Seeking the approaches that enable faster change in the complex world of health and social care
HiPPO is a completely new acronym for me, but it’s such a powerful concept that I felt I had to write about it, especially as it has such a detrimental impact on the pace of change.
HiPPO stands for Highest Paid Person’s Opinion and is prevalent throughout cultures in most organisations. This is the deference to or domination by the most senior person’s views in a team or organisation and that their opinion drives problem definition and solutions. I’ve seen it lots of times, choking collaboration and engagement which are the critical components of success for complex programmes of change.
Every team/organisation has to have a HiPP (Highest Paid Person), it’s just a fact of life. But are they the best people on which to rely on for opinions? Research (Yoshida, 1989) outlines that whilst front line staff understand 100% of problems, their supervisors understand 74%, middle managers only understand 9% and top managers only 4% of problems. Not sure the opinion of those at the higher end of the hierarchy has much validity, based on this research.
Further, I didn’t see the HiPPO dynamic in the two stand out programmes that I studied as part of my thesis on acceleration in complex change, quite the opposite. In both of these, it was clear that the HiPPs saw themselves as facilitators and supporters of those working on and in the changes. One even commented that, he saw his role as at the bottom of the hierarchy, and was only needed when formal governance signoff of key decisions was required. He understood his opinion wasn’t important, but he did understand that in a hierarchical organisation his validation of decisions was. His concern was that the proposals being made to him, were sensible and owned by those that really mattered. This feature led me to identify this devolution of opinion and decision making as one of the key enablers of acceleration in complex change.
Whilst for some years, I’ve often sought to avoid being a HiPPO, i.e. having opinions or making decisions on problems and solutions within the change I’m involved in, I either have moments of weakness or give in to the weight of expectation, Usually regretting giving opinions and making decisions at a later point. For instance, when under pressure of expectation (I was the HiPP), time constraints, and after studying available data, I started articulating an opinion that an organisation I was working with didn’t have enough clinic room capacity and that a move to extended days was required. Turns out, if I’d listened more to frontline staff, they knew perfectly well that there were enough clinic rooms, they were just being heavily protected, giving the impression of under capacity.
So beware, a HiPPO culture will slow down your changes, impact on the benefits you really need to deliver and possibly divert valuable effort. If you are the HiPP, then you will need to be aware of and avoid the cultural expectation that in being so, your opinions are important. I know I will be more aware, but need to be vigilant to avoid lapses
If you need a reminder of the negative impact of the HiPPO, remember that the mammal of the same name, is, ‘extremely unpredictable, making it the most dangerous mammal in Africa’. I rest my case.