Co-design solves resistance to change
How to design change so that front line staff want to change
I just spent a day with some Health Service and County Council social care - front line staff, in the busiest time of the year - winter. They were frustrated because the change that was happening in another part of their organisation was not reaching them quickly enough! The question this raises to me are:
Question; Why are they enthusiastic for change to happen, when in all previous years, they have patiently waited for the change project to lose steam and vanish?
Answer 1; the change was prototyped by their front line colleagues and they have had a taster of what it is about. In previous change, the design has been prescribed by managers and external consultants and imposed on the front line after "consultation".
Answer 2; some of the barriers to the front line doing a good job are removed in the new change. In previous change, barriers have always been added (more assessments, more IT screens to fill in, etc)
Answer 3; staff are freer to make some local decisions and act on what individual patients need. In previous change, staff have to work to increasingly standard procedures that move away from doing what really matters to individuals.
Answer 4; it is the front line staff who are leading the change in the way that is most apporopriate. The senior leaders have just visited the team and gave them a great thimbs up, and asked them what could they do to make the change happen quicker.
This is health and social care community in part of a county in England - underfunded and overstretched.
The senior manager that runs the whole area is excited, more so by the effect it is having on his staff. He has never seen staff eager for change! And he has been told that if the change does not happen some staff will consider leaving his area. And it is reducing waiting lists and improving outcomes.
This is the result of Service Design that creates people focused ways of working, that allows different skills to collaborate together, and the service is designed using systems thinking. Then, create an intervention design that uses real people from the front line and management positions to understand the problems and create the solutions. Help that team with a clear methodology and help them achieve success! Despite their stress, the senior manager has committed more staff to the change team full time, to build on the current results, and to create even more change in the coming 24 months. The new team have jsut been announced and one of the new members was so excited that he could not talk properly on the phone call!
These are some of the obvious differences, but the key thing is that this is not about modifying traditional methods of change, It is about implementing change and real transformation in a new way, with all the design aspects and techniques that are necessary,
Oh and it is a lower cost way of working...
Question; Why are they enthusiastic for change to happen, when in all previous years, they have patiently waited for the change project to lose steam and vanish?
Answer 1; the change was prototyped by their front line colleagues and they have had a taster of what it is about. In previous change, the design has been prescribed by managers and external consultants and imposed on the front line after "consultation".
Answer 2; some of the barriers to the front line doing a good job are removed in the new change. In previous change, barriers have always been added (more assessments, more IT screens to fill in, etc)
Answer 3; staff are freer to make some local decisions and act on what individual patients need. In previous change, staff have to work to increasingly standard procedures that move away from doing what really matters to individuals.
Answer 4; it is the front line staff who are leading the change in the way that is most apporopriate. The senior leaders have just visited the team and gave them a great thimbs up, and asked them what could they do to make the change happen quicker.
This is health and social care community in part of a county in England - underfunded and overstretched.
The senior manager that runs the whole area is excited, more so by the effect it is having on his staff. He has never seen staff eager for change! And he has been told that if the change does not happen some staff will consider leaving his area. And it is reducing waiting lists and improving outcomes.
This is the result of Service Design that creates people focused ways of working, that allows different skills to collaborate together, and the service is designed using systems thinking. Then, create an intervention design that uses real people from the front line and management positions to understand the problems and create the solutions. Help that team with a clear methodology and help them achieve success! Despite their stress, the senior manager has committed more staff to the change team full time, to build on the current results, and to create even more change in the coming 24 months. The new team have jsut been announced and one of the new members was so excited that he could not talk properly on the phone call!
These are some of the obvious differences, but the key thing is that this is not about modifying traditional methods of change, It is about implementing change and real transformation in a new way, with all the design aspects and techniques that are necessary,
Oh and it is a lower cost way of working...
How to get front line staff to want and lead change
I always lead change using a team from the service. It takes up resources, it takes longer, it disrupts the operations, it is a pain, but it is the way that I let the client see how change has to happen if we want to avoid the problems that always occur with traditional change.
So, the discussion is with the leaders of the service, to help them to see and agree to this. I have several techniques that i use:
So, the discussion is with the leaders of the service, to help them to see and agree to this. I have several techniques that i use:
- Take the leader through some case studies that I have done before.
- Explain that by them doing this, the competence and skills will be passed on to their staff after I leave.
- It will be a lower cost in the lomg term as I will spend less tie on a day rate with the client.
- demonstrate how traditional change almost always fails.
- I ask them to agree to short initial investigation with myself, to then feedback to them on the extent of the systemic change needed.
- I ask them to anly allow the team four weeks, and after that the team feedback to the leaders what they have found. In every case the leaders want the team to continue after the four weeks.