@helenbevan

#qs13

Building and aligning energy

for change

Helen Bevan @helenbevan

#QS13

@helenbevan

Most large scale change fails to achieve its objectives

Source: McKinsey Performance Transformation Survey, 3000 respondents to global, multi-industry survey

70%

25%

5%

@helenbevan

The factors that impact the ability to

deliver Lean transformation are

the same as the factors in other large

scale change strategies

@helenbevan

#qs13

What happens to large scale

change efforts in reality?

In order of frequency:

1. the effort effectively “runs out of energy” and simply fades away

2. the change hits a plateau at some level and no longer attracts new supporters

3. the change becomes reasonably well established; several levels across the system have changed to accommodate or support it in a sustainable way.

Source: Leading Large Scale Change:

a practical guide (2011), NHS Institute

@helenbevan

#qs13

Intrinsic

motivators •connecting to

shared purpose

•engaging, mobilising

and calling to action

•motivational leadership

build energy

and creativity

@helenbevan

#qs13

Intrinsic

motivators •connecting to

shared purpose

•engaging, mobilising

and calling to action

•motivational leadership

build energy

and creativity

create focus &

momentum for

delivery

Drivers

of extrinsic

motivation

@helenbevan

#qs13

Drivers

of extrinsic

motivation

create focus &

momentum for

delivery

Intrinsic

motivators •connecting to

shared purpose

•engaging, mobilising

and calling to action

•motivational leadership

build energy

and creativity

•System drivers &

incentives

•Payment by results

•Performance

management

•Measurement for

accountability

@helenbevan

#qs13

Internal

motivators

•connecting to

shared purpose

•engaging, mobilising

and calling to action

•motivational

leadership

build energy and

creativity

Drivers of

extrinsic

motivation •System drivers &

incentives

•Performance

management

•Measurement for

accountability create & focus

momentum for

delivery

Transformation is not a matter of

intent.........

it is a matter of alignment

Peter Fuda

@helenbevan

NHS Change Model

www.changemodel.nhs.uk

@helenbevan

@helenbevan

NHS Change Model

www.changemodel.nhs.uk

@helenbevan

#qs13

Does fear motivate people

to change?

@helenbevan

#qs13

burning platform

versus

burning ambition

@PeterFuda

@helenbevan

#qs13

Insert peter Fuda film

@helenbevan

#qs13

Lessons for transformational change

1. In order to sustain

transformational change, we as

leaders need to move from a

burning platform (fear based

urgency) to a burning ambition

(shared purpose for a better

future)

2. We as leaders need to articulate

personal reasons for change as

well as organisational reasons

3. If the fire (the compelling reason)

goes out, all other factors are

redundant

@PeterFuda

@helenbevan

#qs13

Task

Talk to the person next to you

• What is “my burning ambition” for my service,

my community and /or my patients

• Try to make it personal: tell others why this

ambition connects with your personal

motivations

@helenbevan

You get the best efforts from others not by lighting a fire

beneath them but by building

Source: Bob Nelson

@helenbevan

#qs13

@helenbevan

the capacity and drive of a team, organisation or system to act and make the

difference necessary to

achieve its goals

Psychological

Physical

Spiritual

Social Intellectual

Energy for change is:

@helenbevan

The five energies for change Energy Definitions

Social energy of personal engagement, relationships and connections between people. It reflects a “sense of us”, where people are drawn into an innovation or change because they feel a connection to it as part of the collective group

Spiritual energy of commitment to a common vision for the future, driven by shared values and a higher purpose. It involves giving people the confidence to move towards a different future that is more compelling than the status quo

Psychological energy of courage, trust and feeling safe to do things differently. It involves feeling supported to make a change as well as belief in self and the team, organisation or system, and trust in leadership and direction

Physical energy of action, getting things done and making progress. It is the flexible, responsive drive to make things happen

Intellectual energy of curiosity, analysis and thinking. It involves gaining insight as well as planning and supporting processes, evaluation, and arguing a case on the basis of logic/ evidence

@helenbevan

High and low ends of each energy domain

Low High

Social isolated solidarity

Spiritual uncommitted higher purpose

Psychological risky safe

Physical fatigue vitality

Intellectual Illogical reason

@helenbevan

Facilitated questions - examples

• Are particular energy domains more dominant than others for our team at the moment?

• Is this the optimal energy profile to help us achieve our change goals?

• What would the optimal energy profile look like for our team or community?

Physical

Psychological

Spiritual Social

Intellectual

Energy for change profile

@helenbevan

Facilitated questions - examples

• Are particular energy domains more dominant than others for our team at the moment?

• Is this the optimal energy profile to help us achieve our change goals?

• What would the optimal energy profile look like for our team or community?

Physical

Psychological

Spiritual Social

Intellectual

Energy for change profile

LOW

HIGH

@helenbevan

Team 1

Physical

Psychological

Spiritual Social

Intellectual

@helenbevan

Team 1

Physical

Psychological

Spiritual Social

Intellectual

Team 1’s energy profile is characterised by an environment that has harnessed their interest and momentum for change, but which has failed to engage people fully. This imbalance results in their feeling some uncertainty regarding how they can contribute fully to the change, and therefore a sense of risk and lack of hope for the future. We can build energy by building team solidarity and developing shared purpose

@helenbevan

Team two

Psychological

Social Spiritual

Physical Intellectual

@helenbevan

Team two

Psychological

Social Spiritual

Physical Intellectual

Team 2 enables strong connections between people, a true sense of solidarity, which gives them enough hope for the future, but this energy is undirected, because the rational argument and shared purpose has not been agreed.

@helenbevan

Saskatchewan energy for change

SSPPI Energy Index

Analysis generated on 8th April 2013 by Rosanna Hunt and Paul Woodley

43 respondents

rosanna.hunt@nhsiq.nhs.uk +44 777 070 4056

Energy for Change Model and SSPPI Energy Index by NHS Improving Quality is licensed under a

Creative Commons Attribution-ShareAlike 2.0 UK: England & Wales License.

@helenbevan

The SSPPI Energy Index – V2, Part I This questionnaire enables teams to measure their energy for change.

Please agree the nature of the change context with your team before answering the following statements.

Then answer all statements with your particular change context in mind.

1 = Strongly disagree 2 = Disagree 3 = Neutral 4 = Agree 5 = Strongly Agree

I am energised by the momentum of change____

I have gained insight into the case for change____

I feel a sense of solidarity with those I work with ____

I am weary of change____

I am able to keep expressing hope for the change when presented with

setbacks_____

The reasoning for the change is not compelling___

I don’t feel appreciated by others at work_____

I will be blamed if I try something new and it fails____

I feel isolated from others____

I feel depleted of energy when others express doubt about the change_____

The case for change has stimulated my creativity_____

I feel disconnected from others____

I am committed to our common vision for the future____

I feel safe enough to do things differently____

I am driven by shared values____

I am experiencing change fatigue____

The change does not fit with my sense of purpose_____

I am not driven by a shared purpose for change_____

I think there is no rational argument for change____

The case for change is interesting to me_____

I feel that we are getting things done to achieve the change_____

I feel the change may conflict with my values___

I feel personally engaged in the change___

Clear thinking and analysis underpins the change___

I feel fearful about the change___

I sense openness about the potential to change___

@helenbevan

Social energy is the energy of personal engagement,

relationships and connections between people. It reflects a

“sense of us” and is therefore a collective concept that

captures a situation where people are drawn into an

improvement or change because they feel a connection to it

as part of the collective group.

My social energy is ____

The social energy of those I work with is____

The importance of social energy to me is____

Psychological energy is the energy of courage, trust and

feeling safe to do things differently. It involves feeling

supported to make a change as well as belief in self and the

team, organisation or system, and trust in leadership and

direction.

My psychological energy is ____

The psychological energy of those I work with is____

The importance of psychological energy to me is____

Physical energy is the energy of action, getting things done

and making progress. It is the flexible, responsive drive to

make things happen, with vitality and kinetic force (motion)

My physical energy is ____

The physical energy of those I work with is ____

The importance of physical energy to me is____

Intellectual energy is the energy of curiosity, analysis, thinking and cognition. It involves gaining insight, a thirst for new

knowledge as well as planning and supporting processes, evaluation, and arguing a case on the basis of logic and evidence.

My intellectual energy is ____

The intellectual energy of those I work with is____

The importance of intellectual energy to me is____

Complete these statements on a scale of 1 = low - 5 = high

Spiritual energy is the energy of commitment to a common

vision for the future, driven by shared values and a higher

purpose. It involves giving people the confidence to move

towards a different future that is more compelling than the

status quo, by finding the deep meaning in what they do.

My spiritual energy is ____

The spiritual energy of those I work with is____

The importance of spiritual energy to me is____

The SSPPI Energy Index – V2, Part 2

@helenbevan

min max %

Social 32 100 72

Spiritual 47 100 80

Psychological 47 97 75

Physical 50 95 76

Intellectual 48 100 82

Total 45 98 77

1. The group’s Energy for Change profile

The group’s energy for change is 77% (43 respondents). NHS

groups previously analysed have demonstrated energy levels

between 54% and 84%.

Spiritual and intellectual energies are particularly high in this group

(82% and 80% respectively).

Although social energy appears to be more depleted than the other

energy types (72%), this may be skewed by a small number of

individuals scoring particularly low (32%)

@helenbevan

Profiling data Self-evaluation

Social 72 74

Spiritual 80 80

Psychological 75 72

Physical 76 70

Intellectual 82 82

Total 77 76

The two perspectives on energy support each other

Respondents show good self-awareness of their energy for

change. The group may perceive its physical energy to be more

depleted than it is in reality (they self-evaluate their levels of

physical energy to be at 70% whereas their profile indicates they

have higher physical energy in reality (76%).

2. How does your Energy for Change profile compare

with your self-evaluated view of your energy?

@helenbevan

3. Gaps between current & desired energy levels

There are large gaps (> 1) between the group’s perceived energy

for change ___and its desired energy level ___on physical and

psychological energies. The group would like to enhance its

energy for change in these particular domains.

On average, individuals within the group measure the energy of

those they work with ____to be lower than their own energy

1

2

3

4

5 Social

Spiritual

Psychological Physical

Intellectual

My energy

Energy of those I work with

Importance of this energy

@helenbevan

5. Is Energy for Change influenced by “distance from CEO” and “clinical/non-clinical” role?

NHS dataset shows those in clinical roles have higher levels of energy for

change than those in non-clinical roles, which is mostly influenced by their

higher levels of spiritual energy and may also be influenced by higher levels of

social energy.

The NHS data also showed that individuals in roles that are closer to the CEO

(in hierarchical terms) have higher levels of energy for change**** in four out

of the five energy domains (there were no differences in the physical energy

levels of individuals at different levels of the hierarchy).

In the Saskatchewan dataset there were no differences between those in

clinical roles (n=13) compared with those in non-clinical roles (n=30).

Interestingly, the only difference to emerge between the various levels of the

hierarchy, was on Physical Energy: those closest to the CEO had higher

physical energy for change than those two steps away from the CEO.

The groups are too small to be representative (clinical = 13, proximity to the

CEO = approximately 6 in each group).

@helenbevan

Conclusions

• The group’s energy profile is 77%, but this varies widely across energy domains and individuals

• To build energy for change, the team should focus on the physical and psychological domains

• Physical energy is enhanced by creating opportunities for regular renewal, ensuring workload is appropriate and investing in a healthy work environment

• Psychological energy is enhanced by a safe, secure environment that provides role-models that exhibit courage and trust in change

@helenbevan

#qs13

“Money incentives do not create energy for change; the energy comes from connection to meaningful goals”

Ann-Charlott Norman, Talking about improvements: discursive patterns and their conditions for learning,

Clinical Microsystem Festival, Jönköping March 2012

@helenbevan

[Shared] purpose goes way deeper than vision and mission; it goes right into your gut

and taps some part of your primal self. I believe that if you can bring people with similar primal-purposes together and get them all marching in the same direction,

amazing things can be achieved. Seth Carguilo

@helenbevan

@helenbevan

#qs13

Air sandwich

http://www.amazon.com/gp/mpd/permalink/m3E4LREIVUTDH3/ref=e

nt_fb_link

History has taught us that the number one reason strategies fail is because of the lack of execution.....

History is now teaching us that unless we learn to engage people, not just people called executives, in a conversation about needs, wants and desires we simply cannot expect to meet those needs. Not meeting those needs means we cannot expect people to even want to be engaged with us for whatever purpose

Jay Deragon

@helenbevan

#qs13

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

@helenbevan

#qs13 @SimonJGuilfoyle Police Inspector and systems thinker

@helenbevan

#qs13 @SimonJGuilfoyle Police Inspector and systems thinker

@helenbevan

#qs13

Police

@SimonJGuilfoyle Police Inspector and systems thinker

@helenbevan

#qs13

Education

@SimonJGuilfoyle Police Inspector and systems thinker

@helenbevan

#qs13

Healthcare

@SimonJGuilfoyle Police Inspector and systems thinker

@helenbevan

What focus for our improvement projects?

0

5

10

15

20

25

1 2 3 4 5 6 7 8 9

No

of

pro

jects

Project Score Mainly focussed on

quality, safety &/or

patient experience

Mainly focussed on cost,

productivity or efficiency Source: 100 improvement projects on national improvement

leadership programme October 2012

@helenbevan

#qs13

My three visits to Saskatchewan

2008

2010

2013

@helenbevan

#qs13

....the last era of management was about how much performance we could extract from people

.....the next is all about how much humanity we can inspire

Dov Seidman