Barbara WrenC. Psychol.Consultant Lead Psychologist in Occupational HealthRoyal Free Hampstead NHS Trust Health and Work Centre, London, UK.

Implementing Change:Engaging People and Changing Practice

Was the change one you had made or had it been imposed on you?

How did you feel initially?What was your reaction?

Were you surprised at your reaction?Did your feelings and reactions stay

constant or did they change over time?

Have you now accepted the change?

Barbara Wren , Implementing Change: Engaging People and Changing Practice, Dublin,April 2008

Common Reactions To Change (1)

People are less ready to accept change when it is done ‘to’ them and not ‘by’ them.

Most people adversely react to change unless they know why.

Different people can view the same change as negative or positive depending or their perspective.

Barbara Wren , Implementing Change: Engaging People and Changing Practice, Dublin,April 2008

Common Reactions To Change (2)

People’s emotional responses to change are remarkably similar irrespective of the nature of the change.

People tend to focus on the threat of change rather than the opportunity to them.

Barbara Wren , Implementing Change: Engaging People and Changing Practice, Dublin,April 2008

During Change People revert to previous behaviours

To make it happen you need to constantly

work at it

People need coaching and development to

change the way they do things

People are uncomfortable if they do not

know why change is happeningBarbara Wren , Implementing Change: Engaging People and Changing Practice, Dublin,April 2008

Stages Of Emotional Transition

1. Denial1. Denial

2. Resistance2. Resistance

4. Commitment4. Commitment

3. Exploration3. Exploration

Barbara Wren , Implementing Change: Engaging People and Changing Practice, Dublin,April 2008

The Change Process

PreparePrepare

PlanPlanReviewReview

ImplementImplement

WhyWhy

WhatWhat

CommunicatCommunicatee

Agree Action Agree Action PlanPlan

Success CriteriaSuccess Criteria

Involve TeamInvolve Team

Put plan in to Put plan in to actionaction

Monitor & Monitor & MeasureMeasure

CommunicateCommunicate

What went wellWhat went well

What went less What went less wellwell

What have we What have we learnedlearned

Agree way aheadAgree way ahead

Barbara Wren , Implementing Change: Engaging People and Changing Practice, Dublin,April 2008

1. Defining what will success look like.(Well Formed Outcomes).

2. Identifying who are the stakeholders.(Need to be engaged in the change cycle)

3. Using analytical tools to gather more information. (e.g. Gap analysis / Force field analysis)

4. Being clear about the resourcing issues. (What support is available?)

5. Devising a workable solution to take the change forward to the planning stage.

The Preparation Stage Involves:

Barbara Wren , Implementing Change: Engaging People and Changing Practice, Dublin,April 2008

A Model For Setting ‘Well-Formed Outcomes’

1 State in the positive. What do you want to achieve?

2 Be specific. When, where & with whom do you want this?

3 What evidence would you need to know you had achieved your outcome? What will you see, hear & feel when you achieve this outcome?

Barbara Wren , Implementing Change: Engaging People and Changing Practice, Dublin,April 2008

A Model For Setting ‘Well-Formed Outcomes’

4 What part will you play in the process? (Are you in charge of the changes you require?)

5 Will you lose anything if you achieve this outcome?

6 Is the outcome worth what it takes to get it?

7 What are the consequences in your life if the goal is achieved?

Barbara Wren , Implementing Change: Engaging People and Changing Practice, Dublin,April 2008

Stakeholder Analysis

• Who is needed to make the change happen?

• Whose support is needed to enable it to proceed?

• Who will be affected by the change?

• How do you remove any resistance to change to engage them in the process?

Barbara Wren , Implementing Change: Engaging People and Changing Practice, Dublin,April 2008

Key People in Key RolesCHANGE SPONSOR

CHANGE AGENT

CHANGEADVOCATE

Individual or group who legitimises the change

Individual or group who is responsible forimplementing the change

Individual or group who wants toachieve a change but does not possess legitimisation power

Barbara Wren , Implementing Change: Engaging People and Changing Practice, Dublin,April 2008

GAP ANALYSIS (1).

Ask “Where do we want to be?” (This vision has been clarified by your Well-Formed Outcome).

Ask “Where are we now?”

Measure the gap between the present & the ideal state. Quantify it tangibly

Barbara Wren , Implementing Change: Engaging People and Changing Practice, Dublin,April 2008

GAP ANALYSIS (2)

4. Map out the key changes needed to close the gap, working back from the ideal.

5. State these changes in clear words & figures as a focus for planning change.

Barbara Wren , Implementing Change: Engaging People and Changing Practice, Dublin,April 2008

FORCEFIELD ANALYSISDesiredDesired StateState

RestrainingRestraining ForcesForces

CurrentCurrent StateState

Driving ForcesDriving Forces

Barbara Wren , Implementing Change: Engaging People and Changing Practice, Dublin,April 2008

Four Factors That Influence Behaviour Change.

1. Systems – Forecast, Plan, Control & Report on the work.

2. Process - Are processes simple & logical?

3. Structure - People’s roles & responsibilities.

4. Training - Providing hard & soft skills. Barbara Wren , Implementing Change:

Engaging People and Changing Practice, Dublin,April 2008

Building a Change Action Plan1. From your force-field analysis note down

your driving forces and restraining forces.

2. Take the individual headings and break them down into activities required to either assist the drivers or inhibit the restrainers.

3. Explore each item in detail, (breaking it down again if appropriate) and identify the activities that have to be done between now and implementation of the change.

Barbara Wren , Implementing Change: Engaging People and Changing Practice, Dublin,April 2008

RESOURCE & SUPPORT MAPPING.1. What support & resources will

be required for the change to take place? (Money, People, Skills, Time).

2. Identify where these resources and support will come from. Then highlight any gaps.

(Extra training? Getting people on board? Securing extra funding? Shifting priorities?)

3. Identify how (or if !!) these gaps can be addressed.

Barbara Wren , Implementing Change: Engaging People and Changing Practice, Dublin,April 2008

Degree ofsupport

for thechange

ContactAwareness

Understanding

Engagement

Acceptance

Commitment

“I’m being told about something”

“I know what it is”“I know the implications for me”

“This looks worth a try”

“The new rules”

“I like to do it this way”

Time

Internalisation“This is the way

we do things”

Commitment Curve

1

2

3

4

5

6

7

Barbara Wren , Implementing Change: Engaging People and Changing Practice, Dublin,April 2008

IMPLEMENTATION. Pilot. Adjust. Refine. Improve. Put the Change Action Plan into action Communicate progress Monitor the plan against the success

criteria Control and update the plan Resilience is important.

Barbara Wren , Implementing Change: Engaging People and Changing Practice, Dublin,April 2008

AA BB

Barbara Wren , Implementing Change: Engaging People and Changing Practice, Dublin,April 2008

The Planning Phase

Set a Change Action Plan with a timetable

Agree criteria to measure success

Assign roles to activities

Involve the team in creating the output

Barbara Wren , Implementing Change: Engaging People and Changing Practice, Dublin,April 2008

Barbara Wren , Implementing Change: Engaging People and Changing Practice, Dublin,April 2008

That’s it for today!

Thank you and

Goodbye!barbara.wren@royalfree.n

hs.uk