The profession is facing seismic changes as modern pharmaceutical models demand increasing value for money. A greater focus on clinical services, digital engagement, new contractual arrangements, and interdisciplinary working ultimately spells ‘change’. But how is change implemented successfully?
Failed initiatives display some common characteristics:
- Lacking a compelling reason – employees need to know why change is necessary. Simply telling them what will happen does not promote engagement
- Forgetting change affects people – involving your team early in the change process will reduce the fear factor and address resistance proactively. It is people who ultimately deliver change
- Lack of effective leadership – poor planning coupled with ineffective transitioning certainly breeds failure. Change is continuous. A poor change leader ignores internal politics and personal agendas
- Change fatigue – employees have seen and heard it before! Previous initiatives have failed. Starting and stopping initiatives can cause change fatigue
- Methodology madness – using multiple change models, the latest trends bundled with complicated management lingo is a recipe for disaster
- Ignoring the small wins – recognising and celebrating quick wins along the journey strengthens employee motivation and engagement.
We know that change is constant. But what is meant by change? we must first understand that there is a difference between adapting to change and transitioning to it.2
Change is defined as situations and occurrences that impact organisations and individuals. Change creates the need to move from the way things used to be to the way they are now. This could include new ways of working and external policy changes.
Transition is the internal psychological process of adapting to a new situation. Transition can happen quickly or slowly. It is the process of moving successfully from the old to the new. Transitioning is what happens to people as they go through change.
A well-heeled change plan often fails, because leadership failed to take notice of the transitional requirements. Change literature clearly demonstrates that a top-down controlled approach is out-dated. It is the people element that implements successful change.
In order to survive change in your profession, industry and organisation, you must first: “Lead yourself through the process of transition. This includes finding ways to help yourself feel more grounded, understanding the impact that change is having on you, and understanding the impact of your behaviour on others.”3
The most cited success factor in any change programme is the ability of the leader to adapt2. The leader:
- Understands the requirement to adapt to external market and environmental pressures
- Appreciates the need to alter their management style to changing situations – what worked yesterday may not sustain today
- Understands the difference between change management and leadership – change management is an outside-in approach, focusing on operational and structural changes. Change leadership is people oriented; it’s inside out
- Views change as a positive, while remaining grounded in realism
- Recognises the requirement to review and revise change plans when necessary
- Explores and considers their own and other people’s concerns during any change.
Identify a significant change (personal or work related) that you experienced. As you go back to that time, reflect upon how you responded to change.
Work through the following questions. Did you:
- Accept change positively?
- View it as an opportunity?
- Adopt plans as necessary?
- Master new technologies and/or processes quickly?
- Take other people’s concerns into account?
- Admit personal mistakes? Did you learn from them?
- Lead change by example?
- Seek corrective feedback?
Reflect upon your answers.
Could you have reacted differently? How can you become more flexible?
| Ahead of the game | Go with the flow | Head in the sand |
| Positive and proactive recognition of change | Goes with the flow as change is happening | Not prepared or fails to recognise change (often unintentionally) |
| Planning in advance | Thrives in a fire fighting mode | Someone else will do it! |
| Understands the importance of transitioning people | Can become quickly overwhelmed | Inappropriate response to change |
| Leads self and others through the transition | BUT can also get the plan and employees back on track with change quite quickly | Can do significant damage to their practice or organisation |
Taking time to reflect and assess your personal capabilities is the first sign of a good leader. Those who demonstrate the most flexibility succeed with change.
Successful change leaders evidence three types of flexibility:
• Cognitive – an ability to apply different thinking strategies. They have a plan A, but can visualise back up plans should unexpected situations arise. They easily learn from experience and understand when old approaches no longer work
• Emotional – an ability to vary one’s approach to manage their own emotions and those of others. This leader can easily transition through change and manages resistance and complaints. They understand the importance of recognising employee loss which could include the old ways of doing things, status and role changes. When deficient in this characteristic, they are dismissive of other’s concerns and views and simply shut down the discussion
• Dispositional – an ability to remain optimistic but remain grounded in openness and realism. They avoid being ultra-positive and extremely pessimistic. This type of leader understands and recognises that there will be bad times but keeps focused on a more positive future. They handle ambiguity well.3
There is a vast knowledge base of information pertaining to change approaches. Some of the key models include Kotter’s 8 Step Change, Lewin’s Change Management, nudge theory, ADKA, Kubler-Ross and McKinsey’s 7S.
However, to manage change successfully, you must first ask three major questions.
- What is changing?
- What will actually be different because of the change?
- Who’s going to lose what?
To develop your plan, use this simple 10Q approach:
1. What are your top change priorities for the next 12 to 24 months?
2. Who will lead the change initiative? Do they have the correct skill set?
3. How will you demonstrate measurable progress?
4. What are the timelines, and the milestones to be achieved?
5. Who is accountable and responsible for change activities?
6. What resources are required (training, financial etc)?
7. How will the change plan be communicated internally?
8. How will you continue to engage employees?
9. Which changes activities can deliver quick wins?
10. How will you visually demonstrate progress to employees (e.g. simple vision boards)?
Let’s practise.
Think about one small change that you would like to make within your practice.
Using the simple 10Q approach answer each question relating to the identified change.
1. What is the one small change?
2. Who will lead the change initiative? Do they have the correct skill set?
3. How will you demonstrate measurable progress?
4. What are the timelines, and the milestones to be achieved?
5. Who is accountable and responsible for change activities?
6. What resources are required (training, financial etc)?
7. How will the change plan be communicated internally?
8. How will you continue to engage employees?
9. Which changes activities can deliver quick wins?
10. How will you visually demonstrate progress to employees (e.g. simple vision boards)?
Implement the change and review how successful your team has been.
Start small. And practise.
All change and transition begins with an ending, in that something must cease in order to make way for a new picture. Transitioning Model, which describes three stages of adjustment during change.4
1. The ending phase – signals to employees that something is changing, and the old model will eventually cease. When presented with change, employees enter this phase and it can lead to emotional upheaval and resistance. If not managed well, some can remain in it and impede progress.
2. The neutral zone – somewhere between the old ways of doing things and the start of the new ways. It has been shown that those most affected by change are often confused and uncertain during this period.
3. The beginning phase – energetic movement to and acceptance of a new world. Employees have more energy, are open to learning and committed to their new roles.
Each phase is peppered with challenges. Recognising and addressing such issues will enhance the success of any change initiative.
Bridges’ transitional model*
| Stage | Challenges and pitfalls | Approaches |
| The ending phase | Lack of clarity about the change programme Employees not invited to engage in the change process Lack of acknowledgement that employees need time to accept change (people may grieve for what is lost) | Communicate early and keep employees informed. Set a clear direction. Involve employees and show how their skills, experience and knowledge can support change. Listen and manage employee concerns and fears Explain what was good about the old model. What did not work? Emphasise the WHY for change. Explain how you will support change (e.g. training, resources) |
| The neutral zone | Low morale and energy, impatience and reduced productivity. Resentment to and scepticism about the initiative. Old ways not yet finished and new ways not complete Continuing with top down approach. Anxiety about the future employee’s job, role, status and identity | Keep communication going. Support and guide employees. Celebrate a few quick wins. Feedback to employees Lead by example. Invite staff to ask questions, make suggestions or produce new ideas |
| The beginning phase | Do not link change objectives to employee goals Leader does not celebrate or reward achievements A lack of recognition that employees transition at different rates | During this phase, employees need: Purpose – emphasise again WHY change was requiredPicture – explain how the new beginning looks, feels and soundsPlan – discuss how everyone will work through the change prioritiesPart to play – involve employees in the change plan and transition. |
*Adapted
Employee engagement is central in any change initiative.
Consider how you could proactively engage your team during the ending phase and neutral zone.
What approaches could you use in your practice?
Do you need further development in this area?
What do you need to change to promote positive staff engagement?
Managing change and transitioning is a fundamental role of a good leader, so it should be allocated the appropriate amount of management time.
Many organisations only implement the operational and structural side of change, but underplay the importance of the transitioning phase. Engage employees early and fully and make time to listen and provide feedback throughout the change initiative.
