This presentation examines a number of strategies to enable successful change to take place.

1. Managing Change – Choosing A
Strategy
David Stonehouse
Senior Lecturer
Tel: 01695 657003
E-mail: stonehod@edgehill.ac.uk
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2. Change Tools
■ Rosabeth Moss ■ PDSA Cycle
Kanter ■ Seven Steps For
■ SWOT Analysis Improvement
■ The Change ■ Gannt Charts
Equation ■ Responsibility
■ Process mapping Matrix
■ RAID Model ■ Prince
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3. Ten Commandments For
Executing Change
(Kanter et al, 1992)
1. Analyse the organisation & its need for change
2. Create a shared vision & a common direction
3. Separate from the past
4. Create a sense of urgency
5. Support a strong leader role
6. Line up political sponsorship
7. Craft an implementation plan
8. Develop enabling structures
9. Communicate, involve people & be honest
10. Reinforce & institutionalise change.
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4. SWOT Analysis (Mullins, 2010)
Strengths Weaknesses
Opportunities Threats
■ Analyse the problem
■ Identify priorities for action
■ Consider internal and external factors
■ Consider the consequences of actions
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5. The Change Equation
Dissatis- First
faction X Vision X Capacity X
Steps > Resistance
•Dissatisfaction: with the present situation
•Vision: an understanding of what the change(s) would look like
•Capacity: Sufficient resources to make the change happen
•First Steps: an appreciation of how the change is to be implemented

6. Process Mapping
What is a process?
“A series of connected steps or actions which
achieve an outcome.”
It has:
■ Start and end point. (this is the scope)
■ A purpose or aim.
■ Rules governing the standard or quality of inputs
throughout the process.
■ Can be simple & short, or complex & long.
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7. Think about all the different steps you do
from getting up out of bed to going out the
door to work.
WAKE UP DRINK EXIT FOR WALK
COLLEGE DOG
PREPARE CLEAN EAT GET
LUNCH TEETH DRESSED
GET KIDS WATCH WASH/ GET KIDS
DRESSED T.V. SHOWER UP
GET KIDS TALK TO LISTEN TO TOILET
FOOD PARTNER RADIO

8. A Process Map of this could
look something like this
WASH/
WAKE UP TOILET SHOWER
GET KIDS UP GET DRESSED CLEAN
TEETH
GET KIDS GET KIDS DRINK
EAT
DRESSED FOOD
EXIT HOUSE PREPARE LUNCH

9. How to Process Map?
■ Get ■ Plan 2 events
representatives of - 1st Process
all people mapping
involved, staff - 2nd Action
patients, families, planning
external groups.
■ Use Post-it notes
■ Need support.
in different colours
and flip charts.
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10. RAID Model
■ Review:
■ Agree:
■ Implement:
■ Demonstrate:
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11. REVIEW
■ Teams gain the patients and
families views of the service to
capture the quality of services
delivered and to hear their
suggestions for improvement.
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12. AGREE
■ Results of this listening exercise are
triangulated with a staff listening
exercise and aligned to influence the
strategic direction of the
organisation. Patients are fed back
the findings
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13. IMPLEMENT
■ Teams work with patients to
implement changes in practice, i.e
Patients/carers are involved in audit,
process mapping, training,
influencing committees, on interview
panels.
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14. DEMONSTRATE
■ Demonstrate the improvements to
both patients and staff/organisation.
■ Does it make a difference?
■ Will benefits continue?
■ Identifying lessons
■ Spreading the message
■ Sharing the learning
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15. Model for improvement
What are we trying to project aims
accomplish?
PDSA
CYCLE

16. Model for improvement
What are we trying to project aims
accomplish?
How will we know that a global measurements
change is an improvement?
PDSA
CYCLE

17. Model for improvement
What are we trying to project aims
accomplish?
global measurements
How will we know that a
change is an improvement?
change principles
What changes can we make that
will result in the improvements
that we seek ?
PDSA
CYCLE

18. Model for improvement
What are we trying to project aims
accomplish?
How will we know that a global measurements
change is an improvement?
What changes can we make that change principles
will result in the improvements
that we seek ?
Plan
PDSA
CYCLE

19. Model for improvement
What are we trying to project aims
accomplish?
global measurements
How will we know that a
change is an improvement?
change principles
What changes can we make that
will result in the improvements
that we seek ?
Plan
PDSA
Do CYCLE

20. Model for improvement
What are we trying to project aims
accomplish?
How will we know that a global measurements
change is an improvement?
What changes can we make that change principles
will result in the improvements
that we seek ?
Plan
PDSA
Study Do CYCLE

21. Model for improvement
What are we trying to project aims
accomplish?
How will we know that a global measurements
change is an improvement?
What changes can we make that change principles
will result in the improvements
that we seek ?
Act Plan
PDSA CYCLE
Study Do (NHS Institute For Innovation
And Improvement, 2007)

22. Seven Steps For
Improvement
Step 1. Step 2.
Define the aim for the Consider how you are
project: going to know if a change
- the group of is an improvement:
patients/staff.
-what measures are you
- your targets.
going to use
-how are you going to
report progress to
interested parties

23. Seven Steps For
Improvement
Step 3. Step 4.
Involve everyone in Investigate all the
mapping / analysing the changes that are likely to
process: make an improvement in
- to really understand the line with the aims set:
problems for all parties
- talk to other areas,
- to start to measure &
organisations.
create the baselines for
your improvements.

24. Seven Steps For
Improvement
Step 5. Step 6.
Test out the change ideas Implement the changes
to see if they actually do that you have identified
make improvements: that will make
- consider the knock on improvements.
effects that making one
change will have to that
process & other parts of
the system or different
systems.

25. Seven Steps For
Improvement
Step 7.
Review changes to ensure
improvement
&
Celebrate success
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26. Gantt Charts
■ Are a visual scheduling tool
■ Show dependencies between tasks,
personnel, and other resources
■ Helps track progress towards
completion.
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27. Gantt Charts
• List all tasks and milestones along
the vertical axis
• List time frame along the horizontal
axis.
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29. Responsibility Matrix
■ Creates accountability by assigning
each task to a person.
Task Bob John Betty Albert
Activity 1. X
Activity 2. X X
Activity 3. X
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30. PRINCE2
PRINCE stands for:
Projects
IN
Controlled
Environments
Used extensively by the U.K. government
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31. PRINCE2
■ Process based approach to project
management.
■ Project is divided into manageable
stages.
■ Project plans are focused on
delivering results.
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32. References
Burnes, B. (2000) Managing Change: A Strategic Approach To
Organisational
Dynamics. Third Edition. Essex: Pearson Education Ltd.
Kanter, R.M. (2009) ‘Managing The Human Side Of Change.’ In:
Price, D. (ed) The Principles And Practice Of Change. Hampshire:
Palgrave MacMillan. Pp 175-183.
Kanter, R.M; Stein and Jick (1992) The Challenge of Organizational
Change. New York: Free Press.
Marquis, B. L. & Huston, C. J. (2009) Leadership Roles and
Management Functions in Nursing. Sixth Edition. Philadelphia:
Lippincott Williams & Wilkins.
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33. References
Mullins, L.J. (2010) Management and Organisational Behaviour.
Ninth Edition. London:Financial Times Prentice Hall.
NHS Institute For Innovation And Improvement (2007) Process
Mapping, Analysis And Redesign: General Improvement Skills.
Nottingham: NHS.
Smith, A. & Langston, A. (1999) Managing Staff in Early Years
Settings. London: Routledge.
Stonehouse, D. (2011) ‘Management and Leadership For Support
Workers.’ British Journal of Healthcare Assistants. October. Vol 05.
No 10.
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