1. Change, transformation and quality
improvement: where’s it going and
what’s love got to do with it?
Helen Bevan
@HelenBevan
@sw_fab
#FabFFF2020

2. In this talk
•Taking the power to make improvement happen
•Building an outward mindset: share and learn
•Working inter-dependently rather than
independently
•Working together with shared purpose
•Leading improvement from a place of love
@HelenBevan @sw_fab #FABFFF2020

3. Tomorrow’s management
systems will need to value
diversity, dissent and
divergence as highly as
conformance, consensus
and cohesion.”
Gary Hamel
@HelenBevan @sw_fab #FABFFF2020

4. Source: @NHSChangeDay
4
@HelenBevan @sw_fab #FABFFF2020

5. Jeremy Heimens, Henry Timms New Power: How it’s changing the 21st Century and why you need to know (2018)
new power
Current
Made by many
Pulled in
Shared
Open
Relationship
old power
Currency
Held by a few
Pushed down
Commanded
Closed
Transaction

6. People who are highly connected have
twice as much power to influence
change as people with hierarchical
power
Leandro Herrero
http://t.co/Du6zCbrDBC
@HelenBevan @sw_fab #FABFFF2020

7. Find the 3% “super-connectors”!
Source: Organisational Network Analysis by Innovisor
Just 3% of
people in the
organisation or
system typically
influence 85% of
the other people
.Influencers

8. Why superconnectors?
A major cause of change failure is poor dialogue with
the informal organisation
The 3% informal influencers:
• Have the relationships, networks, content and context
• drive the perceptions of other people
• are the go-to people for advice
• make sense of things and reduce ambiguity for others
• Are trusted by peers more than formal leaders are trusted
• Are largely unknown to formal leaders
Source: Innovisor
Source of graphic:
The Strategy Group
@HelenBevan @sw_fab #FABFFF2020

9. Find the 3%: meet David Morgan,
North East Ambulance Service
• “Dave knows everyone in the
ambulance service, not just in the
North East ”
• “He’s really influential on Twitter
and loads of ambulance staff use
Twitter for work topics”
• “Dave wants to help you sort out
issues”
• “He is respected by senior people
and by frontline”@davemorgan_NEAS

10. Innovisor Evidence-based change
McKinsey Tapping the power of hidden influencers
Mike Klein Internal influencers: actionable and no longer optional
How do you find your superconnectors?
Ask other people!
Who do you
go to for information
when you have concerns
at work?
Who’s advice do you
trust and resect?

11. What does this mean for me?
- Build your connections
and relationships
- Be a model of trust and
positive behaviours
- Always, always follow up
Be a
superconnector
Source of graphic:
The Strategy Group
@HelenBevan @sw_fab #FABFFF2020

12. What does this mean for me?
- Build your connections
and relationships
- Be a model of trust and
positive behaviours
- Always, always follow up
Be a
superconnector
- Get their insights
- Engage them in
change
- Stay connected for the
long haul
Find your
superconnectors
@HelenBevan @sw_fab #FABFFF2020

13. As senior leaders, we may be less
influential than we think
If we want to get the same
level of influence through
top down change as the 3% get,
we need four times more people
Source:
Jeppe
Hansgaard,
Innovisor

14. Complex systems are driven by the quality of the
interactions between the parts, not the quality of the parts.
Working on discrete parts or processes can properly bugger
up the performance at a system level. Never fiddle with a part
unless it also improves the system
@ComplexWales
Source of image: Eclipse

15. An independent initiative
Supported by specific
tools & information
Within a
clear
boundary
Improve
smoking cessation rates
amongst people living
with asthma and COPD

16. An independent initiative An inter-dependent initiative
Improve
the response to
someone presenting
to primary care in a
mental health crisis
Primary careEmergency
Department
Mental
health
service
Supported by specific
tools & information
• Social and collaborative
• Built on shared purpose
• Multiple methods
Within a
clear
boundary
Improve
smoking cessation rates
amongst people living
with asthma and COPD

17. My organisation/group
My interests
Silos
Tunnel vision
Behaviours that protect
and advance me or my
group
The bigger system
Our shared purpose
Collaboration
Awareness
Behaviours that
advance the collective
result
Inward mindset Outward mindset
Source: The Arbinger Institute@HelenBevan @sw_fab #FABFFF2020

18. Why shared purpose?
[Shared] purpose goes way deeper
than vision and mission; it goes right into
your gut and taps some part of your primal
self. I believe that if you can bring people with
similar primal-purposes together and get
them all marching in the same direction,
amazing things can be achieved.
Seth Carguilo
@HelenBevan @sw_fab #FABFFF2020

19. We have to reconnect our health and care
actions back to the shared purpose at the
founding of the NHS, back to principles of
social justice
Prerana Issar
Chief People Officer, NHS
Definition adapted by Helen
Bevan from Janet Finn and
Maxine Jacobson

20. Improvement is
anchored in purpose
@HelenBevan @sw_fab #FABFFF2020

21. Where do we start?
• In improvement methodology, our first question is “What is our
aim”?
• In social movement practice, our first question is “who are our
people?”
Who are our people?
What unites us (our shared purpose)?
What is our aim?

22. The model for improvement
Source: IHI
@HelenBevan @sw_fab #FABFFF2020

23. The model for improvement
Who are our people?
What unites us (our shared purpose?)
@HelenBevan @sw_fab #FABFFF2020

24. Don’t confuse PURPOSE with AIM
•An aim is setting a determined course in order to
achieve a set goal within a specific timescale
•Purpose seeks to make explicit the reason behind
something that is being done. Purpose defines WHY we
are doing what we are doing, and WHAT we hope to
achieve from it
@HelenBevan @sw_fab
#FABFFF2020
We need BOTH but shared purpose comes before aim

25. Avoiding “de facto” purpose
Source: Delivering
Public Services That
Work: The Vanguard
Method in the Public
Sector
• Shared purpose can easily be displaced by a “de
facto” purpose:
 hitting targets, standards or key performance indicators
 reducing costs
 reducing length of stay
 complying with regulators
 completing activities within a timescale and budget
• If purpose isn’t explicit and shared, then it is very
easy for something else to become a de facto
purpose in the minds of the workforce
• De facto purpose is toxic, leads to burn out and
blocks engagement
“de facto” means
that something
exists in reality even
if it isn’t intended

26. “I have some key performance
indicators for the next 12
months” “I have a dream”
Source: @RobertVarnam
@HelenBevan @sw_fab #FABFFF2020

27. “I have some key performance
indicators for the next 12
months”
or
“I have a dream”
Source: @RobertVarnam
@HelenBevan @sw_fab
#FABFFF2020

28. @HelenBevan @sw_fab #FABFFF2020

29. Our shared purpose:
#EndPJParalysis
@HelenBevan @sw_fab #FABFFF2020

31. Purpose is the deepest dimension within us – our
central core or essence – where we have a profound
sense of who we are, where we came from and where
we’re going. Purpose is the quality we choose to
shape our lives around. Purpose is a source of energy
and direction.
Leider
The “purpose” test:
Does your proposed purpose fit with
this?
@HelenBevan @sw_fab

32. Change starts with me

33. …..Ultimately, the secret of
quality is love.
……If you have love, you can
then work backward to
monitor and improve the
system.
Avedis Donabedian
@HelenBevan @sw_fab #FABFFF2020

34. Leading with love is catching on

35. Leading
from a
place of
love
At the most profound level, love is about our deep
affiliation with the moral purpose of the health and
care system and our goal of improving health for
every individual and for whole populations. We
translate this into action by leading with love;
committing to, connecting with, affirming and making
things meaningful for those we serve. We are able to
make our greatest contributions, individually and
collectively, when we work in a loving environment,
enabling everyone to do their best, fulfilling our higher
purpose. Love is a unifying force and it builds
collective power for change.
Helen Bevan and Goran Henriks

36. Tactics for improvement leaders:
Out-love everyone else
Source of image: Bradley Burgess@HelenBevan @sw_fab #FABFFF2020

37. Source: @NHSChangeDay
37
@HelenBevan @sw_fab #FABFFF2020

38. 38 |
Confronting people with
their freedom may be the
ultimate act of love
Peter Block
@HelenBevan @sw_fab #FABFFF2020