Achieving a ‘yes’ to change

Author: Carl Davies

Recently I’ve been asked how I managed to get a ‘yes’ decision to major transformational change, in a climate of significant financial pressure.  The answer is more complex  and requires more discussion than can be written into a blog, but I thought presenting some simple considerations for dealing with complex health systems and the key decision-makers within them may be useful.  Throughout my time as a leader in healthcare,  it’s taken me time to learn lessons that I wish somebody had told me at the start of my journey.  I am sharing some reflections in the hope that this can help others facing resistance to change:

Understand the challenge

It is easy to consider the challenge of transformation to be “problem vs solution”.  If a ‘transformation journey’ is started with that belief, it is likely to lead to significant frustration.  The reality is, the problem is usually very obvious and the solution very simple. However, finding your way through a complex health care system, particularly the contractual and financial models and the personalities within them, are complex and  require an innovative approach to solving.  An appreciation and commitment to working through this is vital to making your case.

Understand the ‘person’

Key decision-makers will likely have a number of objectives and priorities.  In order to get them to see the benefit to your ‘idea’ or project, you need to demonstrate how it can help them solve some of their problems.  That means building a relationship with them, and genuinely trying to find ways to match your objectives to theirs.  If you only want to engage with them to know how you can ‘get’ what you want, you will likely fail.  If you can show them what you can ‘give’ them, you stand a much greater chance of success.

Use ‘no’ on your journey to ‘yes’

‘No’ often carries more power than ‘yes’ because it means you will have to change somebody’s mind.  Influencing people to change their current beliefs is complex, and again I’d urge you to try and get into their mind and understand their thinking.

If somebody gives you a ‘no’, chances are you haven’t properly understood the challenge or the person.  Go over those steps again, and consider if you have approached that with a view to genuine understanding and collaborative working, or whether you have simply brushed over them to understand how you can ‘get’ what you want.  Using ‘No’  in this manner will help you refine your case, which will subsequently improve your chances for ‘yes’ next time.

Achieving yes


Successful change is complex and the journey requires more than just an ‘idea’ or ‘problem vs solution’.  Understanding the challenge of making your way through a complex system, and understanding the people making key decisions is vital to success.  You must approach this with a genuine desire to ‘collaborate’ and ‘give’ to your partners (especially the key decision maker) rather than simply aiming to ‘take’ from them.  If somebody tells you ‘no’, there’s a good chance you haven’t tried to find a solution that ‘gives’ to others and solves their problem.  If your idea is sound, you’ve understood the challenge, the person and you’ve tried to match your own objectives to that of your partners, you will find that chances of success will significantly increase.