Tag Archives: change management

How to Lead Change in an Organization

Change is personal. So, change management has to be personal, too. No matter how we aim to motivate people to change, and no matter how organized we try to make our transformation plan, our change efforts will suffer if we don’t accept the reality of human emotion. People and their strengths, foibles, feelings and notions will be what determine the success of our transformation programs.

Can we afford to ignore the human dynamic in organizational change management?

If the answer is, “no,” then it means our change management plan must also positively influence individual mindsets. The benefit to a thoughtful approach will be lasting organizational impact during an era of digital transformation.

What you, as a leader (everyone behind important changes) need now is what will become ingrained culture (forward-thinking teams and a company that permanently enjoys the benefits of a unified, flexible organization).

That kind of corporate mental preparedness will help organizations respond to future digital shifts and growth with quick, fluid and unhindered movements. A change-ready culture isn’t as susceptible to the fears of unknowing.

So, in this series, we are going to focus on the insurance organization itself and the various people who drive it. We will look at why insurance leaders should consider organizational transformation as an instrumental part of technology modernization. And we’ll examine several considerations that are in some way crucial to finding transformational success. These all share one trait: They each touch on the human element of change management.

Leading outside the lines.

When we talk about change and people, it’s natural to look to leadership strategies and recognize that a lot of real leadership happens outside of the org chart. On the org chart, executives and managers have defined roles and responsibilities. But leading outside of those lines is far more crucial when it comes to change management. Leading change requires “working within the white space” — ignoring some degree of authority and being more concerned with perceptions and personalities. If you think you can dictate change, you can’t. You need to bring people along understanding their pace. Change has to be effectuated in some way outside of official protocol. It is in the white space where penetrating change leadership will happen. We’ll discuss more on white space and leading outside the lines as we move through the articles in this series.

See also: Can Risk Management Even Be Effective?

Leaders should know what is driving change.

It pays for leaders to know why they should be shifting their organizations away from traditional technologies and processes and toward flexible new technologies and processes that will enhance the customer experience. This understanding will help leaders communicate the relevance of change to the people who need to create change.

The insurance business environment is in the midst of a radical shift. For a quick look at the factors involved, see the then vs. now chart below. (Source: Future Trends: A Seismic Shift Underway.)

Understanding these concepts will allow leaders to operate and speak from a position of knowledge when they frame examples of the driving forces of change within the organization.

Leadership should lead the change.

“Change starts at the top,” is a phrase so common that it is cliché.

But what does that really mean? Does it mean that the leadership accepts that change needs to happen and then delegates the work of change out to the various stakeholders? Certainly some delegation will occur, but, in our experience, the best change happens through the well-articulated, well-planned hard work of the leadership. Instead of “Change starts at the top,” perhaps we should say, “The work of change begins at the top. The oversight of change stays at the top,” and, “Leaders should be just as engaged on Day 51 and Day 201 as they were on Day 1.” In fact, it isn’t leadership if leaders aren’t engaged.

Leaders must establish the driving force for change. The foundation you are building is important enough to clearly provide explanation around why the organization is going through transformation. When asked “Why are we changing?”, it is important and easy to be clear in this regard. Possible responses include:

  • “We want to be more competitive to the marketplace. Change is a part of our core business strategy.”
  • “Becoming a digital company requires us to change.”
  • “We are striving to stay relevant to a fickle consumer.”

There may be a number of reasons. But establishing the driving force for change will allow those reluctant to change to see a clear correlation between change and company survival.

Change is difficult, and many people will not be positive about it on Day 1. However, we shouldn’t assume that all people don’t want to change. Many times, people would love to change. It is simply a matter not knowing how to change. Change management helps your valued team members uncover a new paradigm and gives them a new context in which to grow within their role. They will learn how and will become more comfortable as you help them shift.

Focus on outcomes — organizational and individual.

To set the context and shift the paradigm, leaders should focus on two types of outcomes. Successful organizational outcomes are the focal points that every organization needs to stay on course. That focus will also help everyone in the organization release those time-honored, sacred approaches that may no longer be needed. Organizational outcomes won’t be hindered by a lack of understanding.

See also: A Revolution in Risk Management  

But people will also be looking toward their personal outcomes. People like to know where they are currently versus where they will end up. Remind people, “You are here. As the organization transforms, you will be here.That answers their questions about where the organization is headed and where their role is headed (questions such as “Will I lose my job?”, “Will I have more responsibilities on my plate?”, “What’s in it for me?”)

In fact, change leaders should do their best to continually answer the question, “What’s in it for me?”, because that is the context each individual needs. It’s like orienteering with a map and a compass. Hikers feel more comfortable when they can point to their current location on a map.

Change management is helping associates grasp that new paradigm. Communicating the outcome for the individual is just as important as communicating corporate direction.

In my next blog, we’ll discuss organizational change management from the standpoint of skills and understanding. Do we have enough experience to guide change? How do we mold change managers, grow understanding throughout the organization and conquer the fears and myths of transformational change?

Please join me in Part 2 as we uncover the “How To” details of change management.

The 4 Secrets to Managing Change

Confused about change management in your organization? You are not alone. Transformation is difficult. But some companies have succeeded throughout the length and breadth of their organization. So, what is the secret?

1. Adopting a long-term vision

Vision is critical. Companies that commit to the process are more likely to experience a greater acceptance than those that implement short-term or damage-control practices.

See also: Can Insurers Move at the Speed of Change?  

To create that great place to work, the CEO and senior management must show a strong commitment to active communication and to the company vision and values. Equally important, there must be a commitment to ensure that the vision and values of the company are lived and experienced throughout the entire organization.

2. Accepting responsibility

The CEO and other senior individuals have to take the responsibility and lead by example.

3. Communicating the change

The team must plan, execute, evaluate and monitor the change initiatives to ensure the strategy of the organization is aligned with the vision, mission and structures of the company. It is important to note that the change team must understand what needs to be planned and what can emerge.

Additionally, a communication plan must be developed. Communication is that vital link to ensure that an organization change process is successful.

4. Understanding the organizational culture

Although changing an organization’s culture continues to be a highly challenging and often elusive endeavor, according to Levin and Gottlieb, the team must be aware of the people issues because they can enable or block change. Focusing solely on the hard factors and totally neglecting the softer issues can render the whole change process useless.

Any new CEO trying to change the culture of the organization wholesale will run into difficulty. It will be more feasible to get groups of people to change their way of work and teach others how to enact such behaviors. Any other approach can prove to be very unproductive and even destructive to the entire change process.

See also: Building A High Reliability Organization  

3 Main Mistakes in Change Management

In my last blog, my engineer self admitted that the root causes for why core systems replacement projects don’t hit the mark in the business case are more likely related to people, not the technology. I stated that the business only changes when individual contributors each do their jobs differently.

Now let’s take a more detailed look.

There are many models out there that provide a framework for understanding change. One that we use frequently at Wipfli is the Prosci model, which is focused on understanding change at the individual level. Boiling it down to its simplest form, this model says the change must progress for each individual from awareness to desire to knowledge to ability to reinforcement.

Understanding that, Mistake #1 to avoid is measuring the need for change management based on executives’ paths, not their people’s. The executives responsible for the program and ultimately for the change management strategy, approach and investment are by definition the leaders furthest down their own change paths. That is, they are, in all probability, way beyond the awareness and desire stages. (Hint, hint: That’s why this core systems project is underway). And, not uncommonly, because of where they are, they may not understand the need to make a significant investment in change management.

Once you embrace the need for change management, there are an array of tools and techniques at your disposal. These include communications, sponsorship, coaching, training and resistance management. Mistake #2 to avoid is loading everything into communications as a one-and-done approach. In fact, I would guess that when most of us hear the term change management, we immediately think of communication. That’s good because change starts with awareness. But did you know that it takes something like five to seven communications for a message to be truly heard and understood by all? Remember that perfect project kickoff email you sent last week that summarized everything perfectly? Yeah – maybe 20% of your audience remembers it today. So communication must be multiple messages using multiple channels coming from multiple stakeholders.

Multiple studies over the years have reaffirmed the significant correlation between a project’s success and change management’s impact and, more specifically, the importance of the project sponsor’s role in both. Succinctly, the earlier the project sponsor is engaged in the project and the earlier the project sponsor embraces change management, the better the chance for success.

Mistake #3 concerns the project sponsor and her change management role. Just because you have a smart and engaged leader as your sponsor, don’t assume she knows what’s supposed to be done every week in a transformational core systems project if she hasn’t played that role before. For example, does the project sponsor know to build a coalition among the key managers and supervisors whom the affected employees will most want to hear from? At the end of the day, the employee will turn to his immediate boss and not the project sponsor to really get the WIIFM (what’s-in-it-for-me).

You get the idea. As much as agile project management and delivery approaches and methodologies have been embraced, used and hardened over the past 10 years, we need to do the same for change management.

Overcoming Newton's Laws

Like many companies in many industries, and practically every human being I know, the insurance world can be change-resistant. We fight natural laws even as we recognize the very need to adapt and grow. When it comes to adopting technology — a topic I hope to explore in future contributions here — change is particularly difficult.

So how do you get your organization to change, to adjust, to transform? How can you promote and ensure a change in direction or propel a faster change? A few key lessons found in Newton's Laws can shed light on some good answers.

In 1687 Sir Isaac Newton published his work, Philosophiæ Naturalis Principia Mathematica, what we commonly call Newton's laws of motion. I am sure you remember Newton's laws of motion? Here's a layman's version (with apologies to Sir Isaac):

  1. First law: A body (mass m) in motion stays in motion unless it is acted upon by an external force (F). Picture a big boulder rolling down a shallow slope, just enough slope to keep the boulder rolling but not enough for the boulder to gain speed.
  2. Second law: A body will accelerate if pushed in the same direction as it is moving, i.e., F = ma (we'll need the formula later; I know, you were told there would be no math). Same boulder, now rolling slowly so you catch up to it and push it from behind, causing it to go faster.
  3. Third law: The forces of action and reaction between two bodies are equal and opposite. This means that whenever a first body exerts a force F on a second body, the second body exerts a force -F on the first body. F and -F are equal in magnitude and opposite in direction. Our boulder example again, only this time it runs into another boulder, which causes the first boulder to slow or stop and the one it hit to steer off in the opposite direction of the hit.

So that's what you already knew. What I bet you didn't know is that Sir Isaac Newton spent a lot of time at Edward Lloyd's coffee shop in London (Lloyd's of London). Sir Isaac was a professor, after all, and was nothing if not observant. For years he listened in on the conversations of insurance professionals as they talked about their businesses while sipping his nonfat vanilla lattes. He soon postulated the three laws of business:

  1. First law: A business (mass m) will remain on its course, good or bad, profitable or unprofitable, forever if no new forces act upon it.
  2. Second law: The larger or older a business is (big mass m), the more force (change agent F) it will take to accelerate its course.
  3. Third law: If a force (F) is exerted on a business (mass m) to try to change its course, expect some pushback (-F).

Sound familiar? Think about your own organization. Now do these “laws” ring a bell?

It is important to note that I love the insurance business and have been studying the industry from the inside for 34 years. That said, I do think Newton's laws of business have a stranglehold on our industry. While there are exceptions, many companies are in a “state of uniform motion,” and too many companies struggle to change course. Still others try but are forced to give up when change is not well received by those affected.

So what can an organization do to overcome Newton's laws or, in reality, use the laws to their advantage? Let's tackle them one at a time.

First Law in Action
Insurance is cyclical: soft and hard markets, profitable and unprofitable cycles. The common response is, “That's just the way it is, and we can't do anything about it.” To change speed or course requires a strong desire and some planning. It also requires an understanding of your mass m (your “boulder”, i.e., your company).

As Davenport and Harris state in Competing on Analytics: The New Science of Winning, you must know what you are really good at; that is, you must know your distinctive capability. So how do you get a deeper understanding of who you are as a company? How do you discover what you are really good at? You do the analysis — identify your team's talents and limitations; understand what your profitable and unprofitable clients “look like”; determine how and where you make money (or not); pin down your processes; know what additional corporate assets you have to work with; and so on.

Use all the technology tools available, including data analytics, descriptive and predictive modeling, and sometimes, outside help. You really need to understand the composition of your “boulder” and the nature of the landscape it is rolling down, including the other boulders (competition) that you may run into.

Second Law in Action
“We have always done it this way.” It pains me to even write that statement. In a young organization, you don't hear this statement that often, if at all; everything is new. There are no “habits.” Brand new companies are more like a handful of pebbles thrown down the hill than they are boulders. The smaller the mass m (the company), the less force required to change its course; Newton's second law of business.

And generally the larger and/or older the company, the greater the mass m = greater force required to change course. So if you hear, “We have 2,000 claims people scattered across the country; changing will be impossible,” ask yourself, will it really? Sure, change will be hard, maybe really hard. Therefore, F just needs to be larger, making the achievement that much more rewarding.

Here is where talented leadership is very important. Gain a following first (a big part of being a leader), paint a clear picture of where and how fast you want your boulder to roll, and people will get behind and push. Once the momentum picks up, you may encounter many competing forces; therefore, put some governance in place so the most important projects get everyone's attention. And have strong project management to keep the force applied in the right direction. Strive for quick, small successes so people “see” progress. People in IT will help you; they are trained in the discipline of managing projects and portfolios of projects.

Third Law in Action
You have taken a good assessment of your company, you have good leadership in place, and you have charted a new course and speed. You initiated projects with governance in place to assure they are the “right” projects. Everything is rolling along, but Newton's laws are still present. Now the troops start pushing back.

People tend to know the third law best. Proactive collaboration with your teams goes a long way to overcoming human pushback. When people participate in the process and know what they are doing, -F is minimized. Business intelligence and analytics can help here, too — even something as simple as who is using what technology and how often. Metrics on adoption are great.

Eight Steps For Leveraging Newton's Laws Toward Positive Change
Changing course isn't easy. The larger or older an organization is, the harder the course change. Quality change management is worth its weight in gold (even at today's price), and these eight steps can help.

Step 1 — Understand your “boulder.” Get outside help if you aren't really good at introspection. Analyze past history. If you buy into Newton's laws, your history will repeat itself unless acted upon by an “external, unbalanced force.” Today's technology provides unprecedented capabilities to study historical data in ways that were not possible (or at least were really hard to accomplish) just a few short years ago. There are so many ways to gather data and analyze the buyers of your products. Make sure you know your current business and your market.

Step 2 — Recognize that Newton's first law of business exists and that change requires hard work and good, strong leadership. It fact, leadership is the most important aspect needed for changing course. Effective leadership at the top is a must, but it's also a required factor of others who lead people in your company.

Step 3 — Determine your new direction. Use what you learned in Step 1 to establish the speed you want your boulder to go and in what direction. Once you know in which direction to head, you must figure out how to shove your boulder with the right amount of force. Typically, you must shove it hard to get it to change course, pick up speed, or both.

Step 4 — Recognize that talented leadership can exert a significant force. Talented leadership involves cultivating a following of believers, so that the third law is minimized and your team will eagerly follow the new course. It means painting a clear picture of where you want your boulder to roll. Your team must know the “destination” so they can help move your team, department, and company toward it.

Step 5 — Get governance in place. When an organization has bought into change, really bought into it, then there can be many competing forces. Governance must be strong so the “right” forces affect the direction of the company. Governance helps by identifying which way to “push” and ensuring the right amount of force. Remember the first real law: the force has to be unbalanced. If competing projects cancel each other out, the boulder will keep rolling in the same ol' direction, at the same constant (probably slow) speed.

Step 6 — Establish strong project management. A new course is set; the proper force is applied, and is applied in the right direction. Now the change must be monitored. Leadership should be kept informed. Course corrections may be required. It's all part of good project management. At my firm, we are huge Agile Methodology zealots (that's redundant). Breaking the work into manageable chunks and keeping people informed are great ways to accomplish what needs doing. It also helps to address the third law. People like to “see” progress and feel a sense of accomplishment.

Step 7 — Don't forget your people. People are subject to Newton's Laws too. Make sure you have human change management in place. Proactive collaboration with your teams goes a long way to overcoming human pushback. Train early and train often. When people participate in the process, know what they're doing, and understand what's expected, then -F is minimized.

Step 8 — Assess and amend. It is so easy to get off course, since there are many forces F and -F exerting influence on your company, both internally and externally. As you work to change or accelerate course, Newton's Laws will always be in play. Making adjustments as you go is critical to success.

Change is inevitable, whether you're changing your boulder's course or letting your competitors' boulders get in the way. But change can also be fun.

Over the course of 34 years, I have been called many things; one of the good ones is a change agent. I hope this article will help you change your organization in many positive ways. When you think about change, remember Newton's Laws and let them guide your actions. Embrace change. You can make it happen.

Affordability, Effectiveness, and Wellness, Part 4

This is Part 4 in a five-part series which presents a creative solution for today’s health care crisis. Additional articles in the series can be found here: Part 1, Part 2, Part 3, and Part 5.

Emergence Of Health And Wellness Programs As A Solution
For many years wellness has been viewed from somewhat of a skeptical perspective. However recent studies and improved implementation programs are showing considerable health cost savings are associated with health and wellness programs. Our firm’s most recent estimates show that an effectively implemented health and wellness program can reduce aggregate health care costs by as much as 20% – 35%. In addition, these costs savings continue for more than one year. Health and wellness provides a meaningful solution of the affordability crisis. Although there continue to be significant opportunities for efficiency improvements within the health care system, the emergence of the health and wellness solution is encouraging.

Table 7
Illustrative Impact of Health and Wellness Changes

Health & Wellness
% of
Ave $*
Well 50% 20% 10% 52% 10% 55% 11%
Low Risk 20% 50% 10% 22% 11% 23% 12%
Moderate Risk 25% 100% 25% 23% 23% 20% 20%
High Risk 4% 750% 30% 2.5% 19% 1.5% 11%
Complex 1% 2500% 25% 0.5% 13% 0.5% 12%
Total 100% 100% 100% 100% 76% 100% 66%

* Source: Dee W. Eddington, Ph.D., Director of the Health Management Research Center at the University of Michigan

Table 7 shows that with a modest shift in health and wellness level health care costs are reduced 24%, and with a more significant shift costs are reduced 34%. These shifts are very possible under an effectively implemented health and wellness program. These projected savings compare favorably with the potential for efficiency improvements. However, they bring a much more important quality to the table, these are politically correct and desirable initiatives. The efficiency savings, although real savings, have become less desirable for a variety of reasons.

The Change Management Connection
Health and wellness programs are really change management initiatives, focused on personal behavior change management, perhaps the hardest of all changes to make. Traditional change management focuses on moving an entity from its “current world” to a more desired “future world.” Current world in the health and wellness environment is the individual’s current health status. Future world is the hoped-for positive outcome of the health and wellness program (i.e., the individual’s ideal health status). The key ingredient to measure success is determining how to successfully transition the individual from today to the future, from their current world to their future world, from “interested” in true health and wellness to becoming genuinely committed.

It is helpful to look at this from two distinct perspectives: organizational change management and individual change management.

Organizational Change Management
Classical change management principles offer useful ideas and concepts that can be directly applied to the organizational side health and wellness programs to better understand potential success and to design successful programs. A good example of this is shown in Exhibit A. This describes key factors in an organizational change management process. As Exhibit A shows, there are far reaching factors that impact the success of the change management process including leadership, management methods, measurement methods, organizational structure, technology, etc. Only when all are appropriately considered will the organizational change management process achieve its goals. Exhibit A’s overlay of four layers with the individual pieces further demonstrates the forces which can disrupt the change management process.

View Exhibit A

Even the diamond shape of the change management grid is philosophically significant. Organizational and change management experts regularly use the management principle known as “tight-loose”. Exhibit A visually presents an extension of this “tight-loose-tight”. The first tight refers to a tightly defined vision/mission, one that everyone buys into. The second tight refers to a tightly managed execution or process. The loose refers to flexible design and organizational process. Note that the top of Exhibit A comes to a point (i.e., tight, narrow), the middle part is wider, and the bottom again comes to a point. Visually it demonstrates “tight-loose-tight,” which we believe to be the most effective approach.

In terms of Health and Wellness, both the organization’s programmatic health and wellness approach and the individual’s personal interaction with the approach (described in more detail later) can be described in similar terms to that presented in Exhibit A and be mapped to this grid to demonstrate the key success factors. If an organization designs the right strategic program for implementation, the individuals who are participating will respond accordingly. Historically, most health and wellness programs have focused on what the individual should do. The more ideal approach for organizations and individuals is to really focus on and develop the why and how considerations.

The most effective health and wellness programs are ones with the tightest vision and mission statement. This is where the program clearly identifies, incorporates and strengthens the appropriate motivations for change (“the why”). When an organization is truly committed to the process, amazing things can occur. Very specific and definite goals result in the best results. (i.e., Tight and non-negotiable).

We believe a tightly defined health and wellness program vision should include the following three items:

  • A focused program — a program that begins with a particular aspect of health and wellness, rather than trying to be everything to everybody
  • A hope-filled program — a program that provides hope to participants, showing that it can be done and success is likely
  • A redemptive program — a program that encourages participants who participate, motivates them along the way, and incentivizes them to continue their transition. It is a program that gives “partial credit” for sincere participant efforts.

In addition, the most effective health and wellness programs incorporate a loose and flexible process or path. There are so many ways to structure and present programs, many with very similar results, that it is mandatory that the program incorporate flexibility. It is critical that the program tailor the specific application to best meet the needs of the individuals. Historically, this is where most of the narrow focus has occurred, rather than a “loose,” flexible approach. The exact structure and strategy (“the what”) need not be central in the context of genuine commitment and motivation. There is the capacity to customize and design specific strategies based on a host of unique and distinct considerations and preferences (i.e., Loose and flexible).

Finally, the most effective health and wellness programs have attracted highly committed individuals totally invested in the process (i.e., tight commitment). The sustained implementation (“the how”) is key for both short term and long term benefits and outcome. Predictably, having the appropriate commitment in the context of a customized strategy can lead to the implementation of a process that will lead to lasting change and benefit (i.e., Tight and mandatory).

Unfortunately, we find that far too many health and wellness programs are structured Loose-Tight-Loose. There is a very loosely and poorly communicated program vision and goal, nebulous at best, combined with a rigid and tightly defined inflexible structure, and a loosely structured connection with the individuals resulting in less than desired results. A complex and rigid program presented in an apathetic environment will likely lead to extensive expended resources without much meaningful benefit. In contrast, a tight-loose-tight program has a much greater likelihood of success, far above the general programs seen today.

For example, certain weight loss programs provide a rigid manual with points and/or limits forcing people into cookie cutter diet plans while doing little to effectively grow commitment to the end goal. These are clearly loose-tight-loose programs. Yes they oftentimes generate significant revenues to the sponsoring organization through membership and or meeting fees, with less than desired results and discouraged participants.

Individual Change Management
Just as with organization change, focusing on change management is key for any real impact to be made on one’s current health status. Whereas traditional health care for the most part focuses on treating illness and curing diseases, effective health and wellness programs focus on individuals becoming more committed to changing their behavior and hence improving the quality and potential for greater quantity of life. Personal change management principles offer valuable ideas and concepts that individuals can directly apply to improve the very quality of their lives. Exhibit B describes our model of the individual change management process as it relates to obesity. Just like with organizations, there are far reaching factors that impact the success of a person’s journey into new found health and wellness.

View Exhibit B

The egg shape of the personal or individual change management model is again philosophically and symbolically significant. Symbolically, unhealthy personal behavior often leads to carrying around extra weight around our midsections (i.e., egg-shaped physique). Philosophically, like organizational change the proposed individual approach is a tight-loose-tight model but with gentler, softer edges and curves in comparison to the sharp edges of the diamond grid. The top of the egg, being the tightest refers to the need to have tightly defined personal motivation and commitment. The second tighter region at the bottom of the egg refers to the tightly defined outcome of personal empowerment. The larger, “loose,” wider middle of the egg model refers to the customized and flexible design of a personal approach that encompasses certain core healthy pillars that anyone can adopt into the context of their lives. Exhibit B comes to a point of sorts at both ends with a large wider middle area which visually demonstrates the tight-loose-tight of personal change management.

In terms of personal Health and Wellness, an individual’s personal approach can be mapped to this model to demonstrate the key success factors. Just like with an organization, most individuals respond in a very similar way. Most adults who are relatively informed do not just need to be told “what” to do. They may already know at various levels. What they do need the most is the support, encouragement and accountability to just do it. What they need is the inspiration and hope to know it’s possible. Too many times we focus on instruction and neglect inspiration. We prioritize giving people help without adequately providing a sense of hope that change is possible. We emphasize technique and neglect motivation. The ideal approach to individual change management is one that develops motivation, develops sincere commitment to the process, develops hope for the potential that it can be done and builds inspiration about the consequences of it actually occurring.

On the personal or individual level motivation is key! What often is lacking is appropriate and meaningful motivation which translates to a greater sense of commitment. The concepts of health and wellness change are not that complicated. It’s the application of the simple principles into the complexity of an individual’s life which take thoughtful and strategic consideration. The tight-loose-tight structure directly applies here. The individual needs to clearly know (i.e., tight):

  • Why am I part of this program?
  • What is the end goal or outcome?
  • What will I achieve?
  • What are the benefits of me participating?
  • How much personal effort it will take? Too often this is inadequately presented and high recidivism or failure rates result from not buying in up front to what will likely occur.
  • What is the required process to be successful?
  • What are my chances of success?
  • Is this program clinically sound? What are the program’s credentials?

On a loose perspective, the individual needs to know what specific rewards or incentives are involved. Whether personally established by the individual or part of the overall program structure, the participant must value the rewards and let these motivate them in their transition process. There is a wide variety of incentives that could be used and uniquely tailored to each individual. Different individuals respond to different incentives, are motivated differently, and will perform differently. The program needs to react to these different perspectives.

Measurement systems are key to the individual, but their precise structure is less important. The individual needs to see that they apply to their lifestyle and normal thinking process. They have to be comfortable with what is going on.

On the bottom tight perspective, the individual needs to be closely held accountable and encouraged to continue the process they have begun. Without this, the individual may give up, stop the program, lose heart and assume it is hopeless.

1 Change management grid initially developed by Dutch Siedentopf, change management consultant.

David Axene collaborated with Nicholas Yphantides in writing this series of articles. Dr. Nicholas Yphantides serves as the Consulting Chief Medical Officer for San Diego County and is the National Director for Health & Wellness with Axene Health Partners. He is a cancer survivor and is an advocate for those in his community who need it the most. For nine years, Dr. Nick served as Chief Medical Officer of one the largest network of Community Clinics in San Diego County.