{"id":286,"date":"2020-01-04T13:27:46","date_gmt":"2020-01-04T13:27:46","guid":{"rendered":"http:\/\/leadingachildrenshospital.com\/?p=286"},"modified":"2020-01-04T13:33:04","modified_gmt":"2020-01-04T13:33:04","slug":"resources-and-existing-elements-of-effective-management-are-needed-to-drive-change","status":"publish","type":"post","link":"https:\/\/leadingachildrenshospital.com\/?p=286","title":{"rendered":"Resources and existing elements of effective management are needed to drive change"},"content":{"rendered":"

Comments on \u00a0\u201cSpreading at Scale: A Practical Leadership Model for Change\u201d by Amy Compton-Phillips, M\u00a0https:\/\/catalyst.nejm.org\/doi\/full\/10.1056\/CAT.19.1083<\/a><\/p>\n

In a recent NEJM Catalyst blog Dr. Compton-Phillips described a mental model applied to addressing variation across a large network (PSJ).\u00a0 The mental model was presented as being new, however, it can be found in many leadership and management publications over the last 50 years.\u00a0 In fact many don\u2019t need to go further than their own organization to find this model in action.\u00a0 \u00a0Vision, Trust, Data, Capacity and Alignment are not only intuitive, but proven and tested elements.\u00a0 The blog does serve to remind us of these elements telling a story that eloquently illustrates them in action, yet two essential elements are implied but not spoken: resources and effective management.\u00a0 Both are inferred in figure 4.<\/p>\n

Hidden lesson #1 in this post is the requisite need for resources to drive change effectively.\u00a0 Although resources aren\u2019t directly addressed in the blog, the dependence on them is obvious in the change narrative. \u00a0The need for resources makes choosing the right thing on which to focus an important first step; resources are limited and must be used prudently.\u00a0\u00a0 Vision can drive prioritization, and it can also inspire people to action.\u00a0 Inspiration is good fuel for change, especially when resource are limited, yet no amount of inspiration will overcome the error of not providing resources.\u00a0 The process of prioritization also helps shape the \u201cwhy\u201d which is key to each of the 5 elements.\u00a0 The more stakeholders involved in the prioritization the better, but the law of diminishing returns does exist here.<\/p>\n

A lack of resources was a root cause of nearly every failed attempt at change I\u2019ve witnessed.\u00a0 There are multiple examples of why resources are important in the blog.\u00a0 One example is how PSJ utilized the time of leaders and colleagues from high performing hospitals to assist low performing ones through the formation of work groups; work groups are a significant expense.\u00a0 Another example is the use of cascading scorecards or dashboards; you can\u2019t collect, use, manage, present, discuss, or analyze data without resources.\u00a0 In 2007 I was the first to use a scorecard in my organization.\u00a0 It took me hours to build it and maintain it.\u00a0 Some of the fields were populated with estimations, or distant surrogate markers, or nothing at all.\u00a0 It was all done by hand. \u00a0Although it served a purpose and did help to drive change, its effectiveness and efficiency was impacted by a lack of resources.<\/p>\n

Hidden lesson #2 is that change management is, well, management.\u00a0 Leadership is a necessary element at every step especially in the beginning.\u00a0 Yet without local management of people and processes, change initiatives fail.\u00a0 Existing managers, who already possess effective change management skills and tools, are essential.\u00a0 One of those tools is an existing strong daily management system. The blog does mention the need for skills, tools and tactics specific to the change effort, and I agree.\u00a0 Yet, these enablers need to align with the existing daily management system.\u00a0\u00a0 For example, if a team doesn\u2019t take the time to frequently huddle around metrics, run by an effective leader and manger, using an already existing cadence embedded in an established management system, a change effort has a high likelihood of failing.\u00a0 Furthermore, not deliberately leveraging that existing management system to drive engagement around the specific change effort would be unwise. \u00a0\u00a0A daily management system enables alignment.<\/p>\n

Alignment requires leadership and management and starts through establishing a shared vision, both of which are mentioned in the blog.\u00a0\u00a0 Established values and principles embedded in an existing common management system with built in quality improvement skills and tools assist alignment.\u00a0 Constantly communicating the \u201cwhy\u201d and the \u201cwhat\u2019s in it for me\u201d as mentioned in the blog builds alignment.\u00a0 The disciplined cadence of a daily management system is a channel for this constant communication.<\/p>\n

Because all change is local, and alignment is possible only when local groups stay connected to the larger whole in ways that are mutually beneficial, any change management approach needs to consider how to trust local teams with ample autonomy to solve local barriers to change.\u00a0 Change is both individual and team based, and both are dependent on local elements of leadership, management, vision, trust, data, and capacity.\u00a0 Empowering these local environments while driving a common vision through standard work is perhaps the most important deliverable of senior management in any change management initiative.\u00a0 A strong daily management system allows this to happen with greater ease.<\/p>\n","protected":false},"excerpt":{"rendered":"

Comments on \u00a0\u201cSpreading at Scale: A Practical Leadership Model for Change\u201d by Amy Compton-Phillips, M\u00a0https:\/\/catalyst.nejm.org\/doi\/full\/10.1056\/CAT.19.1083 In a recent NEJM Catalyst blog Dr. Compton-Phillips described a mental model applied to addressing variation across a large network (PSJ).\u00a0 The mental model was presented as being new, however, it can be found in many leadership and management publications […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[5],"tags":[],"_links":{"self":[{"href":"https:\/\/leadingachildrenshospital.com\/index.php?rest_route=\/wp\/v2\/posts\/286"}],"collection":[{"href":"https:\/\/leadingachildrenshospital.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/leadingachildrenshospital.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/leadingachildrenshospital.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/leadingachildrenshospital.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=286"}],"version-history":[{"count":2,"href":"https:\/\/leadingachildrenshospital.com\/index.php?rest_route=\/wp\/v2\/posts\/286\/revisions"}],"predecessor-version":[{"id":288,"href":"https:\/\/leadingachildrenshospital.com\/index.php?rest_route=\/wp\/v2\/posts\/286\/revisions\/288"}],"wp:attachment":[{"href":"https:\/\/leadingachildrenshospital.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=286"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/leadingachildrenshospital.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=286"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/leadingachildrenshospital.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=286"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}