Workshop - Towards accreditation: managing the human side of change

Aims

Implementing a quality system in a laboratory is not just about writing procedures and getting your document system right. Very often the biggest challenge lies in convincing your laboratory staff that this new quality management system has a real added value and in motivating them to actually change their behaviors.

In this workshop we want to provide you with some insights on the 'human, behavioral' side of change and we will present you some techniques to manage this part of the change process. We will use case studies and role play to help you apply these insights and techniques on real life situations.

Target group

The participants of this workshop will include quality managers, laboratory directors and everybody who is responsible for driving the qulaity management system in his/her laboratory and who needs to get the buy-inn of others.

The workshop language is English.

List of workshops

• 7/8-02-2008 Nice
• 30/31-05-2008 Barcelona 

Report of Workshop on managing the human side of change - Nice

a. Focus and approach

One of the biggest challenges in implementing a quality system in the laboratory lies in overcoming natural reluctance of team members, and convincing them of the value of quality assurance to justify the effort that will be required.
This workshop aimed to give insight in the human and behavioural aspects of change, including the different (psychological) phases in the whole process. Furthermore, techniques were presented to manage these aspects and to communicate during change processes. Case studies and role play provided illustration and practical training, to help to apply these insights in the own laboratory.

b. Outcome

Implementing a specific change in the laboratory is a linear process. For example, the head of the laboratory decides together with his staff members to implement a quality system. The different steps (writing SOPs, tracking non-conformities …) and when they should be implemented is definable. This linear process is usually organised with the help of techniques like project management and is restricted in time. However, the reaction of the technicians in the laboratory, or what we call behavioural change, cannot be planned in time as it is a cyclic process. The technicians will need to go through a learning process during which they receive new information, experience certain emotions, try out new things etc. This process is individually different and can not be managed in the same linear way. Tension will emerge between those two processes and this will causes resistance during a change process (figure 5). This resistance cannot be avoided, but when managed well, it could increase effectiveness and efficiency of the change you would like to implement.

FIGURE 5- CHANGE MANAGEMENT: TWO INTERFERING PROCESSES

---

The cyclic process mentioned above encloses different phases people may go through when confronted with change:
Initially, people deny the impending change and continue with their work. They progressively become aware that the change is significant and may begin to doubt and become angry. Consequently, people will negotiate and try to maintain the status quo. When it is accepted that change is inevitable, they may become depressed. After a period of inner struggle, people see new opportunities, start exploring them, and develop alternatives to go about with the changes. In the last phase they accept the situation and plans can be made to continue. Each individual will go through these phases, but at different speeds, resulting in the need for flexibility, in particular from the management. Figure 6 gives an overview of the different phases as well as how you should react accordingly when you are implementing change. First, patiently repeat the message and the facts to people in the ‘shock and denial phase’. Secondly, give them the opportunity to blow of some steam and listen. If they start to negotiate, be firm, which can be followed by encouragement. Once people accept what is going to happen, do not minimize their efforts and be positive.

FIGURE 6- PHASES PEOPLE GO THROUGH IN TIMES OF CHANGE

---

A useful tool to manage the human side of change is force field analysis, which helps you to go through the phases of change in a participative way with your team or department (group problem solving tool). It is based on the fact that every situation involves a balance between conflicting forces, called driving forces and restraining forces. Driving forces or enablers are actions, skills, equipment, procedures, people etc. that help to move towards the desired objectives, while restraining forces or disablers inhibit you from reaching the goals. Force field analysis is usefully done as a group exercise, involving identifying the different forces together. The forces can be prioritized and appropriate actions should be defined to minimize the disablers and to stimulate enablers so that change becomes possible. In figure 7 the force field analysis is applied on implementing an IT support system in the laboratory.

FIGURE 7- FORCE FIELD ANALYSIS EXAMPLE: IMPLEMENTING AN IT SUPPORT SYSTEM

---

A second tool to improve insight in the change process is stakeholder analysis. Stakeholders are individuals who have a direct interest in the change process (positive or negative); they have the information, resources and expertise important for the success of the change process or they have the authority to influence the success. The inclusion of all relevant stakeholders in this analysis is essential for the success of the change process. Here is how it works. First create a list of all stakeholders (stakeholder map): e.g. laboratory technicians, quality manager, laboratory director, physicians and patients. Split all stakeholders up into clusters, based on influence and impact (cluster 1-4 in figure 8). This enables you to assign priorities within the stakeholders group (high, low, critical, important for decision making etc.). Finally, strategies should be developed to involve, inform or mobilize the different stakeholders (stakeholder management plan). For example the strategy for stakeholders that have a low influence, but high impact (cluster 3) should be oriented towards empowerment, which encloses involvement by giving limited power to decide.

FIGURE 8- STAKEHOLDER ANALYSIS

---

In case of major change processes, it can be worthwhile to develop a structured communication plan. The stakeholder map acts then as a starting point to identify the people you have to communicate with. The communication plan should include these stakeholders, the message you want to communicate, the actions needed, how and when you will communicate your change process to the stakeholders and finally who will be responsible for the actions. In addition, individuals think in different ways, therefore they should be approached differently. Gardner identified seven levers (“7 RE’s”) that aid or thwart the process of mind change. These levers are: reason, research, resonance, re-descriptions, resources and rewards, real-world events and resistance ¹⁹ (figure 9). Consider these levers to bring about significant changes in perspective and behaviour in order to reach all collaborators and to improve your communication plan.

FIGURE 9- 7 RE’s, H. GARDNER

---

The tension between the cyclic and linear process results mostly in resistance. This resistance is not problematic and if managed well, it could have a positive impact or even optimize the change process. When confronted with resistance you could make an appeal to the following four steps:

1. Listen and reward:
   That is a good question. It is indeed important to take that into account. I understand why you have difficulties with that.
2. Summarize to check if you understood your collaborator:
   If I understand well … So you think that …
3. Keep asking questions:
   Could you give some examples? What do you mean exactly?
4. React, depending on the time you have, the emotion of the collaborator or the difficulty of the question:
   • Park or move the issue: Is it ok that I make a note and come back to it later on?
   • Give more explanation: When you think a collaborator does not understand everything, explain it again in a different way.
   • Start the discussion: If you want to know how others think about it. If it is obvious you cannot continue before a certain point is discussed.
   • Start the discussion: If you want to know how others think about it. If it is obvious you cannot continue before a certain point is discussed.
   • Hold on to your point: If unrealistic questions are asked, stay friendly, but firm.

c. Discussion

When implementing a change process you should be aware that individuals will go through a psychological process which causes resistance. Tools, such as a force field analysis and a stakeholder analysis, help to navigate more efficiently through the whole change process, to stimulate behavioural change and to involve all stakeholders. In addition, a good structured approach, by using for example a communication plan, will help to develop better strategies to overcome resistance. It is essential not to answer resistance with resistance. On the other hand, it is not just enough to listen and acknowledge. It might be a challenge for a manager to dare to deviate from the original change process when it is clear that the resistance revealed some precious indications to do so. It might be a contradiction to defend change while refusing to have an open attitude to change oneself.

References

• H. Gardner. Changing Minds: The art and science of changing our own and other people’s minds (Boston: Harvard Business School Press, 2006)
  [back]

Last changed: 2008-07-07