Building Energy for Change for the Long Haul - Keynote Address by Helen Be…

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Helen Bevan's keynote address at the 2013 Saskatchewan Health Care Quality Summit. For more information about the summit, visit www.qualitysummit.ca. Follow @QualitySummit on Twitter.

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. Helen Bevan will show you powerful methods to unleash the latent energy for change from within your organization to increase the pace and scale of improvement.

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, analyzing and building energy for change.

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Building Energy for Change for the Long Haul - Keynote Address by Helen Be…

  1. 1. @helenbevan #qs13Building and aligning energyfor changeHelen Bevan@helenbevan#QS13
  2. 2. @helenbevanMost large scale change fails toachieve its objectivesSource: McKinsey Performance Transformation Survey, 3000 respondents toglobal, multi-industry survey70%25%5%
  3. 3. @helenbevanThe factors thatimpact the ability todeliver Leantransformation arethe same as thefactors in other largescale changestrategies
  4. 4. @helenbevan #qs13What happens to large scalechange efforts in reality?In order of frequency:1. the effort effectively “runs out of energy” andsimply fades away2. the change hits a plateau at some level andno longer attracts new supporters3. the change becomes reasonably wellestablished; several levels across the systemhave changed to accommodate or support it ina sustainable way.Source: Leading Large Scale Change:a practical guide (2011), NHS Institute
  5. 5. @helenbevan #qs13Intrinsicmotivators•connecting toshared purpose•engaging, mobilisingand calling to action•motivational leadershipbuild energyand creativity
  6. 6. @helenbevan #qs13Intrinsicmotivators•connecting toshared purpose•engaging, mobilisingand calling to action•motivational leadershipbuild energyand creativity create focus &momentum fordeliveryDriversof extrinsicmotivation
  7. 7. @helenbevan #qs13Driversof extrinsicmotivationcreate focus &momentum fordeliveryIntrinsicmotivators•connecting toshared purpose•engaging, mobilisingand calling to action•motivational leadershipbuild energyand creativity•System drivers &incentives•Payment by results•Performancemanagement•Measurement foraccountability
  8. 8. @helenbevan #qs13Internalmotivators•connecting toshared purpose•engaging, mobilisingand calling to action•motivationalleadershipbuild energy andcreativityDrivers ofextrinsicmotivation•System drivers &incentives•Performancemanagement•Measurement foraccountabilitycreate & focusmomentum fordelivery
  9. 9. Transformation is not a matter ofintent.........it is a matter of alignmentPeter Fuda
  10. 10. @helenbevanNHS Change Modelwww.changemodel.nhs.uk
  11. 11. @helenbevan
  12. 12. @helenbevanNHS Change Modelwww.changemodel.nhs.uk
  13. 13. @helenbevan #qs13Does fear motivate peopleto change?
  14. 14. @helenbevan #qs13burning platformversusburning ambition@PeterFuda
  15. 15. @helenbevan #qs13Insert peter Fuda film
  16. 16. @helenbevan #qs13Lessons for transformational change1. In order to sustaintransformational change, we asleaders need to move from aburning platform (fear basedurgency) to a burning ambition(shared purpose for a betterfuture)2. We as leaders need to articulatepersonal reasons for change aswell as organisational reasons3. If the fire (the compelling reason)goes out, all other factors areredundant@PeterFuda
  17. 17. @helenbevan #qs13TaskTalk to the person next to you• What is “my burning ambition” for my service,my community and /or my patients• Try to make it personal: tell others why thisambition connects with your personalmotivations
  18. 18. @helenbevanYou get the best efforts fromothers not by lighting a firebeneath them but by buildingSource: Bob Nelson
  19. 19. @helenbevan #qs13
  20. 20. @helenbevanthe capacity anddrive of a team,organisation orsystem to actand make thedifferencenecessary toachieve its goalsPsychologicalPhysicalSpiritualSocial IntellectualEnergy for change is:
  21. 21. @helenbevanThe five energies for changeEnergy DefinitionsSocial energy of personal engagement, relationships and connections betweenpeople. It reflects a “sense of us”, where people are drawn into aninnovation or change because they feel a connection to it as part of thecollective groupSpiritual energy of commitment to a common vision for the future, driven byshared values and a higher purpose. It involves giving people theconfidence to move towards a different future that is more compellingthan the status quoPsychological energy of courage, trust and feeling safe to do things differently. Itinvolves feeling supported to make a change as well as belief in self andthe team, organisation or system, and trust in leadership and directionPhysical energy of action, getting things done and making progress. It is theflexible, responsive drive to make things happenIntellectual energy of curiosity, analysis and thinking. It involves gaining insight aswell as planning and supporting processes, evaluation, and arguing acase on the basis of logic/ evidence
  22. 22. @helenbevanHigh and low ends of each energy domainLow HighSocial isolated solidaritySpiritual uncommitted higher purposePsychological risky safePhysical fatigue vitalityIntellectual Illogical reason
  23. 23. @helenbevanFacilitated questions -examples• Are particular energydomains more dominantthan others for our team atthe moment?• Is this the optimal energyprofile to help us achieveour change goals?• What would the optimalenergy profile look like forour team or community?PhysicalPsychologicalSpiritualSocialIntellectualEnergy for change profile
  24. 24. @helenbevanFacilitated questions -examples• Are particular energydomains more dominantthan others for our team atthe moment?• Is this the optimal energyprofile to help us achieveour change goals?• What would the optimalenergy profile look like forour team or community?PhysicalPsychologicalSpiritualSocialIntellectualEnergy for change profileLOWHIGH
  25. 25. @helenbevanTeam 1PhysicalPsychologicalSpiritualSocialIntellectual
  26. 26. @helenbevanTeam 1PhysicalPsychologicalSpiritualSocialIntellectualTeam 1’s energy profile is characterised by an environment that has harnessedtheir interest and momentum for change, but which has failed to engage peoplefully. This imbalance results in their feeling some uncertainty regarding how theycan contribute fully to the change, and therefore a sense of risk and lack of hopefor the future. We can build energy by building team solidarity and developingshared purpose
  27. 27. @helenbevanTeam twoPsychologicalSocial SpiritualPhysicalIntellectual
  28. 28. @helenbevanTeam twoPsychologicalSocial SpiritualPhysicalIntellectualTeam 2 enables strong connections between people, a true senseof solidarity, which gives them enough hope for the future, but thisenergy is undirected, because the rational argument and sharedpurpose has not been agreed.
  29. 29. @helenbevanSaskatchewan energy for changeSSPPI Energy IndexAnalysis generated on 8th April 2013by Rosanna Hunt and Paul Woodley43 respondentsrosanna.hunt@nhsiq.nhs.uk+44 777 070 4056Energy for Change Model and SSPPI Energy Index by NHS Improving Quality is licensed under aCreative Commons Attribution-ShareAlike 2.0 UK: England & Wales License.
  30. 30. @helenbevanThe SSPPI Energy Index – V2, Part IThis questionnaire enables teams to measure their energy for change.Please agree the nature of the change context with your team before answering the following statements.Then answer all statements with your particular change context in mind.1 = Strongly disagree 2 = Disagree 3 = Neutral 4 = Agree 5 = Strongly AgreeI am energised by the momentum of change____I have gained insight into the case for change____I feel a sense of solidarity with those I work with ____I am weary of change____I am able to keep expressing hope for the change when presented withsetbacks_____The reasoning for the change is not compelling___I don’t feel appreciated by others at work_____I will be blamed if I try something new and it fails____I feel isolated from others____I feel depleted of energy when others express doubt about the change_____The case for change has stimulated my creativity_____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 change does not fit with my sense of purpose_____I am not driven by a shared purpose for change_____I think there is no rational argument for change____The case for change is interesting to me_____I feel that we are getting things done to achieve the change_____I feel the change may conflict with my values___I feel personally engaged in the change___Clear thinking and analysis underpins the change___I feel fearful about the change___I sense openness about the potential to change___
  31. 31. @helenbevanSocial energy is the energy of personal engagement,relationships and connections between people. It reflects a“sense of us” and is therefore a collective concept thatcaptures a situation where people are drawn into animprovement or change because they feel a connection to itas part of the collective group.My social energy is ____The social energy of those I work with is____The importance of social energy to me is____Psychological energy is the energy of courage, trust andfeeling safe to do things differently. It involves feelingsupported to make a change as well as belief in self and theteam, organisation or system, and trust in leadership anddirection.My psychological energy is ____The psychological energy of those I work with is____The importance of psychological energy to me is____Physical energy is the energy of action, getting things doneand making progress. It is the flexible, responsive drive tomake things happen, with vitality and kinetic force (motion)My physical energy is ____The physical energy of those I work with 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 newknowledge 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 I work with is____The importance of intellectual energy to me is____Complete these statements on a scale of 1 = low - 5 = highSpiritual energy is the energy of commitment to a commonvision for the future, driven by shared values and a higherpurpose. It involves giving people the confidence to movetowards a different future that is more compelling than thestatus quo, by finding the deep meaning in what they do.My spiritual energy is ____The spiritual energy of those I work with is____The importance of spiritual energy to me is____The SSPPI Energy Index – V2, Part 2
  32. 32. @helenbevanmin max %Social 32 100 72Spiritual 47 100 80Psychological 47 97 75Physical 50 95 76Intellectual 48 100 82Total 45 98 771. The group’s Energy for Change profileThe group’s energy for change is 77% (43 respondents). NHSgroups previously analysed have demonstrated energy levelsbetween 54% and 84%.Spiritual and intellectual energies are particularly high in this group(82% and 80% respectively).Although social energy appears to be more depleted than the otherenergy types (72%), this may be skewed by a small number ofindividuals scoring particularly low (32%)
  33. 33. @helenbevanProfiling data Self-evaluationSocial 72 74Spiritual 80 80Psychological 75 72Physical 76 70Intellectual 82 82Total 77 76The two perspectives on energy support each otherRespondents show good self-awareness of their energy forchange. The group may perceive its physical energy to be moredepleted than it is in reality (they self-evaluate their levels ofphysical energy to be at 70% whereas their profile indicates theyhave higher physical energy in reality (76%).2. How does your Energy for Change profile comparewith your self-evaluated view of your energy?
  34. 34. @helenbevan3. Gaps between current & desired energy levelsThere are large gaps (> 1) between the group’s perceived energyfor change ___and its desired energy level ___on physical andpsychological energies. The group would like to enhance itsenergy for change in these particular domains.On average, individuals within the group measure the energy ofthose they work with ____to be lower than their own energy12345SocialSpiritualPsychologicalPhysicalIntellectualMy energyEnergy of those I work withImportance of this energy
  35. 35. @helenbevan5. Is Energy for Change influenced by “distancefrom CEO” and “clinical/non-clinical” role?NHS dataset shows those in clinical roles have higher levels of energy forchange than those in non-clinical roles, which is mostly influenced by theirhigher levels of spiritual energy and may also be influenced by higher levels ofsocial energy.The NHS data also showed that individuals in roles that are closer to the CEO(in hierarchical terms) have higher levels of energy for change**** in four outof the five energy domains (there were no differences in the physical energylevels of individuals at different levels of the hierarchy).In the Saskatchewan dataset there were no differences between those inclinical roles (n=13) compared with those in non-clinical roles (n=30).Interestingly, the only difference to emerge between the various levels of thehierarchy, was on Physical Energy: those closest to the CEO had higherphysical energy for change than those two steps away from the CEO.The groups are too small to be representative (clinical = 13, proximity to theCEO = approximately 6 in each group).
  36. 36. @helenbevanConclusions• The group’s energy profile is 77%, but this varieswidely across energy domains and individuals• To build energy for change, the team should focuson the physical and psychological domains• Physical energy is enhanced by creatingopportunities for regular renewal, ensuringworkload is appropriate and investing in a healthywork environment• Psychological energy is enhanced by a safe, secureenvironment that provides role-models thatexhibit courage and trust in change
  37. 37. @helenbevan #qs13“Money incentives do not create energyfor change; the energy comes fromconnection to meaningful goals”Ann-Charlott Norman, Talking about improvements: discursivepatterns and their conditions for learning,Clinical Microsystem Festival, Jönköping March 2012
  38. 38. @helenbevan[Shared] purpose goes way deeper thanvision and mission; it goes right into your gutand taps some part of your primal self. Ibelieve that if you can bring people withsimilar primal-purposes together and getthem all marching in the same direction,amazing things can be achieved.Seth Carguilo
  39. 39. @helenbevan
  40. 40. @helenbevan #qs13Air sandwichhttp://www.amazon.com/gp/mpd/permalink/m3E4LREIVUTDH3/ref=ent_fb_linkHistory has taught us that the number one reasonstrategies fail is because of the lack of execution.....History is now teaching us that unless we learn toengage people, not just people called executives, in aconversation about needs, wants and desires we simplycannot expect to meet those needs. Not meeting thoseneeds means we cannot expect people to even want tobe engaged with us for whatever purposeJay Deragon
  41. 41. @helenbevan #qs13Avoiding “de facto” purpose• What leaders pay attention to matters to staff, and consequentlystaff 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 forsomething else to become a de facto purpose in the minds of theworkforceSource: Delivering Public Services That Work: The Vanguard Method in the Public Sector
  42. 42. @helenbevan #qs13 @SimonJGuilfoyle Police Inspector and systems thinker
  43. 43. @helenbevan #qs13 @SimonJGuilfoyle Police Inspector and systems thinker
  44. 44. @helenbevan #qs13Police@SimonJGuilfoyle Police Inspector and systems thinker
  45. 45. @helenbevan #qs13Education@SimonJGuilfoyle Police Inspector and systems thinker
  46. 46. @helenbevan #qs13Healthcare@SimonJGuilfoyle Police Inspector and systems thinker
  47. 47. @helenbevanWhat focus for our improvement projects?05101520251 2 3 4 5 6 7 8 9NoofprojectsProject ScoreMainly focussed onquality, safety &/orpatient experienceMainly focussedon cost,productivity orefficiencySource: 100 improvement projects on national improvementleadership programme October 2012
  48. 48. @helenbevan #qs13My three visits to Saskatchewan200820102013
  49. 49. @helenbevan #qs13....the last era of management was about howmuch performance we could extract frompeople.....the next is all about how much humanity wecan inspireDov Seidman

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