# Presentation: 700197

## Transformation:Just Do It (and We Can Help) 

**A. Kathryn Power, M.Ed., Director**
**Center for Mental Health Services**

- May 3, 2007
- Philadelphia, PA

## Defining Transformation

*...**a continuous process, without end,**meant to create or anticipate the future  *
*...**identifies, leverages, and even creates new **underlying principles for the way things are done*
*...**identifies and leverages new sources of power  *
*...**once the process is begun, a profoundly different organization emerges, including changes **in structure, culture, policy, and programs*
**	****	**Retired Vice Admiral Arthur Cebrowski
- 	Special Assistant for Transformation, U.S. Department of Defense

## Conceptualizing Transformation: Achieving the Promise

**Envisions an ideal system**
- 	Consumer-driven care, focused on recovery
**Establishes broad goals to achieve vision**
- 	Excellent mental health care is delivered, and research is accelerated
**Identifies broad pathways to achieve each goal**
- 	Accelerate research, advance evidence-based practices, improve and expand the workforce, and improve the knowledge base in understudied areas

## Conceptualizing Transformation: Delivering for Mental Health*

**Identifies key service elements requiring change**
- 	Manage better admission to, and discharge from, the hospital
**Characterizes the commitment to change**
- 	Provide more effective care in the community and avoid  inappropriate admissions by achieving acute crisis standards by 2009
**Sets measurable performance targets**
- 	Reduce the number of readmissions of people who have been in the hospital for more than 7 days during the previous year by 10% by the end of 2009

- *Available from the Scottish Executive Web site at www.scotland.gov.uk

## Conceptualizing Transformation: The Best Health System in the World*

-  **Identifies major strategies for change**
- Increase transparency and reporting on quality and costs
-  **Substantiates strategies by looking for  models of success**
- State quality reporting efforts ongoing in California, Minnesota, New Jersey, and New York

- *Available from the Commonwealth Fund Web site at www.cmwf.org

## Strategies for Transformation

- Continuous Small Steps
- A  focus on core missions, improving what the system is already doing

- Series of Many Exploratory Medium Jumps
- Pushing the boundaries of core competencies, trying to create something new within the existing paradigm

- A Few Big Jumps
- New rule sets that leverage new ideas

**Strategies for Transformation**

## Dimensions of Transformation

**Culture**—the understandings, beliefs, and practices that define and shape human reaction to change
**Concepts**—structured approaches to expressing how a course of action might be accomplished for current or future systems, supports, and services
**Authorities**—changes in public laws or regulations that may be needed to implement transformation
**Processes**—the changes in steps, tasks, and procedures needed to implement concepts or apply capabilities
**Capabilities**—techniques, tools, and systems that may be required to execute a specified course of action
**Organizational design**—the change in an organization’s division of labor that may be needed to bring about desired results

**Mental Health Services Are **
**Fundamental to Overall Health**

- Do you agree or disagree that health services that address mental health, such as treatment for depression and suicide prevention, are fundamental to overall health and should be part of any basic health care plan?

**71%**

**20%**

**6%**

**3%**

- Source: “America Speaks on Suicide” (2004), Charlton Research Company for Research!America and SPAN USA

## Commonwealth Fund

**Three Paradigms of Organizational Life**

- First objective
- Nature of organization
- Source of power
- Source of credibility
- Orientation to authority
- Orientation to elite
- Orientation to planning
- Communication patterns
- Strategic complexity
- Behavior patterns
- Ease of understanding
- Source of paradigm

- Personal survival
- Technical system
- Technical   competence
- Technical standards
- Cynical
- Rational confrontation
- Rational-tactical
- Factual
- Simple
- Conventional
- Comprehensible
- Professional training

- Personal survival
- Political system
- Effective transactions
- Organizational position
- Responsive
- Compromise
- Rational-strategic
- Conceptual
- Complex
- Conventional
- Comprehensible
- Administrative socialization

- Vision realization
- Moral system
- Core values
- Behavioral integrity
- Self-authorizing
- Complex confrontation
- Action learning
- Symbolic
- Highly complex
- Unconventional
- Nearly incomprehensible
- Personal rebirth

- Paradigm

- Individual
- Contributor

- Leader

- Manager

- Technical

- Transactional

- Transformational

## Though we often prefer to believe that nothing can be done about the...problems we face, there comes a time when we have to take on the system because the system needs to change.  There comes a time when we need to “just do it.” 

- Robert E. Quinn, *Deep Change:*
*Discovering the Leader Within* (1996)