Improvement Leaders’ Guide Managing the …

1 Improvement leaders GuideManaging the human dimensions of changePersonal and organisational developmentManaging the human dimensions of change 1 Improvement leaders GuidesThe ideas and advice in these Improvement leaders Guides will providea foundation for all your Improvement work: Improvement knowledge and skills Managing the human dimensions of change Building and nurturing an Improvement culture Working with groups Evaluating Improvement Leading improvementThese Improvement leaders Guides will give you the basic tools andtechniques: Involving patients and carers Process mapping, analysis and redesign Measurement for Improvement Matching capacity and demandThese Improvement leaders Guides build on the basic tools and techniques.

2 Working in systems Redesigning roles Improving flowYou will find all these Improvement leaders Guides single person is enabled, encouraged andcapable to work with others to improve their part ofthe serviceDiscipline of Improvement in Health and Social Care2 Contents1. Why is this Guide important?32. The process of change63. Frameworks and models to help 14people through the process of change 4. Engaging others in improvement365. Activities 396. Frequently asked questions477. Summary 50 All models are wrong but some are quite usefulDerning1.

3 Why is this Guide important?Many change projects fail, and the most commonly cited reason is neglect ofthe human dimensions of change . This neglect often centres around a lack ofinsight into why people are unhappy with organisational change , a poorappreciation of the process of change , and a limited knowledge of the toolsand techniques that are available to help Improvement leaders . This Guide willhelp you to understand and to better manage these fundamental aspects of thechange management process, and help you to empower, enable and engagethose you work psychology behind the human dimensions of change is an ever-growingarea and there has been much research and theorising on the subject.

4 Thisguide has been written by experienced Improvement leaders who are involvedin healthcare Improvement initiatives. We have put together the models andframeworks that have helped us while working with a wide variety of people inhealthcare. It is a starting point for you as an Improvement approaches to improvementManaging the human dimensions of change 3 Anatomical approach ofimprovement change is a stepby step process it is typicallyinitiated top down objectives set inadvance (and set in stone!) it goes wrongbecause of poorplanning andproject controlIn practice.

5 Both approaches of Improvement are necessary you need to set a direction but need to be flexible top down support is needed forbottom up change objectives need to be set and theteam should be congratulated wheneach objective is achieved butimprovement never ends planning and monitoring is importantbut gaining the commitment of people is vital Physiological approach ofimprovement outcomes cannotbe predetermined change comes typicallybottom up there is noend point it goes wrongbecause of people issues44 People and improvementThere are many different approaches to Improvement .

6 The anatomicalapproach is one way of thinking, which could be described as the hard projectmanagement approach to change . Another approach, the physiologicalapproach , focuses much more on the softer, people side of change . What wehave realised is that for a successful Improvement initiative the ImprovementLeader needs to consider both approaches as shown in the table on page trying to make improvements in healthcare, gaining the commitment ofthe people who are likely to be affected by the change is paramount. If thepeople issues are not identified and managed effectively, the followingproblems may arise: strong emotions, such as fear, anger, hopelessness and frustration can derailyour Improvement initiative people become defensive.

7 They might deny there is problem, over emphasisethe benefits of the present working practice or blame others within the organisation there is often constant complaining, questioning and scepticism there might be an increase in absenteeism, sickness and people leaving theorganisation combined with a fall in morale and job satisfaction people don t match words with deeds , that is, they do not do what they saythey are going to do conflict seems to spiral out of controlThe theme for this Guide is to help you understand these frequent reactions tochange and Guide you through some models and frameworks to help yourespond more successfully to the challenges of Managing the humandimensions of you as an Improvement Leader need to consider is that people havedifferent needs and different styles of working especially in a change is often the lack of understanding of their needs and a lack of recognition

8 Ofthe value of their different perspectives that causes people to be labelled resistant to change .There are no magic wands and no guarantees about how people will follows are some frameworks that you may find useful and you mightwant to investigate in more depth. Managing the human dimensions of change 5 They are far less antagonistic I think they havegot used to the idea, and some of them are actuallyseeing the Clinician, Cancer Services CollaborativeCase studyImprovement for managersA Strategic Health Authority in the North of England has developed a Leadership through change programme aimed particularly atmanagers: ward managers, team leaders , nurse managers.

9 They haverecognised one of the first things to help with leading people throughchange is to encourage discussion about values, feelings and support pack includes a variety of activities that the managers canuse with their teams such as those in this and the other ImprovementLeaders Guides62. The process of Managing TransitionsA round man cannot be expected to fit into a squarehole right away. He must have time to modify his TwainWe go through transitions in everyday life, changes such as getting married,having a baby or buying a new house, some of which are painless and some of which are not!

10 We also help others with a transition in the grieving transition is not a new experience to any of us but that fact is oftenforgotten or ignored when changes are introduced in is not the same as transition. change issituational: the new site, the new structure, the newteam, the new role, the new procedure. Transition isthe psychological process people go through to cometo terms with the new situation. Remember thatchange is external and transition is Bridges Bridges says that transitions can be described in three stages, which are bothnatural and ending when we acknowledge that there are things we need to let go of when we recognise that we have lost something example: changing your job.