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Leading Change in a Tribal Environment

Leading Change in a Tribal Environment. Dr A J Cartwright Consultant Anaesthetist. Introduction. What is a Tribe ? How does this apply to the NHS ? Lessons from Industry Communication – The C Word Lessons Learnt Summary Questions. What is a Tribe ?.

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Leading Change in a Tribal Environment

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  1. Leading Change in a Tribal Environment Dr A J Cartwright Consultant Anaesthetist

  2. Introduction • What is a Tribe ? • How does this apply to the NHS ? • Lessons from Industry • Communication – The C Word • Lessons Learnt • Summary • Questions

  3. What is a Tribe ? • A unit of sociopolitical organisation consisting of a number of families, clans, or other groups who share a common ancestry and culture and among whom leadership is typically neither formalised nor permanent. • A group of people sharing an occupation, interest, or habit.

  4. What is a Tribe ? • Doctors, nurses, managers. • Surgeons, physicians, anaesthetists. • Medical, finance, IT. • IT literate, IT illiterate. • Husbands, wives and other family members.

  5. What is a Tribe ?

  6. What is a Tribe ? You are Here

  7. How does this apply to the NHS ? • 1.7m employees (March 2012). • Healthcare, research, HR, logistics, marketing, publicity, property management – all dependant on IT. • Healthcare : Primary care, outpatients, investigations, operations, palliative care, alternative therapy. • Each sub-area differs in language and acronyms, capacity to tolerate risk, boundaries and culture.

  8. How does this apply to the NHS ? • Multiple stakeholders. • Multiple influences. • Patient Care • Resources • Finance • Government Targets • Personal

  9. How does this apply to the NHS ? • Increasing pressure, target driven culture and a change process can erode tribe membership due to devaluing personal worth within the tribe. • NHS Staff Survey 2011 : • Just under a third of all staff (32%) were satisfied with the extent to which they felt that their trust values their work. • Only 26% said that communication between senior managers and staff is effective. • 14% of staff reported bullying or harassment from a colleague.

  10. Lessons from Industry 現地現物 (GenchiGenbutsu) Go and see for yourself to thoroughly understand the situation Ask ‘Why?’ five times

  11. Lessons from Industry • Involvement • Visioning • Communication • ‘Treating What Hurts’ • Addressing individual’s ability to accept change • Encouraging people to develop new relationships • Increase Social Capital

  12. Lessons from Industry • Involvement • Visioning • Communication • ‘Treating What Hurts’ • Addressing individual’s ability to accept change • Encouraging people to develop new relationships • Increase Social Capital

  13. Communication – The C Word • Multiple modes of communication. • One mode may not be enough. • Increasing technology and therefore availability. • Enable the receive button, not just the transmit button. • Find political allies, popular within each stakeholder group if possible, to help drive the message. • Use friendships.

  14. Lessons Learnt • Be aware of your own tribe and others’ perception of this. • Carrots work really well. • A stick is sometimes needed. • Do not assume that because you use email that everyone checks it even fortnightly. • Doctors already lead people well. • Management training is very useful to learn structure, lingo, acronyms, and gain credibility (you’re a member of our tribe), but leading can’t be taught. • Physicians are ideally placed to lead these sort of projects and should be instrumental in leading the digital revolution.

  15. Summary • Tribal attitudes are hard-wired into human behaviour and cannot be undone. • GenchiGenbutsu. • Communicate. • Increase Social Capital. • Use these to create new tribal boundaries to encompass your project goal.

  16. Questions anthony.cartwright@nhs.net @tonykildare

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