How much is too much training?

Hospital ward
I’m divided in this, but lean towards only brief training, just enough to inform them, rather than enough to practice.
 
On one hand, it pays to understand why change in general is necessary and specifically, why the change that you’re about to implement is necessary. Often I see professionals who spend time with the person sat in front of them (and so they are patient-centred) but ignore the mass of people also requiring the same service. It’s not that they can’t see the queue (whether a real standing queue or a waiting list), it’s that if they recognise the queue then they realise that they can’t serve everyone to the same level. For some, it’s a question of professional ethics, where their professional body demands that they treat the person in front of them to the best of their ability, regardless of the needs of others. There are good reasons for that approach.
 
Usually, someone, e.g. a manager or budget holder, recognises the capacity issue and so increases the eligibility threshold or reduces the professional time available for that treatment. This is an attempt to average it out. However it misses the point that some treatments take time to work, if you half the time available, then you may get zero results, not 50% of the results had you allowed the necessary time for full treatment. It also leads to a worsening service as the capacity gets further reduced through a series of cuts, so that wouldn’t be the answer that we’d choose given a choice.
 
More fundamentally, the communities that the local and regional health providers serve are different to those that existed 30 years ago and the changed communities have different needs. So, it seems obvious that we have to adapt the service to meet the changed needs.
 
On the other hand, the health professionals are just that; professionals in health. There will be some with additional skills; some complementary, some tangential. I wouldn’t expect health professionals to be experts at change. However they do need to be aware of the change and why they have to contribute. As do we all, no matter what job we perform, no matter which sector we work in.
 
By recognising the above issues, we can more easily understand why we have to continually change. It’s a matter of adapting to needs. However that doesn’t feel like it requires a formal training in the guise of a university module, more an hour or so during induction combined with some questions during the interview to assess their attitude to change. I expect the professionals to know the service best, so they should be best placed to change it rather than having budgetary changes applied without thought to impact on patients.
 
To get this message across and gain acceptance and commitment from the group, I usually go through the need for change at the start of any change programme and definitely before each intervention.
 
One area where I think some training could be useful is in negotiating and debating how services will change. The changes will happen, but being able to influence the changes could be invaluable. Oddly enough though, it’s probably not the health professionals who need the training, instead it’s for anyone who’s trying to change the service, e.g. performance improvement staff, HR/OD, commissioners, etc.
 
I think the reason for my varied opinions above is that I see a difference between management and change management. I acknowledge that management techniques should be taught in advance as well as broad concepts of changes management, whereas the required, more detailed parts of change management can be taught as required.
 
I don’t believe we should conduct changes without speaking to the end customer. Taking on the role of patient, I’d much prefer the consultant to have spent their time learning how to treat patients, rather than learning how to manage change. Let’s permit some degree of functional specialisation, with front-line professionals continuing to be good at what they do and change professionals helping them create/design the service that the patients need.
 
However, I recognise that many front-line professionals either don’t have access to change professionals or do have access but that they’re not listened to. Hence the need for a book that’s applied for front-line staff.

High-heels, guitars and cultural expectations

high-heeled-shoes

Expectations can run deeper than you may at first think, especially if those expectations are based on decades of cultural information/misinformation. This may affect attitudes towards quality or acceptance of new ideas, including industry innovations. If we’re aiming to make changes in an organisation, we should look out for the deep-rooted expectations of what’s acceptable.

It’s about the form

high-heeled-shoes
high-heeled-shoes

High-heels have been a feature of women’s attire for centuries, especially since the latter half of the last century. They’ve become a focus for discussing what’s acceptable in our society, to the extent of legislation in some countries banning companies from requiring its female workforce to wear heels. But also, from a moral perspective about whether wearing them can ever be required. Setting the moral and legal arguments aside, let’s take a quick look at what’s behind them.

Morris conducted an experiment analysing the attractiveness of female gait with the observers having no idea that the women were or were not wearing heels or even that the people they were observing were men or women. The observed were all women, and they all wore flats and heels. The observers had no idea that they’d see the same person’s gait twice; once with heels, once with flats. The result was that the “video clips of the walks in high heels were judged to be significantly more attractive than those in flats”. So there is an characteristic that we find more attractive and that characteristic reveals itself in our perception of gait which high heels enable.

A follow-up experiment reached a further conclusion, summarised as “by exaggerating the normal female gait, high heels serve to falsely enhance our perception of the wearer’s femininity”

So we end up with a cultural expectation of femininity based on the shoe type. Wear flats and you appear less feminine. Wear heels and you accentuate your femininity. And this is whether or not the heels are the most attractive (not just the effect that they have on the wearer) or which footwear would be the functionally most appropriate attire.

Consider a woman walking towards you. If she’s wearing flats, she’d be considered less attractive than if she were wearing heels. But it’s the same woman with the same attributes, same personality, even the same body, but her form and gait is altered by the use of the heels. It’s an expectation and it’s deeply rooted. I’m not saying that it’s the right thing or that women should wear heels, just noting the cultural expectation.

It’s about the tone

musician
musician

Guitarist have for decades sought the tone of the electric guitar pioneers. Think Beatles-era guitar sounds. Those are the tones that act as a reference for all modern guitar tones. Later, Jimi Hendrix took that tone and added colour to it through distorting amplifiers and effects units. Tony Iommi of Black Sabbath took Hendrix’s tone and detuned it. And so on. You can trace the line back to 1950’s popular tones.

Let’s say I innovate and introduce an exceptional guitar amplifier based on amazing audio technology that can clearly reproduce the guitar tone as it’s produced from the guitar. It would fall flat and no-one would buy it. Guitarists are not interested in the best (if we define best as “accurate” to the sound made by the guitar). The reference from the 1950s was made using inefficient amplifiers, inefficient cables, substandard guitars, low technology in strings and speakers that were appalling by today’s hifi standards. Even the speaker in your tv has a better response that those 1950s speakers. But that’s the tone we recognise as good. It’s so deeply ingrained in our models of what counts as good, that more accurate to the guitar doesn’t mean better. In fact the opposite.

There’s an additional complication in that the tone we hear for the guitar isn’t even that 1950s tone from the guitar amps. That produced tone is manipulated at the mixing desk, with appropriate equalisation to filter out the parts of the tone that we don’t need and especially to filter out the parts of the tone that would conflict with other instruments. So if you listen to the isolated tone that’s been recorded, it’s reedy and thin compared to what you’d expect. But add that isolated track into the rest of the song and your brain fills in the gaps.

So when we hear a guitar in a song, we expect it to have a compromised frequency range compared to what the guitar and amplifier can actually produce. If we heard what it could do, then it would sound odd, very odd indeed.

Similar to the high heels, we’ve built up a cultural expectation over decades of what constitutes good. It doesn’t mean it is good and, similar to heels, in many ways it is worse than what can be achieved. But it’s difficult to argue with deep-rooted expectations and, while we know it is possible to change minds, changing something this ingrained will take a lot of effort, time and patience.

Thoughts

As transformation agents (whether directors, analysts, managers, etc), we often miss the cultural expectations. We could use the Empathy Map Canvas, Lewin’s Force-field Analysis, Prosci’s ADKAR or whatever model your organisation chooses to use. But we should be careful as we use each of them, because sometimes the expectations are that ingrained, it’s difficult to bring them to surface. If you were to ask members of the public to attend a focus group on guitar tone and then worked through what’s prompting the change or resisting it, would the concept of the tone from the 1950s actually feature as an arrow that resists change? I doubt it. It’s invisible to them.

Instead, these hidden expectations create a risk to the change programme in potentially blocking the changes for what initially appear to be non-sensical reasons. That is, until you uncover the expectations which run deeper than you first thought.

Now consider the above examples of high-heels and guitar tone. Imagine trying to motivate just the people in your organisation to accept the better alternative (i.e. flats for function regardless of event or a hifi guitar sound). How difficult do you think that would be? And how does that compare to recent significant changes you’ve had to introduce?

Any comments, get in touch @alanward

How a Simple Change Can Bring Multiple Benefits

calendar
calendar
calendar

I’m often designing change programmes for large organisations. I’m an external consultant, an outsider coming into the organisation that already exists.

There are already governance boards in place, whether for operational, financial or change governance. These boards happen on a regular basis, often on a set day of the month. As an outsider, I’m not going to be able to change those days. At most, I can influence the shifting of one or two on ad-hoc and in very rare occasions, the executive sponsor is senior enough to be able to change the day because it suits her as well. But remember that a lot of other activity is set around these events and most organisations will resist changing the day.

So why do we need to change the day?

If you think of a typical design sprint, then it’s a week long, starting on a Monday and finishing on a Friday. But we want approval to proceed from relevant sponsors before moving onto the next stage. Or we want guidance or steer or  budget to be able to continue.

Depending on the rate of change, the organisation may not wish to see the delivery delayed as one team finishes on a Friday, then has to wait until Wednesday or Thursday for approval (or rejection).

The solution

So the really simple trick I’ve employed is to build the executive boards into the design sprints by changing the starting day of the sprints.

Figure out your approval mechanism before you plan the sprint, find out what date it meets, gain agreement to present on a regular basis (even if it means extending that board by 30-60 minutes until they become used to the type of content), then plan the start day based on when you’ll be ready to present.

It is that simple.

Typically, for a Wednesday morning board, this will mean starting on Thursday the week before. This cascades back into the planning sessions for the sprint, these will typically have the same starting day once you’ve found your pattern.

This ensures a smoother design-approval-implement pipeline than we’d otherwise achieve.

Additional benefits

The additional advantage is that the weekend provides a break. Sprints can be intensive, should be intensive, and for attendees not used to that level of continued, deep thinking, there are often casualties in terms of attendees not wishing to continue, still trying to carry on with their day job, etc.

The weekend break gives you all chance to refresh, gives the facilitator change to revive spirits on the Monday as it’s only a few days left, not a whole week, and gives you all time to reflect on the positive work you conducted the previous week.

Potential issues

There are three issues that I’m aware of from having done this with numerous clients.

  1. As mentioned above, you need to engage with the board and modify the agenda before you attend for the first time requesting approval. Request additional time for the first round, or create a separate session immediately after the board but with the same membership.
  2. Talking about weeks can get a little confusing, but easy to clarify once you get more rigorous about your choice of words.
  3. You’re more likely to cross into someone’s unavailability due to annual leave.

Stakeholder Analysis

This is just a brief introduction to a classic method for performing stakeholder analysis. It’s a simple concept and I’m including it since it’s another good example of a 4-box model.

To misquote Helmuth von Moltke the Elder:

No project survives contact with the customer

Background

Every change activity has to deal with people. Whatever you’re planning, you’ll affect some people more than others and some of those people you affect will have a greater opportunity to influence your progress.

Continue reading “Stakeholder Analysis”

Rethink the Carrot and Stick

The Wrong Quick Wins

A few thoughts from me on quick wins and why we go for the wrong type.

Hands up if you’ve ever had a project sponsor say they needed quick wins? Usually, it’s about showing that you’re doing something to the company board so your project isn’t cancelled or it’s about showing you can make savings. Both of those indicate an immature organisation that’s ready to cancel change activities before they’re due to return results. Some changes take time, some can be done more quickly. The same change activity isn’t necessarily the right type of activity to achieve short and long-term changes. So if you’re on a long-term change project and you’re asked for quick wins, start to head off the question with looking at the original plan for when you’re due to complete your first phase. A better idea is to use quick wins to generate motivation within the users. They didn’t agree to the change plan, instead their managers signed-up to it. They have some inkling of what’s going to change, or in the case of many organisations, they’ve seen many change activities come and go with little result for them. So you’re on the back foot already. Quick wins should be about the users, such as front-line teams or field workers. Listen to their needs, hear their pain, uncover the activities giving them the most problem. And only after you’ve listened, start to generate a few quick solutions to their problems. These solutions are not intended to be long-term fixes. Instead, the quick wins are simple changes that can alleviate their pain. That’s how you get people to believe in you. At the same time, you can be addressing the longer-term fixes. The best thing is that quick wins, when approached from this perspective are usually easy, sometimes just a case of asking another team to respond differently or moving some office furniture around so people can work with less stress. Remember it’s not about achieving savings but making the working lives easier. What’s your experience and how do you approach quick wins? #changemanagement #motivation

A photo posted by Alan Ward (@awkward2006) on

Rodents Don’t Scuba Dive – Innovation In The Real World

Diving in Black and White
Diving in Black and White

I’ve always liked the concept about innovation being the introduction of something that’s already done in one industry sector into another sector where it’s not (yet) done.

Incomplete Definition

Unfortunately, it doesn’t stand-up as a complete definition of innovation. For instance, it falls short by not recognising innovation from within. By that, I’m not referring to new types of products (e.g. the internal combustion engine) since those would be better classed as inventions. Many new products are existing concepts with new features, so would be better described as improvements. But taking a product and using it for a different purpose, e.g. using an internal combustion engine to power a unicycle could be an innovation.

What I like about the simple concept is that it immediately makes people think about what they Continue reading “Rodents Don’t Scuba Dive – Innovation In The Real World”

When is the Right Time to Change Your Mind?

When is the Right Time to Change Your Mind?

Reflecting
Reflecting

You have many opportunities in life and business to change your mind. Each of us has many opportunities, but we don’t always take those opportunities. We may be conforming to social constraints and expectations or don’t want to risk appearing inconsistent by changing too often. Let’s look at a non-serious example and extract nuggets we can apply in a business context.

1) The Background

I’m in a situation right now where I’m having to re-evaluate my aims. Fortunately it’s not a serious situation and there are a few parallels to my professional life. I play guitar and I own a few guitar amplifiers. Each guitar and amp has its own tonal identity and quirks. I pick the right tools for the job; playing in a 60s Motown/soul band requires different guitars and amplifiers than playing in an 80s hair metal cover band.

At a gig at the beginning of Summer this year, I played using a very nice amplifier and it sounded awesome with the band. I really enjoyed how it sounded and I probably played better because I was comfortable that it did the right job.

2) The Hypothesis

I thought that I could use the same amplifier with a few changes in my set-up (i.e. a different effects pedal or two) and I would again have an awesome sounding rig, but this one would be suited to the 80s hair metal cover band I’m currently playing in.

Two things to learn from this: Continue reading “When is the Right Time to Change Your Mind?”

Service Improvement Book – In Progress

Lean Service Improvement Book

After a year or so working with a large, complex client and some time before that working on a startup, I’m back to writing the book I started a couple of years ago.

Three good things have come from this break:

  1. Both of the experiences have confirmed that the book needs to be written. What I have seen in the last two years has proven to me that there is a gap and this book will fill that gap
  2. Both of the experiences have provided more evidence about which tools and techniques work well
  3. From a personal perspective, the break has given me more motivation to complete the book

I expect to be publishing in 2016.