High involvement is essential for deep transformation. W. Edwards Deming, a statistician, was credited with Japan’s rise in manufacturing after World War II. The improvements were seen clearly in the quality of Japanese cars that began to dominate American highways in the 1970’s. Deming’s processes gradually came to influence the entire auto industry. In his book Out of the Crisis, published in 1982, he detailed 14 points vital to transforming business. His 14th point: Transformation is everyone’s job.
People are more committed to systems, organizations and projects in which they have a say. We are more likely to carry out ideas that we have contributed to. We are more driven when we can clearly see the vision because we have helped shape it.
High involvement, which we (and Deming) define as 100% participation, must be a value that underpins the transformational journey. It begins with leadership listening to everyone in the organization. As each person is truly heard we will find that our efforts are shaped by that input. And it becomes contagious. Everyone becomes more interested in listening.
Many long-term care organizations commission a high involvement team made up of formal and informal leaders, folks from every department and discipline, as well as residents, who sit down at a table together to plan strategies for involving others in the transformation.
High involvement supports transformation by:
- Making sure change penetrates deeply and broadly. When everyone is in a transformation mindset and working for change on different levels and scopes, the organization moves gracefully along the path of change. If changes are initiated, decided upon and dictated by a few, the path will, instead, be full of unexpected roadblocks. Involvement across departments and functions as well as up and down the traditional chain of command will spur a united sense of purpose, an esprit de corps and strong action toward that vision.
- Combating resistance to change by involving those who would resist. Many folks who present themselves as negative feel left out or see issues that they feel the organization is blind to. Get them involved early, respect their devil’s advocate style and expect that they will listen and work with the rest of the team to accomplish what everyone wants for the residents: a good day everyday, filled with quality care, quality relationships and a life with meaning and purpose. Also look for early participation from those whom others seem to listen to. If someone has a say in solving the problem how can he or she continue to be negative about it? Harness their power for progress.
- Growing critical thinking skills in people throughout the organization. As people become involved in transformation in the organization, they experience working as a team. Collecting information, studying, working through conflicts and resistance, making their case, following through, leading, hearing from others, solving problems and making decisions. With each opportunity to be a part of the transformation their knowledge, skills and competencies in these areas grow and strengthen. Shared leadership, authority and responsibility throughout the organization build a solid foundation for sustaining person-centered care.
- Putting many bodies and minds to work at making changes. True transformation to a homey world where residents direct their own lives will require a complete overhaul of the organization, individuals’ roles in it and environmental renovations to assure the outcomes. A handful of formal leaders could never accomplish all that needs to happen. And how could an organization expect to create a resident-directed environment without involving residents in the process? Many minds and viewpoints working together with deep commitment along an agreed upon path will bring the shared vision to life.
How have you witnessed the value of high involvement in your own organization? Please share your stories in the comments section.
LaVrene Norton is the founder of Action Pact, an organization devoted to changing the culture of care environments for elders – making it possible to live in a homey place & have a good day every day, no matter how frail one becomes. Action Pact has assisted care organizations on their journey to households since 1997. Norton is co-author with Steve Shields of In Pursuit of the Sunbeam, and publisher of a variety of educational books, workbooks and videos focusing on the Household Model.