HOSPITAL
KLUSTER
TERENGGANU
SELATAN DR AMRAN BIN JAPAR
PENGARAH HOSPITAL
HOSPITAL KEMAMAN
SESSION 1 :
INTRODUCTION OF
HOSPITAL CLUSTER
PENGENALAN
Hospital Kluster merupakan inisiatif yang telah dikenalpasti untuk pelaksanaan dibawah program Transformasi Sistem Kesihatan.
Ia melibatkan kolaborasi beberapa hospital KKM, berpakar dan tanpa pakar yang terletak di dalam negeri yang sama dan kawasan geografi yang berdekatan, selaras dari segi aliran perkhidmatan dan pesakit.
Bermula daripada tahun 2012, kelulusan bagi
melaksanakan projek kluster rintis telah
diperolehi dan diperluaskan ke seluruh negara
bermula pada 2016.
Sehingga 2017, terdapat 10 kluster dibentuk
dengan melibatkan 36 buah hospital; 15
hospital berpakar dan 21 hospital tanpa pakar.
Sasaran bagi 2018, adalah penglibatan 46 buah
hospital (19 hospital berpakar dan 27 hospital
tanpa pakar).
Pada tahun 2019 sebanyak 25 kluster Hospital
dibentuk termasuk HKTS
PENGENALAN
KLUSTER
TERENGGANU
SELATAN
(HKMN-HD)
IMPLEMENTATION OF CLUSTER HOSPITALS: ROAD
MAP
PHASE IV
NATION WIDE
EXPANSION
PHASE I & II
CLUSTER HOSPITAL INITIATION AND
STRATEGIC PLANNING
PHASE III
PILOT PROJECT
IMPLEMENTATION
Strengthening of Cluster
Hospital Policy & Nation wide
expansion 2016 - 2020
2010 - 2013 MOH hospital transformation;
Cluster Hospital Concept &
formation of policy framework
& identification of Pilot
Clusters
Three pilot sites 1. Hospital Kluster Melaka ( Hospital
Melaka, H. Jasin & H. Alor Gajah
2. Hospital Kluster Pahang Tengah ( H.
HoSHAS, H. Jerantut & H. Jengka
3. Hospital Kluster Tawau ( Hospital
Tawau, H. Semporna & H. Kunak
2014 – 2015
Launching of Cluster
Hospital Pilot Project
through Action
Research
2016 H. K Seberang
Perai
H.K Ipoh
H.K HTAN
2017 H. K Kedah Utara
H. K Perak Utara
H. K Selangor Tengah
H. K Terengganu Utara
2018 H. K Seremban 2
H.K Johor Timur
H.K Kelantan
Utara
2019 25 new Cluster
Hospitals (HKTS)
FROM INDIVIDUAL HOSPITAL TO CLUSTER
HOSPITAL
Current;
25 Cluster Hospital roll out 2014 – 2019
88 total hospitals
• 36 specialist hospitals
• 52 Non Specialist Hospitals
Future;
17 Cluster Hospital planning
phase
to 42 Cluster Hospitals from 145 individual hospitals &
institutions
HKTS
BENEFITS OF CLUSTERING
7
BASIC CONCEPTS IN CLUSTER PLANNING
Decentralisation of services
Workload levelling to redistribute work burden and decongest busier hospitals
Avoid duplication of services within the same cluster
8
HOSPITAL UPGRADES AND NEW DEVELOPMENTS
E X I S T I N G S Y S T E M
Every hospital requires
a certain “standard
basic facilities”
Almost “one size fits
all” model, based on
categories
H O S P I T A L K L U S T E R
Customised facilities tailored to the requirement of specific services to cater to the needs and casemix of the local population.
Each cluster shall map the clinical services in terms of scope, level and standard of services to match the capacity and availability of resources.
9
Single organisation with
pooling of resources
Individual institutions with separate resources
CLUSTER HOSPITAL: BASIC CONCEPT
E X I S T I N G S Y S T E M H O S P I T A L K L U S T E R
Specialist
hospital
Non-specialist
hospital
Lead hospital
Non-lead hospital Non-lead hospital
Non-specialist
hospital
10
Specialist
hospital
EXPANSION OF SERVICES THROUGH CLUSTERS
Lead hospital
Non lead
hospital
Non lead
hospital
Non lead
hospital
Target specialties for each
cluster: Based on the
target for lead hospital
(e.g. 49 if the lead hospital
is a state hospital, 20 if the
lead hospital is major
specialist hospital)
11
Cumulative target specialties
Total target: 49 services
Individual target specialties
Total target: 69 services
HOSPITAL CLUSTER: TARGET NUMBER OF
SPECIALTIES
E X I S T I N G S Y S T E M H O S P I T A L K L U S T E R
State hospital (49 services)
Minor specialist hospital (10 services)
Lead hospital (state)
Non-lead hospital
(minor specialist)
Non-lead hospital
(minor specialist)
12
Minor specialist hospital (10 services)
LEVEL OF SERVICES IN CLUSTER
C O O R D I N AT E D
The Department/Unit remains in the hospital where it was formed.
Services are provided through coordinated visiting/mobile teams.
Staff working in the hospitals receiving the coordinated service do not belong to the Department/ Unit providing the service.
I N T E G R AT E D The Department/Unit cuts
across the hospitals in the cluster.
The Head of Department (HoD) in the hospital where the Department/Unit was formed also acts as the HoD of the staff assigned to the clinical discipline in the hospitals receiving the service within the cluster.
13
EXAMPLE OF PLANNING (1)
14
Lead hospital A: surgical-based specialist centre
• Upgrade OTs
• Move out medical-based specialties
• Retain basic medical specialty for referrals
∴ Specialised facility for surgical-based care
Non-lead hospital B: medical-based specialist centre
• Relocate surgery-based resources to hospital A
• Develop medical-based specialisations
∴ Specialised facility for medical-based care
Non-lead hospital C: step down care centre
• Step down care centre for hospital A & B
• No need for OT or ICU facilities
• Development of rehabilitation facilities
∴ Specialised facility for rehabilitation services
EXAMPLE OF PLANNING (2)
15
Lead hospital A
• Maintain all general specialties
• Move out certain subspecialties to hospital B & C
Non-lead hospital B
• Develop subspecialties moved out from hospital A
• Move some general specialties to hospital C
Non-lead hospital C
• Develop subspecialties moved out from hospital A
• Develop general specialties moved out from hospital
B
GOVERNANCE OF HOSPITAL CLUSTER
16
Hospital Director
TP I TP II TP III
Hospital Director
TP I TP II
Hospital Director
Senior MO
Hospital A Hospital C Hospital B
Head of Cluster
(HD of Hospital A)
Deputy Director (Administration)
Head of Pharmacy
Other hospital directors
Head of services (as required)
Deputy Head of Cluster (HD of Hospital B)
Deputy Head of Cluster (HD of Hospital C)
Hospital
governance
Cluster Management
Committee
(cluster level)
Governing Body
(state level)
State Director of Health
Deputy Director of Health
(Administration)
Deputy Director of Health
(Pharmacy)
Representatives from CMDAC
Head of cluster
Deputy Director of Health (Medical)
Elected members of the
hospitals’ Medical Advisory
Committee will be appointed
as Cluster Medical & Dental
Advisory Committee (CMDAC).
SESSION 2 :
PENGENALAN :
HOSPITAL KLUSTER
TERENGGANU SELATAN
(HKTS)
HOSPITAL KLUSTER
TERENGGANU SELATAN • Pembentukan HKTS adalah sebagaimana saranan
TPKN (Perubatan) supaya Hospital Kemaman dan
Hospital Dungun boleh bertindak sebagai satu entiti
dalam penyampaian perkhidmatan perubatan.
• Dirasmikan di peringkat KKM pada 7 Mac 2019
SEJARAH RINGKAS
2011: Cadangan hospital kluster sebagai projek
Transformasi Sistem
Kesihatan
2012-2013: Projek Rintis
Hospital Kluster diluluskan oleh
Pengarah Kesihatan & mendapat
persetujuan Mesyuarat Khas
KPK
2014: Kelulusan
pelaksanaan hospital kluster
dalam Mesyuarat
Jawatankuasa Pemandu
Perancangan Kementerian
Kesihatan
2014: Projek Rintis
Hospital Kluster di Pahang,
Melaka dan Sabah
Inisiatif awal
hospital kluster di Terengganu bermula
sejak 2014.
Hospital Kluster
Terengganu Utara
ditubuhkan secara
rasmi pada 4
September 2017
Hospital Kluster
Terengganu Selatan
ditubuhkan secara
rasmi pada 7 Mac 2019
1) Mengukuhkan integrasi dalam penyampaian penjagaan perubatan dengan membina rangkaian klinikal lebih baik antara hospital dalam kluster
2) Meningkatkan peluang perkhidmatan kepakaran yang lebih saksama dan berdekatan dengan rumah
3) Mengoptimumkan penggunaan sumber melalui peningkatan kecekapan dan keberkesanan penyampaian perkhidmatan
4) Mengukuhkan dan meningkatkan kecekapan kakitangan melalui jaringan latihan dan pengajaran dalam kluster
5) Meningkatkan kepuasan pelanggan dan anggota kesihatan dengan meningkatkan produktiviti dan pengagihan semula beban kerja
6) Mengukuhkan pelaksanaan pengurusan kewangan melalui perkongsian sumber hospital dalam kluster
7) Penggunaan sumber sedia ada yang optimum dalam perlaksanaan perkhidmatan yang lebih efisien
8) Melaksana komunikasi strategik dan perkongsian data melalui teknologi
OBJEKTIF HOSPITAL KLUSTER
GOVERNANCE BODY
Dr Mohd bin Jusoh
Dr Saifur Rahman bin Muhammad
Dr Sh Najihah binti
Syed Abdullah
Dr Amran bin Japar En Muhamad Fadzil Bin Ali Pn Wan Noraimi Binti Wan
Ibrahim
Dr Shahnon Anuar Dr Khairul Nizam Dr Zahar Azuar
Dr Wan Daizyreena
Dr Zakiah Nurasyikin
Direktorat
Kecemasan dan
Trauma
Dr Nor Akmar Bt
Mohd Sapian
Mencadangkan calon dan melantik Ketua Kluster
Ahli GB dilantik oleh PKN
Melantik ahli jawatankuasa CMC
Memantau hal ehwal tadbir urus dan prestasi pelaksanaan Hospital Kluster
TERMA RUJUKAN GB
CLUSTER
MANAGEMENT
COMMITTEE (CMC)
DR FARAH NAJWA
Timb. Ketua kluster
Unit kluster
Ketua
Jabatan LH
TP Pengurusan LH
PN. FARAH NADHIRAH
PN NORALIZA
MOHAMMAD
K. Jab.
Farmasi
LH
PN NORLIAN
K. Penyelia
Jururawat
LH
EN ZULKIFLI
K. Penyelia PPP
LH
PN KHAIRUL FAZIL
AH K. Unit
Kejuruteraan LH
JK. Sumber Manusia
JK. Perolehan dan Aset
PN AIDA SYAHIRA
JK. Kewangan
DR SHAHNON ANUAR
K. Jab. Perubatan Am
DR HASARUDDIN RIDZAL
K. Jab. Pediatrik
DR KHAIRUL NIZAM
K. Jab. Kecemasan
dan Trauma
DR ZAHAR AZUAR
K. Jab. Obstetrik dan
Ginekologi
DR AHMAD NIZAM
K. Jab. Anestesiologi
DR AMRAN BIN JAPAR Ketua kluster
Daerah Populasi Hospital Bil
katil
Kemaman 450,000 HKM 150
Dungun 173,200 HD 100
HKM
HD
PROFIL HKTS - GEOGRAFI
PROFIL HKTS – BILANGAN KATIL Hospitals Disciplines Number of beds
Hospital
Kemaman
Jumlah katil:
150
Perubatan Am 38
- Pediatrik Am
- Neonatalogi
Katil biasa: 13
SCN : 10, NICU: 4
- Pembedahan Am 15
- Obstetrik
- Ginekologi
32
8
- Orthopedik 19
-psikiatri 5
-ENT 2
- Oftalmologi 2
- HDW 2
Hospital
Dungun
Jumlah katil:
100
Perubatan Am 45
Obstetrik dan Ginekologi 20
Pediatrik 27
Pembedahan (multidisiplin) 4
Ortopedik 4
Jumlah
Anggota
Jumlah
MO
Jumlah
Paramedik
HKMN 933 119 368
HD 449 36 204
PROFIL HKTS – SUMBER MANUSIA DAN KEPAKARAN
Disiplin HKMN Pakar HD
Perubatan 3
Pediatrik 3
Psikiatri 2 *
Nefrologi 1
Pembedahan 3
Ortopedik 3
O&G 3
Oftalmologi 1 *
ORL 1 *
Kecemasan 2 *
Anestesiologi 2
Patologi 2
Radiologi 2 *
Rehabilitasi 1 *
PROFIL HKTS – BOR DAN ALOS
80.7 81.95 83.68
94.57 103.42
108.14
64.05 57.1
49.74 46.41
55.07
55.12
0
20
40
60
80
100
120
BOR HKMN dan HD (2014 –
2018)
HKMN HD
2.55 2.69 2.63 2.75 2.74
2.91
1.91 1.79 1.7
1.7
2.05
1.86
0
0.5
1
1.5
2
2.5
3
3.5
4
ALOS HKMN dan HD (2014 –
2018)
HKMN HD
VISION An intergrated network of Hospital Kemaman and Hospital Dungun, continuously striving for
improvement of excellence in delivery of healthcare, responding to needs of the people of
southern Terengganu
MISSION
1. To share resources and facilities between Lead and Non-lead Hospital
2. To improve the competency of medical officers and paramedic in non-lead Hospital
3. To reduce congestion in Lead Hospital
OBJEKTIF UMUM
Meningkatkan kesamarataan dan kebolehcapaian perkhidmatan kepakaran
bagi populasi Terengganu Selatan, terutamanya di Kemaman dan Dungun.
OBJEKTIF KHUSUS
1. Menurunkan BOR Pediatrik dan Perubatan di HKMN (Lead Hospital, LH)
dan meningkatkan BOR di HD (Non Lean Hospital, NLH).
2. Meningkatkan appropriate management referral pesakit bagi kes
kecemasan di NLH.
3. Menambahbaik competency dan kemahiran Pegawai Perubatan di NLH
4. Meningkatkan bilangan kes pembedahan di LH.
OBJEKTIF AWAL HKTS
Expected outcome
* Dari tahun
sebelumnya
No. Specific Objectives KPI Target
1. To reduce BOR
paediatric and medical
at lead hospital and
to increase BOR at
non-lead hospitals
1. Increment BOR in non-lead hospitals > 5%*
2 . Reducing BOR at LH < 85%
2. Increase
appropriateness
management of
referral in emergency
department non-lead
hospital
3. Percentage of appropriate management of referral from non-
lead Hospital > 90%
3. To improve
competency and skills
of medical officers in
non lead hospital
4. Percentage of referral for first trimester pregnancy
complications in non-lead Hospital < 80%
5. Increase obstetric BOR in non-lead Hospital > 50%
4. Increase numbers of
operation cases at LH 6. Numbers of staff’s NLH undergone attachment at LH > 10 / year
7. Increment of operation case at LH. > 20% *
31
PENCAPAIAN DAN
STATUS PELAKSANAAN
HOSPITAL KLUSTER
CLUSTER ACTIVITIES Major activities and meetings
2018/2019
CMC 1.2018
4 Jan
CMC 2.2018
And inter hospital
visit HKMN HD
3 July
CMC 3.2018
And inter hospital
visit HKMN HD
3 Dec
Action Research Cluster
Hospital Workshop
15-18 August
CMC 4.2019
26 Feb
Meeting and Site visit
ED department
HKMN –HD
27 Dec
KKM kick off
HKTS
7 March
CMC 5.2019
30 April
Policy HKTS
Workshop
18-20 June
CMC 6.2019
23 June
CMC 7.2019
25 July
Majlis Pelancaran
HKTS
Peringkat Negeri
Terengganu
6 August
Bengkel Action
Research di
IPN
20-21 August
Mesy Governing Body
(GB) Bil 1 di JKNT
29 August
CLUSTER ACTIVITIES Gantt Chart 2018-2019
MESYUARAT 2018 2019
F M A M J J O S O N D J F M A M J J O S O N D
1 Mesy. Kick Off HKTS
12 30
2 Mesy. Pengurusan Kluster (CMC) 3 26 7
LATIHAN
1
Bengkel Design Thinking
15-18 Ogos
2 Proposal HKTS ke JKNT
21 Jan.
3
Bengkel Polisi HKTS
18-20 Jun
4 Lawatan Hospital Kluster
PROMOSI
1 Perasmian HKTS (KKM) 7
2 Perasmian HKTS (PTJ) 6
DATA MANAGEMENT
1 Kutipan data KPI
2 Kajian Kepuasan Pelanggan
LOGO & SLOGAN HKTS
Keterangan Maksud
BULAN SABIT MERAH
Bentuk segitiga disusun seperti bulan sabit
merah, symbol perkhidmatan kesihatan
Malaysia.Warna merah
melambangkankeberanian dan disiplin anggota
SEGITIGA WARNA BIRU GELAP dan
BIRU MUDA
Segitiga biru gelap melambangkan warna
daerah kemaman manakala segitiga biru muda
melambangkan warna daerah dungun. Masing
masing ditulis nama hospital bagi menunjukkan
hospital kluster selatan yang terlibat.
JALUR KUNING
Jalur kuning melambangkan perkataan ‘K’
kluster dan warna kuning menunjukkan
harmonization dan intergration yang berlaku
pada program kluster ini.
HOSPITAL KLUSTER
TERENGGANU SELATAN
Bentuk heksagon terhasil daripada kumpulan
segitiga menunjukkan gumpalan kluster. Ia juga
menunjukkan peranan kementerian kesihatan
mengambil lankah menjadikan hospital
kemaman dan dungun sebagai hospital kluster
atau satu gagasan hospital selatan yang akan
menambahbaik kualitri perkhidmatan lebih
efisyen, mengoptimum sumber dan kos efektif.
35
LAIN-LAIN PENCAPAIAN
Pengeluaran garis panduan dan polisi
1. Buku polisi HKTS- Sedang dibuat
2. Garis panduan Penempatan Latihan Kluster Terengganu Selatan
Pengeluaran templat dan format pengumpulan data yang selaras untuk semua hospital
dalam kluster
1. Reten Bulanan (RB)
2. Laporan Bulanan (LB)
Kajian kepuasan pelanggan - cadangan perlaksanaan dua kali setahun
1. KPP Bil 1.2019 – sedang dijalankan
Penyediaan templat surat menyurat dan dokumen rasmi kegunaan dalam kluster
1. Sijil Tamat Penempatan Latihan HKTS
2. Senarai semak Unit Latihan untuk Penempatan Latihan HKTS
3. Pelbagai templat surat menyurat
PERBELANJAAN HKTS
Waran 91000343
Berjumlah RM17,000 pada
7 Mei 2019
RM 7,000 untuk 29000
RM 10,000 untuk 27000
Perbelanjaan Yang Telah Dibuat :
1) Bengkel Latihan Cluster Pada 18-20.6.2019 Di Kertih Damansara Inc.n
- Sewa Dewan Kertih Damansara Inn (2,000.00)
- Perkhdimatan Makan Minum (1,088.00)
- Bayaran Penceramah Dan Fasilitator (846.00)
2) Pelancaran Cluster Pada 6.8.2019
- Sewa Dewan Sri Geliga, MPK (197.00)
- Perkhdimatan Makan Minum (1,957.00)
- Perkhdimatan Cetak Brochure (300.00)
- Perkhdimatan Mencetak Bunting (612.00)
Baki Ckluster RM10,000.00 (29000) Akan digunakan untuk Kursus
Awareness di Hospital Kemaman dan Dungun
Status Perbelanjaan
MAJLIS PERASMIAN HKTS PERINGKAT
KKM 7 MAC 2019
CLUSTER ACTIVITIES 2019
CLUSTER ACTIVITIES 2019
BENGKEL PENYEDIAAN POLISI
HKTS 18-20 JUN 2019
MAJLIS PELANCARAN HKTS - 6 OGOS
2019
CLUSTER ACTIVITIES 2019
• The concept of hospital cluster has proven to be effective in
providing extended specialist hospital to the non lead hospital
• The provision of these services has resulted in improved patient
management and accessible specialist care.
• There will be limitations and hitches which had been
encountered during the implementation thus we come out with
new KPI.
• Hopefully with the regular auditing and meetings, we will learn
to ensure the sustainability of this programme.
Conclusion
SESSION 3
WHAT TO DO FOR SUCCESSFUL HKTS PROGRAMME
Commitment
Acceptance
Ways of working and
Thingking
Work Together
CHALLENGES – GENERAL MEDICINE
1. Shortage of physician especially general physician (3 only).
2. After office hour consultation is to the on-call physician
3. Limited number of ambulances and readily available other form of transport i.e.
minivan etc.
4. HSNZ still the main referral centre for NLH for especially ventilated case, need
for ICU backup, nephrology cases.
5. Refusal of patient for step down care ( Data Will be collected)
CHALLENGES - PEDIATRIC
1. Transportation by vehicle other than
ambulance will require car seats or other
safety precaution for babies and young
children.
2. Refusal of patients for step down care to HD.
3. Both hospital had increasing BOR
IS THE TIMING RIGHT?
DISASTER UNACCEPTANCE
MISTAKE SUCCESS
DECISION
TIME
WRONG
W
R
O
N
G
RIGHT
R
I
G
H
T
PERSONAL OWNERSHIP
WITHIN
BEHIND
AROUND
ABOVE
BESIDE
What do you feel?
What have you learned?
What is happening to others?
What does God expect of you?
What resources are available to you?
LOOK
YOU
SEVEN DEADLY SINS
1 •Trying to be liked rather than respected
2 •Not asking team members for advice and help
3 •Thwarting personal talent by emphasing rules rather
than skills
4 •Not keeping criticism constructive
5 •Not developing a sense of responsibility in team
members
6 •Treating everyone the same way
7 •Failing to keep people informed
BECOME CHARACTER DRIVEN INSTEAD OF EMOTION
DRIVEN
CHARACTER-DRIVEN PEOPLE EMOTION-DRIVEN PEOPLE
Do right, then feel good Feel good, then do right
Are commitment driven Are convenience driven
Make principle-based decisions Make popular based decisions
Let action control attitude Let attitude control action
Believe it, then see it See it, then believe it
Create momentum Wait for momentum
Ask, “What are my
responsibilities?”
Ask, “What are my rights?”
Continue when problems arise Quit when problems arise
Are steady Are moody
Are leaders Are followers
RELEASING
TRAPPED MINDS
INTRODUCTION
Our best friends and worst enemies are
OUR THOUGHTS. A thought can do us
more good than a doctor or banker or a
faithful friend.
It can also do us more harm than a brick.
UNDERSTANDING PEOPLE’S MINDSETS
Blindspots
Assumption
Complacency
Habits
Attitude
B A C H A Mindset Model
B
A
C
H
A
5 CRITICAL WAYS TO TRANSFORM MINDSETS
Eliminating Blindspots
Challenge Assumptions
Reduce Complacency
Break Unproductive Habits
Inculcate Positive Attitude
THE TRAPPED MINDS IN ORGANISATIONS
Tra
pp
ed
Min
ds Unimaginative Mindset
Self Centered Mindset
Complacent Mindset
Defeatist Mindset
Inflexible Mindset
Retrogressive Mindset
MINDSET TRANSFORMATION
Retrogressive Mindset Progressive Mindset
Inflexible Mindset Flexible Mindset
Defeatist Mindset Winning Mindset
Complacent
Mindset
Continous Improvement
Mindset
Self Centered Mindset Team Player Mindset
Unimaginative Mindset Imaginative Mindset
ADVERSITY MANAGEMENT FRAMEWORK
Recognising Reassessment
Repositioning Recharging
DETECTING EARLY WARNING SIGNS (WHY
ORGANISATIONS FAIL)
Poor Control System
Excessive Overheads
Poor Risk Management
Inability to Change
Poor Leadership
VALUE DRIVEN MOTIVATION MODEL (VDMM)
Developing Performance
Track Records
Increasing Value
Providing Rewards
(changing the way we motivate people)
Knowledge
Skills
Experience
B
U
I
L
D
I
N
G
Bre
ak
ing
Min
dse
t
THE POWER OF VISION
Setting Direction
Energising People
Integrating The Organisation
Providing Meaning
Building Leadership
Breaking Paradigms
Driving Performance
Increasing Change Capability
TRANSCEN-DENTAL LEADERSHIP
Feeling Despite
Numbness
Doing the Impossible
Touching
the Untouchables
Seeing the Invisible
Listening to Silence
Smelling the Scentless
Understanding Unarticulated
Needs
Surfacing Courage
From Fear
Creating Positive Future
Thinking the Unthinkable
CREATING CHANGE WINNER
Creating
Change
Winner
THE POWER OF LEADERSHIP
Organisation
People
System
Structure
Technology
Forces of Leadership Forces of Resistance
• Visionary
• Communicative
• Persuasive
• Supportive
• Risk Taking
• Motivating
• Don’t know What
• Don’t know How
• Don’t know Why
• Don’t have Support
• Don’t have Courage
• Don’t have
Motivation
CHANGE
MANAGEMENT
CONTINUATION OF CHANGE
• People sometimes slip back into the old ways of working.
• Once again, COMMUNICATION is crucial.
• Provide staff with evidence that the changes had a positive impact, through a re – audit.
• Keep people informed, keep management on side.
• Reasons why fails:
Lack of resources
Lack of motivation
Inadequate management of the process
Poor communication
Agreement Assimilation
Action
Awareness
Accountability Acceptance
6As CHANGE
COMMITMENT MODEL
66
The first step is to create awareness of change or impending change
Proactive communication which makes people aware of change is more positive rather than surprised change
Key elements to propagate: What specifically is the change Why change is necessary What is the beneficial and implications Who are the people involved What are the approach, process and framework How do we monitor When will the change commence
1. AWARENESS
2. AGREEMENT
• Through a sound and rational approach
• It appeals to their “ head and minds” more than their “hearts”.
• Address the real issues and problems facing by organisation and the people affected by it.
• Requires credible analysis/study and comes with solid backing of hard facts and statistics.
• An objective view , impartial judgment people involvement, participation and input will help the drive towards an agreement
3. ACCEPTANCE
Appealing to the heart and emotions.
Leaders need to address the issues that are drawing them into inner-self, directly affect various staff members and other people; sense of insecure, uncertainty, discomfort
Unload predetermined mindset of their perception, assumptions, habits and attitudes to the untainted, undisguised reality.
Appealing to the sense of achievement, pride, self-esteem, sense of belonging and common & noble vision
4. ACTION
• One test of their commitment is the action they take
• Encouraging action needs motivation; • conducive environment, • avoid punishment ( for undesired mistakes), • rewards , • Teamwork
• Leaders to show the way, monitor and provide constant feedback of the progress.
• Highlight on the small and early “ win” as every success serves as a powerful reinforcement
5. ACCOUNTABILITY
• “Answerable to what happens and to what does not
happen”
• The degree of commitment can be gauged by the
willingness of people to accept accountabilities of the
activities, tasks and programmes
• Providing clear specific roles, responsibilities performance
measures and periodic progress review are a good way in
developing accountabilities.
6. ASSIMILATION
• A stage whereby the thinking, feeling and the actions of the people are synchronized to bring about the desired change.
• It involves the whole intellectual, physical, social, emotional and psychological change towards the desired results. Once implemented, it won’t go back to its original position once again.
• It is a powerful indicator of the degree of commitment of an organization towards change