People’s Needs Defining Change

1 S Needs Defining ChangeHEALTH SERVICES Change GUIDES ource and ReferencingPeople s Needs Defining Change Health Services Change Guide has been developed following a detailed consultation process and written by Caitr ona Heslin and Anne Ryan, Organisation Development and Design, Health Service Executive (HSE), Kells, Co Meath. It represents the second edition of Improving Our Services: A Users Guide to Managing Change in the Health Service Executive (2008).Material from this Change Guide should be referenced as: Health Service Executive Human Resources Division Organisation Development and Design (2018). People s Needs Defining Change Health Services Change Guide. Kells, Co Meath, Ireland: Health Service sourcesIn developing the Health Services Change Guide we have gathered and adapted information and knowledge on Change from many sources.

2 We always seek to do this in a way that respects the work of other people and acknowledges the source of the content. If you feel that we have not adhered to this principle, please contact us. We will either modify the content or remove the ProtectionIn gathering data, particularly regarding service users, citizens, communities and staff, please ensure that you adhere to the requirements of the relevant legislation. This includes the Data Protection Acts 1998-2003 and the General Data Protection Regulation the Change Guide and Additional Supports The Health Services Change Guide is available to use online or to download at The Additional Resources in Appendix A signposts users of the Change Guide to other helpful supports in the system. It will be updated periodically and can be accessed at The following symbol indicates that other helpful information is available in Additional Resources.

3 The Change Hub ( ) provides access to all of the documentation, templates, tools and methodologies referenced. Bibliography references in the document are noted as follows: [number] and relate to literature reviewed by the authors available at This work is also supported by a literature review completed by the Centre for Health Policy and Management, Trinity College Dublin: Understanding Change in Complex Health Systems a review of the literature on Change management in health and social care 2007-2017 available at Further information and feedback We are always open to feedback to help us continually improve the guidance and resources available. If you would like to contact us for further information or with feedback and comments, please email us at Health Service Executive 2018 ISBN: 978-1-78602-081-9 ContentsPeople s Needs Defining Change Health Services Change GuideiContentsIntroduction by Chief Executive Officer viiBuilding Capacity for People and Culture Change viiiMaintaining Commitment to Engagement and Consultation ixPreface xiDevelopment Process xiAcknowledgements xiiIntroduction and Context 1 Key Drivers for Change 2 Why is a Health Services Change Framework Needed?

4 3 Health Services Change Framework 6 Section 1: People and Culture Change Platform Understanding Organisational Culture 9 Organisational culture and subcultures 9 Addressing cultural Change People and Culture the Change priorities 10 Practice collective leadership 11 Model shared values 14 Engage and communicate 17 Understand personal experiences 20 Support behaviour Change 23 Invest in people and teams 25 Network and partner 27 Use evidence and lever technology 30 Deliver public value and be accountable 33 Click to navigateRestart this Section Contents Back Additional Resources People s Needs Defining Change Health Services Change GuideiiContentsSection 2: People s Needs Defining Change Working with Service Users, Families, Citizens, Communities and Staff Develop Engagement Process 40 Identify and map people connections 41 Understand key stakeholders 42 Tailor engagement to key groups 44 Plan and engage with a purpose 48 Develop and sustain engagement and communication 49 Section 3.

5 Define Identify Shared Purpose 52 Identify need 52 Examine divers for Change Understand Current Services 55 Describe the current situation 55 Mobilise people and culture 57 Understand prevailing culture and values 57 Assess readiness and capacity for Change 58 Assess and build energy for Change 59 Identify levers for Change Agree Better Outcomes 62 Co-design the vision for the future 62 Agree Change outcomes and objectives Measure for Success 65 Design measurement plan Make Case for Change 68 Agree governance and mandate 68 Establish Change management team 69 Identify resource requirements 70 Communicate the Business Case 70 Click to navigateContents Restart this Section Back Additional Resources People s Needs Defining Change Health Services Change GuideiiiContentsSection 4: Design Agree to Co-Design 73 Agree service design principles 73 Address enablers of co-design Design Service Operational Model 76 Confirm user need 76 Design service choices and options 77 Determine the detail of the Service Operational Model Test and Refine 80 Test Change in practice 80 Undertake gap analysis 81 Assess impact and interdependency Agree Action Plan 82 Consolidate key changes actions and measures 82 Identify risks and dependencies 82 Identify enabling and sustaining actions 84 Identify impact for resources 84 Clarify responsibility for actions and timeframes Communicate Action Plan 85 Section 5.

6 Deliver Implement Actions 88 Energise collective leadership and governance 88 Scale-up engagement and communication Support Implementation 92 Intensify individual and team supports 92 Prioritise inter-team/service and inter-agency working 93 Sustain engagement with services users, citizens and other key partners Measure Progress 93 Adapt to emerging Needs and take corrective action Celebrate Success 96 Acknowledge increased Change capacity 96 Mark key milestones Sustain Improvement 96 Evaluate and share learning 98 Scale-up innovations 98 Click to navigateContents Restart this Section Back Additional Resources People s Needs Defining Change Health Services Change GuideivContentsSection 6: Essential Templates* Essential Templates Working with service users, families, citizens, communities and staff 102 Template : Influence Interest Mapping Grid 103 Template : Guidance on Stakeholder Mapping and Analysis 105 Template : Guidance to Develop Engagement and Communication Plan Essential Templates Define 109 Template : SWOT Analysis (Strengths, Weaknesses, Opportunities and Threats/Challenges) 110 Template : Context for Change Why What How Method 112 Template : Description of the Current Situation (Service Operational Model) 113 Template : Guidance on Defining your Personal Values 122 Template : Cultural Web Exercise 123 Template : Personal Readiness for Change 126 Template : Team Diagnostic 127 Template.

7 People and Culture Change Platform Readiness Factors 130 Template : Developing a Vision for the Future 134 Template : Clarifying Measures 136 Template : Project Initiation Document (PID) Essential Templates Design 145 Template : Service Design Option Generation and Appraisal 146 Template : Detailed Design of the Service Operational Model 151 Template : Service Design Gap and Impact Analysis 161 Template : Action Plan Essential Templates Deliver 174 Template : Factors to Monitor During Implementation 175 Template : Personal Checklist for Change 181 Template : Working with Emotional Reactions to Change 182 Template : People Indicators to Support Behaviour Change 186 Appendices* Appendix A: Additional Resources 190 Appendix B: Development Process 277 Appendix C: Stakeholder Engagement 279 Glossary of Terms and Definitions* 291 Abbreviations* 301 Bibliography* 303* Note: electronic version of above documents is available at.

8 To navigateContents Restart this Section Back Additional Resources People s Needs Defining Change Health Services Change GuidevHealth Services Change Click diagram to navigate34512 FUTURE VISIONCURRENT SITUATIONP eople s Needs Defining ChangeService Users, Families, Citizens, Communities & StaffUnderstand Personal ExperiencesUse Evidence & Lever TechnologyInvest in People & TeamsPractice Collective LeadershipEngage & CommunicateNetwork & PartnerSupport Behaviour Change Model Shared ValuesBe Accountable for PerformancePeople & Culture Change Platform CREATING READINESS Change ACTIVITIES DELIVER DESIGNDEFINE Safer Better Healthcare, and Staff & Public ValueCHANGE OUTCOMESI ntroduction by Chief Executive OfficerI am very pleased to commend to you People s Needs Defining Change Health Services Change Guide as the policy framework and agreed approach to Change .

9 It is signed off by the HSE Leadership Team and by the Joint Information and Consultation Forum which represents the Trade Unions. It is the overarching policy that guides and connects all our approaches to Change . We must now work together to actively address the following: Change is about people s needsThe Change Framework prioritises people s Needs Defining Change as the central theme and positions an informed understanding of people and culture as the core platform for delivering sustainable Change . The Change Guide specifically focuses on how to work with service users, families, communities and staff to co-design service improvements based on people s Needs and leadership is our shared responsibilityThe Change Guide translates the very best of evidence and practice into a how to do Change well guide and provides all of the resources needed to support teams to drive service improvement and build Change for successWe must continually focus on the impact of our Change efforts and demonstrate improvement in people s lives through robust measurement of our performance and the delivery of and provide directionThe Change Framework provides us with an opportunity to align our existing initiatives in order to benefit from our combined efforts through a more cohesive approach.

10 It unifies people and culture focused initiatives with process and project steps Define, Design, Deliver to achieve Safer Better Healthcare and Staff and Public more Change able Our ambition is to have more people doing Change well so that as an organisation we are more Change able to deliver for our service users and meet the challenges in a complex system such as health services. The Change Guide strengthens our capacity to implement Sl intecare, People Strategy 2019-2024, Our Public Service 2020 and our corporate look forward to working with you all to implement good Change , to relentlessly focus on improving our Change capacity at organisation and team level and to successfully deliver on sustainable service improvements and system Reid Chief Executive Officer, HSEJune 2019 Restart this Section Contents Back Additional Resources People s Needs Defining Change Health Services Change GuideviiThe Health Services People Strategy [170] sets out the direction for people services and identifies the key performance targets to deliver safer better healthcare.