The greatest challenge for the
change agent is to dare to dream in
the reality of the role
Why me as the agent of change?
What was the role and what makes up cancer at STV?
Change part 1 – driven by innocent enthusiasm
Change part 2 – driven by system and role awareness
Role development for improving sustainability of both
self and service
Why me as an agent of
Insider but with sales experience
Nurse – control and fix everything
What was the role and what
made up the service?
Health system influences
Disconnect in funding
Cultural silos and competition
Hospital drivers and barriers
Cancer business drivers (5 & 20)
Separate systems and independent operation
Conflicting primary task – activity V disease focus
the “anything else we want” clause
Change part 1 – driven by
First year - Redesign service and implementation
Strategic planning and governance
Research / grants / education
Second year – Reward and recognition
Third year – Business planning
Strategic alliances and modelling of CC
Fourth year – Commenced personal studies to
understand the change process - masters in
Design and development of cancer centre
Change part 2 – driven by
system and role awareness
Fifth year – Commenced personal role development work
New governance model
Change is now the STV reality
Approval to construct cancer centre
Development of patient case manger role
Development of integrated data and communication
Sixth year – construction to be completed
Staff to be relocated into new roles with new facilities
Cancer departments as well as teams to be integrated
Change provoke system changes and individual unrest
Differing agendas and identified the needed to
manage clinician buy in to maintain satisfaction of
multidisciplinary service delivery model
I felt responsible for the uncertainty aroused in
Role development to the rescue
Systems Psychodynamic Role analysis
(Newton and Long) helped me identify
how I was holding my role in my mind
Began the work of joining the dots between the reality
of the situation and the fantasy of my role
Role given V role taken - Impact of resentment and envy
The concept of boundary management
I must be flexible in the role I take up and it must be
customised to the system, people and situation.
Awareness and acceptance that change is difficult and
anxiety provoking and the role of the agent is to
recognise and manage this and facilitate containment
not necessarily lead the project.
Capacity to continue with a commitment to valuing the
power of influence and the role of followership
An understanding that real power in the system is
accepting the influence of role awareness and
Found the grace to accept the role of followership to
support others to take up their roles to the best of their
ability to manage the uncertainty of the change
process and therefore grow with the service changes.
Our deepest fear is not that we are inadequate.
Our deepest fear is that we are powerful beyond measure.
It is our light, not our darkness, that most frightens us.
We ask ourselves, who am I to be brilliant, gorgeous, talented,
And fabulous? Actually, who are you not to be?
You are a child of God...Your playing small doesn't serve the
world. There's nothing enlightened about shrinking so that other
people won't feel insecure around you. We are all meant to
shine, as children do. We are born to make manifest the glory of
God that is within us. It's not just in some of us, it's in everyone.
And as we let our own light shine, we unconsciously give other
people permission to do the same.
As we are liberated from our own fear, our presence
Automatically liberates others.
Thanks and good luck. Drop past for a coffee and a chat anytime.
You all know where to find me. cheers