Book Review: You can't order change: Lessons from Jim McNerney's Turnaround at Boeing - Peter Cohan

I was attracted to this book because the title said what I have always thought yet doesn't seem to be what I get involved with doing! I spend a lot of time on Boeings so I felt I had an interest in knowing what they doing and how they are doing it.

A while back Boeing was in a mess - stockprice was down, staff were complaining, revenue was not as anticipated, key people were leaving, lawsuits abounded and generally everything was on a downward trend.  Enter CEO Jim McNerney who gained a reputation of requiring results to speak for themselves rather than putting himself on a pedestal.

This book takes you through the CEO perspective and actions in turning around a self-destructing monolith. The view I got form the book was the importance of people stuff, relationships and leadership in times of trouble. Sounds obvious but in my experience I see organisations go down the route of more rules, process redesign and the like when the crunch hits.

Cohan interprets McNerney's approach as expressing what is required from leaders in the organisation, working with people so they jointly own these leadership attributes and encouraging communication at all levels. He also got rid of the people who didn't make the grade while investing in those who were growing into leadership roles with the right skills and capabilities. After people, the big message is the importance of the person who manages the finances. Then there is also the piece about customer involvement.

Written in summary here all this looks like the standard stuff of management and leadership texts. However, Cohan does explain all these actions in the context of Boeing. Still - to me, much of the diagnosis ended up a bit samey. Maybe that is more a reflection of my expectations - was I looking for something unique? Maybe the answer to large scale change in large organisations really is simple - the difficulty is in applying the tactics.

Overall - nothing new in here and maybe that is what is new.

Overcoming resistance to change

Resistance to change is on that "Top Five" list of topcis I get aksed about.

I think the video below is a great answer to the question on how to overcome resistance to change:

Predicting implementation success from organisational readiness

I've wondered for a while whether there is any evidence that we can predict the success of a change based on the organisation's readiness for the change - else why would we bother with worrying about readiness? As always, loads of researchers have not only been worrying about this issue, they have also been investigating it. I found numerous papers, however, one captured my interest - probably because of the rational and detailed way in which the research was conducted.   The conclusion as I figure it, is that it all depends on the biases (or not) in the readiness instrument.

You can read this paper here.

The meaning of Implementation Climate

I've just read a new paper about implementation climate and how it differs from organisational climate - all part of the "readiness for change" strategies than many of us use.  You can read the whole paper at Implementation Science (online - open access). I've pasted the abstract here, though I recommend you read the whole paper.

The meaning and measurement of implementation climate.

Weiner BJ, Belden CM, Bergmire DM, Johnston M.

Abstract

BACKGROUND:

Climate has a long history in organizational studies, but few theoretical models integrate the complex effects of climate during innovation implementation. In 1996, a theoretical model was proposed that organizations could develop a positive climate for implementation by making use of various policies and practices that promote organizational members' means, motives, and opportunities for innovation use. The model proposes that implementation climate--or the extent to which organizational members perceive that innovation use is expected, supported, and rewarded--is positively associated with implementation effectiveness. The implementation climate construct holds significant promise for advancing scientific knowledge about the organizational determinants of innovation implementation. However, the construct has not received sufficient scholarly attention, despite numerous citations in the scientific literature. In this article, we clarify the meaning of implementation climate, discuss several measurement issues, and propose guidelines for empirical study.

DISCUSSION:

Implementation climate differs from constructs like organizational climate, culture, or context in two important respects: first, it has a strategic focus (implementation), and second, it is innovation-specific. Measuring implementation climate is challenging because the construct operates at the organizational-level, but requires the collection of multi-dimensional perceptual data from many expected innovation users within an organization. In order to avoid problems with construct validity, assessments of within-group agreement of implementation climate measures must be carefully considered. Implementation climate implies a high degree of within-group agreement in climate perceptions. However, researchers might find it useful to distinguish implementation climate level (the average of implementation climate perceptions) from implementation climate strength (the variability of implementation climate perceptions). It is important to recognize that the implementation climate construct applies most readily to innovations that require collective, coordinated behavior change by many organizational members both for successful implementation and for realization of anticipated benefits. For innovations that do not possess these attributes, individual level theories of behavior change could be more useful in explaining implementation effectiveness.

SUMMARY:

This construct has considerable value in implementation science, however, further debate and development is necessary to refine and distinguish the construct for empirical use.

Seven Key Factors in how minds change - 1: Changing Minds

Notes from the book "Changing Minds" by Howard Gardner (2004)

What I learnt was that if we want to help someone change their mind about what constitutes good practice (and thereby figure their practice is not the best so they need to decide to adopt a better practice), then it helps if we can:

1. Demonstrate what has to be changed in a way that someone can figure out for themselves what the reason is for them to change. Some people do this analytically and others deduce or infer from what they learn that a change is necessary. I think it's important to understand it's the adopter who needs to reason, not the person pushing the change.
2. Research, evidence, statistical analysis etc is crucial when working with healthcare professionals for whom this is the base of their practice. The onus of evidence is on the person pushing the change.
3. The proposed change needs to connect at the emotional and intuitive level with the potential adopter. The really good proponents of change can combine the emotive, rational and evidence content in their rhetoric.
4. The concept of redesciption intrigued me. I can see now that the person who can describe the proposed change in many different ways, whilst remaining true to the core concepts and values, is more likely to be able to convince others to change.  Not least, being able to redescribe means you know your stuff and this enhances the credibility of the proposal.
5. Rewards are obvious - pay someone and they are more likely to do it. But this doesn't always lead to the mind changing. The most basic reward is praise and confirmation of the new behaviour.
6. Real World Events - means tagging your proposals to outside influences. As a friend pointed out to me recently, a great time to raise the profile of pancreatic cancer would have been in the days after Steve Jobs died. To make the most fo these (not always sad) events, is to be prepared.
7. Resistance... it takes two to create resistance. The best way I know to deal with it is to stop pushing and to see things form the other's perspective - then, find a way to break through the debate.

Guide to facial expressions and emotions

I think http://www.cedarseed.com/fire/emotut.jpg should be in every meeting room - if only as a reminder for us all that we say more with our expressions than with what comes out of our mouths...

Productivity 5: What do we mean by "Productive"?

This is the fifth in the Productivity Series by Sarah Fraser. If you want to sign up to receive updates in your email inbox or your Reader (your choice) then go to the Blog and click on the Subscribe button.

So what do we mean when we say we want to be productive or we want our services to be productive? This is something we think we know but until we articulate exactly what we mean, the term is uncertain and ambiguous. What one person understands as productivity may not be the same meaning that another has.

The online dictionary provides a number of definitions and I liked the way it provides similar, related and dissimilar words.

ThesaurusLegend:  Synonyms Related Words Antonyms

Adj.	1.	productive - producing or capable of producing (especially abundantly); "productive farmland"; "his productive years"; "a productive collaboration" creative, originative - having the ability or power to create; "a creative imagination" fertile - capable of reproducing fruitful - productive or conducive to producing in abundance; "be fruitful and multiply" profitable - yielding material gain or profit; "profitable speculation on the stock market" successful - having succeeded or being marked by a favorable outcome; "a successful architect"; "a successful business venture" unproductive - not producing or capable of producing; "elimination of high-cost or unproductive industries"
	2.	productive - having the ability to produce or originate; "generative power"; "generative forces" generative
	3.	productive - yielding positive results successful - having succeeded or being marked by a favorable outcome; "a successful architect"; "a successful business venture"
	4.	productive - marked by great fruitfulness; "fertile farmland"; "a fat land"; "a productive vineyard"; "rich soil" fertile, rich, fat fruitful - productive or conducive to producing in abundance; "be fruitful and multiply"

Based on WordNet 3.0, Farlex clipart collection. © 2003-2008 Princeton University, Farlex Inc.

Using the above I came up with a number of questions to ask myself and others who claim to be working on increasing productivity:

1. If being productive can be defined as the capability to reproduce I wonder what productive spread is? I think it is about how efficiently we adopt and implement best practises, but that may not be the all of it.
2. If being productive is about abundance, how can we shift our mindset to one where we aim to use and create abundance rather than to streamline, cut and destroy services? How much impact can a mindset shift make?
3. If being productive is about yielding positive results, I wonder for whom these results are? How do we manage the differing expectations of different stakeholders?

How do you define "productive"?

Gartner's Hype Cycle is more useful than the Rogers' Diffusion of Innovation Curve

The classic Diffusion of Innovation curve was created by Everett Rogers back in the 60's, before many improvement facilitators were born.The terms, early adopter, majority, laggard etc have survived because they provide an explanation for something that is often difficult to fathom - how different groups of people respond differently to the same innovation. I have written at length (see previous posts and books) about the limitations of this theory and it inability to predict or provide guidance about what to do next.

Gartner introduced a theory in 1995 designed to explain what happens when a product or innovation is hyped, and then goes through various stages to acceptance. I like this theory because it steps away from the position of blaming people for not doing something and focuses more on the intrinsic value of the innovation or product.

Image from Wikipedia: Hype Cycle

The Trigger is the first breakthrough event that starts the interest in the product/innovation. This is followed by the peak of inflated expectations where the optimism for application outweighs the difficulties. The focus is on the possibility of the product/innovation. The trough of disillusionment comes when the failures start stacking up, expectations are not met, or something new comes along and this idea is no longer fashionable.  The slope of enlightenment may turn up years later when the original idea is tweaked and adapted and made more applicable. The plateau of productivity is reached when the product/innovation becomes mainstream due to its stability and usefulness.

Obviously, this curve will have different shapes for different products. Here are a couple of exercises:

1. Take one product/innovation which you believe to be at the Plateau of Productivity, and track back, seeing how the curve shapes with regards time and visibility (visibility = talked about, in the press, on agendas etc)
2. Map your current products, innovations and ideas on the cycle and see what you learn. Are they grouped in one area? What might you need to do to manage the transition to the next phase?

Let me know how you do by filling in the comments section below.

Scheming Virtuously; A Handbook for Public Servants

Nick Charney (Canada) has written a brief e-guide on how to get things done in the Public Sector, perhaps innovatively, whilst keeping our sanity, job and relationships.

Highly commended and you can download Scheming Virtuously; A Handbook for Public Servants as a pdf from the davepress blog (which is worth subscribing to davepress.net).

When stories and Powerpoint clash

A mantra I keep hearing is "we need to tell stories to influence change." I agree with this, however, I do have a few provisio's

• if the story has no relevance to your message then why are you telling it?
• if you provide a personal story to illustrate your values then please make sure it connects with the audience at the time (please update and avoid repeating)
• when you use PowerPoint to tell your story there seems to be a dissonance - the method is not matching the intent

As a method of influence, especially for large scale change, stories work well because they contain the emotive meme that a PowerPoint presentation usually lacks.  So let's use stories, but let's use them advisedly and with care.

Overcoming resistance to change - isn't it obvious

How to overcome resistance to change is one of the most common questions I am asked. The dominant mindset I encounter is that the person who does not want to change (aka doesn't want to do what they are told to do) is resistant and therefore wrong.  There is as many answers to this issue as there are management consultants. An interesting approach is the animated video with a script by Eliyahu Goldratt of "The Goal" fame. Despite the video being largely a promotion for his new book, it does have some useful content and ideas.

How to implement 7-30-90 Day projects

“Being busy does not always mean real work. The object of all work is production or accomplishment and to either of these ends there must be forethought, system, planning, intelligence, and honest purpose, as well as perspiration. Seeming to do is not doing. “ - Thomas A. Edison

The purpose of this blog is to set out some ideas on the how of a 90-day improvement project within the context of healthcare. This project process is evolving so please add comments to this post so everyone can learn from your experience.

Principles:

• Having more time doesn’t mean getting more done
• Manage the tasks not the time
• Deliver incremental value
• Deliver results within a defined timeframe
• Honour the concept of organisational learning and continuous improvement
• Discover a rhythm of change and implementation that balances risk with results
• Use these ideas as ingredients and make your own recipe
• Ensure a focused, targeted and committed action process

      “Absorb what is useful, reject what is useless, add what is specifically your own.“ –Bruce Lee

There are a variety of approaches. The choice of your approach will depend on your strategic aim, the timing that best suits you as well as the nature of your improvement process.

STEP 1: Create your format based on your timescale

“Once you have mastered time, you will understand how true it is that most people overestimate what they can accomplish in a year - and underestimate what they can achieve in a decade!” - Tony Robbins

It is possible to deliver changes in 3 days (see Kaizen methods for further information). 

Consider your desired results, the amount of people who need to be involved in the process, the team and organisational culture as well as the nature of the problem to be solved / the solution to be implemented.  With this in mind, look at the options below and see which most closely matches your needs.  Where possible make your task

 smaller and the timing shorter.

All of the timescales contain a basic strategic rhythm of

a) diagnostic steps

b) implementation focus

c) review and next steps

 It is possible to design a 90 project so the phases are sequential, or it can be built up from a series of smaller 30 day cycles.  The choice depends on your strategy for change:

“Hell, there are no rules here - we’re trying to accomplish something.” - Thomas A. Edison

Why 90 days?

• Scope is more complex though is manageable within the timescale
• Sufficient interdependencies that will need to be followed through with conversation and negotiation
• Good if have high energy people working on the project who can also maintain their focus

Why 30 days?

• May be easier to commit to than 90 days or 18 months
• Deal with the now; plans remain relevant
• Long enough to see an improvement (or not, so can then change the strategy)
• Scope is such that one individual or a small team can make the changes with no further resource to committees or individuals for permissions

Why 1 week?

• Good for those who are too time / task pressured to commit to improvement
• Able to test an improvement-through-learning process
• If used as part of a longer project the 1 week cycle can provide a mechanism for involvement (different people different weeks)
• Good for working with those with a low energy

	Diagnostic	Implementation	Review
12 week (90 day)	4 weeks	6 weeks	2 weeks
8 week (60 day)	2 weeks	5 weeks	1 week
4 week (30 day)	1 week	2 weeks	1 week
1 week (5 day)	1 day	3 days	1 day

A diagnostic phase includes, to varying degrees, some of the following (remembering that diagnosis is part of the change process as individuals discuss and assess their own situation):

R  What is the current situation, including baseline measures; this needs to be localised to the context of those making the changes. Process and value mapping, relationship mapping and other techniques are useful here.

R  Creating ideas for change and improvement; being creative rather than just implementing known tasks (otherwise we end up with low energy projects)

R  Understanding any interdependencies and carrying out appropriate negotiation

R  Planning, designing, getting in the resources that may be need (like equipment) etc.

An implementation phase includes, to varying degrees, some of the following

R  Action, with measureable results

R  Learning, from personal and team reviews

“Words may show a man’s wit but actions his meaning.” - Benjamin Franklin

A review phase includes, to varying degrees, some of the following

R  Working out what is going well, and why

R  Figuring our and being honest about the problems, and then working through some ideas to resolve these

R  Capturing personal learning as well as team and organisational learning, specifically noting those things you would like to do / feel more of

A project of any length can be constructed from a weekly pattern of activities.

“If we did all the things we are capable of, we would literally astound ourselves. “ - Thomas A. Edison 

Patient Experience; report to help Boards build patient and public experience into quality fo care

If you are steeped in the healthcare quality improvement methods you will know how important it is to understand the patient experience. Scaling up project results to a wider audience does not mean the patient's views are no longer important. While the theory is obvious the practice is not. It can be difficult to engage non-executives and Board members with the patient experience and a new report on the Patient Experience  issued by Dr Foster in the UK covers the following:


Foreword 
Key messages 
The scope of this report 
What is patient experience? 
Good intelligence guide: The basics 
Good intelligence guide: Measuring what matters 
Good intelligence guide: Building an intelligent report 
Good intelligence guide: Advice from the sharp end
Board briefing: Intelligence types and uses 
Board briefing: 2010 policy directions 
Board briefing: Glossary 
Board briefing: The current state of play 
References 
Acknowledgements 

It provides advice on how Boards can produce a meaningful intelligence report on the patient experience. I particularly like the checklists and the brevity with which it is written.  They have nicely avoided the temptation to burst into theoretical concepts.

I found this report via Jocelyn Cornwall's blog at the Kings Fund - another good source of information.

What are 30, 60 and 90 day projects?

We all want results as quickly as possible from any project team.  In fact, we want the results now!  Quality improvement projects are by nature a cyclical process where a few steps are taken, then tested, evaluated and then a few more.In complex organisations and systems such as healthcare, the cycles of change can take a long time It can be challenging to keep staff motivated after the initial months of the project.

The concept of the 90 day project comes from research where the aim has been to shorten the cycle of learning from the often 3 or 5 year project horizon. Projects like these accelerate some of the learning, but not all.   In healthcare improvement programs, accelerated timescales can be useful at the start, in the middle or the end of a formal program. At each stage they will have a different focus.

At the start of a project, short timescales can be used to get some momentum going. A 7 day sub-project is an excellent way to focus on commitment and action right up front. Half way through a project a series of say 3 x 30 day projects can be run in parallel with different teams all focusing on the same result. Or they could be run in series.  At the end, a series of rapid projects can help cover all the loose ends and ensure comprehensive results.

So what is a short project?  We know what it isn't:

• not a replacement for the overall project
• an easy option; all short projects need planning 
• not for everyone

If you want to run a short timescale project then consider the following:

1. for the same topic, different teams will choose different lengths of project. This is because the specific context for change is one of the the biggest factor in the speed of implementing change.
2. be practical, pragmatic and realistic
3. focus on the outcome to be delivered rather than traditional project planning
4. remember this is one technique that may work for some people and may not work for others

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Online Clustered Networks Spread Behavior Change Faster

Online communities have different dynamics to face-to-face communities of practice. New research suggests that for online communities, behaviour spreads more quickly when the community is grouped into networks with overlapping connections than when left to develop more random and distant links.

If you are managing online communities then the research is worth a closer look as it may provide hints on how to design and support it so behaviour and influence can spread amongst the participants.

For communities of practice not online this clustering effect is not new. Research has been around since the 1970's which show the importance of bringing groups together geographically, thematically and/or by profession or person type. As humans we like to be with people similar to ourselves and are most influenced by those the same as us - if Joe can make the change then I will probably be able to as well.

There is a lot of buzz about social movements, mobilising and organising for change in healthcare. One of the success criteria for this work will be the depth to which those doing the organising as well as those participating understand network dynamics, and design accordingly.  Random networks are less influential.

Using Twitter in the Classroom or Organisation

Twitter feels like one of those applications that has been searching for its use. Within healthcare, specifically the NHS in England, its use has been limited. Many organisations see it only as another media channel through which they advertise their services. A few, however, have grasped its potential to spread the word  in a personal way and are using Twitter as a means of engaging with patients and staff. A good example is @OBMH (Oxfordshire and Buckinghamshire Mental Health).

While healthcare is prevaricating and the organisations that preach and teach innovation are being slow to catch onto what is now practically a mainstream communication method, education has been stealing a march. An excellent blog post about using Twitter in the classroom includes a framework which made huge sense to me and helped me think through how best to use twitter in a training event as well as for the duration of a healthcare improvement project.

Not only does it help communication for the project it also adds in the "spread" and "Scale up" component that it so often missing.   If you are worried about the word student, then substitute patient or staff member. What I particularly like about this framework is it is a way for organisations using Twitter to self assess their use of it.

(Picture from Prof Hacker http://chronicle.com/blogPost/A-Framework-for-Teaching-with/26223/)

NHS partnership working and improvement; we've been here before

A number of large scale programmes are running in the NHS in England where communities are getting together to improve health and social care services. The projects have a wide membership from mostly statutory public sector organisations but also some in the voluntary sector. As some of the strategies sounded familiar I checked the Department of Health website.

I was involved in partnership working in the NHS in the mid and late 1990's. At that time in England there were also Healthy Action Zones which seem very similar to many of the programs underway at present. It seems to topic is coming round again but with a new language and consequently a delay in making changes. There are many papers and documents available form around 2002 - 2004 which have self-assessments, methods, best practice examples, case studies and similar. I find it so disappointing that those who are responsible for the spread of good practice and large scale change feel the need to continue to reinvent wheels - thus not practising what they preach.

If you are interesting in learning what has gone on before and in adopting and adapting existing ideas for large scale change then try out these papers from the Department of Health:

Working in Partnership; developing a whole systems approach (notable because it covers productivity - and this was 2002...)

Governance in partnership checklist of good practice

If you only want what is new then try
Working with Stakeholders which is 2010

4 kinds of relationships

So much of spreading good, known and evidenced practice is based on social connections and relationships. John Maxwell has four ways in which relationships can be categorised.

1. Some people add things to life (we enjoy them) +
2. Some people subtract something from life (we tolerate them) -
3. Some people multiply something in life (we value them) *
4. Some people divide something in life (we avoid them) /

If a key role of the person who group is trying to influence others to change their behaviour then it might be useful to reflect on the relationship between the "spreader/pusher" and the "adopter/puller".

There are some people I avoid (4) and I am unlikely to even receive the messages they are pushing out, let alone act on them. In a similar vein, those I tolerate (2) I will probably put them low on my priority list and will be fairly sceptical about what they put out. Whether I adopt anything they are pushing will be a matter of personal judgement.

On the other hand, those whose company I enjoy (1) I will probably get to hear a lot about what they are saying, thinking about and pushing in my direction. I will take their information in quite quickly, though may still toss the ideas about before making any changes to my behaviour.

Those I value I will probably not wait for them to send me information. I will be finding ways to connect, listen out carefully and will most likely shift my behaviour quite quickly when they send out behaviour related messages.

So which types of relationships are you creating and endorsing?

How Twitter can help engage staff by increasing transparency & trust

If you're playing Buzz Word Bingo in the healthcare at the moment then you will know that "Engagement" is a hot word. Nothing new there you say, it's been a consistent buzz word for the last 10 years at least.

Well, there's something new on the horizon. It's a bit scary, you may not like it and it seems to be one way to practically engage some staff. More than that it moves from a passive engagement to an interactive process, which through its transparency leads to increased trust.

Let me explain using a very current example. It is 22nd March 2010 and British Airways is on day 3 of a strike, with another series of strike days looming. It's a mess really, for all involved. As with many crises it's interesting to learn from how companies and individuals manage them to best effect.

I've been following @British_Airways on Twitter. The updates are immediate and a complement to the less frequent and more formal announcements on their website. When I start seeing a string of complaints - or compliments - on Twitter I get a sense of what is going on. I have no idea how many people they have handling the Twitter stream (probably only 1 - if so they need a prize for multitasking while keeping their head about them..). More important than the pattern on Twitter is the manner in which cries of despair, shrieks of delight, moans and queries are being handled. All in public and all is transparent for us all to see. When it gets to personal details they request a DM (direct message). As long as the nice BA person at the end of the Twitter Stream keeps calm I will keep calm. And I'm starting to trust they really will get me to my next destination.

Some hints and tips for using Twitter to engage with staff and customers, especially in a crisis
1) Ensure your Twitter stream is managed by a human and not a computer. Endless feeds of your website will not engage me and will most likely reduce my trust in you.

2) The 3 R's of Regret, Reason and Remedy go down very well. A 140 character Regret is enough of an apology. A quick Reason helps me understand the issue and I then know you also understand what I mean. Then a masterful 140 character or less Remedy will make my day. I don't need 3 page letters within which we all lose the point.

3) Be open. Speaking up in front of the crowd means you need to stick with your tone of voice and content of your speeches. If I know most fo the talk is going on where I can hear it then I will be more trusting. An advantage of the Twitter feed is I can scroll back quite a few days ago to see how the conversation has been going.

4) Allow me to discover people like me. Although the official stuff is importnat, I also like to engage with people like myself. I need to be able to do this without you controlling the place, person and pace./ On Twitter I can see who else is having a problem like me and can contact them to see if they, for example, discovered any easy solution.

Large Scale what? Change, outcome, implementation or impact?

I prefer the phrase "large scale outcome" or "Large scale implementation" to the more generic "large scale change". Why? When the words outcome and implementation are included it feels more active, more directive, more specific.

For example, it is possible to have a large scale change that is not resulting in the outcomes you set out to achieve. A huge amount of change can happen and yet only a small scale impact is achieved.

Equally it is possible to have a large scale impact from a a small change that might affect only a small scale (numbers and geography). Using Pareto analysis can provide organisations with hints on where to leverage the smaller changes for the bigger impacts.

By focusing on impacts, by elevating the results we want, we can design organisation and system interventions to deliver targeted outcomes. In my experience, many groups who talk of large scale change are ending up creating busy-work that is not specifically directed at delivering a large scale outcome. For me change does not equal outcome or impact.

I'm reminded of a quote from Thoreau which runs along the lines of "It is not enough to be industrious; what are you industrious about?"