"Learning to fly while remaining an egg"

I came across an article in one of my stacks of articles (long story, but see my post "Today's word is...tsundoku!" for an explanation) that I think is relevant ("How Old Industries Become Young Again").  The article discusses the five indicators that reveal when a particular industry is about to be transformed (or should be transformed):

1. New Customer Habits

2. New Production Technologies

3. New Lateral Competition

4. New Regulations

5. New Means of Distribution

As I read through this article, I quickly grasped that all five of these indicators are impacting how we deliver health care today.  The writer C.S. Lewis said, "It may be hard for an egg to turn into a bird: It would be a jolly sight harder for it to learn to fly while remaining an egg."  That's my subtle way of saying that we can either proactively manage the changes that are coming or wait and have those changes forced upon us.  

I've been spending the last several posts talking about two great articles published in McKinsey Quarterly on change management.  Once again, Emily Lawson and Colin Price ("The psychology of change management") describe four basic conditions that are critical to the success of any organization-wide change initiative: (1) A compelling "change story"; (2) Role modeling; (3) Reinforcing mechanisms; and (4) Capability building.  Carolyn Aiken and Scott Keller ("The irrational side of change management") provide additional insights that are necessary for successful change.  Today we will finish this series of posts with a discussion on how to build the capacity and capability for change.

There is no question that if organizations want to change, they must invest the time and resources in building the capability for change.  Frontline employees will need to be trained in new skills and behaviors, and they will need the time to be able to learn and practice these newly taught skills and behaviors.  I like to use the analogy of training for a marathon.  You don't just simply decide one day to go out and run 26.2 miles - trust me, you'd never make it!  You have to start slow and build up your endurance slowly over time.  The same is true for any major organization-wide change initiative.  You have to start small, build the capacity and capability for change slowly over time, and then expand as your team develops new skills and behaviors.  

As an example, our organization recently embarked on a major transformational change initiative focused on becoming a High Reliability Organization (a common goal for many health care organizations).  One of the critical components to our initiative focused on building capacity and capability.  Rather than developing a plan and rolling it out immediately to the entire organization, we spent the first year testing and refining our program on just two inpatient units (our Cardiac Intensive Care Unit and one of our medical/surgical units).  We learned a lot during this first year - we listened to feedback from the two teams and modified our program based upon their feedback as well as the results we observed.  Once we felt that we had the right program, then and only then did we decide to spread the initiative to the remaining inpatient units.  We are now starting to test our interventions in other areas of the hospital.

Change leaders should also pay attention to mindsets.  Carol Dweck published a great book in 2006 called Mindset: The New Psychology of Success.  In the book, Dweck talks about the difference between a "growth mindset" and a "fixed mindset".  Individuals with a "growth mindset" are open to change and believe that they can develop new knowledge, skills, and attitudes over time (as opposed to those individuals with a "fixed mindset" who generally believe that we are born with the a certain degree of intelligence and skill that cannot be changed).  

Here's an example of what I am talking about.  Until 1954, no one had ever run a mile in less than four minutes.  Several track and field athletes came close, but they never quite broke this seemingly insurmountable barrier.  No one believed that breaking the four minute mile was possible - no one at least until Roger Bannister came along.  Bannister started his track and field career relatively late at the age of 17 years - he actually had never worn running spikes or even run on a track, but he had a promising start anyway, running a 4:24.6 mile in 1947 after only three weekly half-hour training sessions.  His career slowly progressed, and he ran in the 1952 Olympics in Helsinki.  He broke the British record for the 1500 meter run but finished in fourth place.  He spent the next two months deciding whether or not he should retire.  Instead, he adopted a "growth mindset" and set a new goal of breaking the four minute mile.  On May 2, 1953, he ran a mile in 4:03.6 seconds, shattering the previous British record for the mile set earlier by Sydney Wooderson’s in 1945. Bannister recalls, "This race made me realize that the four-minute mile was not out of reach."

Roger Bannister was the first person to break the four minute mile on May 6, 1954 at the Iffley Road Track (now known as the Roger Bannister Track) in Oxford, England.  Incidentally, he had been working at the hospital earlier that day - he was a medical student at St. Mary's Hospital Medical School at the University of Oxford and graduated that same year and eventually became a neurologist after retiring from track and field.  Bannister ran the mile in 3:59.4, proving that the four minute mile was not impossible.

Bannister's record was short-lived.  Two months later, Australian John Landy broke the four minute mile barrier and set a new record.  Once the psychological barrier had been broken, 24 more athletes broke the four minute mile in the following year!  People's mindsets had shifted - once Bannister showed that a four minute mile was indeed possible, it became relatively easy for the next several athletes to break what was once a seemingly impossible barrier.

To summarize then, leaders have two key responsibilities in building the capacity and capability for change in an organization.  First, building capability takes capacity in terms of time and resources.  It also takes time - change happens slowly.  Leaders need to invest in their teams and in the change initiative in order for it to be successful.  Second, leaders need to help foster the right mindset - a growth mindset - both for themselves and for their teams.  

As I have said repeatedly, change is hard.  Leading change is hard.  But with some of the tools discussed in these last several posts (and with the right growth mindset), change is possible!