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Thomas Tonkin, Ph.D. – Advisory Services
This is not why I went to school!
3 ways to Deal with Change with
Clinical Staff
Dr. Tom Tonkin
Principal, Change Management and Transformation
Thought Leadership & Advisory Services
Dr. Tonkin is an exe...
Daniel Jacobs
Copywriter
Demand Generation Team
Rehan Mirza
Vertical Solutions Manager
Healthcare and Higher Education
Spe...
Thank You To All of Our
Attendees!
4
Change Challenges
Organizationally-Centric
• Hospitals employing the least
engaged nurses spend $1.1
million more per year...
Change Challenges
Organizationally-Centric
• Hospitals employing the least
engaged nurses spend $1.1
million more per year...
Change Challenges
Organizationally-Centric
• Hospitals employing the least
engaged nurses spend $1.1
million more per year...
Agenda
• Change Management vs. Transformation
• The Need for a People-Centric Approach
• The 3 Questions you staff asks th...
“Different isn’t always
better, but better is always
different”
(Unknown)
Change or Transformation?
" The caterpillar starts to
change“
10
Change or Transformation?
" The caterpillar starts to
change“
"The transformation
from caterpillar to butterfly
is one of ...
Change or Transformation?
" The caterpillar starts to
change“
Canisius College
Website
"The transformation
from caterpilla...
Change or Transformation?
" The caterpillar starts to
change“
Canisius College
Website
"The transformation
from caterpilla...
Change or Transformation?
" The caterpillar starts to
change“
Canisius College
Website
"The transformation
from caterpilla...
Change Management v. Transformation
Change
Management
• Reference is the Past
• Efficiency Focused
• Making the current be...
Change v. Transformation1
Change Transformation
Past
Present
Future
CHANGE requires becoming familiar with the current sit...
Change v. Transformation1
Change Transformation
Past
Present
Future
CHANGE requires becoming familiar with the current sit...
Change v. Transformation1
Change Transformation
Past
Present
Future
CHANGE requires becoming familiar with the current sit...
Change v. Transformation1
Change Transformation
Past
Present
Future
CHANGE requires becoming familiar with the current sit...
Common Elements of a Change Plan
20
Common Elements of a Change Plan
• Vision (Why)
21
Common Elements of a Change Plan
• Vision (Why)
• Strategy (What)
22
Common Elements of a Change Plan
• Vision (Why)
• Strategy (What)
• Metrics (How Much)
23
Common Elements of a Change Plan
• Vision (Why)
• Strategy (What)
• Metrics (How Much)
• Communications (Who)
24
Common Elements of a Change Plan
• Vision (Why)
• Strategy (What)
• Metrics (How Much)
• Communications (Who)
• Execution ...
Common Elements of a Change Plan
• Vision (Why)
• Strategy (What)
• Metrics (How Much)
• Communications (Who)
• Execution ...
“The best ways to encourage out of
the box thinking is to draw the box
correctly in the first place”.
Paul Gibbons, (2015).
Standard Change Curve
Population Characteristics
Population Characteristics
• Innovators (2.5%) Highest Social Status
Highest Social Capital
Clo...
Population Characteristics
Population Characteristics
• Innovators (2.5%) Highest Social Status
Highest Social Capital
Clo...
Population Characteristics
Population Characteristics
• Innovators (2.5%) Highest Social Status
Highest Social Capital
Clo...
Population Characteristics
Population Characteristics
• Innovators (2.5%) Highest Social Status
Highest Social Capital
Clo...
Population Characteristics
Population Characteristics
• Innovators (2.5%) Highest Social Status
Highest Social Capital
Clo...
“Communicating” the Chasm
34
“Communicating” the Chasm
35
Maloney’s 16% Rule:
Once you have reached
16% adoption of any
innovation, you must
change you...
36
Standard Change Curve
Standard Change Curve
Again, this is fine, but what about the INDIVIDUAL people?
GLOVES
“People change what they do less because they
are given analysis that shifts their thinking than
because they are shown a ...
The Process of Change and Adjustment
Elisabeth Kubler-Ross (1969)
Three questions every employee answers
everyday
• Do I want to stay?
• Do I need to stay?
• Should I stay?
What is this?
This addresses the positive
emotional connection that
the employee has to the
organization. For example,
wor...
What is this?
This addresses the positive
emotional connection that
the employee has to the
organization. For example,
wor...
What is this?
This addresses the positive
emotional connection that
the employee has to the
organization. For example,
wor...
What is this?
This is when an employee is
calculating the cost of
leaving the organization and
questions what they need to...
What is this?
This is when an employee is
calculating the cost of
leaving the organization and
questions what they need to...
What is this?
This is when an employee is
calculating the cost of
leaving the organization and
questions what they need to...
What is this?
The feeling of obligation to
stay with an organization.
What the employee ought to
do.
52
Should I Stay?
Mos...
What is this?
The feeling of obligation to
stay with an organization.
What the employee ought to
do.
Where does it come fr...
What is this?
The feeling of obligation to
stay with an organization.
What the employee ought to
do.
Where does it come fr...
Putting it All together
Organizationally Centric
• Vision (Why)
• Strategy (What)
• Metrics (How Much)
• Communications (W...
Putting it All together
Organizationally Centric
• Vision (Why)
• Strategy (What)
• Metrics (How Much)
• Communications (W...
Putting it All together
Organizationally Centric
• Vision (Why)
• Strategy (What)
• Metrics (How Much)
• Communications (W...
Conclusion and Wrap-up
• We must:
58
Conclusion and Wrap-up
• We must:
• Understand the difference between a change
management effort and a transformation
59
Conclusion and Wrap-up
• We must:
• Understand the difference between a change
management effort and a transformation
• Be...
Conclusion and Wrap-up
• We must:
• Understand the difference between a change
management effort and a transformation
• Be...
Thank You!
This Isn’t Why I Went to School! – 3 Ways to Deal with Change for Clinical Staff
This Isn’t Why I Went to School! – 3 Ways to Deal with Change for Clinical Staff
This Isn’t Why I Went to School! – 3 Ways to Deal with Change for Clinical Staff
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This Isn’t Why I Went to School! – 3 Ways to Deal with Change for Clinical Staff

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Staff turnover in healthcare is high, costly, and is causing hospital leadership to panic. Replacing just one nurse, for example, can cost upwards of 1.3 times their salary, so care centers need to learn why this is happening - Are team members disengaged? Do they have the right resources? – and how they can provide top quality patient care while also meeting the evolving needs of their staff. This requires a modern, proactive approach to talent management that will enable them to maximize retention rates and provide an engaging environment for healthcare professionals.

Join us for this free webinar sponsored by Cornerstone OnDemand. Dr. Tom Tonkin, Principal Consultant of Thought Leadership & Advisory Services at Cornerstone OnDemand, will share his thoughts and strategies to help identify and reduce the risk of staff departures to healthcare organizations.
During this webinar, Dr. Tonkin will provide easy-to-understand insights on:

• Current attrition trends and challenges that have disrupted traditional recruiting and retention strategies;
• The needs (and demands) of today’s healthcare workforce; and
• Talent strategies that create a more engaged, productive, and passionate workforce.

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This Isn’t Why I Went to School! – 3 Ways to Deal with Change for Clinical Staff

  1. 1. Thomas Tonkin, Ph.D. – Advisory Services This is not why I went to school! 3 ways to Deal with Change with Clinical Staff
  2. 2. Dr. Tom Tonkin Principal, Change Management and Transformation Thought Leadership & Advisory Services Dr. Tonkin is an executive in Professional Services and Software Sales arena and has over 25 years of business and technology experience. Prior to joining CSOD, Dr. Tonkin was the CEO and Co-Founder of the Sales Conservatory where he specialized in helping sales leaders that have revenue generation responsibility between $5M and $1B and are looking for a trusted advisor to guide them to materially increase revenue . He spent 19 years of his career at Oracle Corporation as the Senior Director of the Sales Performance Group in Oracle’s Global Sales Academy. Dr. Tonkin is also a speaker at leadership and business conferences where he also presents throughout the year.
  3. 3. Daniel Jacobs Copywriter Demand Generation Team Rehan Mirza Vertical Solutions Manager Healthcare and Higher Education Special Thanks to These folks as well!
  4. 4. Thank You To All of Our Attendees! 4
  5. 5. Change Challenges Organizationally-Centric • Hospitals employing the least engaged nurses spend $1.1 million more per year in malpractice claims than those with the most engaged nurses. • Higher nurse satisfaction resulted in an 87 percent decrease in infection rate over two years 5
  6. 6. Change Challenges Organizationally-Centric • Hospitals employing the least engaged nurses spend $1.1 million more per year in malpractice claims than those with the most engaged nurses. • Higher nurse satisfaction resulted in an 87 percent decrease in infection rate over two years People-Centric • The cost of replacing a nurse can be upwards of 1.3 times their salaries. • One hospital reports that their health care staff only scored in the 38 percentile in employee engagement suggesting that they were not satisfied with the work 6
  7. 7. Change Challenges Organizationally-Centric • Hospitals employing the least engaged nurses spend $1.1 million more per year in malpractice claims than those with the most engaged nurses. • Higher nurse satisfaction resulted in an 87 percent decrease in infection rate over two years People-Centric • The cost of replacing a nurse can be upwards of 1.3 times their salaries. • One hospital reports that their health care staff only scored in the 38 percentile in employee engagement suggesting that they were not satisfied with the work 7 Why? • “The low engagement levels, survey respondents said, were primarily due to industry changes (such as the burden of transitioning from paper to electronic medical records)”
  8. 8. Agenda • Change Management vs. Transformation • The Need for a People-Centric Approach • The 3 Questions you staff asks themselves everyday 8
  9. 9. “Different isn’t always better, but better is always different” (Unknown)
  10. 10. Change or Transformation? " The caterpillar starts to change“ 10
  11. 11. Change or Transformation? " The caterpillar starts to change“ "The transformation from caterpillar to butterfly is one of the most exquisite in the natural world" 11
  12. 12. Change or Transformation? " The caterpillar starts to change“ Canisius College Website "The transformation from caterpillar to butterfly is one of the most exquisite in the natural world" 12
  13. 13. Change or Transformation? " The caterpillar starts to change“ Canisius College Website "The transformation from caterpillar to butterfly is one of the most exquisite in the natural world" National Geographic Website 13
  14. 14. Change or Transformation? " The caterpillar starts to change“ Canisius College Website "The transformation from caterpillar to butterfly is one of the most exquisite in the natural world" National Geographic Website 14 So, Change = Transformation?
  15. 15. Change Management v. Transformation Change Management • Reference is the Past • Efficiency Focused • Making the current better Transformation • Reference is the Future • Effectiveness Focused • Birthing a new state “AS IS” Urgency Results
  16. 16. Change v. Transformation1 Change Transformation Past Present Future CHANGE requires becoming familiar with the current situation, and working to make things better, faster, cheaper, or some other “er” word. The past is the fundamental reference point and actions are intended to alter what already happened. 1"Change vs. Transformation." Change vs. Transformation. The Primes. Web. 15 Sept. 2015.
  17. 17. Change v. Transformation1 Change Transformation Past Present Future CHANGE requires becoming familiar with the current situation, and working to make things better, faster, cheaper, or some other “er” word. The past is the fundamental reference point and actions are intended to alter what already happened. TRANSFORMATION is an assertion that our actions today create our future tomorrow. The future can be described and realized when you free yourself from constraints of the past. In transformation, you design your future and invent ways to bring it about. Transformation doesn’t describe the future by referencing the past (better, faster, or cheaper); it births a future that is entirely new. 1"Change vs. Transformation." Change vs. Transformation. The Primes. Web. 15 Sept. 2015.
  18. 18. Change v. Transformation1 Change Transformation Past Present Future CHANGE requires becoming familiar with the current situation, and working to make things better, faster, cheaper, or some other “er” word. The past is the fundamental reference point and actions are intended to alter what already happened. TRANSFORMATION is an assertion that our actions today create our future tomorrow. The future can be described and realized when you free yourself from constraints of the past. In transformation, you design your future and invent ways to bring it about. Transformation doesn’t describe the future by referencing the past (better, faster, or cheaper); it births a future that is entirely new. BOTH require a firm grasp the current state of affairs — the ”As Is”. Without an intimate understanding of our As Is, we’re delusional about the future from the outset. 1"Change vs. Transformation." Change vs. Transformation. The Primes. Web. 15 Sept. 2015.
  19. 19. Change v. Transformation1 Change Transformation Past Present Future CHANGE requires becoming familiar with the current situation, and working to make things better, faster, cheaper, or some other “er” word. The past is the fundamental reference point and actions are intended to alter what already happened. TRANSFORMATION is an assertion that our actions today create our future tomorrow. The future can be described and realized when you free yourself from constraints of the past. In transformation, you design your future and invent ways to bring it about. Transformation doesn’t describe the future by referencing the past (better, faster, or cheaper); it births a future that is entirely new. BOTH require a firm grasp the current state of affairs — the ”As Is”. Without an intimate understanding of our As Is, we’re delusional about the future from the outset. EXAMPLE - A butterfly is a transformation, not a better caterpillar. 1"Change vs. Transformation." Change vs. Transformation. The Primes. Web. 15 Sept. 2015.
  20. 20. Common Elements of a Change Plan 20
  21. 21. Common Elements of a Change Plan • Vision (Why) 21
  22. 22. Common Elements of a Change Plan • Vision (Why) • Strategy (What) 22
  23. 23. Common Elements of a Change Plan • Vision (Why) • Strategy (What) • Metrics (How Much) 23
  24. 24. Common Elements of a Change Plan • Vision (Why) • Strategy (What) • Metrics (How Much) • Communications (Who) 24
  25. 25. Common Elements of a Change Plan • Vision (Why) • Strategy (What) • Metrics (How Much) • Communications (Who) • Execution Plan (When & How) 25
  26. 26. Common Elements of a Change Plan • Vision (Why) • Strategy (What) • Metrics (How Much) • Communications (Who) • Execution Plan (When & How) 26 This is fine, but what about the people?
  27. 27. “The best ways to encourage out of the box thinking is to draw the box correctly in the first place”. Paul Gibbons, (2015).
  28. 28. Standard Change Curve
  29. 29. Population Characteristics Population Characteristics • Innovators (2.5%) Highest Social Status Highest Social Capital Close Contact with Innovators (Sensitive to Scarcity) Rogers, E. M. (1962). Diffusion of innovations. New York: Free Press of Glencoe.
  30. 30. Population Characteristics Population Characteristics • Innovators (2.5%) Highest Social Status Highest Social Capital Close Contact with Innovators (Sensitive to Scarcity) • Early Adopter (13.5) High Opinion Leadership More discreet than Innovators (Greater levels of Judgment) More judicious to maintain control Rogers, E. M. (1962). Diffusion of innovations. New York: Free Press of Glencoe.
  31. 31. Population Characteristics Population Characteristics • Innovators (2.5%) Highest Social Status Highest Social Capital Close Contact with Innovators (Sensitive to Scarcity) • Early Adopter (13.5) High Opinion Leadership More discreet than Innovators (Greater levels of Judgment) More judicious to maintain control • Early Majority (34%) Above Average Social Status and Capital No Opinion Leadership (Sensitive to Social Proof) Do have direct contact with early adaptors Rogers, E. M. (1962). Diffusion of innovations. New York: Free Press of Glencoe.
  32. 32. Population Characteristics Population Characteristics • Innovators (2.5%) Highest Social Status Highest Social Capital Close Contact with Innovators (Sensitive to Scarcity) • Early Adopter (13.5) High Opinion Leadership More discreet than Innovators (Greater levels of Judgment) More judicious to maintain control • Early Majority (34%) Above Average Social Status and Capital No Opinion Leadership (Sensitive to Social Proof) Do have direct contact with early adaptors • Late Majority (34%) Adopt after the average end user (Looking for more than 50% adoption) High levels of Healthy Skepticism Average Social Status and Capital Rogers, E. M. (1962). Diffusion of innovations. New York: Free Press of Glencoe.
  33. 33. Population Characteristics Population Characteristics • Innovators (2.5%) Highest Social Status Highest Social Capital Close Contact with Innovators (Sensitive to Scarcity) • Early Adopter (13.5) High Opinion Leadership More discreet than Innovators (Greater levels of Judgment) More judicious to maintain control • Early Majority (34%) Above Average Social Status and Capital No Opinion Leadership (Sensitive to Social Proof) Do have direct contact with early adaptors • Late Majority (34%) Adopt after the average end user (Looking for more than 50% adoption) High levels of Healthy Skepticism Average Social Status and Capital • Laggards (16%) Little to no opinion leadership. Aversion to change-agents, “tradition“ Contact with only family and close friends. Rogers, E. M. (1962). Diffusion of innovations. New York: Free Press of Glencoe.
  34. 34. “Communicating” the Chasm 34
  35. 35. “Communicating” the Chasm 35 Maloney’s 16% Rule: Once you have reached 16% adoption of any innovation, you must change your messaging and media strategy. Your message must change from scarcity to social proof. Use this media type available to you to communicate. This is how you accelerate past the chasm to the tipping point of adoption.
  36. 36. 36
  37. 37. Standard Change Curve
  38. 38. Standard Change Curve Again, this is fine, but what about the INDIVIDUAL people?
  39. 39. GLOVES
  40. 40. “People change what they do less because they are given analysis that shifts their thinking than because they are shown a truth that influences their feelings. This is especially so in large-scale organizational change, where you are dealing with new technologies, mergers and acquisitions, restructuring, new strategies, cultural transformation, globalization, and e- business – whether in an entire organization, an office, a department or a work group”. Kotter and Cohen, 2002).
  41. 41. The Process of Change and Adjustment Elisabeth Kubler-Ross (1969)
  42. 42. Three questions every employee answers everyday • Do I want to stay? • Do I need to stay? • Should I stay?
  43. 43. What is this? This addresses the positive emotional connection that the employee has to the organization. For example, working at here, whether the people or the work itself, makes them happy. 46 Do I want to Stay? Most employees formulate their long-term organizational commitment in their first 30 days
  44. 44. What is this? This addresses the positive emotional connection that the employee has to the organization. For example, working at here, whether the people or the work itself, makes them happy. Where does it come from? This feeling is induced from positive work experiences at your organization. 47 Do I want to Stay? Most employees formulate their long-term organizational commitment in their first 30 days
  45. 45. What is this? This addresses the positive emotional connection that the employee has to the organization. For example, working at here, whether the people or the work itself, makes them happy. Where does it come from? This feeling is induced from positive work experiences at your organization. Proposed Action/Curriculum: • Testimonial videos • Professional Development Classes that coincides with employee's career aspirations. • Reoccurring team meetings at every level (i.e. regional or national) 48 Do I want to Stay? Most employees formulate their long-term organizational commitment in their first 30 days
  46. 46. What is this? This is when an employee is calculating the cost of leaving the organization and questions what they need to do. 49 Do I need to Stay? Most employees formulate their long-term organizational commitment in their first 30 days
  47. 47. What is this? This is when an employee is calculating the cost of leaving the organization and questions what they need to do. Where does it come from? Leaving is more difficult when the employee invests more and more into the company. How vested are they in the company. 50 Do I need to Stay? Most employees formulate their long-term organizational commitment in their first 30 days
  48. 48. What is this? This is when an employee is calculating the cost of leaving the organization and questions what they need to do. Where does it come from? Leaving is more difficult when the employee invests more and more into the company. How vested are they in the company. Proposed Action/Curriculum: • Exposure to all of the organization through cross line of business training. • Have employee invest in the organization and be visible about it like filling out their profile page. • Special internal projects that makes the company better. • Increasing employee engagement 51 Do I need to Stay? Most employees formulate their long-term organizational commitment in their first 30 days
  49. 49. What is this? The feeling of obligation to stay with an organization. What the employee ought to do. 52 Should I Stay? Most employees formulate their long-term organizational commitment in their first 30 days
  50. 50. What is this? The feeling of obligation to stay with an organization. What the employee ought to do. Where does it come from? When employee is socialized into the organization and the company invests in the employee. 53 Should I Stay? Most employees formulate their long-term organizational commitment in their first 30 days
  51. 51. What is this? The feeling of obligation to stay with an organization. What the employee ought to do. Where does it come from? When employee is socialized into the organization and the company invests in the employee. Proposed Action/Curriculum: • Early investments in the employee, for example during on-boarding • Help employee build a personal network • Job satisfaction and career advancement surveys 54 Should I Stay? Most employees formulate their long-term organizational commitment in their first 30 days
  52. 52. Putting it All together Organizationally Centric • Vision (Why) • Strategy (What) • Metrics (How Much) • Communications (Who) • Execution Plan (When & How) 55
  53. 53. Putting it All together Organizationally Centric • Vision (Why) • Strategy (What) • Metrics (How Much) • Communications (Who) • Execution Plan (When & How) 56
  54. 54. Putting it All together Organizationally Centric • Vision (Why) • Strategy (What) • Metrics (How Much) • Communications (Who) • Execution Plan (When & How) People Centered • Do I want to Stay? • Do I need to stay? • Should I stay? 57
  55. 55. Conclusion and Wrap-up • We must: 58
  56. 56. Conclusion and Wrap-up • We must: • Understand the difference between a change management effort and a transformation 59
  57. 57. Conclusion and Wrap-up • We must: • Understand the difference between a change management effort and a transformation • Be sensitive to the needs of the people effected by change 60
  58. 58. Conclusion and Wrap-up • We must: • Understand the difference between a change management effort and a transformation • Be sensitive to the needs of the people effected by change • Plan for both organizational change as well as a people-centric change 61
  59. 59. Thank You!

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