How would you know if your organization is ready for a change?

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Dear idea guy (or lady), your plans to change organizational performance will fail without support.  Unless you truly understand your organization’s readiness for change, do not begin implementation.

Consider this case example.  Assistant Chief Dunkin works at a mid-size metropolitan ambulance service.  For months he’s been planning a change in his organization’s training methodology.   Chief Dunkin’s vision is to move from compliance oriented training towards competency-based training.  After an extensive review of his department’s training methods and data from EMS cases, a disturbing trend emerged.  Despite mandatory training for all staff on the management of cardiac arrest, a large number of cardiac arrest victims received insufficient care.

Chief Dunkin discovered a pattern when reviewing cardiac arrest cases.  In 40% of such calls, the patient received poor quality CPR.  Three trends were clear.  1.) Long periods where no CPR was being performed (no blood being circulated) because of distraction from defibrillation and airway related activities.  2.) EMS provider’s failure to fully recoil on the upstroke of CPR compression (heart not able to fill) and 3.) Serious inconsistency in compression rate (probably from provider fatigue).

Clearly, the clinical errors represent potential harm to patients.  Also clear to Chief Dunkin is the current approach to training is not producing the expected results.  A change is indicated.  And fast!  Dunkin proposes significant disruptions to the training organization.  This will impact methodology, scheduling, measurement, feedback and record keeping.  Not a small endeavor.

As Dunkin gains a clear vision for what’s needed, he enlists the support from strategic leaders in the organization – Classic Change Management thinking.  He and a handful of supporters share a sense of urgency.  They gather evidence for change.  They begin to share their vision with additional key stakeholders.  Mostly, they talk.  At people.  The discussion feels one-way.  While Dunkin and their team feel emboldened from the discussion, others quietly question the approach.

As word spreads about the pending change, skepticism builds.  Not towards the reason for change – everyone wants to provide exemplary care to patients.  It’s the approach.  It’s the timing.  It’s the other projects currently underway.  Confidence is low in the project succeeding if it were to be initiated now.

What Dunkin fails to understand in this example is how his vision for change is being perceived by the organization.  This oversight increases risk for the project to fail.

According to Change Management expert Brian Weiner, “Organizational readiness for change is considered a critical precursor to the successful implementation of complex changes in healthcare settings.”

A leading cause of unsuccessful change efforts is the failure to ensure the organization readiness for change.  Sounds simple enough.  Or, is it?

What is Organization Readiness for Change?

Change Readiness refers to the organizational members resolve to change, their perception of their ability to be successful and the organization’s infrastructure capabilities.  Resolve and perception are subjective group judgments whereas infrastructure is more or less binary – capable or incapable.

Organization change readiness exists on multiple levels.  First, there’s commitment – are the members motivated for the change?  Sometimes, commitment exists sporadically.  Like other team sports, change cannot succeed if the entire team isn’t committed to a common goal.

Next, consider change efficacy – this is the group’s belief in their collective ability to organize and execute the actions required to implement the change.  Change efficacy is based on cognitive judgments about the task demands, capability to meet the demands and situational factors such as faith in leadership and the timing of the change.  Change efficacy may include situational factors.  These are conditions that are specific to the organization, relationships, and culture.  It may also include judgments about previous change efforts.

Dunkin’s revelation – Sensing the project was about to fail before it even got started, Chief Dunkin recalled work he previously read about measuring Organizational Readiness.  He found the paper called…

Five Tips for Measuring Organizational Readiness

  1. Adopt the Basic Assumption – People want to do a good job and they will support change only when they understand the change and how it will impact them.  Team members come to work with a whole lot of frames (or experiences) that shape their beliefs, thoughts and behaviors.  If you’re lucky, and you’ve earned their trust, they will share their frames with you.  Build trust by asking for their insights and listen.  Really listen to them.  How would you score Chief Dunkin on building trust?
  2. Recognize Organizational Change Readiness is Like a Multi-Level Chess Match – People are organized in various groups; the groups of people are often distributed over a wide area; groups have culture, history and priorities that may differ with your interests as a leader; and the organization may be tapped out in its capacity to do more.  Each of the dimensions may impact the success of a change effort.  Carefully consider taking the pulse of these dimensions before beginning implementation.  Consider the dimensions you’ll need to measure.  Don’t forget to ask the important question, “Who’s not at the table, but should be?”  What advice would you give Chief Dunkin on managing the multi-level complexity of change?
  3. Commit to Asking for Input – Effective leaders consider advice from their teams.  Listening is an invaluable skill.  It demonstrates a willingness to consider various points of view.  It helps to build trust and it is the foundation for understanding – deeply understanding – issues.  Listening is a skill.  It requires commitment and practice.  Most leaders have had really bad role models in the listening department.  If you’re wanting to hone your listening skills, commit to managing by walking around.  Ask people questions like “What’s gets in your way when you are trying to get a job done?” or “What’s something we do that brings no value to our patients?”  See how people respond when you start asking more questions.  What advice would you give Chief Duncan to improve the quality of his discussions about change?
  4. Prepare to Survey to Measure Organizational Readiness to Change – OK, this is key…please commit to doing this.
    1. Ask questions in context to your project.  Avoid downloading a generic assessment – this won’t provide the results you’re looking for.  Explain your vision for change and ask for input about the specific change effort
    2. Organize questions around commitment (to the idea), efficacy (judgments about ability) and infrastructure (resources).
    3. Consider asking about confidence in leadership’s support of the project.  Just ask, “How much confidence do you have in the leadership’s commitment to this project?”  Alternately, you could ask “What does our leadership need to do to demonstrate their support to this project?”
    4. Develop the survey using a mix of question types.  Include questions where respondents select answers from a list (such as a Likert Scale 1-5) and open text where type personalized input.
  5. Analyze and Share the Results – Hey, we’re all in this together.  Asking people questions demonstrates you care about them.  Sharing results from the survey sends the message that you are serious and committed to finding the formula for change in your organization.  If the survey results suggest a lack of organizational readiness, sharing the results becomes the basis for continued discussion about what needs to happen to improve the readiness conditions.

After rereading the Five Tips for  Measuring Organizational Readiness, Chief Dunkin called the project supporters in for a chat.  Dunkin shared reflections about his approach so far.  He spoke of the importance of measuring commitment, efficacy and capability.  He emphasized that change management is a team sport and committed to being more inclusive.  Dunkin shared the article with his team and ask them to read it in advance of their next meeting where they would resume planning.

So, all you out there with big ideas…I hope you learned from Chief Dunkin and will do as Dunkin does.

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