Human Dimensions of Change and Team Working Hannah Wall National Improvement Lead
Dec 07, 2014
Human Dimensions of Change
and Team Working
Hannah Wall
National Improvement Lead
Aims of this session
• To understand the importance of team working to create successful improvements
• To recognise that managing change for individuals and within teams is a fundamental part of service improvement
• To recognise individual styles within teams and how those styles respond to change
• To offer tools to help in the acceptance of new ways of working
• To understand the role of improvement leader
Teams in endoscopy
• Scheduling/ booking
• Decon
• Procedure room
• Whole unit
Good team work is essential everyday for:
safety, efficiency, productivity and morale.
You just can’t get it done alone…
Successful improvement teams
• Share the work load
• Generate new ideas
• Conduct PDSA and testing
• Embed for sustainability
Working with a team during
improvement
All improvement requires change, but not all change is improvement.
Anonymous
A round man cannot be expected to fit into a square hole right away. He must have time to modify his shape.
Mark Twain
Diffusion of Innovations
We have all been laggards
• iPhone 7?• Self-service scans at the checkout?• Hybrid cars?• eBay?• Flat screen TV?• Analogue vs digital?
Transition CurveC
om
pe
ten
ce
/ C
on
fid
en
ce
/Se
lf e
ste
em
Time
1. Shock
3. Denial
5. Bargaining
8. Acceptance
7. Testing
Source – Based on Kubler-Ross 1969, Adam,
Hayes and Hopson, 1976 and Virginia Satir (1991)
4. Anger
6. Depression
2. Hysteria
Mobilise Move Sustain
Transition CurveC
om
pete
nce/
Confidence/S
elf e
ste
em
Time
1. Shock
3. Denial
5. Bargaining
8. Acceptance
7. Testing
4. Anger
6. Depression
2. Hysteria
Mobilise Move Sustain
Minimise shock
Full and early
communication
of intentions,
possibilities and
overall change of
direction
Discuss implications with
individuals and
teams
Pay attention to
people’s needs
and concerns
Practice patience
Listenempathise, support
Don’t suppress
conflict or different
views of emotions
Remember people
aren’t necessarily
attacking you
personally
Encourage
Paint a vision
Foster
communication
Create goals and
opportunities
Coach
Delegate
Discuss
Reflect
Celebrate
success
Prepare to start again!
Source – Based on Kubler-Ross 1969, Adam,
Hayes and Hopson, 1976 and Virginia Satir (1991)
We are all different
• Amiable
• Driver
• Analyst
• Expressive
Merrill D.W. and Reid R.H.(1999)
Personal Styles and Effective Performance:
make your style work for you
Analyst: the Technical Specialist
• Accurate
• Conscientious
• Serious
• Persistent
• Organised
• Deliberate
• Cautious
The Expressive: Social Specialist
• Verbal
• Inspiring
• Ambitious
• Enthusiastic
• Energetic
• Confident
• Friendly
• Influential
Amiable: The Relationship Specialist
• Patient
• Respectful
• Willing
• Agreeable
• Dependable
• Concerned
• Relaxed
• Organised
• Mature
• Empathetic
Driver: Command Specialist
• Decisive
• Independent
• Practical
• Determined
• Efficient
• Assertive
• A risk taker
• Direct
• Problem solver
Which type are you?
Analyst Amiable Expressive Driver
Analytical Patient Verbal Action-orientated
Controlled Loyal Motivating Decisive
Orderly Sympathetic Enthusiastic Problem solver
Precise Team person Gregarious Direct
Disciplined Relaxed Convincing Assertive
Deliberate Mature Impulsive Demanding
Cautious Supportive Generous Risk-taker
Diplomatic Stable Influential Forceful
Accurate Considerate Charming Competitive
Conscientious Empathetic Confident Independent
Fact finder Persevering Inspiring Determined
Systematic Trusting Dramatic Results-orientated
Logical Congenial Optimistic
Conventional Animated
How do you feel about change?
How do you behave under stress?
The Analyst
The Analyst:
Technical Specialist
May be perceived
positively as
May be perceived
negatively as
How to work better
with analysts
• accurate • critical • tell how first
• conscientious • picky • list pros & cons
• serious • moralistic • be accurate & logical
• persistent • stuffy • provide evidence
• organised • stubborn • provide deadlines
• deliberate • indecisive • give them time
• cautious • don’t rush or surprise
The Amiable
The Amiable: Relationship Specialist
May be perceived
positively as
May be perceived
negatively as
How to work better
with amiables
• patient • hesitant • tell why & who first
• respectful • ‘wishy-washy’ • ask instead of telling
• willing • pliant • draw out their opinions
• agreeable • conforming • chat about their life
• dependable • dependent • define expectations
• concerned • unsure • strive for harmony
• relaxed • laid back
• organised
• mature
• empathetic
The Expressive
The Expressive: Social Specialist
May be perceived
positively as
May be perceived
negatively as
How to work better
with expressives
• verbal • a talker • tell who first
• inspiring • overly dramatic • be enthusiastic
• ambitious • impulsive • allow for fun
• enthusiastic • undisciplined • support their creativity & intuition
• energetic • excitable • talk about people & goals
• confident • egotistical • value feelings & opinions
• friendly • flaky • keep fast paced
• influential • manipulating • be flexible
The Driver
The Driver: Command Specialist
May be perceived
positively as
May be perceived
negatively as
How to work better
with drivers
• decisive • pushy • tell what & when first
• independent • one man show • keep fast paced
• practical • tough • don’t waste time
• determined • demanding • be business like
• efficient • dominating • give some freedom
• assertive • an agitator • talk results
• risk-taker • cuts corners • find shortcuts
• direct • insensitive
• a problem solver
Analytical•not enough information
•making a wrong decision
•being forced to decide
Driver•loss of control
•failure
•lack of purpose
Amiable•damaged relationships
•confrontations
•not being recognised
for efforts
Expressive•being ignored
•being asked for detail
•being linked with failure
Merrill D, Reid R (1991) Personal Styles and Effective Performance, CRC Press, London
Fears about change
Case study
An Improvement Leader (driver) was keen to bring about a change to reduce waiting times for patients. However, she initially failed to realise her list of pros and cons was not sufficient to convince her ‘amiable’ colleague. Her colleague needed to feel convinced that it was a real improvement from the patients’ point of view.
How can we take this forward?
• Recognise different types within your teams
• Understand individuals must see the ‘what’s in it for me?’
• Consider the strengths of each type and how they will
respond when faced with change
• Which types are similar and which clash
• Remember everyone will go through the transition curve at
a different speed
• Fears should be dealt with and expectations should be
managed realistically
Diffusion of Innovations
• Work with people initially who want to get involved
• Rather than repeating the argument for change modify your approach to those who fall in the latter half of the curve
• If you engage 20% of a population, the rest will follow
Improvement tools (1)
1. Verbal communication
- 1:1s
- Team meetings
- Daily ‘huddle’ – highly inclusive 15 min meeting every morning led by different people every day
2. Encourage and act upon staff feedback
- Create opportunities for people to express their views e.g. anonymous opinion board in a less used area with frequent responses or a staff survey
Improvement tools (2)
Improvement tools (3)
3. Visual management
- Show publically how the unit is performing and praise achievements
Leading Improvement
http://www.changemodel.nhs.uk/pg/groups/12195
Leading Improvement
Leading improvement – basically it’s all about the leader
having a mind set change from one of fire fighting to one of
continuous improvement
Quote from NHS Institute
Changing leadership styles