These are the slides for SHCR II Module 3: Rolling with Resistance.
This module looks at the issue of 'resistance to change’: rather than seeing resistance as a negative thing, we shift our perspective so that we see dissent, diversity and disruption as essential components of effective change.
Agenda:
What do we mean by resistance to change?
What are some of the ways to look at resistance to change?
Importance of diversity in leading change and its implications in terms of resistance
Diversity is critical to innovation and change
Being a champion for diversity
Impact and intent
The effectiveness of a change agent is not a matter of intention; it’s a matter of impact
How to stop talking at someone and start talking to them
What you can do to build impact and intent
Using the Stages of Change model to help people through change
Why do people resist change?
What is the transtheoretical model of behaviour change?
An example of the model in practice
What we tend to do when dealing with resistance and what we should do
Questions and call to action
Questions for reflection:
What does resistance mean to you?
Think about the things you resist as well as your responses to others’ resistance
How do you work with resistance as a change leader?
How can you make sure that the changes you make achieve the impact you desire and are sustainable?
….. do not create dependency?
….. generate self-efficacy in others?
Who are you interacting with and where they are on the Stages of Change model?
Call to action:
Reflect deeply on how you operate as an agent for change.
Consider the impact of your communication and behaviour beyond your intent.
Listen to others’ views, engage others in change and help others through the stages of change.
This document provides a study guide for Module 3 of the School for Health and Care Radicals program, which focuses on rolling with resistance to change. It discusses understanding resistance as an inevitable force that can be harnessed rather than opposed. It also explores embracing diversity to gain different perspectives, distinguishing between intent and impact, and using the Stages of Change model to understand where individuals are in the change process. The study guide aims to help participants think critically about resistance and develop strategies for working with it constructively.
Prochaska and DiClemente's Trans-theoretical Model of Change. By Theresa Lowr...Theresa Lowry-Lehnen
The document summarizes the Trans-theoretical Model of Change proposed by psychologists James Prochaska and Carlo DiClemente. The model outlines five stages of change that people progress through when trying to change an addictive behavior: pre-contemplation, contemplation, preparation, action, and maintenance. It also includes the possibility of relapse. The model can be used by therapists and coaches to assess what stage a client is at and determine appropriate strategies to help them progress to the next stage of change.
This document discusses the Transtheoretical Model of behavior change, also known as the Stages of Change Model. It describes the five stages of change that individuals progress through when modifying a problem behavior: pre-contemplation, contemplation, preparation, action, and maintenance. For each stage, goals for the patient and physician are provided, as well as approaches and techniques. The model was developed by Prochaska and DiClemente to understand how individuals intentionally change behaviors. The stages are not linear, as relapse can occur. The document also reviews the Decisional Balance technique, a counseling approach used to help patients weigh the pros and cons of behavior change.
The document discusses using the Transtheoretical Model (TTM) to promote behavior change for climate change adaptation. [1] The TTM describes how people modify behaviors through stages of change: precontemplation, contemplation, preparation, action, and maintenance. [2] People progress between stages as the perceived pros of changing outweigh the cons (decisional balance) and their confidence in making changes grows (self-efficacy). [3] Different processes of change like consciousness raising and self-liberation can effectively promote progression between stages.
The document describes two models of stages of change: the Transtheoretical Model which includes the stages of precontemplation, contemplation, preparation, action, and maintenance; and the Kübler-Ross model which includes the stages of shock, denial, self-doubt, acceptance, experimentation, search for meaning, and integration. Each stage is characterized and strategies are provided to support moving through the stages of change when making or adapting to changes in one's life.
Setting and defining the context
Exploring resilience
Navigating change
Sharing with, and learning from, peers
Confirming actions
Summary and questions
This document provides a study guide for Module 3 of the School for Health and Care Radicals program, which focuses on rolling with resistance to change. It discusses understanding resistance as an inevitable force that can be harnessed rather than opposed. It also explores embracing diversity to gain different perspectives, distinguishing between intent and impact, and using the Stages of Change model to understand where individuals are in the change process. The study guide aims to help participants think critically about resistance and develop strategies for working with it constructively.
Prochaska and DiClemente's Trans-theoretical Model of Change. By Theresa Lowr...Theresa Lowry-Lehnen
The document summarizes the Trans-theoretical Model of Change proposed by psychologists James Prochaska and Carlo DiClemente. The model outlines five stages of change that people progress through when trying to change an addictive behavior: pre-contemplation, contemplation, preparation, action, and maintenance. It also includes the possibility of relapse. The model can be used by therapists and coaches to assess what stage a client is at and determine appropriate strategies to help them progress to the next stage of change.
This document discusses the Transtheoretical Model of behavior change, also known as the Stages of Change Model. It describes the five stages of change that individuals progress through when modifying a problem behavior: pre-contemplation, contemplation, preparation, action, and maintenance. For each stage, goals for the patient and physician are provided, as well as approaches and techniques. The model was developed by Prochaska and DiClemente to understand how individuals intentionally change behaviors. The stages are not linear, as relapse can occur. The document also reviews the Decisional Balance technique, a counseling approach used to help patients weigh the pros and cons of behavior change.
The document discusses using the Transtheoretical Model (TTM) to promote behavior change for climate change adaptation. [1] The TTM describes how people modify behaviors through stages of change: precontemplation, contemplation, preparation, action, and maintenance. [2] People progress between stages as the perceived pros of changing outweigh the cons (decisional balance) and their confidence in making changes grows (self-efficacy). [3] Different processes of change like consciousness raising and self-liberation can effectively promote progression between stages.
The document describes two models of stages of change: the Transtheoretical Model which includes the stages of precontemplation, contemplation, preparation, action, and maintenance; and the Kübler-Ross model which includes the stages of shock, denial, self-doubt, acceptance, experimentation, search for meaning, and integration. Each stage is characterized and strategies are provided to support moving through the stages of change when making or adapting to changes in one's life.
Setting and defining the context
Exploring resilience
Navigating change
Sharing with, and learning from, peers
Confirming actions
Summary and questions
This presentation will introduce the Stages of Change model and describe the processes that an individual will go through when deciding to implement healthy lifestyle behaviors.
A Journey Towards Physical Fitness and Awareness: Applying the TTM to Modify...Elisah Mugwagwa
This document describes one woman's personal journey to improve her physical fitness and wellness through applying the Transtheoretical Model of behavior change to exercise. It introduces the Transtheoretical Model, which describes stages of behavior change, and explains how the woman used it to structure her exercise goals and track her progress over 7 weeks. Through self-monitoring and goal setting based on the model's components, she was able to gradually increase her exercise time and frequency each week from an initial 3 days per week to exercising daily by the 7th week. The document concludes by noting that while the Transtheoretical Model helped structure her exercise program, maintaining well-being requires more than just exercise.
The document provides an overview of motivational interviewing. It discusses the efficacy of MI, which has been shown to be effective in treating addiction and other health behaviors in as little as 1-4 sessions. It outlines the stages of change model and describes strategies and principles of MI, including expressing empathy, developing discrepancy, avoiding argumentation, and supporting self-efficacy. The document emphasizes that the spirit of MI is collaborative and aims to evoke motivation for change from clients in a warm, respectful manner.
Transtheoretical Model (Stages of Change Model)Rozanne Clarke
The Transtheoretical Model (TTM) speaks on suggested strategies for public health interventions to address people at various stages of the decision-making process. Acknowledgements of this and other behavioural change models will resulting in social marketing campaigns being implemented as they're tailored to suit the target audience.
Babitha's Note On critical thinking in nursingBabitha Devu
The document discusses critical thinking in nursing. It begins by introducing critical thinking as an important educational outcome in nursing. It then outlines the objectives of describing critical thinking concepts and skills used in nursing practice.
The document explains that critical thinking involves making accurate clinical decisions and problem solving to help patients maintain or improve their health. It presents definitions of nursing and critical thinking. Critical thinking requires reflection, using language effectively, and trusting intuition gained from experience.
A model of critical thinking involves knowledge, experience, competencies, attitudes, and standards. Nurses progress from basic to complex critical thinking and commitment. The components of critical thinking are applied through clinical reasoning, decision making, and using the nursing process.
The document discusses motivational interviewing, a counseling technique used to encourage behavior change by exploring an individual's own motivations for change in a non-confrontational manner. It is used in academic settings to help students who are struggling with workload stress, have discrepancies between goals and behaviors, or are ambivalent about abilities or services. The document outlines techniques of motivational interviewing like reflective listening, decisional balancing, affirmations, and summaries.
The document outlines the stages of change in the Transtheoretical Model of Change, also known as the Stages of Change model. The stages are pre-contemplation, contemplation, preparation, action, and maintenance. Relapse can occur if motivation is lost or triggers are not avoided after initial success. The model was conceived in the 1980s by psychologist James Prochaska and encourages rethinking assumptions about readiness to change.
This document discusses critical thinking and decision making in nursing. It begins by defining critical thinking as the process of applying reasoning to guide beliefs and actions. Key concepts of critical thinking discussed include interpretation, analysis, evaluation, and self-regulation. Common pitfalls and biases are also outlined. The document then discusses decision making, noting that nurses must make many rapid decisions. A case example illustrates the decision challenges nurses may face. The conclusion emphasizes that nurses are key decision makers expected to use evidence in their judgments.
The document discusses motivational interviewing (MI) and the transtheoretical model of health behavior change (TTM). The TTM proposes that behavior change involves progress through six stages: precontemplation, contemplation, preparation, action, maintenance, and termination. MI is a counseling approach used to help people progress through the stages by expressing empathy, developing discrepancy, rolling with resistance, and supporting self-efficacy. The document provides examples of questions counselors can ask and behaviors to watch for at each stage to support movement toward behavior change.
William Glasser developed Choice Theory and Reality Therapy which focus on meeting basic human needs. The five basic needs are survival, love/belonging, freedom, fun, and power. According to Glasser, all behavior is purposeful and aimed at satisfying one or more of these needs. In the classroom, Choice Theory emphasizes giving students choice in what and how they learn to engage their basic needs. Effective discipline involves students taking responsibility for their actions through negotiated contracts rather than punishment.
Open Talk - Decision Making with young people: Children and Young People's Me...NHSECYPMH
This presentation will:
*Set out some of the dilemmas of Shared Decision Making – particularly with groups of CYP who we may feel find it hard to make positive decisions for themselves – for example CYP with eating disorders or psychosis and other vulnerable groups.
* Look at developments in practice around Shared Decision Making
* Share some down right good ideas on how to improve on your Shared Decision Making skills and knowledge
This document discusses nursing health assessment and the nursing process. It is presented by Maria Carmela L. Domocmat, an instructor of nursing health assessment. The document covers the nursing process, which includes assessment, diagnosis, planning, implementation, and evaluation. It is the framework for professional nursing practice and promotes systematic, outcome-focused care. Critical thinking in nursing requires purposeful, results-oriented thinking based on nursing principles and scientific methods. It involves identifying problems, analyzing them, developing responses, and following through. Critical thinkers in nursing are constantly re-evaluating and improving.
I understand this is difficult to discuss. Let's take a step back - my role is not to judge but to understand your perspective and support you in making choices that align with your values and priorities. Perhaps we could explore how drinking fits into your life goals and what matters most to you.
Critical thinking in nursing involves recognizing issues, analyzing clinical data, evaluating information, and making conclusions. It is a continuous process of open-minded inquiry to determine which assumptions are true and relevant for each unique patient situation. Critical thinking skills for nurses include interpretation, analysis, inference, evaluation, explanation, and self-regulation. There are three levels of critical thinking - basic, complex, and commitment. Critical thinking competencies for nurses encompass general skills like scientific method and problem solving, as well as specific skills like diagnostic reasoning, clinical inference, and clinical decision making. Attitudes that are important for critical thinking include confidence, independent thinking, fairness, responsibility, risk taking, discipline, perseverance, creativity, curiosity, integrity, and
This document discusses strategies for enhancing nurse-physician collaboration. It defines collaboration as nurses and physicians working cooperatively together to solve problems and make care decisions, rather than competing or asserting power over one another. The benefits of collaboration include improved patient and staff outcomes. Key aspects of collaboration include effective communication, managing disruptive behaviors, and developing competence and confidence. Communication tools like SBAR are recommended to structure nurse-physician discussions. Addressing disruptive behaviors respectfully by focusing on facts and impacts is advised. With practice over time using strategies like these, nurses can develop skills to confidently enhance collaboration.
This document discusses applying the Transtheoretical Model to promote safer sex behaviors among older HIV-infected African Americans in Nevada. It outlines the sexual risk factors older individuals face, such as lack of knowledge, inconsistent condom use, and multiple partners. Statistics provided show that African Americans are disproportionately impacted by HIV in Nevada and nationwide. The document then applies the stages of change from the Transtheoretical Model - precontemplation, contemplation, preparation, action, and maintenance - to design interventions to promote behavior change. Interventions include encouraging evaluation of risks, problem solving, skill building, and maintaining protective behaviors.
Crisis counselling provides short-term assistance and support to individuals experiencing extreme distress from a traumatic event. It aims to help clients cope with their current stressors, receive resources, stabilize their situation, and prevent long-term damage from the crisis. Crisis counselling focuses on strategies for the immediate aftermath of trauma and is often a precursor to longer-term counselling to support mental health and well-being. It educates individuals on normal reactions to abnormal situations and aims to restore them to their pre-crisis level of functioning within a temporary framework of around 1-3 months.
This study investigated whether increasing gratitude through daily exercises could increase hope. 86 university students were randomly assigned to complete either a gratitude list or record daily activities for one week. Measures of gratitude and hope were taken before and after the intervention. While gratitude increased in the gratitude list group, hope did not significantly change in either group. The results did not support the hypothesis that increasing gratitude causes an increase in hope. Future research could analyze participants' responses to better understand the effects of the interventions.
The document discusses the 3 stages of stress and their effects on the body and mind. Stage 1 involves the release of adrenaline and increased heart rate and breathing. Stage 2 sees the release of sugars and fats and feelings of pressure and fatigue. Stage 3 can lead to personality changes, illness, and heart disease if stress is not resolved. Stress can also trigger depression symptoms like changes in appetite, sleep, and mood. Simple steps to coping with stress include identifying problems, solving them, talking about them, learning stress management techniques, reducing tension, and taking the mind off problems. Managing thoughts involves breaking tasks into smaller steps, using positive self-talk, learning new things, spending time outside, and seeking support from others. Pat
The document discusses facilitating behavior change using the Transtheoretical Model of Behavior Change and Motivational Interviewing. It defines the 5 stages of change in the Transtheoretical Model and describes how Motivational Interviewing uses person-centered counseling skills to help patients resolve ambivalence and increase intrinsic motivation for behavior change. Key principles of Motivational Interviewing include expressing empathy, developing discrepancies between current behaviors and goals, rolling with resistance, and supporting self-efficacy. The document provides examples of reflective listening, open-ended questions, summarizing, and assessing readiness to change using tools like importance and confidence rulers.
This presentation will introduce the Stages of Change model and describe the processes that an individual will go through when deciding to implement healthy lifestyle behaviors.
A Journey Towards Physical Fitness and Awareness: Applying the TTM to Modify...Elisah Mugwagwa
This document describes one woman's personal journey to improve her physical fitness and wellness through applying the Transtheoretical Model of behavior change to exercise. It introduces the Transtheoretical Model, which describes stages of behavior change, and explains how the woman used it to structure her exercise goals and track her progress over 7 weeks. Through self-monitoring and goal setting based on the model's components, she was able to gradually increase her exercise time and frequency each week from an initial 3 days per week to exercising daily by the 7th week. The document concludes by noting that while the Transtheoretical Model helped structure her exercise program, maintaining well-being requires more than just exercise.
The document provides an overview of motivational interviewing. It discusses the efficacy of MI, which has been shown to be effective in treating addiction and other health behaviors in as little as 1-4 sessions. It outlines the stages of change model and describes strategies and principles of MI, including expressing empathy, developing discrepancy, avoiding argumentation, and supporting self-efficacy. The document emphasizes that the spirit of MI is collaborative and aims to evoke motivation for change from clients in a warm, respectful manner.
Transtheoretical Model (Stages of Change Model)Rozanne Clarke
The Transtheoretical Model (TTM) speaks on suggested strategies for public health interventions to address people at various stages of the decision-making process. Acknowledgements of this and other behavioural change models will resulting in social marketing campaigns being implemented as they're tailored to suit the target audience.
Babitha's Note On critical thinking in nursingBabitha Devu
The document discusses critical thinking in nursing. It begins by introducing critical thinking as an important educational outcome in nursing. It then outlines the objectives of describing critical thinking concepts and skills used in nursing practice.
The document explains that critical thinking involves making accurate clinical decisions and problem solving to help patients maintain or improve their health. It presents definitions of nursing and critical thinking. Critical thinking requires reflection, using language effectively, and trusting intuition gained from experience.
A model of critical thinking involves knowledge, experience, competencies, attitudes, and standards. Nurses progress from basic to complex critical thinking and commitment. The components of critical thinking are applied through clinical reasoning, decision making, and using the nursing process.
The document discusses motivational interviewing, a counseling technique used to encourage behavior change by exploring an individual's own motivations for change in a non-confrontational manner. It is used in academic settings to help students who are struggling with workload stress, have discrepancies between goals and behaviors, or are ambivalent about abilities or services. The document outlines techniques of motivational interviewing like reflective listening, decisional balancing, affirmations, and summaries.
The document outlines the stages of change in the Transtheoretical Model of Change, also known as the Stages of Change model. The stages are pre-contemplation, contemplation, preparation, action, and maintenance. Relapse can occur if motivation is lost or triggers are not avoided after initial success. The model was conceived in the 1980s by psychologist James Prochaska and encourages rethinking assumptions about readiness to change.
This document discusses critical thinking and decision making in nursing. It begins by defining critical thinking as the process of applying reasoning to guide beliefs and actions. Key concepts of critical thinking discussed include interpretation, analysis, evaluation, and self-regulation. Common pitfalls and biases are also outlined. The document then discusses decision making, noting that nurses must make many rapid decisions. A case example illustrates the decision challenges nurses may face. The conclusion emphasizes that nurses are key decision makers expected to use evidence in their judgments.
The document discusses motivational interviewing (MI) and the transtheoretical model of health behavior change (TTM). The TTM proposes that behavior change involves progress through six stages: precontemplation, contemplation, preparation, action, maintenance, and termination. MI is a counseling approach used to help people progress through the stages by expressing empathy, developing discrepancy, rolling with resistance, and supporting self-efficacy. The document provides examples of questions counselors can ask and behaviors to watch for at each stage to support movement toward behavior change.
William Glasser developed Choice Theory and Reality Therapy which focus on meeting basic human needs. The five basic needs are survival, love/belonging, freedom, fun, and power. According to Glasser, all behavior is purposeful and aimed at satisfying one or more of these needs. In the classroom, Choice Theory emphasizes giving students choice in what and how they learn to engage their basic needs. Effective discipline involves students taking responsibility for their actions through negotiated contracts rather than punishment.
Open Talk - Decision Making with young people: Children and Young People's Me...NHSECYPMH
This presentation will:
*Set out some of the dilemmas of Shared Decision Making – particularly with groups of CYP who we may feel find it hard to make positive decisions for themselves – for example CYP with eating disorders or psychosis and other vulnerable groups.
* Look at developments in practice around Shared Decision Making
* Share some down right good ideas on how to improve on your Shared Decision Making skills and knowledge
This document discusses nursing health assessment and the nursing process. It is presented by Maria Carmela L. Domocmat, an instructor of nursing health assessment. The document covers the nursing process, which includes assessment, diagnosis, planning, implementation, and evaluation. It is the framework for professional nursing practice and promotes systematic, outcome-focused care. Critical thinking in nursing requires purposeful, results-oriented thinking based on nursing principles and scientific methods. It involves identifying problems, analyzing them, developing responses, and following through. Critical thinkers in nursing are constantly re-evaluating and improving.
I understand this is difficult to discuss. Let's take a step back - my role is not to judge but to understand your perspective and support you in making choices that align with your values and priorities. Perhaps we could explore how drinking fits into your life goals and what matters most to you.
Critical thinking in nursing involves recognizing issues, analyzing clinical data, evaluating information, and making conclusions. It is a continuous process of open-minded inquiry to determine which assumptions are true and relevant for each unique patient situation. Critical thinking skills for nurses include interpretation, analysis, inference, evaluation, explanation, and self-regulation. There are three levels of critical thinking - basic, complex, and commitment. Critical thinking competencies for nurses encompass general skills like scientific method and problem solving, as well as specific skills like diagnostic reasoning, clinical inference, and clinical decision making. Attitudes that are important for critical thinking include confidence, independent thinking, fairness, responsibility, risk taking, discipline, perseverance, creativity, curiosity, integrity, and
This document discusses strategies for enhancing nurse-physician collaboration. It defines collaboration as nurses and physicians working cooperatively together to solve problems and make care decisions, rather than competing or asserting power over one another. The benefits of collaboration include improved patient and staff outcomes. Key aspects of collaboration include effective communication, managing disruptive behaviors, and developing competence and confidence. Communication tools like SBAR are recommended to structure nurse-physician discussions. Addressing disruptive behaviors respectfully by focusing on facts and impacts is advised. With practice over time using strategies like these, nurses can develop skills to confidently enhance collaboration.
This document discusses applying the Transtheoretical Model to promote safer sex behaviors among older HIV-infected African Americans in Nevada. It outlines the sexual risk factors older individuals face, such as lack of knowledge, inconsistent condom use, and multiple partners. Statistics provided show that African Americans are disproportionately impacted by HIV in Nevada and nationwide. The document then applies the stages of change from the Transtheoretical Model - precontemplation, contemplation, preparation, action, and maintenance - to design interventions to promote behavior change. Interventions include encouraging evaluation of risks, problem solving, skill building, and maintaining protective behaviors.
Crisis counselling provides short-term assistance and support to individuals experiencing extreme distress from a traumatic event. It aims to help clients cope with their current stressors, receive resources, stabilize their situation, and prevent long-term damage from the crisis. Crisis counselling focuses on strategies for the immediate aftermath of trauma and is often a precursor to longer-term counselling to support mental health and well-being. It educates individuals on normal reactions to abnormal situations and aims to restore them to their pre-crisis level of functioning within a temporary framework of around 1-3 months.
This study investigated whether increasing gratitude through daily exercises could increase hope. 86 university students were randomly assigned to complete either a gratitude list or record daily activities for one week. Measures of gratitude and hope were taken before and after the intervention. While gratitude increased in the gratitude list group, hope did not significantly change in either group. The results did not support the hypothesis that increasing gratitude causes an increase in hope. Future research could analyze participants' responses to better understand the effects of the interventions.
The document discusses the 3 stages of stress and their effects on the body and mind. Stage 1 involves the release of adrenaline and increased heart rate and breathing. Stage 2 sees the release of sugars and fats and feelings of pressure and fatigue. Stage 3 can lead to personality changes, illness, and heart disease if stress is not resolved. Stress can also trigger depression symptoms like changes in appetite, sleep, and mood. Simple steps to coping with stress include identifying problems, solving them, talking about them, learning stress management techniques, reducing tension, and taking the mind off problems. Managing thoughts involves breaking tasks into smaller steps, using positive self-talk, learning new things, spending time outside, and seeking support from others. Pat
The document discusses facilitating behavior change using the Transtheoretical Model of Behavior Change and Motivational Interviewing. It defines the 5 stages of change in the Transtheoretical Model and describes how Motivational Interviewing uses person-centered counseling skills to help patients resolve ambivalence and increase intrinsic motivation for behavior change. Key principles of Motivational Interviewing include expressing empathy, developing discrepancies between current behaviors and goals, rolling with resistance, and supporting self-efficacy. The document provides examples of reflective listening, open-ended questions, summarizing, and assessing readiness to change using tools like importance and confidence rulers.
This document discusses technology integration in education. It defines technology integration as combining hardware, software, and curriculum content to enhance learning. Some key benefits of technology integration include motivating students, providing unique applications, and enabling new approaches to instruction. However, barriers like lack of training, budget constraints, and resistance to change can impede technology integration. The document provides strategies for successful integration, such as identifying learning objectives, selecting appropriate tools, and allowing students opportunities to work with technology. It also gives examples of how specific technologies like productivity software, the internet, and digital cameras can support different subject areas.
Factors affecting financial sustainability of microfinance institutionsAlexander Decker
This document discusses factors that affect the financial sustainability of microfinance institutions (MFIs). It begins with background on microfinance programs and defines financial sustainability. The study aims to identify factors influencing MFI financial sustainability and develop a financial sustainability index. Regression analysis of MFI data from India and Bangladesh found that capital/asset ratio, operating expenses/loan portfolio, and portfolio at risk >30 days influence sustainability. The document proposes a financial sustainability index model based on these factors and operational self-sufficiency, assigning weights based on various agencies' use of the indicators. The model converts indicator data to a common scale to calculate total standard scores as a sustainability index.
Compensation management involves designing and implementing a total compensation package to provide monetary value to employees in exchange for work. It is an important part of human resource management that helps attract, retain, and motivate talent. Compensation includes direct pay like salary as well as indirect benefits and incentives that can achieve business and employee goals. Factors like an employee's skills, market rates, and organizational affordability influence compensation structure, which is also governed by employment laws.
This document discusses factors that affect working capital. It defines working capital and circulating capital. It then lists and describes 12 key factors that can influence a company's working capital needs: 1) nature of business, 2) size of business, 3) production policy, 4) length of production cycle, 5) seasonal variations, 6) working capital cycle, 7) stock turnover rate, 8) credit policy, 9) business cycle, 10) growth rate of business, 11) earnings and dividend policy, and 12) price level changes. Each of these factors can increase or decrease the amount of funds required to operate the business on a day-to-day basis.
Lifestyle change demands an understanding of the stages of change. Not only the person need to understand the stages of change but also the coach need to be fully aware of these stages in order for them to be effective. The resistance to change is sure a real stumbling block to our new evolution toward our journey
The document discusses compensation management and various compensation systems. It defines compensation and its key elements, including job evaluation methods, pay structures, and incentive schemes. It outlines the objectives and components of an effective compensation system, and how such systems are used, developed, and administered.
Optimise-GB presents the stages of change management and how you can use programme and project tools to ensure delivery. This presentation also takes you through the elements of change resistance and what can be done about it. Thank you Simon Misiewicz
The document discusses compensation, employee payroll, and incentive management. It defines compensation as monetary and non-monetary benefits provided to employees in return for their services. Direct compensation includes salaries, bonuses, and allowances, while indirect compensation refers to non-monetary benefits like leave policies, insurance, and retirement benefits. Payroll management involves administering employee salaries, wages, deductions, and taxes. Incentive programs are used to motivate employees and maintain internal pay equity.
125 slides include: organizational change, maintenance organization, parallel organization, fantasies about change, controlling change, describing change, 5 stages of change acceptance, turning avoidance into acceptance, understanding loss, resistance, the 4 phases of change transition, strategies for each phase, management of each phase, 3 standard stages of change, communicating about change, ways for stifling innovation and more.
The document discusses compensation and benefits management. It defines key terms like salary, wages, and compensation. It outlines components of compensation including fixed pay, variable pay, benefits, and financial and non-financial rewards. It discusses factors that influence compensation strategy and policies, different compensation models and structures commonly used in India.
School for Health and Care Radicals Slides for Module ThreeHorizons NHS
This document summarizes a discussion on rolling with resistance to change from the School for Health and Care Radicals. It provides an overview of different perspectives on resistance, including viewing it through an "old power" lens of needing to overcome resistance, versus a "new power" lens of embracing resistance and seeing change as emergent. It also discusses building resilience when facing resistance by getting social support, maintaining a hopeful outlook, and building self-efficacy. The discussion emphasized that as change agents, our impact is more important than our intentions, and that we need to create the conditions for transformational conversations about change.
Module 1: Being a health and care radical - change starts with meNHS Improving Quality
These are the slides for module one of The School for Health and Care Radicals, a five week virtual programme, designed to equip people across the health and care system with the core skills to improve their skills as change agents. It supports NHS Change Day 2014, the grassroots movement in which everyone who values the NHS can make a pledge of action to improve things for patients and the health and care system.
Big change only happens in health and care because of heretics and radicals: passionate people who are willing to take responsibility and work with others to make change happen. Being a radical isn't related to hierarchy or position and you don't have to work in the NHS or social care to qualify as one. Registrants to the school so far include patients and carers, students, senior leaders, improvement facilitators and clinical and care staff.
Starting on 31 January, there will be a live weekly web seminar which will be available to 'listen again', supported by a raft of other opportunities, including coaching and mentoring, virtual discussions and tweet chats, and an ever- expanding portal of useful resources.
Programme
The programme focuses on five modules over five weeks, 9:30 to 11:00 am GMT
• Friday 31 January: Being a health and care radical: change starts with me
• Friday 7 February: Forming communities: building alliances for change
• Friday 14 February: Rolling with resistance
• Friday 21 February: Making change happen
• Friday 28 February: Moving beyond the edge
Tweetchat
We will run a tweetchat each Wednesday from 16:00 to 17:00 GMT, based on the content of the module from the previous Friday. A tweetchat is a facilitated conversation using Twitter. The hashtag we will use for the tweetchats is #SHCRchat. The dates for the tweetchats are:
• 5 February
• 12 February
• 19 February
• 26 February
• 5 March
There is no charge to join the School of Health and Care Radicals and it is open to all, whatever your role or level, and whether or not you work in the NHS. There will be additional learning materials and opportunities in addition to the web seminars but there is no set syllabus for learners to work through - you can join for as much or as little as you want.
More information: http://changeday.nhs.uk/healthcareradicals
These are the slides for Module 2 of the School for Health and Care Radicals.
A golden rule for change activists: You can’t be a radical on your own. This module gives you an understanding of the power of working together by exploring communities of practice and social movements. We identify techniques for connecting with our own and others values and emotions to create a call for action.
Agenda:
•Why we can’t be radicals on our own: building communities for change
–What is a community and how can you find power within communities?
•What can we learn from leaders of social movements?
–The power of one, the power of many
–Calls to action – what are they and how are they powerful?
–What are the characteristics of people or groups within effective social movements?
–How to create change at scale
–What is strategy in this context and how can we define resources?
•Effective framing: telling our stories
–What is framing?
–How to connect with people to take action – connecting with emotions through values
–Creating your narrative and the power of telling stories
•Bridging disconnected groups
–Strong vs. weak ties
•Building your own community
–Who are your communities?
–How to build new communities
•Questions and call to action
Questions for reflection from this module:
•What learning and inspiration can you take from social movement leaders to help you in your role as an agent of change in health and care?
•How will you attract the attention of the people you want to call to action?
•Who are the people who are currently disconnected that you want to unite in order to achieve your goal for change? How can you build a sense of “us” with them?
Call to action from this module:
•Identify which communities you are currently part of and how you can utilise your existing communities for change.
•Reflect on who else you would like to be part of your community for change and take action to connect with them.
•Create your narrative or “call to action” to win other people to your cause.
Pre work for minicourse M1 at the IHI National Forum 7th December 2015NHS Improving Quality
This is the "flipped classroom" pre-reading for minicourse M1 "a one day school for health and care radicals" at the Institute for Healthcare Improvement National Forum 7th December 2015
Module 5 Moving beyond the edge
These are the slides for Module 5 of The School for Health and Care Radicals, a five week virtual programme, designed to equip people across the health and care system with the core skills to improve their skills as change agents.
Change always starts at the edge and always starts with the activists. This module looks at ways we can move towards the edge and towards sustainable change.
Agenda:
• Review of what we have learnt so far; characteristics of a transformational change agent
– Peter Fuda’s Transformation Change Agent framework
– ‘Being’ a health and care radical – going back to ‘change starts with me’
– ‘Seeing’ as a health and care radical
– ‘Doing’ as a health and care radical
– Quick review of some models and theories
• 'From’ the edge – views about emerging directions for change and change agents
– What do we mean when we say 'from the edge?'
– What is happening with change?
– What is the difference between tacit and explicit knowledge?
– Opportunities for health and care radicals – being bridge-builders and curators
• Reflections and key messages about The School
– Some things we have learned from delivering The School
• What next for The School?
– Gaining a certificate as a health and care change agent and claiming continuing professional development (CPD) points
• Questions and call to action
Questions for reflection:
• How can I move in the direction of change in ways that will help me bring about the changes I want to see?
• How will I build on my experiences of the School for Health and Care Radicals?
• How will I build networks and communities in support of the changes I want to see?
Call to action:
• Consider why it would be beneficial for you to be a certified change agent.
• Identify people who might help you with this process.
• Take action and, if your change action is something that could be shared for Change Day, please add it on www.changeday.nhs.uk
• Complete the follow-up work for certification.
These are the slides from Module 4: Making change happen
This module brings together themes from earlier modules and examines ways of bringing your aspirations for change to fruition. We will look at the NHS Change model and the energy model and consider the importance of balancing different types of energy and recognising the need for both extrinsic and intrinsic motivation.
Agenda:
Why change efforts often fail to achieve their objectives
What happens to large-scale change efforts in reality?
Leaders and their role as ‘signal generators’
10 key principles of large-scale change
Intrinsic vs extrinsic motivation and drivers
What is the NHS Change Model and how does it align with the above?
How can you build both intrinsic and extrinsic motivators of change into your efforts?
How can you managed the tension between the two?
Building energy for change
What is energy for change?
What are the five energies?
Characteristics of the high and low end of the energies
What is an energy for change profile?
Creating shared purpose
What is our approach to change?
What is the value of a shared purpose?
How to avoid de facto purpose?
Questions and call to action
Questions for reflection:
How can I make the most of both intrinsic and extrinsic aspects of change?
How can I build energy for change for the long haul?
How can I ensure shared purpose throughout my change process?
What can I do tomorrow to accelerate change?
Call to action:
Reflect on how you can use both intrinsic and extrinsic motivators in your practice as a leader or agent of change.
Seek to ignite energy for change in everyone involved in your project.
Build commitment to shared purpose in all your change efforts.
These are the presentation slides for Module 5 of The School for Health and Care Radicals, a five week virtual programme, designed to equip people across the health and care system with the core skills to improve their skills as change agents. It supports NHS Change Day 2014, the grassroots movement in which everyone who values the NHS can make a pledge of action to improve things for patients and the health and care system.
Big change only happens in health and care because of heretics and radicals: passionate people who are willing to take responsibility and work with others to make change happen. Being a radical isn't related to hierarchy or position and you don't have to work in the NHS or social care to qualify as one. Registrants to the school so far include patients and carers, students, senior leaders, improvement facilitators and clinical and care staff.
There is also a live weekly web seminar which will be available to 'listen again', supported by a raft of other opportunities, including coaching and mentoring, virtual discussions and tweet chats, and an ever- expanding portal of useful resources.
Programme
The programme focused on five modules over five weeks, 9:30 to 11:00 am GMT
Friday 31 January 2014: Being a health and care radical: change starts with me
Friday 7 February 2014: Forming communities: building alliances for change
Friday 14 February 2014: Rolling with resistance
Friday 21 February 2014: Making change happen
Friday 28 February 2014: Moving beyond the edge
Tweetchat
We will run a tweetchat each Wednesday from 16:00 to 17:00 GMT, based on the content of the module from the previous Friday. A tweetchat is a facilitated conversation using Twitter. The hashtag we will use for the tweetchats is #SHCRchat. The date for the next tweetchat is 5 March 2014.
There is no charge to join the School of Health and Care Radicals and it is open to all, whatever your role or level, and whether or not you work in the NHS
Resources from all modules can be found at: http://www.nhsiq.nhs.uk/9059.aspx
Managing Change- Steve Fairman presentationmckenln
This document discusses leading change from the front lines in healthcare organizations. It summarizes research showing that most sales are made after multiple contacts, indicating the need for persistence in change efforts. A large crowd-sourced initiative identified the top 10 barriers to change as including confusing strategies, over-controlling leadership, and stifling innovation. The top 11 solutions focused on inspiring leadership, collaborative working, and fostering an open culture. The document advocates empowering all staff to act as change agents by building self-efficacy through setting small, routine change goals and learning from others. Using a change model can provide a framework to address challenges like poor workforce planning.
School for Health and Care Radicals - Module 2 slides 2016Horizons NHS
Module 2 of the School for Health and Care Radicals ran on Thursday 11th February from 14:30-16:00 GMT and was led by Helen Bevan, Chief Transformation Officer, Horizons Group, NHS England. A recording of this module can be found at: http://theedge.nhsiq.nhs.uk/school/module-2/#resources
The golden rule for change activists is: ‘You can’t be a radical on your own’. This module gives us an understanding of the power of working together by exploring communities of practice and social movements. We identify techniques for connecting with our own and others’ values and emotions to create a call for action.
To find out more about the School for Health and Care Radicals, click and paste this link into your address bar: http://theedge.nhsiq.nhs.uk/school
Helen Bevan presents to Kaiser Permanente’s Innovation Leadership NetworkNHS Improving Quality
Helen Bevan's presentation to members of Kaiser Permanente’s Innovation Leadership Network on Friday 4 October 2013 about NHS Change Day.
In 2013, the first NHS Change Day brought together thousands of NHS staff from across clinical and non-clinical areas of work, in a single day of collective action to improve care for patients, their families and their carers. More than 189,000 online pledges of action were made to make a positive difference to the NHS, proving that large scale improvement is possible in the NHS.
The document discusses factors that contribute to successful change agents or "boat rockers". It identifies four key things: 1) having a strong sense of self-efficacy or belief in one's ability to create change; 2) being able to join forces with others to take action; 3) being able to achieve small wins which build momentum; and 4) viewing obstacles as challenges to overcome rather than barriers. Building self-efficacy involves tactics like starting with small, achievable changes and reframing failures as learning opportunities. Social support and learning from exemplars are also discussed.
California presentation March 2015 final version used in DisneyNHS Improving Quality
The document discusses leading change and transformation in health and care. It talks about how most large-scale change efforts do not fully deliver their objectives. It argues that new approaches to change are needed that move beyond traditional hierarchical models and instead focus on building networks and weak ties between diverse groups. The document advocates connecting change efforts to people's values and emotions to generate commitment and motivate action. It also discusses different frames that can be used to construct compelling messages to win people to a cause and call them to action.
Those who embrace and value change inspire others to be more daring. Service users and health care workers must be seen as one team. This workshop intends to share the experience and knowledge of the presenters in order to inspire others to view change as an intrinsic part of care.
Kate Pound and Jenny Clarke, delivered this session at Health and Care Innovation Expo 2015.
This document summarizes a web seminar on rolling with resistance to change. It discusses diagnostic and dialogic approaches to resistance, with diagnostic viewing it as something to overcome and dialogic seeing it as inevitable given diversity. It emphasizes embracing diversity of thought and using the stages of change model to meet people where they are. A story is presented about changing paint color. The stages of change model is explained using smoking cessation as an example. Most change tools focus on the action stage but most people are earlier. The seminar advocates listening to understand different perspectives, building shared purpose, and helping people progress through the stages of change. A panel discusses assessing where key people are at and helping them advance. Participants are called to reflect deeply on
The document summarizes a presentation by Jackie Lynton on social change. The presentation covered Lynton's experience with the NHS, 10 design principles for social change, and how a grassroots movement called NHS Change Day sparked large-scale improvements in the British healthcare system. NHS Change Day encouraged hundreds of thousands of pledges by individuals to make small changes that collectively improved patient care. It showed how empowering people at all levels can drive significant positive change in a large organization.
School for Health and Care radicals - Slides for module fourHorizons NHS
Making change happen: This module will help us create and sustain the energy we need to make change happen. We will look at a number of practical ideas, tools and resources to help us change the way we do change.
Change as an intrinsic part of care, pop up uni, 9am, 3 september 2015NHS England
Expo is the most significant annual health and social care event in the calendar, uniting more NHS and care leaders, commissioners, clinicians, voluntary sector partners, innovators and media than any other health and care event.
Expo 15 returned to Manchester and was hosted once again by NHS England. Around 5000 people a day from health and care, the voluntary sector, local government, and industry joined together at Manchester Central Convention Centre for two packed days of speakers, workshops, exhibitions and professional development.
This year, Expo was more relevant and engaging than ever before, happening within the first 100 days of the new Government, and almost 12 months after the publication of the NHS Five Year Forward View. It was also a great opportunity to check on and learn from the progress of Greater Manchester as the area prepares to take over a £6 billion devolved health and social care budget, pledging to integrate hospital, community, primary and social care and vastly improve health and well-being.
More information is available online: www.expo.nhs.uk
Module 3 slides - School for Change Agents NHS Horizons
It is natural to resist change. Rather than seeing resistance as something negative, here we shift our perspective so that we see dissent, diversity and disruption as essential components of effective change. However, we need to build resilience in order to work effectively with resistance. This module offers some tools and techniques to ensure that we remain strong, adaptable and able to continue our work as change agents.
To find otu more about the School, please visit the website http://theedge.nhsiq.nhs.uk/school/module-3/
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Health Tech Market Intelligence Prelim Questions -Gokul Rangarajan
The Ultimate Guide to Setting up Market Research in Health Tech part -1
How to effectively start market research in the health tech industry by defining objectives, crafting problem statements, selecting methods, identifying data collection sources, and setting clear timelines. This guide covers all the preliminary steps needed to lay a strong foundation for your research.
This lays foundation of scoping research project what are the
Before embarking on a research project, especially one aimed at scoping and defining parameters like the one described for health tech IT, several crucial considerations should be addressed. Here’s a comprehensive guide covering key aspects to ensure a well-structured and successful research initiative:
1. Define Research Objectives and Scope
Clear Objectives: Define specific goals such as understanding market needs, identifying new opportunities, assessing risks, or refining pricing strategies.
Scope Definition: Clearly outline the boundaries of the research in terms of geographical focus, target demographics (e.g., age, socio-economic status), and industry sectors (e.g., healthcare IT).
3. Review Existing Literature and Resources
Literature Review: Conduct a thorough review of existing research, market reports, and relevant literature to build foundational knowledge.
Gap Analysis: Identify gaps in existing knowledge or areas where further exploration is needed.
4. Select Research Methodology and Tools
Methodological Approach: Choose appropriate research methods such as surveys, interviews, focus groups, or data analytics.
Tools and Resources: Select tools like Google Forms for surveys, analytics platforms (e.g., SimilarWeb, Statista), and expert consultations.
5. Ethical Considerations and Compliance
Ethical Approval: Ensure compliance with ethical guidelines for research involving human subjects.
Data Privacy: Implement measures to protect participant confidentiality and adhere to data protection regulations (e.g., GDPR, HIPAA).
6. Budget and Resource Allocation
Resource Planning: Allocate resources including time, budget, and personnel required for each phase of the research.
Contingency Planning: Anticipate and plan for unforeseen challenges or adjustments to the research plan.
7. Develop Research Instruments
Survey Design: Create well-structured surveys using tools like Google Forms to gather quantitative data.
Interview and Focus Group Guides: Prepare detailed scripts and discussion points for qualitative data collection.
8. Sampling Strategy
Sampling Design: Define the sampling frame, size, and method (e.g., random sampling, stratified sampling) to ensure representation of target demographics.
Participant Recruitment: Plan recruitment strategies to reach and engage the intended participant groups effectively.
9. Data Collection and Analysis Plan
Data Collection: Implement methods for data gathering, ensuring consistency and validity.
Analysis Techniques: Decide on analytical approaches (e.g., statistical
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"Market Research it too text-booky, I am in the market for a decade, I am living research book" this is what the founder I met on the event claimed, few of my colleagues rolled their eyes. Its true that one cannot over look the real life experience, but one cannot out beat structured gold mine of market research.
Many 0 to 1 startup founders often overlook market research, but this critical step can make or break a venture, especially in health tech.
But Why do they skip it?
Limited resources—time, money, and manpower—are common culprits.
"In fact, a survey by CB Insights found that 42% of startups fail due to no market need, which is like building a spaceship to Mars only to realise you forgot the fuel."
Sudharsan Srinivasan
Operational Partner Pitchworks VC Studio
Overconfidence in their product’s success leads founders to assume it will naturally find its market, especially in health tech where patient needs, entire system issues and regulatory requirements are as complex as trying to perform brain surgery with a butter knife. Additionally, the pressure to launch quickly and the belief in their own intuition further contribute to this oversight. Yet, thorough market research in health tech could be the key to transforming a startup's vision into a life-saving reality, instead of a medical mishap waiting to happen.
Example of Market Research working
Innovaccer, founded by Abhinav Shashank in 2014, focuses on improving healthcare delivery through data-driven insights and interoperability solutions. Before launching their platform, Innovaccer conducted extensive market research to understand the challenges faced by healthcare organizations and the potential for innovation in healthcare IT.
Identifying Pain Points: Innovaccer surveyed healthcare providers to understand their difficulties with data integration, care coordination, and patient engagement. They found widespread frustration with siloed systems and inefficient workflows.
Competitive Analysis: Analyzed competitors offering similar solutions in healthcare analytics and interoperability. Identified gaps in comprehensive data aggregation, real-time analytics, and actionable insights.
Regulatory Compliance: Ensured their platform complied with HIPAA and other healthcare data privacy regulations. This compliance was crucial to gaining trust from healthcare providers wary of data security issues.
Customer Validation: Conducted pilot programs with several healthcare organizations to validate the platform's effectiveness in improving care outcomes and operational efficiency. Gathered feedback to refine features and user interface.
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2. #SHCR @School4Radicals
Joining in today and beyond
• Please use the chat box to contribute continuously during the
web seminar
• Please tweet using hashtag #SHCR and the handle
@School4Radicals
• Join our Facebook group School for Health and Care Radicals
• We will produce summaries of the discussions on each module
using Storify and Pinterest and put on the website
• Join in the Tweetchat each Wednesday at 4-5pm (GMT) using
the hashtag #SHCR
3. #SHCR @School4Radicals
The team today
Session lead:
Helen Bevan
@HelenBevan
Learning lead
and case study:
Pip Hardy
@PilgrimPip
Chat monitor:
Dominic Cushman
@domcushnan
Case study alumna:
Vanessa Garrity
@VanessaLGarrity
Icebreaker & twitter
monitor:
Kate Pound
@kateslater2
4. #SHCR @School4Radicals
When I meet with resistance at work, I…
… initiate a
conversation in the
hope of understanding
the other point(s) of
view.
… know I’m right – I
just have to persuade
the resisters!
… bring together
people with different
ideas and encourage
them to use their
energy for change.
5. #SHCR @School4Radicals
With which role do you most closely identify?
Receiver of care Campaigner
Change agentAwesome Chief listener
Giver of care
7. #SHCR @School4Radicals
Who are the students of the School for
Health and Care Radicals?
• 77% - healthcare workforce (all sectors)
• 6% - local government which include social
workers, public health
• 6% - education (research and universities)
• 11% - “others” which includes patients and
carers, voluntary sector, consultant /private
sector and police
8. #SHCR @School4Radicals
The biggest learning groups in the
School for Health and Care Radicals
• Nottingham University Hospitals, England – 65
people
• NHS England – 36 people
• Kingston General Hospital, England – 29 people
• Nelson Marlborough District Health Board, New
Zealand – 23 people
The #WARuralHealth learning group
9. #SHCR @School4Radicals
• What do we mean by resistance to change?
• Some different ways to look at resistance
• Importance of diversity in leading change and its
implications in terms of resistance
• Impact and intent
• Using the Stages of Change model to understand
“resistance” and help people through change
• What we tend to do when dealing with resistance and
what we should do?
• Call to action and reflection Source of image: www.freshnessmag.com
for
today
10. #SHCR @School4Radicals
Employee resistance is the
most common reason
executives cite for the
failure of big
organizational-change
efforts
Scott Keller and Colin Price
(2011), Beyond Performance: How
Great Organizations Build Ultimate
Competitive Advantage
Source of image:
Businessconjunctions.com
11. #SHCR @School4Radicals
“
Thousands of patients have died
needlessly because of a
damaging reluctance amongst
doctors and the public to accept
changes in the NHS, according to
the country’s top emergency
doctor
“
16. #SHCR @School4Radicals
Leading change in a new era
Dominant approach Emerging direction
• Change can be planned and
managed through a rigorous
process
• Resistance is a force to
overcome
• Resistance prevents change
• Change agents must
diagnose, manage and/or
overcome resistance
• Resisters can otherwise be
known as “laggards”,
“blockers”, “in denial”
19. #SHCR @School4Radicals
“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
Dominant approach:
the role of the change agent
20. #SHCR @School4Radicals
Leading change in a new era
• Change in human systems is
often emergent and hard to
predict
• Change results from
connections/interactions
stimulating different
perspectives, shaping how
people think about things
• Resistance is an inevitable
consequence of a complex
change process
• Resistance should be embraced
and rolled with
Dominant approach Emerging direction
• Change can be planned and
managed through a rigorous
process
• Resistance is a force to
overcome
• Resistance prevents change
• Change agents must
diagnose, manage and/or
overcome resistance
• Resisters can otherwise be
known as “laggards”,
“blockers”, “in denial”
21. #SHCR @School4Radicals
“Change doesn’t rain down on us from on high. Rather, its stories are co-
created and co-owned by the community. Or, at least they are if you want
the change to stick”
Julian Stodd
https://julianstodd.wordpress.com/2013/11/29/the-co-creation-and-co-ownership-of-organisational-change/
22. #SHCR @School4Radicals
Leaders ask their staff to be ready for change,
but do not engage enough in
sensemaking........
Sensemaking is not done via marketing...or
slogans but by emotional connection with
employees
Ron Weil
23. #SHCR @School4Radicals
Resistant behaviour is a good
indicator of missing relevance.”
Harald Schirmer
http://de.slideshare.net/haraldschirmer/strategies-for-corporate-change-the-new-
role-of-hr-driving-social-adoption-and-change-in-the-enterprise
Source of image: driverlayer.com
‘‘
25. #SHCR @School4Radicals
Language constructs our world(s) rather than
reports the objective facts about the world.
Therefore changing when, where, how and
which people talk about things – changing the
conversation – will lead to organisational
change.”
Robert J Marshak
Source of image: createbusiness.net.au
‘‘
26. #SHCR @School4Radicals
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
Emerging direction:
the role of the change agent
Source of image: rachtalks.pressprestige.com
27. #SHCR @School4Radicals
“Having care wrapped around the person rather
than the person pushed through the system.”
Lesley Young-Murphy
North Tyneside Clinical Care Group
30. #SHCR @School4Radicals
The evidence of experience
‘Statistics tell us the
system’s experience
of the individual,
whereas stories tell
us the individual’s
experience of the
system…’
Tony Sumner, 2009
31. #SHCR @School4Radicals
The Patient Voices mandala
‘The stories go out, like
flashes of light over the
waves, as markers and
guides, comfort and
warning.’
Winterson 2004
32. #SHCR @School4Radicals
“The most basic not-so-secret formula for building an
innovation culture is pretty simple - embrace diversity
and start to attract, retain and promote a diverse
workforce that looks differently, works differently, dress
differently, speaks differently and is inclusive of the full
spectrum of human sexual orientation and gender
identities. Do this before you start hiring consultants
and rethinking your innovation process, there is no
process that works without true diversity.”
Idris Moore
Source of image: idsgn.org
Diversity is critical to innovation and change
33. #SHCR @School4Radicals
“Leaders and organisations must let go of the
idea that there is “one right way” and instead
focus on creating a learning culture where
people feel accepted, are comfortable
contributing ideas, and actively seek to learn
from each other”
Diaz_Uda, Medina and Schill (2013)
Source of image:fineartamerica.com
As health and care radicals, we should be
champions of diversity for change
34. #SHCR @School4Radicals
In the context of “rolling with resistance”
• What are the implications of embracing
diversity of thought, experience and
background in our change efforts?
• What skills and perspectives do health and
care radicals need to work effectively with
diverse teams for change?
Source of image:fineartamerica.com
Discussion
36. #SHCR @School4Radicals
• Helen’s intent was to give people quick
solutions, help them do their work faster
and get on to the next problem at hand
• However, her impact was that people did
not know how to solve their own
problems so that Helen’s style was
impeding their development
Source: adapted from Intent vs. Impact: A Leadership Lesson by Claudia Busch Lee
Source of image: thedigitalawards.com
38. #SHCR @School4Radicals
• Build a trusting and supportive work
environment
• Listen like an ally
• Be open with my intent
• Fully commit to the change
• Seek common purpose and common
interests
• Take time to build relationships
• Take responsibility for my own actions
What can I do?
49. #SHCR @School4Radicals
Research from the sales industry:
How many NOs should we be seeking to get?
• 2% of sales are made on the first contact
• 3% of sales are made on the second contact
• 5% of sales are made on the third contact
• 10% of sales are made on the fourth contact
• 80% of sales are made on the fifth to twelfth
contact
Source: http://www.slideshare.net/bryandaly/go-for-no
50. #SHCR @School4Radicals
“Papers that are more likely to contend against
the status quo are more likely to find an
opponent in the review system—and thus be
rejected —but those papers are also more
likely to have an impact on people across the
system, earning them more citations when
finally published.”
V. Calcagno et al., “Flows of research manuscripts among
scientific journals reveal hidden submission patterns,”
Science, doi:10.1126/science.1227833, 2012.
—
53. #SHCR @School4Radicals
• smoking cessation
• exercise adoption
• alcohol and drug use
• weight control
• fruit and vegetable intake
• domestic violence
• HIV prevention
• use of sunscreens to prevent skin cancer
• medication compliance
• mammography screening
The model is mostly used around
health-related behaviours
54. #SHCR @School4Radicals
• smoking cessation
• exercise adoption
• alcohol and drug use
• weight control
• fruit and vegetable intake
• domestic violence
• HIV prevention
• use of sunscreens to prevent skin cancer
• medication compliance
• mammography screening
It works for
organisational and
service change too!
The model is mostly used around
health-related behaviours
55. #SHCR @School4Radicals
“Stages of change”
Smoking
I am not aware my
smoking is a
problem – I have no
intention to quit
Prochaska, DiClemente & Norcross (1992)
56. #SHCR @School4Radicals
“Stages of change”
Smoking
I am not aware my
smoking is a
problem – I have no
intention to quit
I know my smoking
is a problem – I
want to stop but no
plans yet
Prochaska, DiClemente & Norcross (1992)
57. #SHCR @School4Radicals
I am not aware my
smoking is a
problem – I have no
intention to quit
I know my smoking
is a problem – I
want to stop but no
plans yet
I am making plans
& changing things
I do in
preparation.
“Stages of change”
Smoking
Prochaska, DiClemente & Norcross (1992)
58. #SHCR @School4Radicals
I am not aware my
smoking is a
problem – I have no
intention to quit
I know my smoking
is a problem – I
want to stop but no
plans yet
I am making plans
& changing things
I do in
preparation.
I have
stopped
smoking!
“Stages of change”
Smoking
Prochaska, DiClemente & Norcross (1992)
59. #SHCR @School4Radicals
I am not aware my
smoking is a
problem – I have no
intention to quit
I know my smoking
is a problem – I
want to stop but no
plans yet
I am making plans
& changing things
I do in
preparation.
I have
stopped
smoking!
I am continuing to
not smoke.
I sometimes miss it
– but I am still not
smoking
“Stages of change”
Smoking
Prochaska, DiClemente & Norcross (1992)
60. #SHCR @School4Radicals
I am not aware my
smoking is a
problem – I have no
intention to quit
I know my smoking
is a problem – I
want to stop but no
plans yet
I am making plans
& changing things
I do in
preparation.
I have
stopped
smoking!
I am continuing to
not smoke.
I sometimes miss it
– but I am still not
smoking
“Stages of change”
Smoking
Prochaska, DiClemente & Norcross (1992)
62. #SHCR @School4Radicals
• Which stage do most change activities in
health and care focus on?
• Which stage are most people actually
at?
Some questions
63. #SHCR @School4Radicals
The reality of our change situation
• Our tools are often not effective at the stage of change
that most people we work with are at
• It’s hard to engage people in change
• It’s hard to get people to make the changes we want
them to make
• People get irritated, defensive, irrational
• We feel powerless in our ability to lead or facilitate the
change
90% of the tools available for health and care change
agents are designed for the “action” stage
64. #SHCR @School4Radicals
• Designed for Stage 4 –
ACTION!
• Mandated it through
targets
• Despite compelling
case for change –
people resisted it – no
values connection
• People did the task
and missed the point
Example – WHO Surgical Safety Checklist
65. #SHCR @School4Radicals
IN A NUTSHELL
• Evidence from observational studies that the use of surgical safety
checklists results in striking improvements in outcomes
• Led to rapid adoption of such checklists worldwide
• Researchers studied effect of mandatory adoption of checklists in
Ontario, Canada
• Use of checklists not associated with significant reductions in
operative mortality or complications
66. #SHCR @School4Radicals
• Lower our ambitions for improvement
• Focus our energies on those who are
already in the “action” stage
• Put negative labels on those who are
not yet at the action stage such as
“blocker” or “resister” or “laggard”
• Blame “the management” for not
enforcing change
So what do we TEND to do when people
resist?
68. #SHCR @School4Radicals
• Listen and understand
• appreciate the starting point
• elaborate interests
• Roll with resistance (Singh)
• Don’t argue against it
• Encourage elaboration of resistance
•What makes it so hard?
•What would help?
• Build meaning and conviction in the
change
So what SHOULD we do?
69. #SHCR @School4Radicals
• The focus should be on
creating awareness for me of
the need to change
• Remember the goal is not to
make me (as a
precontemplator) change
immediately, but to help me
move to contemplation
• I am not thinking about
changing my behaviours,
actions or work processes
• The problem or issue is
outside my frame of
awareness or my perceived
need
70. #SHCR @School4Radicals
Focussing on Prochaska, DiClemente and
Norcross’s Stages of Change model:
• What stage of change are some of the
key people that you need to influence
for your change initiative at?
• What actions can you take to help them
move to the next stage?
Thinking about your own situation
74. #SHCR @School4Radicals
Call to action for this week
• Reflect deeply on how you operate as
an agent for change
• Consider the impact of your
communication and behaviour beyond
your intent
• Listen to others’ views, engage others in
change and help others through the
stages of change
75. #SHCR @School4Radicals
• Wednesday 18th February
16:00-17:00 Tweet chat #SHCR
• Next Friday morning 20th February
module 4: Making change happen
Next opportunities for learning
76. #SHCR @School4Radicals
1. What does resistance mean to you?
think about the things you resist as well as your
responses to others’ resistance
2. How do you work with resistance as a change leader?
3. How can you make sure that the changes you make
achieve the impact you desire and also
are sustainable?
do not create dependency?
generate self-efficacy in others?
4. Who you are interacting with and where they are on
the Stages of Change model?
Questions for reflection