C7+D7 Katie Procter - Power of loose connections can build relationships - Impromptu Networking
Power of loose connections can build relationships Impromptu Networking
Speed Networking2 minute per person in pairsSpeak with 3 people you don’t knowAsk 2 questions: 1. What motivates you to be in healthcare? 2. What is your biggest challenge in healthcare?
The Speed Network• What did you notice when you spoke to people??• What happened in that process?
Speed Networking – Why start this way? What did you notice?•Encourages dialogue•Attracts deeper engagement around your questions•Invites stories to deepen as they are repeated•Gets you energized and engaged quickly•Allows everyone to participate despite learning styles
Speed Networking – keys to success•Start with a brief introduction•Make questions simple and one that everyone can participate in•Space: • Open • Movement across the room•Configuration: • in pairs • Speak to new people (Encourages new connections)• 3 rounds minimum•If you choose to share output in a group share back, do it carefully andpreserve confidentiality
Objectives for this mini-workshop• Experience and apply 6 aids to facilitate change in complex environments where behaviors are a challenge• Understand some of the theory that supports behavioral changes
Liberating Structures Liberating Structures Rapid innovation MinimumStructure or Control Maximum Liberation/Freedom More instant execution Lipmanowicz, McCandless
• First experience is enough to get you started•No mastery achieved!!! It is on-going!!!•LS are simple, powerful, and subtle•YOU will decide how to achieve results with your group•You can design a potpourri•Learn through practice while failing forward
From Keith McCandless – www.socialinvention.com
Min SpecsDon’t attempt to define the outcome or behavior of the system in detail Few rules
15 solutionsNoticing and Using the Influence, Discretion and Power Individuals Have Right Now What can YOU do right now to address your biggest professional challenge?
15 Keys to Success: 15% • Include routinely in meeting designs •Use in-the-moment to respond to opportunities •Make sure question or purpose is clear •Give yourself reflection time • Each 15% solution will add to your understanding of what is possible •Keep the spaces safe, share judiciously
TRIZ Teoriya Resheriya Izobreatatelskikh Zadatch Or TIPS Theory of Inventive Problem Solving
DESIGNING A PERFECTLY ADVERSE SYSTEM – A VERY UNWANTED RESULT OF YOUR WORK
Through creativity and idea generation, what can we discover together about our practicesthat contribute to the problem, and what must we stop doing to make progress around our purpose.
Examples in 2 key areas (there is nothing to say that you can’t use this at home)• For reducing harm to patients experiencing a safety lapse (wrong side surgery, patient falls, medication errors, iatrogenic infections) with cross-functional groups. “How can we reliably make sure that every patient receives a surgical site infection?”• For helping institutional leaders notice how it is they inadvertently exclude diverse voices. “How can we devise policies that only work for a select few?” “How can we build an IT system that no one will use?”
Some Topic Ideas if you can’t come up with your own:• Medication • Hand Hygiene Reconciliation • Healthcare Worker• Hospital Acquired Education Infections • Physician Engagement• Surgical Checklist • Emergency• Transitions of Care Department Access• Handovers • Catheter Associated Infection
Example: TRIZ – First Step• First reflect alone, then in yoursmall group, make a list of “todo’s” in answer to:•How can we ensure 100% of thetime that we get an unwantedresult? An ideal, reliable adversesystem?•5minutes – GO WILD!!
TRIZ – Second Step•First reflect alone, then in your group.Go down the list and ask:“ Is there anything on this list that wecurrently practice, even remotely?”•Cross out the ones that you aren’tdoing EVER•Tick the ones that you are doing LOTSor ALL THE TIME•Star the ones that need some work –that you might be doing SOMETIMES•Be unforgiving•5 minutes
TRIZ – Third Step •First reflect alone, then in your group, what needs to stop or change? •Take one item at a time and ask:“ How am I and how are we going to stop it? What would be thefirst move? What could I personally commit to stopping rightnow. What could we do in the next few days? Next week? Weneed leadership help? Organizational support? •Be as concrete as you can •Identify who else is needed to stop the activity •5 minutes
TRIZ – why use it?•You can speak the unspeakable – get elephants into the room•Make room for innovation and change•You stop doing nasty things – creative destruction – doinghard work in fun way•Substitute for visioning sessions•Builds trust•Builds momentum and commitment
TRIZ Success•Begin with spirit of serious fun•Don’t accept ideas to start something new– be suresuggestions are about stopping activities and behaviors,•You can do it in minutes, or hours in a big project•Begin with a very unwanted result•Take time to check out and be honest with what you arecurrently practicing that contributes to the harm•Include the people that will be involved in stopping theactivities that will be brought forward•Make real committed decisions aboutwhat will be stopped•Set a time-line – Now, tomorrow, in amonth
Large groups of peopleare smarter than anelite few, no matter howbrilliant – better atsolving problems,fostering innovation,coming to wisedecisions, evenpredicting the future.
Taking time to listen• It is important to have at least 4 people at each table as you want to have a challenge presenter/listener PLUS the wise crowd to do some creative problem solving for the presenter• It is important that the presenter/listener put their back to the table and just take notes – you will have some astonishing revelations by just listening• It is important to stick to the time allotted during the 8 minutes – it is really tempting to avoid those uncomfortable silences and idea pauses to conclude there is nothing more and to move on – PLEASE LISTEN TO THE TIME KEEPER and take advantage of the time that you have.
•2 minutes to present your challenge and answer anyquestions from your crowd• 4 minutes for your consult (in this time you will turn yourchair around to face away from the crowd. You will justlisten and take notes)• 2 minutes for debrief together to share what you heardand what insights you had.• 8 min per person at your table (total of 5 rounds today)
What is an idea that you have that might influence a behavior shift with a group of clinicians in your working environment/project? What would be your first step/PDSA towards that goal.Write your idea and your first step on the FRONT of the recipe card on your tables. NO NAMES BE REALISTIC WRITE LEGIBLY
•5 rounds of 20 seconds each•I will time you with bells•Pass cards around while moving around the room –do not look at the cards while doing so!•At the end of each round (bells), read the idea on thefront of the card•If you get the same card switch it off with someoneimmediately•Rate the idea from 0 – 5 (zero is not my cup of tea 5 sends me over the moon)•At the end of the 5 rounds you will have 5 numberson the back of the card that will total something out of25•Add the numbers
What is made possible?• A large crowd can generate and sort their bold ideas for action in 20 minutes or less!!• Helps spread innovations• Helps people to notice patterns in what emerges
• Innovations are owned and more likely to endure• Sparks synergy and coherence in diversity (difference)• Gives novice innovators a bold voice
Ideas for where to use• Prioritizing ideas and bringing coherence after a meeting• For illuminating bold ideas at the start of a conference or task force meeting
Variations• Ask “If you could un-make one decision that is holding us back, what would it be? What is your first step to un-make it?”• Ask “What courageous conversation are we not having? What first step could spark our courage?”• Ask “What do you hope can happen for us in the future? What practical first step can you take now to tip the balance in this direction?”
You can stackyour ideas on awall or a posterlike a stack ofcards!!
REFLECTIONS • Personal and organizational changes • You don’t need certification •Get started with a partner •Culture eats strategy for lunch – we must begin to change behaviors in innovative ways by tackling habits, values and beliefs
Liberating Structures Concepts and a little theory • Experiential learning with minimal “telling” and maximal self-discovery •You can weave them into themselves and other improvement work that you are doing •Easily applied to your own complex challenge •They draw out and build on the direct experience of everyone in the room • Use minimum structure to liberate the maximum innovation. “Min Specs”
www.liberatingstructures.com Keith McCandless and Henri Lipmanowitz/Plexus Institute 2004
Why on earth would anysensible healthcare leader, And that means YOU! Be interested in complexity science?
Frustration Strategic planning isn’t working like it should be – the future is unpredictable and emerges from interrelationships Traditional methods aren’t working anymore – top down nope! Doing to the system breeds apathy over time.
Have you seen these behaviors? Aggression, Forcing Buy-In Over- Secrecy and Invulnerability Control Over-extension and Burn Out NOT Taking Responsibility Dependency Blame and Mistrust Caution + Gaming the SystemAdapted by Keith McCandless in part from Bob Anderson,“From Patriarchy to Partnership”
We can ask someseriously important Withquestions of our Complexitysystem and explore! and LS• How does change happen?•What are the conditions forinnovation?• How do creativity and potential getreleased?•How do they get trapped?•How can we change behavior?
We get NEW Behaviors… Asking Questions, Asking for Help, Listening Relying On & Inviting “Local” Discovery Letting Go Removing Barriers To Innovation Working Interdependently Taking More Responsibility, Ownership with Shared Accountability Seeking Expertise, Not Rank Self- Sharing Information Freely Organization Seeking Multiple Interpretations; Risking Multiple ActionsAdapted by Keith McCandless in part from Bob Anderson,“From Patriarchy to Partnership”
Power in Relationships Not fixing Not fixing system partsNotfixingpeople
Performance naturally emerges out of the relationships and interactions on the frontline through the art of the questions and guidance.
Unleashing is all about Engaging your PEOPLE developing SKILLS, changing BEHAVIOR, INSPIRING & MOBILIZING them51
LS & Other Improvement Methods DIFFERENCES SIMILARITIES • Fits entangled & everyday problems with behavioural components• Leadership support is vital • Leaders must believe solutions• Clear goal is required already exist among those whose• Metrics and data necessary behaviours need to change• Front-line engagement is • Facilitators guide “unleashing” of required tacit and latent solutions• Multidisciplinary team • Extensive participation & involvement is important measurement by front-line staff• Teamwork, communication • As solutions surface, efforts expand are key elements beyond initial expectations• Small tests of change are • By invitation, not assignment helpful • Many improvement discoveries are acted on immediately because there is local-social proof they “work” Lipmanowicz, McCandless 52