around me trust in our direction of travel____The argument for change enables those around me to prioritise activities at work____Those around me feel disconnected from others____Those around me are committed to our common vision for the future____Those around me feel safe enough to do things differently____Those around me are driven by shared values____Those around me are experiencing change fatigue____The current state is more attractive to those around me than the future picture____Those around me feel that their values are compromised at work____Those around me think there is no rational argument for change____Those around me cannot make a difference as part of this group____Those around me believe there is a healthy pace to change____
My energy The energy of those around me
@helenbevan
Team 1
Physical
Psychological
SpiritualSocial
Intellectual
@helenbevan
Team 1
Physical
Psychological
SpiritualSocial
Intellectual
Team 1’s energy profile is characterised by an environment that has harnessed their interest and momentum for change, but which has failed to engage people fully. This imbalance results in their feeling some uncertainty regarding how they can contribute fully to the change, and therefore a sense of risk and lack of hope for the future. We can build energy by building team solidarity and developing shared purpose
@helenbevan
Team two
Psychological
Social Spiritual
PhysicalIntellectual
@helenbevan
Team twoPsychological
Social Spiritual
PhysicalIntellectual
Team 2 enables strong connections between people, a true sense of solidarity, which gives them enough hope for the future, but this energy is undirected, because the rational argument and shared purpose has not been agreed.
@helenbevan
SSPPI - The five energy domains
Social energy is the energy of personal engagement, relationships and connections between people. It reflects a “sense of us” and is therefore a collective concept that captures a situation where people are drawn into an improvement or change because they feel a connection to it as part of the collective group.
My social energy is ____The social energy of those around me is____The importance of social energy to me is____
Psychological energy is the energy of courage, trust and feeling safe to do things differently. It involves feeling supported to make a change as well as belief in self and the team, organisation or system, and trust in leadership and direction.
My psychological energy is ____The psychological energy of those around me is____The importance of psychological energy to me is____
Physical energy is the energy of action, getting things done and making progress. It is the flexible, responsive drive to make things happen, with vitality and kinetic force (motion)
My physical energy is ____The physical energy of those around me is____The importance of physical energy to me is____
Intellectual energy is the energy of curiosity, analysis, thinking and cognition. It involves gaining insight, a thirst for new knowledge as well as planning and supporting processes, evaluation, and arguing a case on the basis of logic and evidence.
My intellectual energy is ____The intellectual energy of those around me is____The importance of intellectual energy to me is____
Complete these statements on a scale of 1 = low - 5 = high
Spiritual energy is the energy of commitment to a common vision for the future, driven by shared values and a higher purpose. It involves giving people the confidence to move towards a different future that is more compelling than the status quo, by finding the deep meaning in what they do.
My spiritual energy is ____The spiritual energy of those around me is____The importance of spiritual energy to me is____
@helenbevan
Profile Preference
Psych
Physical
Social
Spiritual
Intellectual
= individual
Profiles vs. preferences
@helenbevan
Facilitated questions - examples
• Do we need to manage certain energies better (e.g. is social energy really important to the whole team, but poorly managed... is there is an over-emphasis on intellectual energy, which only satisfies two out of fifteen team members?).
• Do we have a bias towards a particular energy preference in our team?
• Should we look to future recruitment to help us create a more balanced team?
Profile (score>3)
Preference (score>3)
Psych
Physical
Social
Spiritual
Intellectual
= individual
Profiles vs. preferences
@helenbevan
An organisation can only realise its
highest potential when each
individual is fully valued and feels fully
vested in a shared purpose
The Energy Project
http://theenergyproject.com/
@helenbevan
Discretionary effort
is contractual
is personal
@helenbevan
[Shared] purpose goes way deeper than vision and mission; it goes right into your gut
and taps some part of your primal self. I believe that if you can bring people with similar primal-purposes together and get them all marching in the same direction,
amazing things can be achieved.Seth Garguilo
@helenbevan
Avoiding “de facto” purpose• What leaders pay attention to matters to staff, and consequently
staff pay attention to that too• Shared purpose can easily be displaced by a “de facto” purpose:
hitting a target reducing costs reducing length of stay eliminating waste completing activities within a timescale complying with an inspection regime
• If purpose isn’t explicit and shared, then it is very easy for something else to become a de facto purpose in the minds of the workforce
Source: Delivering Public Services That Work: The Vanguard Method in the Public Sector
@helenbevan
What focus for our improvement projects?
Source: 100 improvement projects on national improvement leadership programme October 2012
@helenbevan
You get the best efforts from others not by lighting a fire
beneath them but by building
Source: Bob Nelson
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