Masterclass on Best Practices of Managing Change - Day 3 Case Hospital - learning and teams
- 1. Bu proje Avrupa Birliği ve Türkiye Cumhuriyeti tarafından finanse edilmektedir IMPROVED STRATEGIC MANAGEMENT CAPACITY PROJECT Management of Change: Learning from International Best Practices 9.10.2013 - Ankara
- 2. Bu proje Avrupa Birliği ve Türkiye Cumhuriyeti tarafından finanse edilmektedir The Long Conversation: Building Key Org. Capabilities
- 3. Bu proje Avrupa Birliği ve Türkiye Cumhuriyeti tarafından finanse edilmektedir Hospital of Children in Minnesota, USA • Medical errors are estimated to kill 44,000 to 98,000 patients annually. • Each year, in USA’s hospitals, 6.7% of all admitted patients experience a medical accident.
- 4. Bu proje Avrupa Birliği ve Türkiye Cumhuriyeti tarafından finanse edilmektedir Hospital of Children in Minnesota, USA • Anne Wilson is the Chief Operating Officer at the Hospital • She was recently witness of a nearly fatal event related to a morphine overdose at the Hospital. Immediately after the incident, a team began to examine its causes. • Anne prepared her meeting with the child’s parents. This was a challenging and stressful situation for her and the parents.
- 5. Bu proje Avrupa Birliği ve Türkiye Cumhuriyeti tarafından finanse edilmektedir • Hospital of Children in Minnesota, USA Anne came to Hospital with the expressed intent to make safety her highest priority. • She began by assembling a core team of people to help design and launch the Patient Safety Initiative. • She also started to gather data on the current state of patient safety; she conducted 18 confidential focus groups with doctors, nurses, pharmacist, etc. Employees felt relieved to have a safe place to discuss their experiences with medical errors. • “As we conducted the focus groups, my office became a confessional”.
- 6. Bu proje Avrupa Birliği ve Türkiye Cumhuriyeti tarafından finanse edilmektedir Hospital of Children in Minnesota, USA • Anne launched a strategic planning process to define the organization’s goals and objectives for the next five years. • Anne coined the acronym SAFE to summarize the four components of the Hospital’s strategic plan. SAFE stood for Safety, Access, Financial, and Experience. • The safety component established the objective of achieving zero defects in the delivery of clinical care and medications to patients. • Access involved eliminating deferrals, improving cycle time, and increasing the number of patients served each year. • The financial component established goals related to cash flow, return on capital and productivity. • Experience focused on enhancing patient/family satisfaction.
- 7. Bu proje Avrupa Birliği ve Türkiye Cumhuriyeti tarafından finanse edilmektedir Improve performance against Agency Mission Type of Public Organization Mission Examples Performance Objectives/Metrics Service Delivery Provide specified services to the public as efficiently and effectively as possible Health care agencies, Efficient delivery, infrastructure security and integrity, development error minimization programs, financial services, information distribution, social service agencies Analysis and reporting Provide policy makers Treasuries, budget with specified authorities, information and intelligence agencies analysis Accuracy, timeliness, risk management What is my organization’s mission? How is it expected to create public value?
- 8. Bu proje Avrupa Birliği ve Türkiye Cumhuriyeti tarafından finanse edilmektedir Lack of a performance culture Before Change: • • • OSHA measured success in terms of the number of inspections and fines (sanctions) imposed. Punitive attitude toward business. Employees lose sight of the overall mission.
- 9. Bu proje Avrupa Birliği ve Türkiye Cumhuriyeti tarafından finanse edilmektedir Lack of a performance culture After Reform: • • • • Commitment to Mission. “Reducing the number of injuries, illness, and eaths in the workplace.” Goals and metrics related to “the elimination of all preventable workplace ills in ten years.” Literally impossible to achieve --) goal was to stimulate innovative thinking.
- 10. Bu proje Avrupa Birliği ve Türkiye Cumhuriyeti tarafından finanse edilmektedir Hospital of Children in Minnesota, USA Anne wanted to transform the organizational culture to provide an environment conducive to discussing medical accidents in a constructive manner
- 11. Bu proje Avrupa Birliği ve Türkiye Cumhuriyeti tarafından finanse edilmektedir Hospital of Children in Minnesota, USA She took several important steps. She created forums where staff members could come together to discuss safety issues and learn more about current research in the field. Second, she instituted a blameless reporting system for recording medical errors.
- 12. Bu proje Avrupa Birliği ve Türkiye Cumhuriyeti tarafından finanse edilmektedir Hospital of Children in Minnesota, USA Anne established several structures and processes to oversee and implement the patient safety initiative • Patient Safety Steering Committee • Focused Event Analysis Process • Medication Administration Process • Safety Actions Teams
- 13. Bu proje Avrupa Birliği ve Türkiye Cumhuriyeti tarafından finanse edilmektedir Hospital of Children in Minnesota, USA Patient Safety Steering Committee: • Oversee the safety initiative. • Included many physicians as well as nursing union leaders, a Board member. • Committee took collective responsibility for setting goals for the safety initiative and for revising hospital policies and procedures. • For example, the committee created the Event Analysis Process. Focused
- 14. Bu proje Avrupa Birliği ve Türkiye Cumhuriyeti tarafından finanse edilmektedir Change Program must be… Element Description Organizational structure Teams and Social Open Networks combined to provide both depth of dimensional (function, processes) detail, and breadth of multi-dimensional perspective. Effective governance by the cross-unit management team with participation of key users.
- 15. Bu proje Avrupa Birliği ve Türkiye Cumhuriyeti tarafından finanse edilmektedir Hospital of Children in Minnesota, USA Focused Event Studies: Conduct investigations following serious (and less serious) medical accidents, Learn a great deal about improving patient safety by applying this structured procedure frequently. problem-solving Conducting a confidential blameless analysis of the incident.
- 16. Bu proje Avrupa Birliği ve Türkiye Cumhuriyeti tarafından finanse edilmektedir Hospital of Children in Minnesota, USA Medication Administration Process: Effort to overhaul the hospital’s medication administration system with the goal of achieving zero defects. Effort to demonstrate how the organization could improve patient safety by redesigning processes and systems.
- 17. Bu proje Avrupa Birliği ve Türkiye Cumhuriyeti tarafından finanse edilmektedir Hospital of Children in Minnesota, USA Safety Actions Teams: Mary, a clinical nurse specialist, decided to create a safety action team in the hematology/oncology unit. This cross-functional team of eight employees began to meet monthly to discuss medication safety issues. After the meetings, the team members briefed their coworkers about the problems they discussed and the improvements they hoped to implement. Each person also gathered ideas and suggestions to share with the rest of the team at the next meeting.
- 18. Bu proje Avrupa Birliği ve Türkiye Cumhuriyeti tarafından finanse edilmektedir Hospital of Children in Minnesota, USA Safety Actions Teams: Two other units observed the Mary s efforts and launched safety actions team in their areas. Witnessing these successful efforts, the Core Committee directed the manager of each clinical unit to establish a safety action team.
- 19. Bu proje Avrupa Birliği ve Türkiye Cumhuriyeti tarafından finanse edilmektedir Hospital of Children in Minnesota, USA Safety Actions Teams: Mary, a clinical nurse specialist, decided to create a safety action team in the hematology/oncology unit. This cross-functional team of eight employees began to meet monthly to discuss medication safety issues. After the meetings, the team members briefed their coworkers about the problems they discussed and the improvements they hoped to implement. Each person also gathered ideas and suggestions to share with the rest of the team at the next meeting.
- 20. Bu proje Avrupa Birliği ve Türkiye Cumhuriyeti tarafından finanse edilmektedir The Long Conversation: Building Organizational Capabilities Changing the collective behaviour of the group changes the culture…
- 21. Bu proje Avrupa Birliği ve Türkiye Cumhuriyeti tarafından finanse edilmektedir The Long Conversation: Building Organizational Capabilities
- 22. Bu proje Avrupa Birliği ve Türkiye Cumhuriyeti tarafından finanse edilmektedir Collaborative network Element Intra-unit team Social network Org. Scope Functional or business units Multi-functional and multi-business Size and cohesiveness Small, closed and tight Large, open, and loose Members Employees affiliated to functional or business unit Users across the organization at all levels. Perspective Depth of dimensional detail, regarding function, product, geography or channel. Breadth of multi-dimensional interdependences Paradigm Variety Low. Social and technological affinity induces shared paradigms among members. High. Paradigms may clash, exposing conflicts and dilemmas. Coordination Role Key user coordinates intra-unit work and learning, connecting it to the larger multidimensional perspective addressed by the social network. Key users participate in crossfunctional action-learning and knowledge diffusion across the social network, informing it with their narrow intra-unit perspective.
- 23. Bu proje Avrupa Birliği ve Türkiye Cumhuriyeti tarafından finanse edilmektedir Final Thoughts
- 24. Bu proje Avrupa Birliği ve Türkiye Cumhuriyeti tarafından finanse edilmektedir The Long Conversation: Building Organizational Capabilities Leading through an involved and developmental style of leadership that creates a supporting atmosphere for learning & exploration
- 25. Bu proje Avrupa Birliği ve Türkiye Cumhuriyeti tarafından finanse edilmektedir The Long Conversation: Building Organizational Capabilities …working on the short and long terms in parallel, you are going to be stronger.
- 26. Bu proje Avrupa Birliği ve Türkiye Cumhuriyeti tarafından finanse edilmektedir Change Program must be based on… A structured chronological framework A Development and Learning process
- 27. Bu proje Avrupa Birliği ve Türkiye Cumhuriyeti tarafından finanse edilmektedir Change Program must be… Element Description Strategy Bidirectional alignment between organization and the adoption strategy. Automation, coordination and information support opportunities are identified by a discovery process that contains Osmosis, Growth and Adaptation. Strategy is not only deliberate, but also emergent. Leadership Top managers create the appropriate environment for exploring opportunities and learning; this environment is neither directive nor laissez faire but “involved and developmental”. Cross-unit management team stimulates convergence of the learning process. People Key users/agents are catalysts of learning acting as pivots between the deep intra-area perspective in their units and functional domains and the broad interarea perspective of internal and external business processes and systems. Supporting specialists work under a “prototype” mindset. Organizational structure Teams and Social Open Networks combined to provide both depth of dimensional (function, processes) detail, and breadth of multi-dimensional perspective. Effective governance by the cross-unit management team with participation of key users.
- 28. Bu proje Avrupa Birliği ve Türkiye Cumhuriyeti tarafından finanse edilmektedir Change Program must be… Element Description Planning and Control Directed incrementalism: a management decision making approach that balances direction (expressed as vision and objectives) with incremental execution. Visions are translated into strategic options and put into practice through action-learning. Fast learning cycles eliminate non promising options and concentrate resources on most promising ones, progressively revealing appropriate transition paths. This approach is key to handle the inherent uncertainty and political context of the Long Conversation. Motivation People motivated by an environment of collaboration, discovery, conjoint design and public recognition of contribution, combined with the satisfaction that results from achieving business value from ES by co-creating a path of small, progressive victories.
- 29. Bu proje Avrupa Birliği ve Türkiye Cumhuriyeti tarafından finanse edilmektedir The Long Conversation: Building Organizational Capabilities Be a Leader, not a Bureaucrat
- 30. Bu proje Avrupa Birliği ve Türkiye Cumhuriyeti tarafından finanse edilmektedir Oswaldo Lorenzo Professor of Management Deusto Business School, Spain Blog: www.longconversation.com @Lorenzooswaldo