Category Archives: Change Principles

Lessons from Florence Nightingale 200 years on…

Contribution by Kent alumna Dr Rachel Black     (SSPSSR 2011)
Chief Executive at the Orpheus Centre

12 May 2020 marks 200 years since the birth of Florence Nightingale, pioneering nurse, researcher and social reformer.

 

Florence Nightingale combined phenomenal caring skills with brilliant intelligence. She was a fan of data and used it to change practices and improve people’s health outcomes. During the Crimean War, many more men died of infection than of war wounds. Florence Nightingale radically reduced mortality rates by delivering outstanding infection control and nursing care to those people.

The Covid 19 pandemic is also being managed in large part through rigorous infection prevention and control to prevent people needing to be hospitalised. People are washing their hands frequently, staying at home, practicing social distancing, and self-isolating if required. We have all radically changed our lives to accommodate such changes.

I have been a nurse for my whole adult life, starting my training when I was just 18 years old. In some ways my role as CEO at Orpheus has felt like the furthest move from clinical practice I have ever made. Not anymore! With Covid 19, I am absorbed in physical and mental health risk assessments, designing and implementing practices to control and prevent infection, reviewing presentation of symptoms and deciding on courses of action. All of my accumulated nursing knowledge and skills are being utilised.

I hold the following words of Florence Nightingale in esteem:

Let whoever is in charge keep this simple question in her head:
not, how can I always do this right thing myself, but how can I provide for this right thing to be always done?

(Florence Nightingale, Notes on Nursing: What It Is, and What It Is Not).

In keeping our services running, I am always aiming for the Orpheus Centre and all our workforce, volunteer and paid, to do the right thing: to keep our students safe and well above all, to maintain their care, to promote their independence, and to keep them learning. I am of course prepared to step in anywhere, but I need to ensure the workforce and families have the resources and support to play their parts excellently. It is a tribute to our wonderful donors and funders that we continue to have those resources available and we are forever grateful.

The Domiciliary Care Team at Orpheus are not registered nurses, but they do nursing care. They develop supportive and trusting relationships, they enable students to feel confident when they are most vulnerable, and, in partnership with other professionals, they tend to the needs of students when they are at physical or mental low ebbs. Like many care services, the range and complexity of skills they are expected to practice is ever growing and increasingly complex, particularly at this time. Our Domiciliary Care Team is brilliant. In the world’s hour of need, it is the traditionally under-valued, customer-facing job roles which have kept people safe and even alive. During the Covid-19 lock-down we clap for carers on Thursdays and put up our rainbow posters. It should not have taken a pandemic to see how the world needs these people. We must not lose sight of their importance in the months and years to come.

Florence Nightingale also said:
Were there none who were discontented with what they have, the world would never reach anything better.

Faced with the unknown of a pandemic, all the Orpheus Centre students, parents, volunteers and staff have made tremendous changes to their personal and working lives to make the world better by keep themselves and each other safe. People have been amazingly flexible and good-natured in really trying circumstances. They find themselves undertaking tasks they do not usually do and, frankly, may prefer not to do. Above all, people have been hugely kind and so very patient.

Dr Rachel Black, CEO, the Orpheus Centre

I think Florence Nightingale would look on the Orpheus Centre with approval. She would see a large team of students, parents, volunteers and staff who are all working for the good of the students and each other. She would see a team of staff who are always empathising, prioritising the wellbeing of students and parents, looking out for each other’s needs, and, essentially, keeping the working space and their hands so very clean.

I am in awe of Florence, but I am also in awe of the Orpheus Family and so very proud to be in it.

 

Reading:

Nightingale, F. (1992). Notes on nursing: What it is, and what it is not. Lippincott Williams & Wilkins.

Orpheus (2020) About us https://www.orpheus.org.uk/about-us

 

Things will always go wrong…better to look at what is predictable

Ed Deming used to say that ‘things will always go wrong’. This is true in the complex work and business environments that are encountered day-to-day.

We can be victims to this, much as we would be for unforeseen natural disasters: hurricanes, tsunamis, volcanic eruptions. Alternatively we can prepare for a likely disaster and have plans in place to mitigate its effects: bunkers, safe havens, evacuation plans.

Better is for us to be able to predict these occurrences. This is true for natural disasters, but for most of us are not obviously threatened by such calamity (which is why we probably fuss more with the trivia of the world of work!). So lets talk work – the importance of prediction is true in how we handle day-to-day ‘disasters’.

Things go wrong for two reasons – (1) underlying problems in the way things are set up we means we have cycles of good days and bad days, and (2) problems caused by an assignable factor. Deming called the first ‘common causes’ and the second ‘special causes’. the importance of this differentiation is n what we do in response to those issues. Things will always go wrong.

If performance is below the level we need on a predictable basis then we have an underlying set of ‘common causes’ which are built into the system of work – its design, the training of people, the job design, raw materials, plans. This takes a lot of effort to test new methods, monitor progress and change and embed new approaches. No quick fix.

If a one off problem occurs think – do we know the cause? Is it a one-off? Can we mitigate for that cause? What would we do if it occurs again? Fr this situation never go through redesign of the system – that will only make things worse and put what was under control, to now spin out of control. However if you find the cause then stop and think – does knowing this fact give us a clue to future fundamental improvements?

Deming W.E. (1982) Out of the Crisis, MIT CAES, Cambridge MA.

Deming W.E. (1993) The New Economics, MIT CAES, Cambridge MA.

Systems ignorance and unintended damage

Cause and Effect Analysis is often considered a comprehensive approach to addressing problems and identifying solutions. This approach is true in closed systems where linear cause-effect relationships typically occur. Many areas of manufacturing and assembly would fit into this model.

Most work situations do not occur in a closed system but instead are in open systems where many factors affect an outcome.

Ishikawa recognised this in his ‘fishbone analysis’ approach to problems. He recognised that many causes, and layers of causes  can affect an outcome. He also advocated for the collection of data on causes and outcomes before relying on an intervention to have a desired affect.

If we ignore this advice we will implement actions which will have unintended consequences. Send a ‘communication’ and it is interpreted as a threat. Give a pay-rise to one person and it is seen as a betrayal of trust by a dozen other people. Instigate an inspection system and it generates a new industry (and associated cost) to the sector. Seek to drive down costs by reducing resources and it will increase costs by causing repeated failures.

If you have a lunchtime to spare it is worth listening to Peter Senge’s discussion about systems in organisations:

Peter Senge’s keynote speech “Systems Thinking for a Better World” at the 30th Anniversary Seminar of the Systems Analysis Laboratory “Being Better in the World of Systems” at Aalto University, 20 November 2014.

The myth of restructuring

 

Re-structuring and re-organising is probably the most common change management method used in organisations. It is the organisational equivalent of management accounting – moving things to make an impression that things have changed.

managers like to make an impression, and many are prepared to even if it involves complete illusion. The problem with restructuring is twofold.

First organisational structure has much less influence on organisation performance than does organisational culture. uit is the behaviour of

The phenomenon is not new. In the magazine article “Merrill’s Marauders” (Harper’s Magazine, 1957)  Charlton Ogburn described his experiences in the british Army during the  Burma Campaign of World War II thus:

“We trained hard, but it seemed that every time we were beginning to form up into teams we would be reorganized. Presumably the plans for our employment were being changed. I was to learn later in life that, perhaps because we are so good at organizing, we tend [as a nation] to meet any new situation by reorganizing; and a wonderful method it can be for creating the illusion of progress while producing confusion, inefficiency and demoralization.”

If you want to look busy spend your time, and other people’s time doing a restructure. Aside form wasting time and resources (including redundancies, pay rises, consultants fees, etc) it will have the added benefit of making things worse.

On the other hand act professionally, use knowledge accrued by organisation development over 50 years and consider the overall system of work, what is affecting people’s effectiveness and work with them to make things better. It involves everyone, fixes the problems which people are actually experiencing, and is a lot cheaper.

Reading:

Beckhard, R. (1972) Optimizing Team Building Effort, J. Contemporary Business.  1:3,  pp.23-32

MacDonald, J. (1998) Calling a Halt to Mindless Change, Amacom, UK

 

Leadership lessons from Deming

It is 90 years this month since Ed Deming completed his PhD in Physics, but it is his work with statistical understanding of processes and performance of organisations, and its impact on human behaviour and leadership which is his lasting legacy. Deming was alays open to learning new things, up to the end of his life at the age of 93 – a lesson for us all.

A few important concepts which he identified for leaders include:

  • 90% of problems are cause by the system – and the system belongs to management
  • Banish any form of individual ranking or reward because 90% of variation is due to the system and not individual performance.
  • There is no substitute for knowledge. Seek knowledge not opinion or assumption.
  • Engage people in change. From day-to-day activity they know the problems and issues of work better than managers. Give them the measures to understand the activity and they can better make efforts to improve it.
  • Best efforts tend to cause problems. If we just ‘try harder’ it is likely to make things worse, unless we change the system of work
  • Drive out fear. Innovation, ideas, creativity enable high work performance. Fear crushes all of these things.

Reading:

Deming W.E. (1982) Out of the Crisis, MIT CAES, Cambridge MA.

Deming W.E. (1993) The New Economics, MIT CAES, Cambridge MA.

Voehl, F. (1995) Deming the way we knew him. St Lucie Press, FLA

 

Change can’t be planned – it emerges

Traditional change management follows a linear approach, defining a goal, identifying a plan and delivering to that plan. The process is logical and surely unquestionable. The approach to setting targets for change and measuring progress now has its own name ‘deliverology’ – but this does not change traditional linear thinking.

The problem is that organisations do not act in a linear fashion, they are much more complex systems. This means that if you change one thing then something unexpected is likely to happen somewhere else – and what you had intended may or may not happen.

Of course understanding systems can be a difficult thing to do. Instead managers either resort to ‘giving their view’ on things, or  setting success measures, kpi’s and so on, based on those views. Having a view on why things are a problem is one thing, but  for John Seddon, it is better to get knowledge by collecting data.

He suggests that it is better to define the following:

  • Purpose is the definition of why we are here, best understood from the customer (or user’s) perspective.
  • Measures allow us to understand what is likely to happen going forward if the systems doesn’t change.
  • Method – can be addressed when we understand the data derived from our measures.

Systems Theory tells us that Purpose Measures and Method are fundamentally linked – it is a systemic relationship. This systemic relationship can either work for you or against you depending on how you set things up.

If you impose arbitrary measuresyou create a de facto purpose, which is the one that the workforce will follow. This will constrain method. It will prevent people from improving the work.

On the other hand if you derive measures from the users point of view (e.g. customers)  and then put those measures in the hands of people doing the work you and enable people to improve method so that measurable improvements can be pursued, then you can systematically deliver success.

The paradox is that in this system, change requires no plan. For Seddon, change is simply an emergent property. Innovation can only occur if you set things up that enable people to innovate in response to the real system of customers and organisation – what happens.

Any attempt to plan change otherwise is fiction.

Instead Seddon suggests that you need to see your organisation as it really behaves – how things work relative to your purpose ‘warts and all’ – because then at least you will know. Once you know that you can respond by innovating – enable people to innovate and overseee the changes that need to happen and you will improve morale.

John Seddon speaks briefly about innovation and change.

 

 

The Need for Speed : change need not be a slow business

An earlier version of this was first posted on 13th February 2012

Change is very often considered to be a slow and often difficult process. In particular, ‘culture change’ is seen as a long and winding road. Human beings are notable as creatures that have mastered  (or, at least, have developed) the art of adapting. We have changed our knowledge, decisions, behaviour, environment, relationships, societies. It is too easy to think that we ‘don’t like change’. This is simply not the case. We are beings that not only adapt to what is around us, but we often actively choose to change what is around us. After all, it is not uncommon for us to seek to find ways to make things better or different (either for ourselves or, sometimes, others!).

My great-grandfather (who was still around when I was a youngster) was born into the Victorian age in the 1880s. He was already a young man when the Wright brothers first flew at Kitty Hawk, yet lived to experience flying in jet airliners and even saw the Apollo astronauts land on the moon. His life experiences, work and education had to adapt fairly radically, but I imagine it was a fairly natural process – that’s life.

Organisations can change faster that society as a whole. Whilst change should be seen as a ‘natural’ process, it is one which we should actively influence ourselves. Change can occur in noticeable timescales; weeks and months not years. Changes should move into short timescales to become noticeable, rather than at barely-observable ‘glacial’ rates. Herrero (2006) goes further, suggesting that if cultural changes cannot be observed in short time-frames, then something is wrong.

  • “Cultural change does NOT need to be a slow and painful long-term affair.” – there is a better way.
  • “Short-term wins CAN represent real change.”  with viral networks which engage many people, small changes can lead to a big impact.

We need to accelerate change by engaging networks of people in making things happen. In a previous post it was suggested that small sets of behavioural changes, taken on and shared by informal groups of people can generate improvements in a non-linear way, as Hererro terms it, a ‘viral’ spread.

To influence others we need to encourage quick, meaningful changes; not just ticking items off the ‘to do’ list, but adopting new behaviours, new ways of thinking, new habits. These things may appear less tangible, but they do have impact, they don’t need to wait for a sign-off by top management and they do allow change to happen much quicker.

Remember to read:

Herrero, L. (2006) Viral Change, meetingminds, UK.

Never forget this fact: There is no such thing as factual information

hand countThis blog title is provocatively paradoxical. The assumption is that something measured is something proved.

This is not the case.

In practice, when we decide to define a fact, we then define what it is, how it is to be measured, then measure to verify.

In deciding the measurement, we simply place a judgment – our opinion of reality, onto something that isn’t there. For example:

The label on a blanket reads “50 per cent wool” What does this mean? Half wool, on the average, over this blanket, or half wool over a month’s production? What is half wool? Half by weight? If so, at what humidity? By what method of chemical analysis? How many analyses? The bottom half of the blanket is wool and the top half is something else. Is it 50 per cent wool? Does 50 per cent wool mean that there must be some wool in any random cross-section the size of a half dollar? If so, how many cuts shall be tested? How select them? What criterion must the average satisfy? And how much variation between cuts is permissible? Obviously, the meaning of 50 per cent wool can only be stated in statistical terms (Deming 1975).

Is it now becoming clear?

“Without theory (hypothesis), data are meangingless or nonexistent. There is thus no true value of anything: true value is undefinable operationally. There are, however, numerical values that people can use with confidence if they understand their meaning (for the tensile strength of a batch of wire, for example, or for the proportion of the labor force unemployed last month).” (Deming 1967).

The trick is to understand the meaning of numbers.

Not everything that can be counted counts.
Not everything that counts can be counted.

Just because you can measure something it does not mean that you can manage it. Many things are relatively unmeasurable, but important, like staff morale, contentment of customers (or even their excitement!). Mintzberg (2015) suggests that “when we hear the word ‘efficiency’ we zero in―subconsciously―on the most measurable criteria, like speed of service or consumption of energy. Efficiency means measurable efficiency. That’s not neutral at all, since it favors what can best be measured

Deming was very clear on this point: “It is wrong to suppose that if you can’t measure it, you can’t manage it – a costly myth.” We can end up spending effort measuring and reporting the wrong things and also losing sight of the ball – forgetting the real purpose of our work.

So the first useful question about an issue of performance is:

“what do we know about this?”, then “what will help us to improve?”

Think about this next time you set a goal, or measure results…

 

Further Reading:

Deming W.E. (1967) Walter A. Shewhart, 1891-1967. The American Statistician, 21(2): 39-40

Deming (1974) On probability as a basis for action. The American Statistician, 29 (4): 146-152

Fellers G. (1994) Why Things go Wrong: Deming Philosophy in a Dozen Ten-Minute Sessions. Pelican Publishing

Mintzberg, H. (2015) What could possibly be wring with efficiency? Plenty. 9 September 2015. http://www.mintzberg.org/blog/wrong-efficiency

Let’s focus on ‘what’ and worry less about ‘how’

Right Way and Wrong thingsThe emerging consensus in discussions about leadership and management behaviour in recent decades  has focused on ‘changing the way that you lead’.

Although the ‘how’ you do it and ‘what’ you do both contribute to effective leadership, the research literature is overwhelmingly focused on the how (Kaiser et al, 2012). Hunt (1991) reviewed the body of published scholarly articles on leadership and estimated that 90% of them were focused on interpersonal processes. It is also most likely that the majority of leadership developers and consultants have a ‘how’ bias, which may influence the debate. The focus is on how you go about things.

But do leaders know ‘what’ to do? Should we agree aims, develop a vision, inspire people, create teams, empower, engage, delegate, set targets, punish, reward, restructure, enable, measure results, improve services, prioritise, plan or problem-solve? What do these things mean? Which are helpful and which just cause problems?

Of course, HOW we think about these things is important. What is the logic behind reward, recognition or blame? Is it sound logic, or convenient logic, or unfounded assumption, or testable theory (if you are into that). Do we really know what we are doing and assuming? These things must be tested in our own minds, or else we are doing little more than sleepwalking. But the outcome from this thinking must start with what needs to be done. Otherwise we will focus on the hows e.g. (doing it nicely or respectfully or considerately) and end up doing the “wrong things righter”!

Let’s be clear, of course, there is never any excuse for ‘doing the wrong things wronger’, and little benefit in ‘doing the right things wrong’. So this doesn’t let bad management off the hook. Instead, getting our own thinking right (‘what’) is an important start point because it drives better consideration of ‘how’ to go about our business.

Our own styles and preferences (hows) are different to the preferences of each member of our team. We need to be able to adapt in order to interrelate with others effectively. Whilst positive interactions with people are sometimes the icing on the cake, the cake itself must be always be sound. Remember – if we don’t get the ‘whats’ right we will only be deluding ourselves.

Hunt, J. G. (1991). Leadership: A new synthesis. Newbury Park, CA: Sage.

Kaiser, R. B., McGinnis, J. L., & Overfield, D. V. (2012). The how and the what of leadership. Consulting Psychology Journal: Practice and Research, 64(2), 119.

Seddon, J. (2003). Freedom from Command and Control. Buckingham: Vanguard Press.

Don’t do it to people

vader
One person’s management hero is another’s villain

Management involves getting the most efficient utility from people and resources;

Leadership involves getting people to do things they would not otherwise choose to do.”

EVEN IF TRUE
DOES THAT MAKE IT RIGHT?

In a nutshell the statements on management and leadership summarise conventional wisdom  accrued since 1900, first through the ‘scientific management’ methods of Frederick Taylor and later the alternative ‘human relations’ approach advocated by Elton Mayo. The latter’s approach was apparently set to counteract the rigidity and hierarchies of the former. Unfortunately both approaches have the same defective focus – ‘doing it to people’. They are both a reflection of a command-and -control mindset which many would percieve as ‘managerialism‘.

Improvement comes from understanding the system and making meaningful improvements to ensure better outcomes. Doing it to people does not achieve this. Whilst efficiency in car manufacture  increases, so do the additional costs of salaries to compensate boring jobs, and industrial relations and (at best) static levels of quality – in other words total costs go up.

Whilst most managers and leaders do not want to be working for the ‘dark side’ and genuinely want the better for their teams, they must understand that if they follow the scientific/human relations approach the consequences of their actions are: de-motivation, a loss of dignity, a diminished sense of purpose, and reduction of productivity in their staff.

In knowledge industries, additional contributions to the total cost of this disruption is hidden, for example losses of skilled workers, high staff turnover and recruitment and so on.

The choice is clear: managers and leaders need to find a better way…

Reading:

Hanlon G. (2015) The Dark Side of Management: A secret history of management theory, Routledge

Roscoe, P. (2015) How the takers took over from the makers. Times Higher Education, 26 November, p48

Seddon, J. (2003). Freedom from Command and Control. Buckingham: Vanguard Press.