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DICK AXELROD AND EMILY AXELROD

Collaborative Loops

You never change things by fighting the existing reality. To change something, build a new model that makes the existing model obsolete.

—Buckminster Fuller

Making a Difference at Fraser Health Authority

The Collaborative Loops process—an engagement-based approach to organizational change—is making a difference at Fraser Health Authority.

Fraser Health, located on the lower mainland of British Columbia, is responsible for the delivery of all publicly funded acute and community health-care services for the 1.5 million people who live in the largest and fastest growing health-care region in Canada. In practical terms, this means everything from public health issues like immunizations, to end-of-life issues like hospice. In 2001, three separate health-care regions were merged to form this 23,000-person organization, which includes hospitals, clinics, nearly 2,200 physicians, and community health facilities. Fraser works within an annual budget of $1.8 billion.

The Collaborative Loops process brings dissimilar project teams together in a workshop setting to develop their own change processes. Rather than relying on a set methodology, people are freed to develop their own strategies. By providing frameworks and principles, participants are then able to use their own experience to create more effective change. The teams share insights and provide feedback, stimulating innovation and learning. This in turn strengthens the bonds within and among the teams and dramatically improves the organization as a whole. Each team learns to create a Collaborative Loop using the four engagement principles: (1) widen the circle of involvement, (2) connect people to each other, (3) create communities for action, and (4) embrace democracy. How all this occurs is described later in the chapter, but first, let’s learn about Fraser Health’s experience.

Here is what Susan Good, managing consultant for Fraser Health, has to say:

People in health care experience constant change. Most change methodologies don’t engage the people who have the direct knowledge or experience. The result: staff, managers, and physicians often report feeling devalued, disengaged. And we don’t get the business results we want.

Engagement values people by honoring their knowledge and experience. People come to work to make a contribution. When they are directly involved in designing and implementing important organizational changes, they are energized and the outcomes are better.

When we create Collaborative Loops, we learn how to create our own change processes. In doing so, we tap into the wisdom of people in our system.¹ Here are examples of projects that were designed and implemented by Fraser Health:

• Example 1: The Child Health Initiative team originally thought their purpose was to establish a central place where services such as immunization, vision and hearing testing, and counseling could be provided. To the team, this meant constructing a building that would cost millions of dollars. However, the team came up with an entirely different idea based on feedback from other teams in their Collaborative Loop: Child health services would be provided by a mobile van that cost $150,000. This van would take health services out into the community.

The team was able to let go of the building idea when they understood that their purpose was not to create a building but to provide health services to children. They got feedback from other teams in their Collaborative Loop that the building would probably go unused most of the time because it would be difficult for parents to bring their children. When the Child Health Initiative team focused on their purpose instead of the outcome, with the help of the other teams in the room, they developed the mobile van idea. Instead of spending millions, they spent thousands.

• Example 2: Teams across Fraser Health are using Collaborative Loops to reduce the time it takes to complete the hospital accreditation self-assessment process from six months to a matter of weeks. Accreditation is a bugaboo at any hospital. Everything grinds to a halt as teams work to provide the necessary documentation. The stakes are high: If an accrediting body takes away a hospital’s accreditation, the hospital will have to close its doors.

Normally done by small groups working independently, at Fraser Health, up to 80 participants provide feedback, rate effectiveness, and identify key actions/opportunities in a one-day Accreditation Conference. Key clinicians, physicians, and administrators are all in the same room working together. The results: decreased redundancy and duplication. Even though the self-assessment now involves more people, it takes less than a month, whereas before it took several months.

• Example 3: The first project at Fraser Health’s Langley Hospital helped long-term care patients become more independent so successfully that Langley decided to implement projects in the maternity unit, licensed practical nurse interface, registered nurse care delivery model, and total hip replacement unit. In the hip replacement project, the length of stay for patients was reduced by 33 percent. Rhonda Veldhoen, a nurse and manager of health services, describes what happened this way:

The change was amazing—the staff were so pleased to be part of the process. Previously, nurses, physical therapists, and other staff worked independently. It was the “not my job” syndrome. Now they work cooperatively. In the long-term care project, nurses learned that it wasn’t just the physical therapist’s job to walk the patient; if they were in the room, they could do it too. This results in more satisfying work for staff and shorter stays for the patients.

The Basics

The results in all these examples were achieved by applying three basic ideas (figure 1):

• Basic Idea 1—We hold a workshop with dissimilar project teams.

• Basic Idea 2—During the workshop, teams work together to create their own change process.

• Basic Idea 3—Organizational or community capacity builds when people learn principles rather than methods.

BASIC IDEA 1

Today, organizations and communities are implementing many changes simultaneously. They are improving their supply chains while installing a performance management system and incorporating lean thinking into the business. Communities are working to improve service delivery and upgrade their schools. These are not isolated events. The teams responsible for these changes need to understand how they impact one another.

Collaborative Loops brings multiple teams together in a workshop to learn how to design and implement their own change strategies. In most organizations, everyone has good intentions, but people work at cross-purposes. By bringing the network together, participants realize that they are bound together by a higher purpose: the overall success of the organization or community. In Fraser Health’s case, this meant improved patient satisfaction.

When people interact with those who don’t think the same way they do, new options are formed. When people see how others are working, they see what could be done differently in their own work. Everyone’s work is enhanced in this creative environment.

Figure 1. Collaborative Loops

BASIC IDEA 2

During a typical workshop, teams will:

• Examine the upside and downside of current change methodologies

• Examine the upside and downside of using the engagement principles

• Create a compelling purpose for their work

• Identify whom to include

• Develop the key events that make up their change strategy

• Learn frameworks and principles for designing collaborative gatherings

• Design their first gathering

Let’s sample what happens during a typical workshop by looking at how teams identify their purpose.

A Collaborative Loop has a meaningful purpose, but this is usually not the case in the beginning. Most teams responsible for bringing about change don’t know what they want to accomplish. They think they know it, but when you ask them what they’re trying to get done, you get different opinions.

Even if they have a purpose, the purpose they have is less than compelling to them. A nurse might say, “I want to make the emergency room experience more efficient.” By exploring why that is important to her, the nurse may eventually realize: “It bothers me when I see patients sitting out there for hours, when we could take care of them sooner. I want patients to get the care they deserve. I want them to be treated with dignity and respect.”

Discussions help teams become clearer about what they want to accomplish. Participants come to understand why their project is important to them and to their fellow team members. The nurse and everyone else in the group moves from a textbook understanding (making the emergency room more efficient) to a personal understanding of what needs to be done (giving patients the care they deserve).

In this workshop, in addition to working on the project, they provide feedback to others. People get so much value from having others look at and critique their work that they want to keep working together. One team might hear another team’s purpose and say, “I don’t even know what you are talking about.” This helps them realize that they need to clarify their purpose.

People learn from others, even when they’re working on parts of the organization that seem to have nothing to do with them. We advise them to copy ideas that they like and apply them to their own situation. It’s not a one-way process where they’re giving and not getting anything out of it.

BASIC IDEA 3

Dissimilar project teams come to a Collaborative Loops Workshop wanting to include people, but they don’t know how. They want tools. The workshop provides the most practical tool we know—the engagement principles: widen the circle of involvement, connect people to each other, create communities for action, and embrace democracy.

The principles are guides, providing direction, focusing on what needs to be done. Principles are not prescriptions; they don’t say what to do, rather, they help decide what to do. For example, say you wanted to build a room addition. If you were following a lighting methodology, the first step would be to open up your lighting handbook. You would look up the lighting standards for a 400-square-foot room and find out that you need a certain number of two-foot-square windows and standard light fixtures. In doing so, you would ignore other ways to make your room lighter, such as picture windows, skylights, mirrors, and bright paint.

If you follow a set methodology, you have only one way to light the room: two windows and one light fixture. If you use principles to guide your actions, many possibilities emerge.

While the engagement principles provide guidance for the overall change process, two other frameworks are needed: the “meeting canoe” and the “little e” engagement principles.

Any change process includes a myriad of meetings, workshops, training sessions, and large group events. Each of these represents an opportunity to engage people in your change process. In Collaborative Loops workshops, people learn to design their own collaborative gatherings using the meeting canoe (figure 2).²

Figure 2. The Meeting Canoe

The meeting canoe’s shape represents a discussion’s progress from beginning to end. Conversations begin with a welcome and reach their widest point as participants discover the current state and dream of possibilities. They begin to narrow as decisions are made and the meeting is brought to a close.

The “little e” engagement principles help people decide what happens in each part of the meeting.

Principle	Example
Take time to connect before discussing content.	Ask people what interests them, what is important to them, and why they care.
Engage the whole person through sight, sound, and movement.	Having stand-up meetings or taking a walk shifts energy. Incorporate music and art; they stimulate ideas.
Make the whole visible.	Create a living map of your organization or process. You’ll be surprised at what you learn.
Foster curiosity.	Take the opposite side of an issue. Instead of asking people how to make the project successful, ask them how they could make it fail.
Establish creative tension between the current reality and the future.	Create a mind map of current issues facing the organization. Ask people what they want to create in the future.
Take time to reflect.	Take a time-out, go for a walk, or sleep on an idea.
Ask for public commitments to create momentum.	Ask people what they would be willing to do in the next 30 days to move the process forward.

To summarize the basics, Collaborative Loops derive their power not just from the fact that people are able to design and implement successful change processes. They build Collaborative Loops between, among, and within the different project teams and with the people impacted by these changes. Most important, teams take what they learn and apply those lessons to new and different conditions.

Table of Uses

How to Get Started

First, you need to arrange a meeting with the sponsors of the project teams you think would benefit from using Collaborative Loops. Typically, we like to work with projects that are in the beginning stages, but we can also work with projects that are already under way. During this meeting we provide an overview of Collaborative Loops and ask the sponsors to examine the upside and downside of participating. Experience shows that a number of sponsors are interested in moving forward.

Once sponsors agree, each clarifies his or her project’s purpose, boundaries, and team composition. A robust group, representing different levels and functions and opinions works best.

Next, the sponsors need to meet with their teams and discuss their expectations for the work. Each team’s job is to engage the organization in solving a problem. The change effort isn’t to be created by some special group. Most teams don’t understand this right away; they think their job is to solve the problem and then sell their solution to the organization. Don’t worry if they don’t get this right away; they will eventually.

Once the project teams have been identified, they attend a Collaborative Loops Workshop. During the workshop, two things happen: The project teams develop their strategy for engaging the organization in the work, and the project team network is built.

Roles and Responsibilities

Now that you know what you have to do in setting up the process, there is also work for the sponsors, participants, and the facilitators.

Good sponsors are active. It’s more than meeting with the teams once and then forgetting about them. Periodic progress checks help make sure teams have the resources they need for success. Sponsors need to support the teams throughout the projects and let go when needed.

Sponsors should think about attending a Collaborative Loops Workshop with their teams. Why? Sponsors have ideas about what they want to happen, and those ideas may be essential parts of the plan. Certain information needs to be in the room.

Sponsors must be neither omnipresent nor among the missing. Leaders sometimes try to control a conversation to get the result they want. Other times, they don’t want to overinfluence the group, so they don’t say anything. When leaders go silent, people get nervous. Sponsors need to be able to give opinions without dictating. They must balance being available to the group and letting the group work on its own.

Participants have a special role in Collaborative Loops. Active participants—people willing to offer ideas, suggestions, and insights—matter. A few contrarians to stir the pot enrich the stew. People are not there just for themselves; they are also there for the network. Skepticism helps; when participants question the content, build on it using their experiences, and decide what is best for them and their organization, the projects succeed.

How do you find participants like this? One great way is to solicit volunteers. You may want to handpick some participants, but volunteers bring their own brand of energy. A combination of personally selected participants and volunteers usually works best. The participants should not expect to attend the workshop and then forget about it; they are required to implement the plans they develop.

Facilitators act as coaches supporting participants in transitioning from dependence on consultants to independence. Facilitators are there to give participants confidence in their own experiences and equip them to get where they want to go. The facilitator’s job is not to do the work for participants or to make them fit into a prescribed methodology. In the end, the participants decide what needs to be done. Facilitators provide models, frameworks, experiences, and coaching, painting pictures of what’s possible.

Facilitators strive to create an environment where people feel safe to do what they need to do. How do you create such a place? By working with their project; honoring their experiences. There’s no sitting in judgment, no attempts to prove what fits and what doesn’t. The goal is to help teams see possibilities that they don’t see in themselves and then support them in achieving what they want to do.

Outside facilitators can’t do this work alone; it takes assistance from people inside the organization who understand the engagement principles. Training internal people in the concepts, they can support teams during and after the workshop. If participants get in trouble, they know whom they can count on for support. They know that someone will coach them through a tough period. To this end, facilitators need to be available to the groups both during the workshop and on an as-needed basis.

This is a lot to think about; and it’s important. No doubt it is clear by now that Collaborative Loops is something you don’t use with trivial issues.

Conditions for Success

A meaningful purpose is critical. The work of the project team must matter. It must matter to the organization and to the team members. Team members must be able to articulate why this work is personally important to them not just to the organization.

Team composition is critical to success. You need a robust team made up people with diverse opinions, who have a stake in the outcome, and who possess the ability and authority to get things done.

Post-workshop support is important. After the workshop, a flurry of activity occurs as project teams begin to involve the organization in their work. Once they attend the workshop, your people will feel excited about the change effort, and if sponsors don’t support them, they’ll feel abandoned and betrayed.

This is an important point. Most leaders underestimate the excitement that is generated and are not prepared to support the teams. The teams that you send to the workshop will need time to meet and the resources to do their jobs.

Collaborative Loops requires courage. It’s not enough to say you want people in the organization to be involved in Collaborative Loops or even just to fund the process. At times, the solutions the teams suggest will require taking a stand, like the chief executive officer who refused to pass on increasing health-care costs to employees. Rather, he engaged employees in addressing the issue and implemented their recommendations, such as paying for health screenings, implementing wellness plans, and hiring a nurse to answer employee questions—all of which significantly reduced health-care costs.

The Theoretical Basis for Collaborative Loops

How did all of this come about? Peter Block founded the School for Applied Leadership and asked us, along with Kathie Dannemiller, Meg Wheatley, Peter Koestenbaum, John Shuster, Jamie Schotier, and Cliff Bolster, to join him. The school’s basis is to put the organization development skills of consultants in the hands of managers to bring together people from companies, government, and nonprofit organizations. We were teamed with Kathie Dannemiller to teach people how to do large group work.

We decided that the best way to equip people to do large group work was to teach them the underlying principles of what we did with our clients. For us, this meant teaching the engagement principles, which came out of the large group process we created, the Conference Model. What we saw over and over again in the School for Applied Leadership was that teams took these ideas and immediately applied them.

We started using what we learned in the School for Applied Leadership in different organizations. What we discovered about teaching others to create their own change processes eventually became Collaborative Loops.

Collaborative Loops are rooted in three constructs: open systems theory, adult learning theory, and democracy.

• Open systems theory: If you change one part of a system, you change the whole system. Living systems require feedback loops to maintain themselves. If you don’t get feedback on how you’re doing, you essentially die. These ideas play out in Collaborative Loops Workshops as teams give each other feedback. Different groups charged with making change do not operate in isolation. In the workshops, they provide each other feedback—outside information—to stimulate their thinking. This enables people to think differently and produces learning.

• Adult learning theory: Adults bring into a learning situation a whole host of experiences, something to be honored. Adults learn by doing, so they learn how to involve people by being involved themselves. Collaborative Loops Workshops are working sessions where people learn how to develop their change strategy by building it in real time. Workshop attendees often say, “Oh, you’re doing with us what you want us to do with others.” They get it.

• Democracy: We want to make change more democratic. Why? Because change becomes more legitimate when those impacted by it are included in its development and implementation.

For us, democracy is sharing information, involving others in decisions, and treating people fairly and equitably. It’s a mind-set about the way we work with others. Democracy is always bounded. Without boundaries, there is chaos. Democracy includes rights, rules, and responsibilities. By bringing more people together, our goal is not to create anarchy of the mob; rather, it is to benefit the whole by using the wisdom of crowds.

Democracy is embedded in what Eric Trist and Fred Emery call “minimal critical specifications.”³ We provide people with some core ideas, simple guidelines, and say, “go for it.” We don’t do for them what they can do for themselves.

Many people discount democracy by taking it to the extreme: “Does democracy mean we have to vote on everything?”For us, democracy is not an all-or-nothing proposition. We ask, “What can we do to treat people better?”“Can we share more information than we did before?”“How can we widen the circle to include more people?” Democracy is not just about voting. It’s bigger than that.

By now you must be asking yourself, “If I put all this time and energy into Collaborative Loops, how do I make sure the ideas get implemented?”

How Do I Sustain the Results?

It’s actually easier than you think. People sustain the results because they are not looking after someone else’s plan; they are implementing a plan that they developed. That is why you don’t need elaborate follow-up systems.

People sustain the results because they now have skills to design their own change process. When they meet an unexpected bump in the road, they know how to design alternate routes.

People sustain the results because they know they have support. They are connected to the project leader and to internal resources. They created new relationships during the workshop that help them with their project and make daily work go more smoothly. Teams are not left to flounder. Support is available if they need it.

Learning fairs, initiated by people within the company, help sustain the results. The teams come back together and share what they have learned as they worked on their projects. In these settings, teams learn from each other, pick up ideas, and renew their commitment.

People sustain the results because the culture begins to shift. One of the ways the culture shifts is reflected in the way people talk. Instead of asking how to get people to “buy into our plan,” they ask, “Whom do we need to engage to accomplish this?”

People sustain the results because they are successful. Their success is mutually reinforcing, so they want to do more.

Burning Question

In the back of the mind of everyone who participates in Collaborative Loops is this question: Is it worth my time? After all, the projects the participants work on aren’t part of their regular job assignment.

What people find out is that their concerns are unfounded. They develop a plan. They have access to more resources. Their team has coalesced around a goal. They’re working better together. They walk out feeling energized and supported. They walk out feeling their project isn’t so overwhelming. They have a direction. They have new tools. They come in not knowing how or where to start, and they walk out knowing where they’re going.

Final Comments

Most other change work involves a set design. With this process, the design is open and the principles are set. It’s not that the other processes don’t have principles. They do, but their principles guide you in following a set way of working. Here, the engagement principles guide you as you develop your own methodology.

Collaborative Loops is an open architecture. You could put ideas from Appreciative Inquiry, Future Search, or Open Space into Collaborative Loops and you wouldn’t be violating anything. They would work.

Participants often say that what they learn in Collaborative Loops workshop is common sense. We agree. Harriet Beecher Stowe called common sense, “The knack of seeing things as they are and doing what ought to be done.” Collaborative Loops workshops provide frameworks that enable people to organize what they know about change and use that knowledge to improve their organization or community.

About the Authors

Dick Axelrod ([email protected]) and Emily Axelrod ([email protected]) pioneered the use of large groups for change processes when they cocreated the Conference Model. Collaborative Loops extends this work, providing people with the principles and frameworks to create their own change processes. Dick authored Terms of Engagement: Changing the Way We Change Organizations. Dick and Emily, along with Julie Beedon and Robert Jacobs, coauthored You Don’t Have to Do It Alone: How to Involve Others to Get Things Done.

Where to Go for More Information

REFERENCES

Axelrod, Richard. Terms of Engagement: Changing the Way We Change Organizations. San Francisco: Berrett-Koehler, 2000.

———. “Why Change Management Needs Changing.” Reflections 2, no. 3 (2001): 46–57.

Axelrod, Richard, and Emily Axelrod. The Conference Model. San Francisco: Berrett-Koehler, 2000.

Axelrod, Richard, Emily Axelrod, Julie Beedon, and Robert Jacobs. You Don’t Have to Do It Alone: How to Involve Others to Get Things Done. San Francisco: Berrett-Koehler, 2004.

Beer, M., R. A. Eisenstat, and B. Spector. “Why Change Programs Don’t Produce Change.” Harvard Business Review 68 (November/December 1990): 158–166.

McCormick, M. T. “The Impact of Large-Scale Participative Interventions on Participants.” Ph.D. dissertation, UMI Dissertation Services, Ann Arbor, MI, 1999.

Passmore, W. A., and M. R. Faganz. “Participation, Individual Development, and Organizational Change: A Review and Synthesis.” Journal of Management 18 (1992): 375–397.

Senge, P., A. Kleiner, and C. Roberts, et al. The Dance of Change: The Challenges to Sustaining Momentum in Learning Organizations. New York: Currency Doubleday, 1999, 319–334.

INFLUENTIAL SOURCES

Bertalanffy, L. von. General Systems Theory. New York: Braziller, 1969.

Block, Peter. Stewardship: Choosing Service over Self-Interest. San Francisco: Berrett Koehler, 1993.

Emery, Fred E., and Eric L. Trist. Toward a Social Ecology. New York: Plenum, 1973.

Knowles, M. The Modern Practice of Adult Education. New York: Cambridge, The Adult Education Company, 1980.

Weisbord, Marvin, and Sandra Janoff. Future Search: An Action Guide to Finding Common Ground in Organizations and Community. San Francisco: Berrett-Koehler, 1995.

ORGANIZATIONS

The Axelrod Group—www.axelrodgroup.com

The Learning Consortium—www.tlc-usa.com

OTHER RESOURCES

E-learning program, How to Make Collaboration Work—http://axelrodgroup.com/training.shtml

The Collaborative Systems Reader newsletter—http://axelrodgroup.com/newsletter.shtml

1. Susan Good (managing consultant, Fraser Health), interview by authors, November 2005.

2. R. H. Axelrod, Emily M. Axelrod, J. Beedon, and R. W. Jacobs, You Don’t Have to Do It Alone: How to Involve Others to Get Things Done (San Francisco: Berrett-Koehler, 2004).

3. Eric Trist, “The Evolution of Socio-technical Systems: A Conceptual Framework and Action Research Program,” occasional paper, Quality of Working Life Centre, Toronto, Ontario.