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

Aug 23, 2014

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Healthcare

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.
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Page 1: Helen Bevan Manchester

@HelenBevan

Three paradoxes to manage for big change

20th May 2014Helen Bevan@HelenBevan

“something that is made up of two opposite things and that

seems impossible but is actually true or possible”

Page 2: Helen Bevan Manchester

@HelenBevan

Page 3: Helen Bevan Manchester

@HelenBevan Source of image: Whatsthebigideascwartzy.blogspot.com

Page 4: Helen Bevan Manchester

@HelenBevan

Most change initiatives don’t fullydeliver 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

Page 5: Helen Bevan Manchester

@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 fullydeliver their objectives

Page 6: Helen Bevan Manchester

@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 goalPeter Fuda http://www.peterfuda.com/wp-content/themes/peterfuda-bootstrap/content/Why-Change-Efforts-Fail.pdf Source of image: Whatsthebigideascwartzy.blogspot.com

Page 7: Helen Bevan Manchester

@HelenBevanImage from: @TheWorldStories

Page 8: Helen Bevan Manchester

@HelenBevanImage from: @TheWorldStories

Page 9: Helen Bevan Manchester

@HelenBevan

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@HelenBevan

Leading change in a new eraDominant approach Emerging direction

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@HelenBevan

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@HelenBevan

Page 13: Helen Bevan Manchester

@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/mexicanwave/champions-trolls-10-years-of-the-cipd-online-community

Page 14: Helen Bevan Manchester

@HelenBevan

The Network Secrets of Great Change AgentsJulie 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

Page 15: Helen Bevan Manchester

@HelenBevan

Page 16: Helen Bevan Manchester

@HelenBevan

Different thinking for different results

Transitional change

“Designing a co-ordinated system”

Page 17: Helen Bevan Manchester

@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

Page 18: Helen Bevan Manchester

@HelenBevan

Building an enduring capacity for change

Different thinking for different results

Transformational change

Page 19: Helen Bevan Manchester

@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

Page 20: Helen Bevan Manchester

@HelenBevan

Page 21: Helen Bevan Manchester

@HelenBevan

Diagnostic and

dialogic approaches

to resistance to change

Page 22: Helen Bevan Manchester

@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

Page 23: Helen Bevan Manchester

@HelenBevanImage from: @TheWorldStories

Page 24: Helen Bevan Manchester

@HelenBevan@HelenBevan #transformkp

Resistance to change

Page 25: Helen Bevan Manchester

@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 changeBritish Journal of Healthcare Management, Vol. 19, Iss. 9, 09 Sep 2013, pp 443 - 445

Diagnostic: the role of the change agent

Page 26: Helen Bevan Manchester

@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

Page 27: Helen Bevan Manchester

@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. Creat e 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

Page 28: Helen Bevan Manchester

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

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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