5 Top Tips for Making Change Happen By Jan Filochowski, author of Too Good to Fail? Why Management Gets it Wrong and How You Can Get It Right 1. Explain and show the need for change, including why we can’t go on as we are. Get as much airtime as you can. When I took over West Herts Hospitals its staff assumed they were doing what patients wanted, but surveys showed that to be far from the case: we were creating much higher levels of dissatisfaction than other hospitals because we were not communicating with our patients, or with each other enough or well enough. As a result many things were being done without proper thought and many expectations were being defeated. When I realised this, I got the organisation to look through exactly what we were failing on, and how we were failing to communicate, reassure patients and often meet their very basic needs. The reaction of staff wasn’t to say that none of this was true or that it was nothing to do with them. Instead they showed a huge determination to sort the problems out and proactively put in place systems to communicate with patients. Following directly from that response, a wide range of changes was brought in from the bottom up, using what staff knew and understood about patients. 2. Understand who you have to convince and why they might be resistant. In one organisation I went into, I needed to change the view of a leading doctor who had been misled about the real commitment of the previous regime to solving rather than masking the problem he faced. He made his concerns and suspicions very clear to me in a pivotal meeting with 20 staff crucial to delivery of this objective. I went through his concerns point by point, explaining how it would be different this time and making a public commitment I would have to fulfil. After a silence that seemed like an eternity but was probably a few seconds, he warily agreed we should try again - but properly this time. I was as good as my word, and he as his: he was actually a brilliant but frustrated implementer. We made enormous strides very quickly as a result: we moved from 30% to 80% of patients being seen promptly in our Emergency Department. An account of such debates will very definitely go round, particularly among key staff because it will have been a key debate. And there will be a clear message: things are going to change, it’s worth getting on board. 3. Create a win/win scenario – show why and how those changing will gain. The overwhelming majority of your staff will be capable but in need of reassurance, support and possibly redirection. It is therefore crucial to signal your own positive judgements clearly and quickly. Do not leave the sword of Damocles hanging over people. Tell them they have your confidence, and why. It will send a wave of relief and motivation through the organisation. It will have a dramatic impact. People will
think: “Not only is there a way forward – which looks as though it will work – I am part of it!” At Medway hospital when we started to implement a redesign of basic processes, it became evident that this was creating big improvements around the organisation and, very importantly, it was based on the insights of existing staff. As a result, individuals and teams offered to redesign other processes that they thought were defective. They felt confident that they would be supported by management, and they were. There was a blossoming of constructive process redesign, with the result that all over the organisation everything started to be done better. 4. Don’t wait for the perfect answer, approximate, go for 80/20. When I started working to reduce waiting lists at Medway, my team and I were pioneers. There was no guidance available from anyone on what we had to do. So we tried one thing, and then another. If something half-worked, we developed it; we looked for new ideas from the new ground we had secured. At first slowly, but then more rapidly, we made progress. When we looked back on what we had achieved, we could see the pathway we had trodden, but while we were doing it we had effectively been slashing through the undergrowth blindfolded. That is what I call relentless management. It’s about trying things until they succeed and, as and when they do, building on them – endless iterations until a virtuous loop is created. 5. Tackle the uncertain, the unknown and the unchangeable. The manager’s task is to find the pattern, whatever it is, and use it to reduce the area of the unknown and the unmanageable bit by bit. By breaking the problems down into small manageable bits, much of what appears to be random can be distilled into patterns based upon what people do when and what they need. There will always be a residue that is beyond anyone’s control, but by reducing the ‘unknown’ substantially, management can increase its capacity to act, and then have a fresh go at what remains. ‘This book is a must for anyone interested in improving their management skills.’ Chris Green, Former Chief Executive, Virgin Trains ‘A rare combination of general principles and concrete advice. Wholeheartedly recommended.’ Professor Alison Wolf CBE, Director of Public Services Policy and Management, King’s College, London ‘A very wise and reflective book. Valuable lessons for every senior manager in every organisation.’ Professor Daniel T. Jones, author of Lean Thinking For more information about this book please go to: www.pearson-books.com