org transformation proposal

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MSF-USA ORGANIZATIONAL TRANSFORMATION Implementation Plan, December 2017


Executive Summary

DESIRED FUTURE We heard from both Executive Director and Chief of Operations that MSF-USA wants to have increased ability to respond to change through removing the constraints to speed. Key three elements are: Portfolio Aligned to Value Clear alignment across all functional areas of the organization to user-focused outcomes. This allows the organization to achieve maximum impact.

Value Driven Funding

Continuous Innovation

Evidence-based funding methods enabling teams to solve problems, not just work on projects.

Quick cycles between new ideas, validation, and measurement of the value to end users. This fosters an innovative culture within the organization.

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Current State

INSIGHTS FROM TW In order to create the journey to the change, we must have clear understanding of where we are.

Benefits of the culture MSF-USA is uniquely positioned in this transformation journey. The culture of the organization that values people over efficiency, non-hierarchical over hierarchical system where command and control is primary ways of working, makes the organization one step ahead in this journey than any other organization.

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Current State

INSIGHTS FROM TW Barriers to future state During years of working with MSF-USA, TW identified a few challenges that are barriers to achieving the desired future. Complex Environment

Ambiguity

Cognitive Overload

MSF-USA operates in a complex environment where many external changes impact the organization. This requires MSF-USA to be more responsive to face unknown future challenges.

Needing to meet too many requirements (e.g. OCP, MSF-USA, Patients, Expats) without clear understanding of the relationship between them creates confusion and frustration among people. It also leads to ineffective outcomes.

With limited resources, there are many objectives to achieve at a given time. This is not helpful for people needing to switch context constantly and not able to deliver outcome fast enough.

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1.0 FUTURE STATE


Future State

LEADING ADAPTIVE ORGANIZATION Executive: Organizational Vision, Goals and Strategies are clearly articulated by executive and used to drive decisions at the next level.

Adaptive Leadership

Aligned to Outcome

Clarity of Purpose

Impact-Driven Investment

Adaptive Leadership: Leading through uncertainty Aligned to Outcome: Understanding what is truly important to the organisation Clarity of Purpose: Articulating where you are going and why it is important Impact-Driven Portfolio: Focusing on delivering outcome

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Future State

END USER FOCUSED PROGRAMS Management: Lean and Agile practices are used to manage departments and projects to deliver outcome to the organization as defined by its goals. Service Aligned Teams Responsive Programs

Lean Portfolio Management Patient/ Field Focused Continuous Innovation

Patient and Field Focused: Needs, desires and satisfaction of the patient and field are key drivers Service Aligned Teams: User focus is enhanced by aligning teams around the services they use Lean Portfolio Management: Adaptability and flexibility are supported by lightweight governance Responsive Programs: Responsiveness is achieved by stripping away unnecessary complexity Continuous Innovation: Innovation is an integrated part of the overall planning process

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Future State

OVERVIEW Working groups: Lean and Agile practices are used to design initiatives to deliver outcome to the organization.

Continuous Improvement

Data & Analysis

Continuous Delivery

Lean Project Definition

Lean Project Definition: Lean and Agile principles are used to rapid project definition Continuous Delivery: Projects deliver outcomes quickly and continuously to end users Data & Analytics: Delivery of outcome is continually monitored and fed back to the organisation Continuous Improvement: A culture of continuous improvement promotes a mindset of adaptability (personal growth through feedback) 8


Future State

OVERVIEW Adaptive Leadership

Aligned to Value

Clarity of Purpose

Outcome Driven Investment

Executive: Leading Adaptive Organization

Service Aligned Teams Responsive Programs

Lean Portfolio Management Patient/Field Focused Continuous Innovation

Management: End User Focused

Continuous Improvement Working Groups: Practicing Agile

Data & Analysis

Continuous Delivery

Lean Project Definition 9


2.0 THE APPROACH


Thin Slice

APPROACH TO CHANGE When it comes to evolving ways of working, it requires that change happens at many different levels and scales; from individual to organizational structure.

LEADERSHIP

ALIGNMENT PATIENT/ FIELD FOCUS VALUE DELIVERY THROUGH AGILE

TW’ method is designed to show the future quickly, by creating and managing this evolution through testing thin slices. By thinly slicing four key layers—leadership, alignment, end user focus, and value delivery—we can stress test the organization and learn about the best way to create sustainable change. 11


Thin Slice

APPROACH TO CHANGE Experiencing the future through a thin slice allows more people at the organization to become believers. The efficacy of the approach creates an increased momentum for change among the culture.

LEADERSHIP

ALIGNMENT PATIENT/ FIELD FOCUS VALUE DELIVERY THROUGH AGILE

The outcome of a thin slice approach is greater visibility of the constraints and low hanging opportunities for improvement. At the completion of the first thin slice we can add another to test out scaling patterns. By the third or fourth thin slice, momentum will take over. Each layer on its own is valuable but the greatest impact lies in connecting all four layers to provide the amplification needed to create real change. 12


Thin Slice

SUGGESTED THIN SLICE We believe thin slicing within the Field HR department is a good place to start. FHR is uniquely positioned to serve both MSF-USA and OCP. It has clear end users (expats) that can validate the value and it aligns closely with MSF’s vision.

LEADERSHIP

Help guide the Executive Director and FHR director on how to lead and champion the pilot team in FHR with new ways of working (e.g. lightweight governance).

ALIGNMENT

Align pilot team’s goals to organizational goals and visualize the alignment.

PATIENT/ FIELD FOCUS

Set up a pilot team which centers around the field and service they provide.

VALUE DELIVERY THROUGH AGILE

Within the pilot team, use test and learn to deliver value quickly to the patient and field. This might require building a testing environment (e.g. data collection).

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3.0 ACTION PLAN


Action Plan

ROADMAP 2-3 WEEKS

Change Management Foundational ๏ Change Competence Rating ๏ Establish Governance Team ๏ Identify & Establish Pilot Team (Thin Slice) ๏ Visualize Value Stream ๏ Visualize Current Work

1-2 WEEKS

12 WEEKS x

Form Pilot Team

Run Pilot Team

๏ Establish Pilot Team ๏ Define Success Criteria and Measurement Plan ๏ Workplan & Initial Story Backlog ๏ Lean Portfolio Management Kick-off ๏ Expat Focused Team

2-3 Times* Pivot Point

๏ Capacity Building Activities ๏ Aligned to Value ๏ Identify and Implement New Measurement ๏ Lean Portfolio Management ๏ Expat Focused Team ๏ Build Feedback Loop with the End-user (data collection)

Oct 2018

2019 Annual Planning

๏ Report and Review of The Pilot Team(s) ๏ Plan Aligned to Value ๏ Identify New Measurement ๏ More Functional Teams Ready for New Ways of Working

Executive Support ๏ Maturing agile leadership ๏ Helps define value, the principles and metrics to prioritize work ๏ A clear understanding of the elements that make up value to the organisation – and those that don’t

Governance

๏ Regular Change Management Team Meeting ๏ Progress Report ๏ Risk Mitigation (RAID) *Times for change work sprints would be adjusted depending on external schedule at MSF-USA; summer vacation, U.S. holidays, etc.

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Action Plan

TEAM COMPOSITION 2-3 WEEKS

Change Management Foundational

1-2 WEEKS

12 WEEKS x

Form Pilot Team

Run Pilot Team

๏ Specialist (70%) ๏ Transformation Lead (70%) ๏ Program Manager (70%)

๏ ๏ ๏ ๏

3 Times

Transformation Lead (50%) Org Design Lead (20%) Program Manager (70%) Business Analyst (100%)

Oct 2018

2019 Annual Planning ๏ Org Design Lead (50%) ๏ Program Manager (50%) ๏ Business Analyst (100%)

Executive Support ๏ Transformation Lead (30%) ๏ Org Design Lead (50%) ๏ Communication Design (30%)

๏ Transformation Lead (20%) ๏ Org Design Lead (80%) ๏ Communication Design (30%)

๏ Org Design Lead (50%) ๏ Communication Design (50%)

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4.0 BIG PICTURE “HOW”


Journey to the future state

HOW TO START We believe that we are in the Stage 1 currently, will be in Stage 2 most of 2018. Based on the outcomes of the thin slice we intend to transition to Stage 3 by end of the 2018.

• Understand what the future of your organisation could look like and current state • Design the journey required for change • Demonstrate value early

• Self-sustaining culture of collaboration and acceleration

1 SETTING THE FUTURE

SUSTAIN

4

2

EXPERIENCI NG THE FUTURE

SCALE

3

• Rapidly create capability amongst team members internally • Create proof points of success • Develop critical mass and embed into organisation, whilst learning

• Scale across portfolio / organisation, focus on impact. • Adopt new ways of working

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Journey to the future state

1. SETTING THE FUTURE: UNDERSTAND, DESIGN & SHOW

OUTCOMES: •

A clear understanding of the vision and strategy for the organization

An understanding of the approach to change and actions for each leader to participate and lead change within their own teams

A view of the resources required to enable the change across the organization

A set of possible options to establish change across the organization

POTENTIAL ACTIVITIES:

FRAME PURPOSE AND OUTCOMES

FORM A TEAM TO DRIVE THE CHANGE

STUDY HOW VALUE FLOWS THROUGH THE ORGANISATIO N

VISUALISE THE JOURNEY

VISUALISE THE CURRENT WORK

DEVELOP A ROADMAP FOR OUTCOMES

Activities will be determined based on discussion with the team.

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Journey to the future state

2. EXPERIENCING THE FUTURE: SHIFT

OUTCOMES: •

POTENTIAL ACTIVITIES:

A learning culture and new work practices to drive incremental change

Seeds of organizational change with functions focused around realisation of the value

Increased confidence and autonomy in decision making for individuals and teams

Measures that keep actions connected to our strategy and drive the right behaviours

Assets to support growth (e.g. resources better positioned to deliver patient/expat value: project management, portfolio management… etc)

Activities will be determined based on discussion with the team.

FORM EXEMPLAR / PILOT TEAMS

CREATE FUNCTIONAL ALIGNMENT

IDENTIFY & IMPLEMENT NEW MEASURES

BUILD ASSETS TO DELIVER VALUE

DEVELOP PLAYBOOKS

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Journey to the future state

3. SCALE

OUTCOMES: •

More of the organization onboarded to new way of working

New teams launched without ThoughtWorks support

All functions focused around realisation of the end user value

Improved decision making at all levels of the organisation

Assets to continue building scale

4. SUSTAIN

OUTCOMES: An organization that is self-sustaining without ThoughtWorks support

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Journey to the future state

ROADMAP: 4,000 FT. VIEW

Sustaining the future Scaling the future Experiencing the future Setting the future Current state: Understanding and articulating the desired future Design the journey for change (e.g. competence assessment, roadmap, work plan, activity backlog)

Create the change through pilot team: Thin slice through change pilot team

Scale: More of the organization is onboarded to change

Sustain: Continue practicing new ways of working Continue growth in portfolio, leadership, individual capabilities

Pilot team become change agents and leaders Multiple change Initiatives

Activities may include: Portfolio management Project management User-centered project mgmt. Capability building

Showing the value of the change 22


5.0 APPENDIX


Appendix

OVERVIEW Adaptive Leadership

Aligned to Outcome

Clarity of Purpose

Impact Driven Investment

Executive: Leading Adaptive Organization

Service Aligned Teams Responsive Programs

Lean Portfolio Management Patient/Field Focused Continuous Innovation

Management: End User Focused

Continuous Improvement Working Groups: Doing Agile

Data & Analysis

Continuous Delivery

Lean Project Definition 24


Future State

EXECUTIVE Leading Adaptive Organization Organizational Vision, Goals and Strategies are clearly articulated and used to drive decisions at the next level. ● ● ● ●

Adaptive Leadership: Leading through uncertainty Aligned to Outcome: Understanding what is truly important to the organisation Clarity of Purpose: Articulating where you are going and why it is important Impact Driven Portfolio: Focusing on delivering outcome

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Future State: Executive

ADAPTIVE LEADERSHIP Adaptive Leadership: Leading through uncertainty ● ● ●

Humanitarian space is increasing in complexity and complication Its is becoming harder to predict where disruption and challengers may come from The traditional hierarchical, command and control approach to running an organisation is not suited in a time where adaptability and resilience take precedent and organization agility is paramount To survive executives are turning to the models and principles of adaptive leadership to transform their organisations to lead through uncertainty and change

Key Adaptive Leaders Mindset ●

● ●

Adaptive: Accepts and embrace ambiguity and change over ‘perceived’ certainty and clarity of a defined plan Exploring: Envisions and Evolves rather than Plan and Do Facilitating: Enables, collaborate and importantly clarifies direction towards purpose amid confusion rather than dictates and drives Riding Paradox: ”And” rather than “Or” leadership, viewing issues from different perspectives, gathers data without undue prejudice to formulate both/and rather than either/or solutions. ○ Accountability versus Autonomy ○ Hierarchical control versus Selforganization ○ Predictability versus Adaptability ○ Efficiency versus Responsiveness 26


Future State: Executive

ALIGN ORGANIZATION TO OUTCOME Understanding the Outcome (Impact) ●

There is a fundamental difference between change and transformation: Change fixes the current and the past. Transformation creates the future To truly transform you need to redesign the entire organization around what is valuable to the organization In practical terms this means changing; ○ How you are structured ○ How people are measured and rewarded ○ How your HR policies are written ○ How your systems and processes are architected to deliver outcome

● ●

● ●

Understand your organization's value stream What needs to change to deliver your vision, goals, strategy, improve outcome and therefore provide organisational benefit Do you have the right team and structures in place to deliver current and future impact How will you measure performance going forward

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Future State: Executive

CLARITY OF PURPOSE ● ●

Leaders provide their teams with clarity of purpose, the ‘why’ People need to know why the organization (MSFUSA) exists. They want a reason to support the organization and the people in it “Conveying strategic intent is one of the skills essential to aligning people across an organization to reach a common goal - leaders must then rely on the people’s ingenuity for getting there” 1 Adaptive leaders define and articulate the Vision, Goals & Strategy and understand their role is to focused on the destination not the route to create an environment that promotes autonomy, mastery and purpose, to motivate their teams It creates the safe environment for people to learn from testing and failing without fear

Alignment Enables Autonomy ●

“The stronger the alignment, the more autonomy you can grant because you don’t have to worry that people are going in a million different directions” 2 “The leader’s job is to communicate what problem needs to be solved and why, and the team collaborate with each other to find the best solution.” 2 Executive teams need to align and own the vision, goals and strategy that drives autonomy

1 - https://hbr.org/2010/11/four-lessons-in-adaptive-leadership 2 - Henrik Kniberg - https://labs.spotify.com/2014/03/27/spotify-engineering-culture-part-1/

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Future State: Executive

IMPACT DRIVEN INVESTMENT ●

● ● ●

With such a fine line between success and failure, portfolio decisions need to be based on facts - not guesswork, political agendas, intuition or the opinions of the loudest voice in the room Successful portfolios are anchored by a clear articulation of impact with impact based on what is impact to your patient and field as opposed to what is a benefit to the organisation Successful organization recognise benefits are a product of delivering impact Utilize a systematic and open process of prioritization and investment allocation to drive organizational benefit Focus beyond budgeting and look to break cycle of 12 month planning where success is measured by time and cost not impact

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Future State

MANAGEMENT End User Focused Lean and Agile practices are used to design initiatives to deliver impact to the organization as defined by its goals. ● ● ● ● ●

Patient/Field Focused: Needs, desires and satisfaction of the patients and field are key drivers for the organization Service Aligned Teams: Patient focus is enhanced by structuring the organization around the services they use Lean Portfolio Management: Adaptability and flexibility are supported by light-weight governance allowing high levels of responsiveness to change Responsive Programs: Responsiveness is achieved by stripping away unnecessary complexity and using evolutionary design and planning Continuous Innovation: Innovation is an integrated part of the overall planning process, and commonly owned by the Service teams 30


Future State: Management

PATIENT/FIELD FOCUSED

SERVICE ALIGNED TEAMS

Putting patient/field (end user) at the center of strategy to ensure that MSF-USA always deliver highest value to them

Align organizational structure around maximizing impact to the end user

● ● ●

End user research and insight User centered design End to end service design (looking through the lense of patients/field)

● ● ●

Teams structured around the services that end user consume Effectiveness is valued over efficiency Ownership of service delivery empowers teams

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Future State: Management

PORTFOLIO MANAGEMENT

RESPONSIVE PROGRAMS

Lean and Agile principles are applied to managing opportunities and change over a number of horizons (H1, H2, H3)

End user focus, service aligned teams and lean portfolio management allow programs of change to be highly responsive

● ● ● ●

Work is prioritized according to urgency and impact Work is broken into small chunks to support incremental and iterative outputs Progress is monitored on an ongoing basis Blockers are dealt rapidly

● ● ●

Remove unnecessary organizational complexity through shared knowledge Lightweight requirements management Incremental and Iterative delivery

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Future State: Management

CONTINUOUS INNOVATION Innovation is built in element of the organization ● ● ● ●

Innovation is expected and budgeted for It’s managed through portfolio management approach Structured around delivering impact to end users through services that organization provides Success and potential for future investment determined by what has been achieved and potential future achievements

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Future State

WORKING GROUP Doing Agile Lean and Agile practices are used to design initiatives to deliver outcome to the organization. ● ● ● ●

Lean Project Definition: Lean and Agile principles are used to rapid project definition Continuous Delivery: Projects deliver outcome/impact continuously to end users Data & Analytics (Learnings): Delivery of value through products and services is continually monitored and fed back to the organisation Continuous Improvement: A culture of continuous improvement promotes a mindset of adaptability

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Future State: Working Group

LEAN PROJECT DEFINITION

CONTINUOUS DELIVERY

Maximize value for developing new services or major enhancements

Capable of delivering continuous outcome to end users by meeting their existing and emerging needs

● ● ●

Focus on early realization of value through thin slice testing Lightweight estimation and Agile planning to minimize project planning and setup time Empowered cross-functional team to shape delivery and form core of ongoing team

● ● ●

Visualized workflow Multi-skilled teams focused on end user value and domain knowledge Culture of ‘Plan, Deliver, Test’ removing silos and unnecessary steps

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Future State: Working Group

DATA AND ANALYTICS

CONTINUOUS IMPROVEMENT

Evidence based decision making

The key component of adaptiveness

● ●

Data is collected with a clear understanding of its impact to the organization Data feeds all aspects of decision making to ensure that the value/potential of ongoing investments are clearly understood Data and Analytics can be easily revised as new definitions of value emerge

● ●

Beliefs such as ‘test & learn’ and ‘controlled risk taking’ are ingrained in the organisational culture Open and honest constructive feedback is commonplace and valued Value based behaviours are well understood, recognised and rewarded to reinforce culture

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END


Executive Summary

TW COMMITMENT FOR SUCCESS We are excited to create a dedicated team with expertise in program management and organizational transformation advisory that will enable MSF-USA to walk this journey. This team will include executive coaching and change management as well as onthe-ground analysis and service design support at the department level. We are excited to provide XYZ commitment....

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Executive Summary

MSF-USA COMMITMENT FOR SUCCESS Setting a contract of investment will allow you to best prepare for the change to come. This means:

A long term commitment to change by the executive group. A prioritized investment in building executive, team and individual capability with clear decision-making rights that support transformation. An engaged Executive stakeholder, who is prepared to spend time with our TW team every day.

Engaged stakeholders at all levels, especially internal leadership, who are willing to execute the transformation as a partnership with TW. An engaged leadership committed to reinforcing the what and the why of transformation throughout the transformation journey.

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Executive Summary

PARTNERSHIP FOR SUCCESS By meeting the success conditions executive and leadership partnership can deliver:

A compelling case for change, that can unite the executive group and inspire leaders and people across the organization. A clear what and why for transformation that is communicated simply, clearly and repeatedly to people throughout the organization. A plan for those roles who will be most affected by the change and most likely to block progress of the transformation.

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