C’est quasiment un mémoire que j’ai découvert, par mon alerte google, sur un cas majeur de conduite du changement: la réforme hospitalière. Sur le site cairn.info , créé par 4 maisons d’édition de revues de sciences humaines et sociales, Etienne Minvielle et André-Pierre Contandriopoulos partagent leur travail d’analyse approfondie des leçons à tirer de la restructuration hospitalière.

Les auteurs présentent 3 cas différents:

• Une fusion de complémentarité entre deux hôpitaux publics – nommée BAR –;
• Une « absorption » d’un hôpital par un autre dans le secteur du privé participant au service public hospitalier – nommée ASP –
• Une recomposition de secteurs psychiatriques entraînant la fermeture d’un établissement – nommée OSS

La question centrale de ce travail était de savoir si un modèle de gestion du changement propre aux restructurations hospitalières était identifiable. A cela, en analysant les 3 cas évoqués, les auteurs ont répondu oui, en dégageant 6 principes généraux:

1. Transformer les événements environnementaux en conditions favorables au changement
2. Gérer des temporalités
3. Développer l’apprentissage de la « connaissance d’une nouvelle réalité »
4. Arbitrer entre des approches volontaristes et négociées
5. Nouer des alliances pour créer un leadership collectif
6. La présentation du projet : entre explicitation et incomplétude

Ce qui me paraît intéressant, c’est que la définition de ces principes s’appuie sur des études de cas et en réalité je ne vois pas pourquoi ils ne s’appliqueraient pas à n’importe quel autre changement. On retrouve d’ailleurs dans ces principes des notions qui font penser à certaines des 8 étapes de Kotter comme le leadership collectif (coalition du changement pour Kotter), l’apprentissage de la connaissance d’une nouvelle réalité qui me fait penser à l’étape 1 de Kotter “créer un sentiment d’urgence”.

I couldn’t seriously have this change leadership blog without mentioning the work of John Kotter. His 8 steps for leading change model formed the basis of the knowledge and experience I personaly gathered in the field, first during my MBA, then in the consulting firm where I was employed. For those who are not familiar yet with these 8 steps, based on research about why transformation efforts fail, here they are :

1. Create a sense of urgency
2. Creating the guiding coalition
3. Developing a change vision
4. Communicating the vision for buy-in
5. Empowering people and removing barriers
6. Generating short-term wins
7. Don’t let up
8. Make change stick

This recipe for success has always been present in the change projects I worked on through various ways: to help designing the change program, to help analysing problems and identifying their solutions, to get new ideas and simply to use as a checklist during the change effort. My personal learning from applying the model and from hearing senior professionals advices, has told me that:

• The steps don’t necessarily have to be chronological, ie you can do step 3 while you’re doing step 1 and in fact…
• Step 1, creating the sense of urgency is continuous, it hardly ever ends because feeling this urgency during the whole process is what fuels people to action; and so as Kotter explains himself below, it is probably the most important of all steps

It seems to me (please tell me if you think I’m wrong) that no other framework has had such an impact on the way change is lead. A lot of people, consultants firms have come up with their own model, many of which are adaptations of Kotters in 3, 5 or 9 steps.

From knowing to doing

Nevertheless, one could argue that despite the widespread use of the model, the organistations’ ability to lead change hasn’t really improved:  success rate remains stuck at a worrying 30% . What does it mean? Is the model outdated? Do we need something new?

In his excellent online community of change mangement professionals, Rick Maurer, while looking for ideas for his next book, sparked a very interesting debate about what people felt was missing in the current literature. The conclusion was: nothing is, but what people need to do is to close the gap between knowing and doing. In other words, moving from doing the right thing to doing it right. To me that fits very much with what I’ve seen happening in organisations recently. An example of that is the necessity to generate quick wins. A lot of managers talk about quick wins but there are enormous differences in what they each call a quick win and how they actually make it happen. The same thing applies to  ”involving”: “we need to involve those guys” is what we hear all the time; yes that’s easily said but how? Do you consult them, do you empower them or do you just inform them?

This knowing-doing gap is probably one of the biggest challenges everybody faces today, because all the ideas, models, recipes, tools, methodologies are available, but what do we do, practically, what actions do we take and how? This is precisely why external help is still necessary but perhaps in different ways (many of you will be more qualified than me to verify that statement): more than knowledge it’s about skills like creativity, analysis, communication, rigour, energy and drive.

Kotter 2.0

So what does this leave us with, with regards to Kotter? The model is still valid as Kotter’s own research seems to prove and we need to get better at applying it by closing this knowing-doing gap. As we enter the entreprise 2.0 era, we have lots of new possibilities to communicate more interactively, to empower and collaborate, all of which are key levers to help us implement the strategy dictated by the 8 step model.