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Getting Everyone on the Bus:
The Art of Influence
Marlies van Dijk, Quality and Healthcare Improvement
@tweetvandijk
@HCRCentral
Where are you focusing your
“influence”?
What is the change you are
working on right now?
-chat-
Why do you think the failure
rate of change is so high?
-chat-
#SCHR #Quality2015 @HelenBevan @BoelGare @jackielynton
The Reality
“What the leader cares about (and typically bases at
least 80% of his or her message to others on) does
not tap into roughly 80% of the workforce’s primary
motivators for putting extra energy into the change
programme”
Scott Keller and Carolyn Aiken (2009)
Source of image: swedenbourg-openlearning.org.uk
#SCHR #Quality2015 @HelenBevan @BoelGare @jackielynton
If we want people to take action, we have to
connect with their emotions through values
valuesvalues
emotionemotion
Source: Marshall Ganz
actionaction
#SCHR #Quality2015 @HelenBevan @BoelGare @jackielynton#IQTGOLD#SCHR #Quality2015 @HelenBevan @BoelGare @jackielynton
“We have new
set of clinical
Guidelines”
oror
“I have a dream”
Source: @RobertVarnam
#hellomynameis
#SCHR #Quality2015 @HelenBevan @BoelGare @jackielynton
Kinds of people at work
The
Contributors
The
Compliant
The
Contras
Adapted from The Emotional Economy http://emotionaleconomy.com.au/papers-articles/why-the-
winners-in-business-are-taking-the-time-to-build-a-positive-kind-social-culture/
#SCHR #Quality2015 @HelenBevan @BoelGare @jackielynton
Kinds of people at work
The
Contributors
The
Compliant
The
Contras
Gallup global research:
•Only 13% of the workforce are
engaged (Contributors)
•Contributors create six times the
value to an organisation compared
to the Compliant
http://www.gallup.com/poll/165269/wo
rldwide-employees-engaged-work.aspx
Adapted from The Emotional Economy http://emotionaleconomy.com.au/papers-articles/why-the-
winners-in-business-are-taking-the-time-to-build-a-positive-kind-social-culture/
#SHCR @School4Radicals
There has never been a time in the history
of healthcare when this advice has been
more pertinent
“Leadership is not about making clever
decisions and doing bigger deals. It is about
helping release the positive energy that
exists naturally within people”
Henry Mintzberg
Purpose is good: Shared Purpose is Better. HBR @MarkBonchek
#SHCR @School4Radicals@HelenBevan
A 3-word concept
Examples
Adidas
The Adidas Group strives to be the global leader
in the sporting goods industry with brands built
on a passion for sports and a sporting lifestyle
Nike
To bring inspiration and innovation to every
athlete* in the world
(*if you have a body, you are an athlete)
Example
Dunkin Donuts:
Make and serve the freshest, most delicious
coffee and donuts quickly and courteously in
modern, well-merchandised stores.
Starbucks:
Our mission: to inspire and nurture the human
spirit – one person, one cup and one
neighborhood at a time.
#SCHR #Quality2015 @HelenBevan @BoelGare @jackielynton
Avoiding “de facto” purpose
• What leaders pay attention to matters to staff, and consequently
staff pay attention to that too
• Shared purpose can easily be displaced by a “de facto” purpose:
 hitting a target
 reducing costs
 reducing length of stay
 eliminating waste
 completing activities within a timescale
 complying with an inspection regime
• If purpose isn’t explicit and shared, then it is very easy for
something else to become a de facto purpose in the minds of the
workforce
Source: Delivering Public Services That Work: The Vanguard Method in the Public Sector
What purposes do we primarily
use in healthcare?
Poll
#SCHR #Quality2015 @HelenBevan @BoelGare @jackielynton
Effective framing:
what do we need to do?
1. Tell a story
2. Make it personal
3. Be authentic
4. Create a sense of “us” (and be clear who the “us”
is)
5. Build in a call for urgent action
Source of image: woccdoc.org
Which do you like better?
1. Our infection rates are higher than they should be.
We have new clinical guidelines. Let’s work
together to implement them!
2. You are the one at the bedside. You know what
works and what doesn’t. How can we tackle our
infection rates?
3. Remember Mrs. Smith. She fully recovered from C-
diff that she picked up on our unit. Just like you, I
want to protect more of the chronic elderly. What
do you think we can do?
Change Management
• Creating a compelling story
• Role modelling
• Capability Building
The irrational side of change management: McKinsey and Co.
#SCHR #Quality2015 @HelenBevan @BoelGare @jackielynton#SCHR #Quality2015 @HelenBevan @BoelGare @jackielynton
What are the traits of
“inspirational”
leaders?
-chat-
#WhatsYourStory Oct 5-9
What motivates people?
• Impact on Society (building community)
• Impact on Customer (patients and families)
• Impact on Organization
• Impact on Team (work environment)
• Impact on me (development or bonus)
#SCHR #Quality2015 @HelenBevan @BoelGare @jackielynton
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
#SCHR #Quality2015 @HelenBevan @BoelGare @jackielynton
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
‘‘‘‘
Leading change in a new era
Dominant approach Emerging direction
Leading change in a new era
Dominant approach Emerging direction
Most healthcare
transformation
efforts are driven
from this side
Most healthcare
transformation
efforts are driven
from this side
John Kotter: “Accelerate!”
• We won’t create big change
through hierarchy on its own
• We need hierarchy AND network
• Many change agents, not just a
few, with many acts of
leadership
• At least 50% buy-in required
• Changing our mindset
– From “have to” to “want to”
TO
#SCHR #Quality2015 @HelenBevan @BoelGare @jackielynton#SCHR #Quality2015 @HelenBevan @BoelGare @jackielynton
‘‘Leaders must wake people out of
inertia. They must get people excited
about something they’ve never seen
before, something that does not yet
exist”
Rosa Beth Moss Kanter
Viral Change, Leandro Herrero
#ChangeDayAB
Thank you
marlies.vandijk@albertahealthservices.ca
@HCRcentral @tweetvandijk

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Getting everyone on the bus: The art of influence final

  • 1. Getting Everyone on the Bus: The Art of Influence Marlies van Dijk, Quality and Healthcare Improvement @tweetvandijk @HCRCentral
  • 2.
  • 3. Where are you focusing your “influence”? What is the change you are working on right now? -chat-
  • 4.
  • 5. Why do you think the failure rate of change is so high? -chat-
  • 6. #SCHR #Quality2015 @HelenBevan @BoelGare @jackielynton The Reality “What the leader cares about (and typically bases at least 80% of his or her message to others on) does not tap into roughly 80% of the workforce’s primary motivators for putting extra energy into the change programme” Scott Keller and Carolyn Aiken (2009) Source of image: swedenbourg-openlearning.org.uk
  • 7.
  • 8. #SCHR #Quality2015 @HelenBevan @BoelGare @jackielynton If we want people to take action, we have to connect with their emotions through values valuesvalues emotionemotion Source: Marshall Ganz actionaction
  • 9. #SCHR #Quality2015 @HelenBevan @BoelGare @jackielynton#IQTGOLD#SCHR #Quality2015 @HelenBevan @BoelGare @jackielynton “We have new set of clinical Guidelines” oror “I have a dream” Source: @RobertVarnam
  • 10.
  • 12.
  • 13. #SCHR #Quality2015 @HelenBevan @BoelGare @jackielynton Kinds of people at work The Contributors The Compliant The Contras Adapted from The Emotional Economy http://emotionaleconomy.com.au/papers-articles/why-the- winners-in-business-are-taking-the-time-to-build-a-positive-kind-social-culture/
  • 14. #SCHR #Quality2015 @HelenBevan @BoelGare @jackielynton Kinds of people at work The Contributors The Compliant The Contras Gallup global research: •Only 13% of the workforce are engaged (Contributors) •Contributors create six times the value to an organisation compared to the Compliant http://www.gallup.com/poll/165269/wo rldwide-employees-engaged-work.aspx Adapted from The Emotional Economy http://emotionaleconomy.com.au/papers-articles/why-the- winners-in-business-are-taking-the-time-to-build-a-positive-kind-social-culture/
  • 15.
  • 16. #SHCR @School4Radicals There has never been a time in the history of healthcare when this advice has been more pertinent “Leadership is not about making clever decisions and doing bigger deals. It is about helping release the positive energy that exists naturally within people” Henry Mintzberg
  • 17. Purpose is good: Shared Purpose is Better. HBR @MarkBonchek
  • 19. Examples Adidas The Adidas Group strives to be the global leader in the sporting goods industry with brands built on a passion for sports and a sporting lifestyle Nike To bring inspiration and innovation to every athlete* in the world (*if you have a body, you are an athlete)
  • 20. Example Dunkin Donuts: Make and serve the freshest, most delicious coffee and donuts quickly and courteously in modern, well-merchandised stores. Starbucks: Our mission: to inspire and nurture the human spirit – one person, one cup and one neighborhood at a time.
  • 21.
  • 22. #SCHR #Quality2015 @HelenBevan @BoelGare @jackielynton Avoiding “de facto” purpose • What leaders pay attention to matters to staff, and consequently staff pay attention to that too • Shared purpose can easily be displaced by a “de facto” purpose:  hitting a target  reducing costs  reducing length of stay  eliminating waste  completing activities within a timescale  complying with an inspection regime • If purpose isn’t explicit and shared, then it is very easy for something else to become a de facto purpose in the minds of the workforce Source: Delivering Public Services That Work: The Vanguard Method in the Public Sector
  • 23. What purposes do we primarily use in healthcare? Poll
  • 24.
  • 25.
  • 26.
  • 27.
  • 28. #SCHR #Quality2015 @HelenBevan @BoelGare @jackielynton Effective framing: what do we need to do? 1. Tell a story 2. Make it personal 3. Be authentic 4. Create a sense of “us” (and be clear who the “us” is) 5. Build in a call for urgent action Source of image: woccdoc.org
  • 29. Which do you like better? 1. Our infection rates are higher than they should be. We have new clinical guidelines. Let’s work together to implement them! 2. You are the one at the bedside. You know what works and what doesn’t. How can we tackle our infection rates? 3. Remember Mrs. Smith. She fully recovered from C- diff that she picked up on our unit. Just like you, I want to protect more of the chronic elderly. What do you think we can do?
  • 30. Change Management • Creating a compelling story • Role modelling • Capability Building The irrational side of change management: McKinsey and Co.
  • 31. #SCHR #Quality2015 @HelenBevan @BoelGare @jackielynton#SCHR #Quality2015 @HelenBevan @BoelGare @jackielynton What are the traits of “inspirational” leaders? -chat-
  • 33. What motivates people? • Impact on Society (building community) • Impact on Customer (patients and families) • Impact on Organization • Impact on Team (work environment) • Impact on me (development or bonus)
  • 34. #SCHR #Quality2015 @HelenBevan @BoelGare @jackielynton 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
  • 35. #SCHR #Quality2015 @HelenBevan @BoelGare @jackielynton 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 ‘‘‘‘
  • 36. Leading change in a new era Dominant approach Emerging direction
  • 37. Leading change in a new era Dominant approach Emerging direction Most healthcare transformation efforts are driven from this side Most healthcare transformation efforts are driven from this side
  • 38. John Kotter: “Accelerate!” • We won’t create big change through hierarchy on its own • We need hierarchy AND network • Many change agents, not just a few, with many acts of leadership • At least 50% buy-in required • Changing our mindset – From “have to” to “want to” TO
  • 39. #SCHR #Quality2015 @HelenBevan @BoelGare @jackielynton#SCHR #Quality2015 @HelenBevan @BoelGare @jackielynton ‘‘Leaders must wake people out of inertia. They must get people excited about something they’ve never seen before, something that does not yet exist” Rosa Beth Moss Kanter
  • 42.
  • 43.

Notas del editor

  1. Why is change so hard? I want to talk about organizational radicals!!! Colleen On average, it takes 17 years for research to translate into practice Big change only happens in healthcare organizations because of radicals The passionate people who are willing to take responsibility for change!!
  2. What is the change you are working on right now? Chat
  3. Why do you think the failure rate of change is so high?
  4. So Emotions help us understand what we value in the world. Why did the story of Alice work ? So why was this story powerful? Why do we respond differently when we hear about Alice rather than when we see the policy data and financial balance sheet? So public narrative when used intentionally for a purpose to connect with others to move to action is a powerful skills set and leadership gift. When we hear stories that make us feel a certain way those stories remind us of our core values. We experience our values through emotions. Then we are prepared to take action on those values. Through our emotions we are more likely to take action Research by Martha Nussbaum a Moral philosopher, tells us that people who have a damaged (a-mig-da- la) Amygadla the part of the brain which controls emotions, when faced with decisions can come up with many options from which to choose but cannot make a decision because the decision rests upon judgements of value. If we cannot feel emotion we cannot experience values that orient us to the choices we must make Shortly we will be thinking about the lived experiences that have moved you to action…we’ll be drawing on those a few minutes as you start to craft your own stories.
  5. Link belowhttp://www.bbc.co.uk/news/magazine-23790147http://www.bbc.co.uk/learningzone/clips/martin-luther-king-i-have-a-dream-pt-1-2/1293.html With the brooding statue of Abraham Lincoln peering down at him, King began by telling protesters that their presence in the symbolic shadow of the "great emancipator" offered proof of the marvellous new militancy sweeping the country. For too long, he complained, black Americans had been exiles in their own land, "crippled by the manacles of segregation and the chains of discrimination". The whirlwinds of revolt would continue to shake the very foundations of the country: "And those who hope that the Negro needed to blow off steam and will now be content will have a rude awakening if the nation returns to business as normal," King said. It would be fatal for the nation "to overlook the urgency of the moment and to underestimate the determination of the Negro". “He's good - he's damned good” Kennedy on King Wearied by the suffocating heat, the crowd's initial response was muted. The speech was not going well. "Tell 'em about the dream, Martin," shouted Mahalia Jackson, referring to a rhetorical riff that King had used several times before, but which had not made it into his prepared speech because aides insisted he needed fresh material. But King decided to cast aside his prepared notes, and launched extemporaneously into the refrain for which he will forever be remembered. "I have a dream that one day this nation will rise up and live out the true meaning of its creed," he shouted, his out-stretched right arm reaching towards the sky. Soon he was hitting his rhythm, invigorated by the chants and cries of the crowd. "Dream on!" they shouted. "Dream on!" With his voice thundering down the Mall, King imagined a future in which his children could "live in a nation where they will not be judged by the colour of their skin but by the content of their character". Then he reached his impassioned finale. King asked the crowd to yell so it was heard the world over Watching at the White House, the president was riveted. Like so many Americans, it was the first time he had heard the 34-year-old preacher deliver a speech in its entirety - the first time he had taken its measure, listened to its cadence. "He's good," Kennedy told one of his advisors. "He's damned good." The aide was struck, however, that the president seemed impressed more by the quality of King's performance rather than the power of his message.
  6. All have the common element of “the heart” and “energy”
  7. Shared purpose
  8. What purposes do we primarily use in this organization? Defacto purpose (targets etc) Shared purpose Neither
  9. Poll. Our infection rates are higher than they should be. We have new clinical guidelines. Let’s work together to implement them! You are the one at the bedside. You know what works and what doesn’t. How can we tackle our infection rates? Remember Mrs. Smith. She fully recovered from C-diff that she picked up on our unit. Just like you, I want to protect more of the chronic elderly. What do you think we can do? Pick 1,2,3 or none.