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