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Steven Allder, "Everything is design. Everything!" - Paul Rand

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Steven Allder, Consultant Neurologist on designing for clinical change presentation at "Everything is design. Everything!" - Paul Rand event.

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Steven Allder, "Everything is design. Everything!" - Paul Rand

  1. 1. Everything is design. Everything Dr Steven Allder Consultant Neurologist
  2. 2. Introduction My Background • Doctor • Clinical Researcher • Consultant Neurologist • Interest in ‘Hysteria” • Management, leadership and Improvement • Harvard Executive Development Programme My view of title and talk • Wow! • Resonated • Resonated but, BUT… • Design is essential but on its own not sufficient • Design is a social process • Embedded in a social system • To fully exploit what design can offer societies: • we need to cultivate our understanding of these social elements = MIND • DESIGN of our MINDS
  3. 3. Phase 1 Phase 2 Phase 3 Phase 4 Back to start! I will be 68! Born Qualified Consultant
  4. 4. The Healthcare challenge Stability of growth of current system
  5. 5. There is hope!
  6. 6. Redesigning health care is possible…
  7. 7. My results were bewildering… CVA1 N1 4hr RTT CVA2 Medicology CVA3 Strateg y JT Taunt on Step 1: CT SA own service SA CD 8/2006 AMD NSS AMD post FT CVA performan ce FT Via JDY Step 2: ACT 1 - Analysis SA LOS IP SA SA SA FT risk table Mine- theirs SL Good Step 3: ACT 2 Deliver change SA Via attendi ng Via OBS Via Dept Via redesign Medicology SW vs ESD Manda te Progra m Step 4: Provoke SC JDP AW PDR GV/PV loads CST Strategic implicatio ns Await AJ In all 5! Step 5: Name and see TR TR IC after crisis PV after crisis Ian yes Yes 1:1 Dec Step 6:SMT PLAY and explore Step 7: Experimen t 2 Step 8: Roll-in Won.. Lost.. Won.. Battle Won.. Lost Won.. Lost Supporti ve Lost.. Lost Bury me Mana ged better ! DESIGN ALWAYS APPLICABLE! SMALL SCALE SUCCESS! LARGE SCALE FAILURE!
  8. 8. A sudden insight… These board meetings feel like my consultations with my ‘hysterical’ patients! LEON FESTINGER Cognitive dissonance
  9. 9. Design of the Mind: Three Loops Stimulus 1. Innate Wisdom 2. Conditioned Intuition 3a. Reasoned Judgement Delivered Action Outcome 3b. Action Logics Moments: Embedded in streams activity 500- 700ms Ever present: Move Towards or Away Controversial idea Implicit learning ‘Good’ (Automatic) ‘Bad’ (Should) Explicit awareness: Own view, Choices and decisions Action Options: Create Deliver Avoid Outcome: Who’s ‘Truth’ Extended choice theory Learning Loop (s)
  10. 10. Design of the Mind: Temporal development Stimulus 1. Innate Wisdom 2. Conditioned Intuition 3a. Reasoned Judgement Delivered Action Outcome 3b. Action Logic Learning Loops 0-5 yrs moments (Reactive) Learning to walk Learning to talk 5-23 yrs moments (Proactive) Learning an instrument Learning to drive “Hysteria” Loop 1 buried..
  11. 11. Design of the Mind: The developed ‘successful’ mind Stimulus 1. Innate Wisdom 2. Conditioned Intuition 3a. Reasoned Judgement Delivered Action Outcome 3b. Action Logic Learning Loops With expertise comes: More Choice, Opinions and Decisions CAPABILITY FOR DESIGN! Creativity Influence Leadership As we mature, 23 and beyond…
  12. 12. The prevailing MIND paradox! Why Important? Why Happens? Beyond the Stable state: VUCA Designed to exist in the pack!
  13. 13. Design of the Mind: The dangerous rational delusion Stimulus Innate Wisdom Conditioned Intuition Reasoned Judgement Delivered Action Outcome Action Logic Learning Loop VITAL NEED FOR: Different Options, braver choices and hard decisions NEW ,NON ROUTINE, DESIGN! True Creativity Real leadership WHEN THE HEAT IS ON… Prof Chris Argyris: 99% of executive teams with critical moments act defensively not creatively Totally, unconscious.. Barry Oshry – Living Systems
  14. 14. Results CVA1 N1 4hr RTT CVA2 Medicology CVA3 Strategy JT Taunton Step 1: CT SA own service SA CD 8/2006 AMD NSS AMD post FT CVA performan ce FT Via JDY Step 2: ACT 1 - Analysis SA LOS IP SA SA SA FT risk table Mine- theirs SL Good Step 3: ACT 2 Deliver change SA Via attending Via OBS Via Dept Via redesign Medicology SW vs ESD Mandate Program Step 4: Provoke SC JDP AW PDR GV/PV loads CST Strategic implication s Await AJ In all 5! Step 5: Name and see TR TR IC after crisis PV after crisis Ian yes Yes 1:1 Dec Step 6:SMT PLAY and explore Step 7: Experiment 2 Step 8: Roll-in Won.. Lost.. Won.. Battle Won.. Lost Won.. Lost Supportive Lost.. Lost Bury me Managed better! The explanation: I was advocating a non-routine design 99% of executive teams mess up critical moments Totally, unconscious.. Emotional repression….
  15. 15. It can be overcome… Adult Cognitive Complexity Small % of individuals reclaim Their creativity Via Destructive process!
  16. 16. Reality of change currently.. Undeniable need to change…
  17. 17. It really is No pain, No gain… Doesn’t really capture it… HERD! Courageous individuals!
  18. 18. I mean, real pain: Dante’s Inferno
  19. 19. A better way forward: Vertical Development Stimulus Meta-cognition (Mindset) “Prism” Innate Wisdom Conditioned Intuition Reasoned Judgement Delivered Action Outcome Action Logic Learning Loop 7 6 5 4 3 2 1
  20. 20. Design of the Mind: New Skills Stimulus Meta-cognition (Mindset) “Prism” Innate Wisdom Conditioned Intuition Reasoned Judgement Delivered Action Outcome Action Logic Clear Intent Learning Loop Re-learn to be creative Right teams Realistic Theory of change Honest feedback: Fail often, fail safely, know failed Reclaim your emotional world via your body 7 6 5 4 3 2 1 Identify context specific critical events and moments Real time monitoring
  21. 21. IMPLICIT Powerlessness Poor Self worth ACTING REQUIRES: Vulnerability And Courage Increasingly Intangible… Transpersonal phenomena Broadening the PRISM: Why so hard?
  22. 22. Bob’s Big idea: The real reason we are getting older: the need for WISDOM
  23. 23. The route forward, is a lesson from ancient times – via our Hearts…. Brene Brown Barbara Friedrickson
  24. 24. Everything is design. Everything Including the tool and environment in which design can contribute…

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