The Key to Organizational Transformation is Personal Transformation:

Transcription

1 The Key to Organizational Transformation is Personal Transformation: Transforming the Way We Lead Change NHLC June 10, 2013

2 Background Transferring from St. Joseph s Health Care London Neonatal Intensive Care Unit Perinatal Services Women s Ambulatory Care 500 staff and physicians $43M budget Relocating at LHSC Pediatrics/Children s Hospital Perinatal Services Women s Ambulatory Care 2

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4 Complex Organizational Change C Well planned and implemented complex change is messy. It will: Disrupt the workplace Destabilize people Impacts of change cannot be eliminated, but they can be reduced through skillful change leadership and transition management 4

5 Patients, People, Processes High quality care provided before, during and after transfers and moves Patient safety maintained Impacts to people and operations minimized Staff and Physicians supported in the new environment Patients, Families, Staff, Physicians, Community informed and engaged 5

6 Strategy: Four Key Elements Building Organizational Readiness and Change Capability: 1 Leader Development 2 Cultural Change Significant Planning for Safe Quality Care...During an Incredibly Complex Initiative (pre, during and post) 3 Redesign Integration and Alignment 4 Talent Management 6

7 . Transformational Change Builds permanent change in the organization culture Vision Produces change in individual and organization performance Acknowledge and respect Course Correct Local history Culture of the organizations involved Knowledge and experience of all stakeholders Uniqueness of the previous journeys that have been taken Learn & Share Through Middle Layers Current Reality Course Correct Learning Experiment No going back Adapted from Beyond Change Management by D. Anderson & L. Ackerman Anderson 7

8 What We Thought We Knew Resistance is a normal reaction during transformational change Encourage people to discuss fears and concerns in teams When the human side of change is left unattended, the effects will surface in many ways Allow for processing of the resistance and conflict Identify and discuss barriers Address what s in it for me Give people in the organization(s) time to connect and establish relationships Provide processes that emotionally support people through all parts of the change Work to resolve issues 8

9 Developing Change Leaders Develop leadership capacity for leading and navigating transformational change Focus on emotional intelligence Resiliency of leaders in order to lead staff effectively through complex program transfer Manage operational and change complexity Support staff undergoing transitions and new beginnings Coach and mentor teams coming together 9

10 Emotional Intelligence Ability to recognize and understand your emotions and the emotions of others, and to use this awareness to effectively manage yourself and your relations with others Dan Goleman, Emotional Intelligence 10

11 . St. Joseph s Health Care London Merging of Two Cultures London Health Sciences Centre Faith-based organization Small academic teaching hospital 4200 employees, many longstanding Services being transferred were the pinnacle programs Big fish in a small pond Tertiary and quaternary hospital on two sites Large academic teaching hospital 10,000 employees Higher employee turn-over One of many high profile programs Small fish in a big pond 11

12 . Cultural and Team Integration Cultural integration strategy designed to honor the unique culture of both organizations Interdisciplinary Steering Committee Builds on the cultural strengths that will create the new culture, aligned with a compelling vision for the future Develop common values and objectives to come together in a unified manner Leveraged: ethics and ethical decision making, commitment to shared leadership, and family centred care 12

13 . Engaging frontline staff and physicians through open forums, one on one meetings Create a shared vision and desired culture Understand cultural affinities and the real differences Acknowledge and manage endings and building readiness for new beginnings Build staff engagement pre and post transfer Shared Leadership High involvement in decision making and improvement in care processes 13

14 . Process: Outcomes: 6 interdisciplinary city wide task teams (including patients) Analyze the differences between the clinical services at both sites Redesign based on: Patient Experience LEAN processes Best Practices Evidence Shared Leadership Budget constraints and no new money Patient and family centred care 272 recommendations Alignment /revision of five unit specific care delivery models based on best practice Team development Efficiencies 14

15 Staff Engagement Model of care and staff mix based on best practices Options available to staff to follow work or accept packages Recruitment strategy in development Physician and Midwife Engagement Identification of clinical issues Develop strategies and services Plan space allocations 15

16 . Prepared Staff, Physician & Midwives Education, Orientation and Integration Completed for each move or transfer to ensure the delivery of safe, high quality care and service in the new clinical space and within the new inter-professional team The Learning Simulation Pilot Project designed to augment and enrich education and orientation strategies Mock codes C-Sections Deliveries Purposeful visits for staff to work in and test flow and processes prior to move of patients 4 hour blocks of time with actual patient care scenarios 16

17 . Identify and mentor formal and informal leaders affected by the change Operational Leaders Physician and Midwifery Leaders Union Leaders Clinical Leaders Coaching 1:1 Succession Planning Move leaders into new organization prior to transfer to support culture change prior to staff 17

18 Communication Staff engagement Staff forums, meetings Transitions newsletters Corporate Building our Future newsletters Web Patients/public London Free Press/media relations Communicate regularly with LHINs Web Newsletter for regional medical centres Patient info cards, memos, reminders Virtual tour/video Celebration activities Celebrate new space Recognize St. Joseph s I was born at St. Joseph s campaign 18

19 Monitoring and Evaluation Currently tracking metrics associated with transfer and moves based on activities, timelines and risks Post transfer evaluation based on: Critical HR factors: Absenteeism and sick time Overtime Turn-over rates Time to fill vacancy Workload grievances Workplace climate pre and post move: Relationships with Leader Relationships across the team (interpersonal conflict) Experience with workload 19

20 Front Line Manager Lived Experience Becoming Part of a New Organization 20

21 The Starting Point A long history in the NICU - Nurse, NP First and only employer Suspicious of change theory and Emotional Intelligence concepts Not a big fan of the receiving hospital Big, bureaucratic blowhards Moments of aggressive response in meetings 21

22 Hope The Beginning of the End Early initiation of the change strategy ensured enough time for personal transformation Enormous value in ensuring that leaders have moved through the change process a few steps ahead of the team Personal Coach incredibly helpful Assumed an Operational Leadership role 2 years prior to Program Transfer 22

23 Postcards from the Edge Cannot over-estimate the pain of change for individuals Be prepared when experts decompensate If possible, separate support role from logistics role Become comfortable saying I don t know Resist the temptation to reduce ambiguity embrace co-creation 23

24 Front Line Manager Lived Experience Integrating A New Team 24

25 My EI Journey Emotional Intelligent development work: the light bulbs Beyond Personal Style: deep personal work Uncomfortable at times and takes a personal commitment 25

26 7 Core Needs Safety Inclusion Control Power Competence Justice/Fairness Desire to be liked/connected 26

27 7 Core Needs Lessons Learned Create the space for staff emotions to surface i.e. town hall meetings, open forums The small stuff matters i.e. where will I park, changes to commute 27

28 Physicians Are People Too Ask questions to better understand core needs e.g. What will need to be in place for you to feel capable of delivering your best at LHSC? What do you most want to preserve in your practice? How would you define success in this transfer? Build relationships on these needs or areas of interest The patient creates mutual purpose 28

29 When Your Best is Not Enough For many the emotional reaction comes when the change actually happens Be ready to launch a recovery strategy and plans when impacts warrant Be prepared for performance dip Round for feedback/acknowledge Staff Contributions Feedback loops in place to identify negative impacts to operations, team capability and stakeholder relationships Build a strategy to engage physicians in problem solving and issue resolution 29

30 Measures Workplace Climate Survey Performance Reviews Excellent opportunity to take stock at a personal level, how staff were doing Adverse Events Marked decrease after the first year of the program transfer (150 to 90) Sick Time Different trend than expected, increase came later in the transition 30

31 My Insights Understand the source of staff emotions Create space to share and acknowledge emotions You will never get it perfect Plan for the need to course correct People need to be heard and understood before they can listen and understand 31

32 Lessons Learned 32

33 Lessons Learned Through Stumbles, Struggles & Missteps 1. Staff change effort with right people 2. Accurately assess the complexity of the project/change process and capability of the organization 3. Help people invent their own future they are unlikely to do it on their own 4. Leaders and other key champions must be EI ready 5. Talent Management should focus on leaders who are high performing and on learning agility 33

34 Lessons Learned Through Successes 1. You will need a comprehensive not just a project plan 2. Access expertise in change leadership, leadership development and cultural change 3. Apply a common change model and methodology to all organizational, people and culture changes 4. Leaders are the leverage point for successful change. Complete leader development WELL in advance of change. 5. Reducing variation in how people work/will work together is critical prior to integrating services and teams 34

35 Lessons Learned Through Successes cont d 6. Cultural differences do matter Build bridges by leveraging what is important in both organizations 7. Communicate, communicate, communicate Even when there is nothing new to communicate 8. Ensure reliable feedback loops in place to enable timely course corrections 9. The impacts of change (to people and operations) will begin well before the change date and continue well after - plan accordingly 35

36 Question & Answer Session. 36

37 . Contact Us Laurie Gould, Executive Vice President: Tim Rice, Interim Director, Women s Care: laurie.gould@lhsc.on.ca tim.rice@lhsc.on.ca Julia Marchesan, Manager, Children s Specialty Services julia.marchesan@lhsc.on.ca Lianne Collins, Senior Consultant, Change Strategy: lianne.collins@lhsc.on.ca 37