Seeking the approaches that enable faster change in the complex world of health and social care
Accelerating change is something we all want to achieve. It seems that unleashing those people involved and impacted by change can be one of the catalysts for acceleration.
Recently, I undertook some work analysing the features of acceleration and found some commonality, at the heart of this commonality is something I call, Operational Delivery Groups.
Operational Delivery Groups (ODGs)
These are designed to take ownership of the ‘how’ of change initiatives, additionally ensuring that those involved ‘want’ to change rather feel engaged into someone else’s need to change them.
These ODGs are large, often 20 to 30 people, populated by those people who are directly involved and/or impacted by changes. They own the vision and associated outcomes, meet regularly and I have observed that they have the following features:
Vision – the ODG will develop the detailed vision, spending a chunk of meeting time getting the vision right and then adjusting this, through ongoing discussion. Patient/people narratives and case studies, generated by members of the group, seem to be really helpful in articulating and adapting the vision and associated outcomes.
Relationships – good relationships are key to the effectiveness of the ODG and in order to support open and engaging conversations, time needs to be spent developing these relationships. A coordinator role seems to be important in supporting the development of these relationships. Although this role could be independent, this doesn’t seem to matter, as long as coordinator behaviour is seen to be independent.
Focused on outcomes – the success of the group needs to focus on outcomes, defined and adapted, alongside the vision. These outcomes will need to be supported by robust, up to date and regularly reported information. Outcomes will also be described in narrative form, through patient/people stories and case studies.
Delegated authority – the ODG should have genuine delegated authority, including the change budget. This delegated authority should be clearly described in governance.
Membership – is made of a cross section of the people involved/impacted by changes. Members won’t be forced to be part of the ODG, as initially people may not want to be involved, however if the ODG is operating well they will want to be part of the group, so this may need open invites until people are ready to be involved.
Project Team – supported by rather than driven by the project team.
Leadership – the leadership of these meetings needs to be open, honest and encourage collaboration.
Adaptive plans – not the focus of the group, but they ought to be mindful of key dates and support and enable an adaptive plan, particularly any blockers to the plan.
Senior support – the involvement of senior people, should be focused on support i.e. unblocking any barriers or arranging for approvals to support the ODG in achieving their outcomes. Senior people will still need to be involved in setting strategic direction at the beginning, however this should be seen as an ‘initiate and support’ approach.
I’m sure that are other approaches that would achieve a similar end (it would be good to hear about these), however following some research into acceleration in health and social change programmes, I wanted to outline some of the commonality I found in sustained periods of acceleration. For me, this discovery was unexpected, as my project and programme management training would never have led me to this approach.
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