12th January 2006
**This is a longer version of the article published in the Health Service Journal.**
Whoever said ‘change is the only constant’? Like many witty truisms, it suffers from overuse and isn’t particularly helpful given the unprecedented changes currently underway as a result of
Commissioning a Patient-led NHS. However, there are resources available that are useful in these turbulent times.
Blue Ocean Strategy is primarily a book about strategy, but the second half focuses on making change happen. The authors identify four hurdles to overcome during strategy implementation:
- cognitive – alerting employees to the need for a change in strategy;
- limited resources – the greater the shift in strategy, the greater the resources required to effect it;
- motivation – getting key players in the organisation to put their weight behind change;
- politics – navigating the murky waters of powerful people’s often competing interests.
In their recent article, The Hard Side of Change Management, Boston Consulting Group’s Harold Sirkin, Perry Keenan and Alan Jackson point out that often the more things change the more they stay the same. To tackle this paradox effectively, the authors advocate that change leaders need to conduct a DICE assessment:
- duration – a long project reviewed frequently stands a far better chance of succeeding than a short project reviewed infrequently. Review complex projects every two weeks;
- integrity – recruit people to the project team that have the right portfolio of skills
- commitment – senior executives and line mangers need to visibly endorse the initiative;
- effort – if adopting a change increases employees’ workload by more than 10 per cent, it is unlikely to stick.
Finally, the US Institute of Healthcare Improvement’s Steven Spear in his article Fixing Healthcare from the Inside, Today, argues that learning to improve the work you do while you actually do it can deliver extraordinary savings in lives and money. His research has found that four basic organisational capabilities – based on the principle of ongoing experimentation - if properly developed and nurtured, deliver operational excellence.
Next time I’ll review some resources for helping readers effectively manage the process of organisational transition.
Jay Bevington is associate director of board development at the NHS clinical governance support team.
More information
Blue Ocean Strategy: How to Create Uncontested Market Space and Make the Competition Irrelevant, by W.Chan Kim and Renee Mauborgne. Harvard Business School Press, 2005.
Steven Spear, Fixing Healthcare from Inside, Today. Harvard Business Review, September 2005.
Harold Sirkin, Perry Keenan and Alan Jackson, The Hard Side of Change Management. Harvard Business Review, October 2005
Harvard Business Review
17th November 2005
**This is a longer version of the article published in the Health Service Journal.**
Who’d want to be a CEO? It can be lonely and tough at the top, as David Nadler writes in his
Harvard Business Review article Confessions of a trusted counsellor. The article explores some of the unique problems that come with being a chief executive:
- Chief executives need to hear hard truths. Yet in their presence people are guarded and unwilling to raise difficult topics. Everyone who seeks their attention has an agenda.
- Chief executives act as a lightening rod for criticism of the business.
- They are the final arbiter in many vital business decisions, and consequently vulnerable to self-doubt.
- They are the only person with no true peers in the organisation that they can unreservedly confide in.
Chief executives need close, long-term relationships with trusted professional advisers, including an executive coach, who they can work with to produce behavioural change and growth.
A fundamental question is whether these coaching relationships are effective at producing behavioural change and growth in the chief executive. A report for the NHS Leadership Centre by Manchester Business School reviews the impact on the person being coached and the wider organisation.
Nadler explores some of the political and emotional dilemmas that can derail the coach, their client or even the client’s company. For instance, he asks whether the coach’s ultimate responsibility is to the CEO who pays for their services or to the institution that pays for his? And when these interests collide, where should the coach’s professional obligations fall?
Finally, Stephen Berglas points out some of the very real dangers of executive coaching.
In HBR he draws a distinction between a ‘problem executive’, who can be coached to function effectively, and an ‘executive with a problem’, who can be best helped by psychotherapy.
Jay Bevington is associate director of board development at the NHS clinical governance support team.
More information
Harvard Business Review
For copies of David Nadler’s publication: CE at Home Organizational Architecture
The article ‘Confessions of a trusted counsellor’, is listed on this website but you need a log-in to access the information.
Read the Manchester Business School Literature review: coaching effectiveness – a summary report by Dr Sandra Fielden. [PDF]
The NHS Institute for Innovation and Improvement has drawn up a register of coaches, enlisting the help of senior leaders from across trusts and workforce development confederations to identify ideal coaches. All the coaches selected have previously worked with senior NHS leaders and can demonstrate a clear understanding of the complex environment and challenges facing the NHS. In addition, many have worked with other public and private sector organisation leaders. They all also have a proven track record. More information
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