Leadership for Improvement

Personal Development through Challenging Times

Dr Catherine HannawayDurham University

13th May 2011

Leadership and Management -definitions

• Leadership is showing the way-showing what to do next. Leadership is not dependent on role or seniority.

• Management is the responsibility for the use of resources. Management is dependent on role and includes seniority.

Leadership and Management

Leaders lead people Managers manage tasks

The Context

• Since 1974, the NHS has undergone 11 major reorganisations (1 every 3 years)

• The average career expectancy of a Chief Executive is currently 22 months

• Leadership instability is not conducive to change because it creates a ‘trust’ deficit.

From the ‘Leadership for Health Improvement Programme’ in ‘Managing for Health’ Chapter 7. Hannaway, Hunter & Plsek 2007

What Matters?

• What matters is the approach to leadership and management

• What matters is how you do it• What matters is what you say, what

you do and how you behave.

Leadership Framework for Improvement 1. Set Direction: Mission, Vision and Strategy

Make the status quo uncomfortable

Make the future attractive

3. Build Will

• Plan for improvement• Set aims/allocate resources• Measure system performance• Provide encouragement• Make financial linkages• Learn subject matter

5. Execute Change

• Use Model for Improvement for design and redesign

• Review and guide key initiatives• Spread ideas• Communicate results• Sustain improved levels of performance

4. Generate Ideas

• Understand organisation as a system

• Read and scan widely, learning from other industries and disciplines

• Benchmark to find ideas• Listen to patients• Invest in research & development• Manage knowledge

2. Establish the Foundation•Prepare personally•Choose and align the senior team

•Build relationships•Develop future leaders

•Reframe operating values•Build improvement capability

Source: Robert LloydExecutive Director Performance Improvement

Institute for Healthcare Improvement January 16, 2007

D x V x FS > R Richard Beckhard's Change Formula

• D = Dissatisfaction: The higher your dissatisfaction with the status quo gets, the more likely you are to initiate change.

• V = Vision: The clearer and specific your vision is the more traction you can acquire in making change.

• FS = First Steps: The clearer you are on your ‘First Steps’ the more capable you are at following through on change.

D x V x FS > R

R = Resistance to Change: Resistance can be about fear, time or monetary costs, emotional concerns or any number of issues or reasons that hold you back. Basically, resistance is anything that stops you from making change.

Richard Beckhard's Change Formula

The definition of insanity is continuing to do the same thing over and over again and expecting a different result.Albert Einstein

“ People do not resist change per se. People resist loss.” (Heifetz and Linsky 2002)

Change is situational: new site, new boss, new team roles, new policy.

Transition is the psychological process people go through to come to terms with new situations

Change is different from transition

Change is external, transition is internal.

Bridges, W. (2003) Managing transitions: Making the most of change, 2nd ed London, Nicholas Brearley.

Unless transition occurs, change will not work

NEUTRAL ZONE

BEGINNING

ENDING

transition starts with an ending the neutral zone is the no-man’s-land between old reality and new transitions end with a new beginning

A Leaders Role in Preparing for Change• Create a compelling narrative about the status quo and the

consequences of failing to change that is tangible, logical, has intellectual rigour and touches individuals

• Articulate a coherent vision about a future state that is both inspirational and desirable, and the role of the individual within it that makes them want to go there

• Develop a strategy which has clear and ambitious goals aligned wholly with the vision (not National targets!)

• Empower the staff, give them the permission and the skills, and help them develop their plans to deliver the strategy and achieve the vision

• But there must be:– Consequences for not changing– Disincentives for resisting– Benefits from moving to the new state– Incentives for getting there quickly

Some thoughts on leadership and management

• Genuine concern for others• Ability to communicate and inspire• Decency• Humanity• Humility• Sensitivity• Respect for others Prof Beverley Alimo-Metcalfe summarises the 7 qualities as the leader being a servant not a hero

What are we trying toaccomplish?

How will we know that achange is an improvement?

What change can we make thatwill result in improvement?

Model for ImprovementUnderstanding the problem. Knowing what you’re trying to do - clear and desirable aims and objectives

Measuring processes and outcomes

What have others done? What hunches do we have? What can we learn as we go along?Langley G, Moen R, Nolan K, Nolan

T, Norman C, Provost L, (2009), The improvement guide: a practical approach to enhancing organisational performance 2nd ed, Jossey Bass Publishers, San Francisco

One to one coaching

• Coach will contact you to arrange date, time and location

• Works well when participants can provide a suitable location

• Allow around 2 hours for the session • Please provide at least seven days notice to re-

arrange a session

LEADERSHIP QUALITIES FRAMEWORK (LQF)

The 360 Degree QuestionnaireThe LQF 360-degree feedback questionnaire has been specifically designed in conjunction with the Leadership Qualities Framework tool.

The feedback you receive will enable you to relate where your strengths and development areas lie in line with the Leadership Qualities.

Some Questions For You ……• Why are you doing it? • What do you want to get out of it?• How will it help inform you Personal

Development?• Is it the right time for you to do it?• Can you identify enough of the right people

who are prepared to complete the questionnaire (within the time frame)?

• What use might you make of it following your feedback?

Buddying or Learning Trios

Develop a habit for valuing diversity and different perspectives. We want you to become accustomed or strengthening your working across boundaries of geography, organisation, experience, and styles and also giving others the opportunity for doing so.