Helen Bevan spent 20th May with leaders of the Central Manchester health community, helping them with their ambitious strategies to transform local services. Her role was to challenge these leaders in their approach to large scale change and to help with “thinking differently for different results”. They are aware of the mantra that “70% of large scale change efforts fail” and want to make sure they are in the other 30%. I talked to them about “the three paradoxes in large scale change” (transactional v relational; transitional v transformational; diagnostic v dialogic approaches to change). They are using these frameworks to assure their emerging implementation approach.

1. @HelenBevan
Three paradoxes to
manage for big change
20th May 2014
Helen Bevan
@HelenBevan
“something that is made up of two
opposite things and that seems
impossible but is actually true or
possible”

2. @HelenBevan

3. @HelenBevan Source of image: Whatsthebigideascwartzy.blogspot.com

4. @HelenBevan
Most change initiatives don’t fully
deliver their objectives
Source: McKinsey Performance Transformation Survey, 3000 respondents to
global, multi-industry survey
70%
25%
5%
Gets anywhere near
achieving the
change and
delivering the
benefits

5. @HelenBevan
Source: McKinsey Performance Transformation Survey, 3000 respondents to
global, multi-industry survey
70%
25%
5% Delivers and
sustains the change
Most change initiatives don’t fully
deliver their objectives

6. @HelenBevan
Most change efforts are built upon the shaky foundation of
five flawed assumptions; that change can be managed, that
human beings are objective, that there are ‘X’ steps to
change, that we have a neutral starting point for change, and
that change, itself, is the goal
Peter Fuda
http://www.peterfuda.com/wp-content/themes/peterfuda-
bootstrap/content/Why-Change-Efforts-Fail.pdf
Source of image: Whatsthebigideascwartzy.blogspot.com

7. @HelenBevan
Image from: @TheWorldStories

8. @HelenBevan
Image from: @TheWorldStories

9. @HelenBevan

10. @HelenBevan
Leading change in a new era
Dominant approach Emerging direction

11. @HelenBevan

12. @HelenBevan

13. @HelenBevan
John Kotter: “Accelerate!”
• We won’t create big change through hierarchy
on its own
• We need hierarchy AND network
• Many change agents, many acts of leadership
• At least 50% buy-in
• Changing our mindset
• From “have to” to “want to”
Source of
image:www.slideshare.net/m
exicanwave/champions-trolls-
10-years-of-the-cipd-online-
community

14. @HelenBevan
The Network Secrets of Great Change Agents
Julie Battilana &Tiziana Casciaro
1. As a change agent, my centrality in the informal
network is more important than my position in
the formal hierarchy
2. If you want to create small scale change, work
through a cohesive network
If you want to create big change, create
bridge networks between disconnected groups

15. @HelenBevan

16. @HelenBevan
Different thinking for different results
Transitional change
“Designing a co-ordinated
system”

17. @HelenBevan
Different thinking for different results
Transitional change
“Designing a co-ordinated
system”
 A focus on methods, systems,
and behaviours
 Improving what we know
already (structures, systems,
implementing best practices)
 New payment systems
 Refining incentives
 Measures of success
 Make the current system
“leaner” and less wasteful
 Performance improvement

18. @HelenBevan
Building an enduring capacity for change
Different thinking for different results
Transformational change

19. @HelenBevan
Different thinking for different results
 Changing the way we think about
the problem
 Not just changing behaviours but
beliefs and assumptions
 Exploring unusual and innovative
alternatives
• Requires a high tolerance for
ambiguity and paradox
• Shifting power by designing a truly
person-centred system
• Continuously learns, adapts and
improves
Transformational change
Building an enduring capacity for change

20. @HelenBevan

21. @HelenBevan
Diagnostic
and
dialogic
approaches
to
resistance to change

22. @HelenBevan@HelenBevan #transformkp
• Change is something that happens “out there”
in the organisation or system
• Resistance is a force to overcome
• Resistance prevents change
• Change agents must diagnose, manage and/or
overcome resistance
• Resisters may be otherwise known as
“laggards”, “blockers”, “in denial”
Resistance: a “diagnostic” approach

23. @HelenBevan
Image from: @TheWorldStories

24. @HelenBevan@HelenBevan #transformkp
Resistance to change

25. @HelenBevan@HelenBevan #transformkp
“The role of the change agent is to
recognise the causes of resistance and
address each one. If this is not done,
then the change will be much harder to
implement successfully and may not
succeed at all”
David Stonehouse
The change agent: the manager’s role in change
British Journal of Healthcare Management, Vol. 19, Iss.
9, 09 Sep 2013, pp 443 - 445
Diagnostic: the role of the change agent

26. @HelenBevan@HelenBevan #transformkp
• People make their own reality
• Change results from transformational
conversations
 involving more and different people in change discussions
 altering how and which people engage with each other
 by stimulating different perspectives to shape how people
think about things
• Resistance is an inevitable consequence of a
complex change process (based on diversity)
• Resistance should be embraced and worked with
Resistance: a “dialogic” approach

27. @HelenBevan@HelenBevan #transformkp
1. Create the conditions for transformational
conversations by asking questions that are focussed
on future possibilities, by inviting diversity into the
system, and by being welcoming
2. Create opportunities for everyone to express their
views, spot opportunities and build on each other’s
ideas
3. Create ways for people to reflect together to find
meaning, understanding and shared purpose in the
change
Source: Peggy Holman
Dialogic: the role of the change agent

28. Ten key principles of large scale change
1. Movement towards a new vision that is better and
fundamentally different from the status quo
2. Identification and communication of key themes that people
can relate to and that will make a big difference
3. Multiples of things (‘lots of lots’)
4. Framing the issues in ways that engage and mobilise the
imagination, energy and will of a large number of diverse
stakeholders in order to create a shift in the balance of power
and distribute the leadership
5. Mutually reinforcing change across multiple
processes/subsystems

29. 6. Continually refreshing the story and attracting new, active
supporters
7. Emergent planning and design, based on monitoring progress
and adapting as you go
8. Many people contribute to the leadership of change, beyond
organisational boundaries
9. Transforming mindsets, leading to inherently sustainable
change
10. Maintaining and refreshing the leaders’
energy over the long haul
Ten key principles of large scale change