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Rocking the boat and staying in it: how to be a great change agent

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Rocking the boat and staying in it: how to be a great change agent

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Slides for the morning workshop that Lynne Maher and Helen Bevan ran at the International Forum on Quality and Safety in Healthcare, 12th April 2016.

Slides for the morning workshop that Lynne Maher and Helen Bevan ran at the International Forum on Quality and Safety in Healthcare, 12th April 2016.

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Rocking the boat and staying in it: how to be a great change agent

  1. 1. @LynneMaher1 @helenbevan #qfm5 #quality2016 Rocking The Boat But Staying In It: How to be a great change agent Supported by: http://www.theedge.nhsiq.nhs.uk/school/ Taken from the
  2. 2. @LynneMaher1 @helenbevan #qfm5 #quality2016 Taken from the School for Health and Care Radicals A global community of change agents Over 7000 people have now taken part in The School for Health and Care Radicals, from around the world, including: Argentina, Australia, Austria, Belgium, Brazil, Canada, Denmark, England, France, Georgia, Germany, Greece, India, Ireland (Republic), Italy, Netherlands, New Zealand, Nigeria, Norway, Northern Ireland, Pakistan, Qatar, Russian Federation, Saudi Arabia, Scotland, Singapore, Slovenia, South Africa, Spain, Sweden, Switzerland, Thailand, Tunisia, Ukraine, USA, Wales
  3. 3. @LynneMaher1 @helenbevan #qfm5 #quality2016 Source: http://www.slideshare.net/alwynlau/learning-theories-learner-needs
  4. 4. @LynneMaher1 @helenbevan #qfm5 #quality2016 Today is a PRIMER • Context: emerging directions in transformation and change • Some challenges for health and care radicals • Creating connections and building communities • Rolling with resistance • Making change happen Sourceofimage:www.freshnessmag.com
  5. 5. @LynneMaher1 @helenbevan #qfm5 #quality2016 Where on earth are you?
  6. 6. @LynneMaher1 @helenbevan #qfm5 #quality2016 How are you feeling today? I’m ready to be radical! I’m cautiously optimistic. I remain unconvinced or sceptical. I’m feeling positive, let’s see how I can make this work!
  7. 7. @LynneMaher1 @helenbevan #qfm5 #quality2016 • Please tweet using hashtags #qfm5 and #quality2016 • Download the slides from SlideShare • Follow us on Twitter @LynneMaher1 and @HelenBevan Joining in today
  8. 8. @LynneMaher1 @helenbevan #qfm5 #quality2016 Jeremy Heimens TED talk “What new power looks like” https://www.youtube.com/watch?v=j-S03JfgHEA old power new power Currency Held by a few Pushed down Commanded Closed Transaction Current Made by many Pulled in Shared Open Relationship
  9. 9. @LynneMaher1 @helenbevan #qfm5 #quality2016 The essential flaw of quality improvement methods The essential flaw of [quality improvement methodology] is that, when implemented, it tends to reinforce the mechanistic and hierarchical models that are consistent with the mental maps of most managers Chris Argyris, Flawed advice and the management trapSource of image: www.biblicalcreation.org.uk Read more at: http://www.slideshare.net/jurgenappelo/management-30-workout
  10. 10. @LynneMaher1 @helenbevan #qfm5 #quality2016 • systematic “change management” • too often, leaders prescribe outcome and method of change in a top-down way • change is experienced by people at the front line as “have to” (imposed) rather than “want to” (embraced) Change Programmes • everyone (including service users and families) can help tackle the most challenging issues • value diversity of thought • connect people, ideas and learning • Role of formal leaders is to create the conditions and get out of the way Change Platforms “Tear down the walls”
  11. 11. @LynneMaher1 @helenbevan #qfm5 #quality2016 What is a rebel? •The principal champion of a change initiative, cause or action •Rebels don’t wait for permission to lead, innovate, strategise •They are responsible; they do what is right •They name things that others don’t see yet •They point to new horizons •Without rebels, the storyline never changes Source : @PeterVan http://t.co/6CQtA4wUv1
  12. 12. @LynneMaher1 @helenbevan #qfm5 #quality2016 If you put fences around people, you get sheep. Give people the room they need William L McKnight
  13. 13. @LynneMaher1 @helenbevan #qfm5 #quality2016 What happens to heretics/radicals/rebels/mavericks in organisations?
  14. 14. @LynneMaher1 @helenbevan #qfm5 #quality2016
  15. 15. @LynneMaher1 @helenbevan #qfm5 #quality2016Source: Lois Kelly http://www.slideshare.net/Foghound/rocking-the-boat-without-falling-out
  16. 16. @LynneMaher1 @helenbevan #qfm5 #quality2016 We need to be boatrockers! • Walk the fine line between difference and fit, inside and outside, rock the boat but manage to stay in it • Able to challenge the status quo when we see that there could be a better way • Conform AND rebel • Capable of working with others to create success NOT a destructive troublemaker Source: Debra Meyerson
  17. 17. @LynneMaher1 @helenbevan #qfm5 #quality2016 Source : Lois Kelly www.foghound.com There’s a big difference between a rebel and a troublemaker Rebel
  18. 18. @LynneMaher1 @helenbevan #qfm5 #quality2016 Reflection • What are your insights around “rebels” and “troublemakers”? • What moves people from being “rebel” to “troublemaker”? • How do we protect against this?
  19. 19. @LynneMaher1 @helenbevan #qfm5 #quality2016 Source : Lois Kelly www.rebelsatwork.com There’s a big difference between a rebel and a troublemaker Rebel
  20. 20. @LynneMaher1 @helenbevan #qfm5 #quality2016 Change starts with me Source of image: jasonkeath.com
  21. 21. @LynneMaher1 @helenbevan #qfm5 #quality2016 "There’s only one corner of the universe you can be certain of improving, and that’s your own self." Aldous Huxley Source of image: timcoffeyart.wordpress.com
  22. 22. @LynneMaher1 @helenbevan #qfm5 #quality2016 1. able to join forces with others to create action 2. able to achieve small wins which create a sense of hope, possibility and confidence 3. More likely to view obstacles as challenges to overcome 4. strong sense of “self-efficacy”  belief that I am personally able to create the change Four things we know about successful boat rockers Source: adapted from Debra E Meyerson CHANGE me BEGINS WITH
  23. 23. @LynneMaher1 @helenbevan #qfm5 #quality2016 Self-efficacy There is a positive, significant relationship between the self-efficacy beliefs of a change agent and her/his ability to facilitate change and get good outcomes Source of image:www.h3daily.com
  24. 24. @LynneMaher1 @helenbevan #qfm5 #quality2016 Source: @NHSChangeDay
  25. 25. @LynneMaher1 @helenbevan #qfm5 #quality2016 Source: @NHSChangeDay What is the issue here? “permission” ? (externally generated) or Self efficacy ? (internally generated)
  26. 26. @LynneMaher1 @helenbevan #qfm5 #quality2016 Building self-efficacy: some tactics 1. Create change one small step at a time 2. Reframe your thinking: • failed attempts are learning opportunities • uncertainty becomes curiousity 3. Make change routine rather than an exceptional activity 4. Get social support 5. Learn from the best
  27. 27. @LynneMaher1 @helenbevan #qfm5 #quality2016 Creating connections and building communities
  28. 28. @LynneMaher1 @helenbevan #qfm5 #quality2016 The Network Secrets of Great Change Agents 1. As a change agent, my centrality in the informal network is more important than my position in the formal hierarchy 2. If you want to create small scale change, work through a cohesive network If you want to create big change, create bridge networks between disconnected groups
  29. 29. @LynneMaher1 @helenbevan #qfm5 #quality2016 People who are highly connected have twice as much power to influence change as people with hierarchical power. Leandro Herrero http://t.co/Du6zCbrDBC
  30. 30. @LynneMaher1 @helenbevan #qfm5 #quality2016 strong ties vs. weak ties Source of image: http://www.forbes.com/fdc/welcome_mjx.shtml
  31. 31. @LynneMaher1 @helenbevan #qfm5 #quality2016 When we spread change through strong ties: • we interact with “people like us”, with the same life experiences, beliefs and values • Change is “peer to peer”; GP to GP, social worker to social worker, nurse to nurse, community leader to community leader • Influence is spread through people who are strongly connected to each other, like and trust each other
  32. 32. @LynneMaher1 @helenbevan #qfm5 #quality2016 The pros and cons of strong ties Pros Cons
  33. 33. @LynneMaher1 @helenbevan #qfm5 #quality2016 When we seek to spread change through weak ties • we build bridges between groups and individuals who were previously different and separate • we create relationships based not on pre-existing similarities but on common purpose and commitments that people make to each other to take action • We can mobilise all the assets in our organisation, system or community to help achieve our goals
  34. 34. @LynneMaher1 @helenbevan #qfm5 #quality2016 Why we need to build weak ties AS WELL AS strong ties • Weak ties are more likely to lead to change at scale because they enable us to access more people with fewer barriers • In situations of uncertainty, we have a tendency to revert to our strong tie relationships  yet the evidence tells us that weak ties are much more important than strong ties when it comes to searching out resources in times of scarcity • The most breakthrough innovations and most radical change will come when we tap into our weak ties
  35. 35. @LynneMaher1 @helenbevan #qfm5 #quality2016 Sources of weak ties
  36. 36. @LynneMaher1 @helenbevan #qfm5 #quality2016 Think about a change you are making or want to make. Who are your strong and weak ties? Source of image:brucemacvaresh.com
  37. 37. @LynneMaher1 @helenbevan #qfm5 #quality2016 Take part in an RCT What is a RCT?
  38. 38. @LynneMaher1 @helenbevan #qfm5 #quality2016 • Randomised Coffee Trial! • Randomised Coffee Trial! Randomised Coffee Trial!
  39. 39. @LynneMaher1 @helenbevan #qfm5 #quality2016 Outcomes of Randomised Coffee Trials
  40. 40. @LynneMaher1 @helenbevan #qfm5 #quality2016 Debrief RCT
  41. 41. @LynneMaher1 @helenbevan #qfm5 #quality2016 “When we talk of social change, we talk of movements, a word that suggest vast groups of people walking together, leaving behind one way and travelling towards another” Rebecca Solnit
  42. 42. @LynneMaher1 @helenbevan #qfm5 #quality2016 Framing … is the process by which leaders construct, articulate and put across their message in a powerful and compelling way in order to win people to their cause and call them to action. Snow D A and Benford R D (1992)
  43. 43. @LynneMaher1 @helenbevan #qfm5 #quality2016 “What the leader cares about (and typically bases at least 80% of his or her message to others on) does not tap into roughly 80% of the workforce’s primary motivators for putting extra energy into the change programme” Scott Keller and Carolyn Aiken (2009) The Inconvenient Truth about Change Management Source of image: swedenbourg-openlearning.org.uk The reality
  44. 44. @LynneMaher1 @helenbevan #qfm5 #quality2016 1. People speak intellectually but engage emotionally 2. Facts are hard to remember and easy to challenge 3. If we only talk about our success people won’t believe us 4. People don’t want more communication; they want meaningful communication http://www.peterfuda.com/2014/10/30/traditional-comms-fail-engage/ Four gaps between how we communicate change how people engage with that communication
  45. 45. @LynneMaher1 @helenbevan #qfm5 #quality2016 Leaders ask their staff to be ready for change, but do not engage enough in sensemaking........ Sensemaking is not done via marketing...or slogans but by emotional connection with employees Ron Weil
  46. 46. @LynneMaher1 @helenbevan #qfm5 #quality2016 “I have some Key Performance Indicators for you” or “I have a dream” Source: @RobertVarnam
  47. 47. @LynneMaher1 @helenbevan #qfm5 #quality2016 Three components of a great narrative • Diagnostic – what is the problem that we are addressing? What is the extent of the problem? What is the specific source or sources? • Prognostic – what could the future look like? What is our “plan of attack” and our strategy for carrying out the plan? • Motivational – why is this urgent? What is our call for action that connects with the motivational and emotional drivers of our audience? Source: Benford and Snow Source of image: www.ecommercedefense.com
  48. 48. @LynneMaher1 @helenbevan #qfm5 #quality2016 If we want people to take action, we have to connect with their emotions through values action values emotion Source: Marshall Ganz “Storytelling is the best way to help the person in front of you build trust and ultimately be able to connect to you”. IDEO
  49. 49. @LynneMaher1 @helenbevan #qfm5 #quality2016
  50. 50. @LynneMaher1 @helenbevan #qfm5 #quality2016
  51. 51. @LynneMaher1 @helenbevan #qfm5 #quality2016 Effective framing: what do we need to do? 1. Tell a story 2. Make it personal 3. Be authentic 4. Create a sense of “us” (and be clear who the “us” is) 5. Build in a call for urgent action Source of image: woccdoc.org
  52. 52. @LynneMaher1 @helenbevan #qfm5 #quality2016 Vivid details Source: Marshall Ganz
  53. 53. @LynneMaher1 @helenbevan #qfm5 #quality2016 Effective Communication continues throughout the change • Q- How is the project going? • Change Agent- Good. The number of people who did not attend reduced by 20% and the staff survey showed that satisfaction had improved. Are you excited by this?
  54. 54. @LynneMaher1 @helenbevan #qfm5 #quality2016 •Possible exercise on framing
  55. 55. A ‘resilient’ material can bend under strain then spring back. Human resilience, however, is a much more complex, dynamic process, one fundamentally based on interconnectedness – with strong connections to others, a sense of meaning and purpose, and the capacity to deal with each unfolding moment by flexibly responding to life’s pressures and constraints Jennifer Napier Resilience: how we keep sailing A description of resilience fit for a health and care radical Source of image: pinterest.com
  56. 56. @LynneMaher1 @helenbevan #qfm5 #quality2016 Early thinking on resilience “Hardy” “Invulnerable” “Invincible” Source of image: forums.marvelheroes.com http://go.sdsu.edu/education/do c/files/01370- ResiliencyLiteratureReview(SDSU ).pdf
  57. 57. @LynneMaher1 @helenbevan #qfm5 #quality2016 Resilience: what does the evidence base tell us? • Researchers increasingly view resilience not as fixed attributes but as an alterable set of processes that can be fostered and cultivated • Resilience can grow or decline over time depending on the interactions taking place between a person and their environment and between risk and protective factors in that person’s life • We can build protective factors that enable us to reduce the negative impact of stressors and support positive change Source: Ryan Santos http://go.sdsu.edu/education/doc/files/01370- ResiliencyLiteratureReview(SDSU).pdf
  58. 58. ‘We cannot direct the wind but we can adjust the sails’ Jennifer Napier Source of image: www.encore-editions.com
  59. 59. @LynneMaher1 @helenbevan #qfm5 #quality2016 Ways to build resilience as a leader of change 1. Get social support 2. Try not to see crisis as insurmountable problems 3. Accept that change is part of living and alter the things you can alter 4. Find ways to move towards your goals 5. Keep a hopeful outlook 6. Build your own self efficacy 7. Look after yourself Source: adapted from The road to resilience, American Psychological Society
  60. 60. @LynneMaher1 @helenbevan #qfm5 #quality2016 1. strong sense of “self-efficacy”  belief that I am personally able to create the change 2. able to join forces with others to create action 3. able to achieve small wins which create a sense of hope, possibility and confidence 4. More likely to view obstacles as challenges to overcome Four things we know about successful boat rockers Source: adapted from Debra E Meyerson CHANGE me BEGINS WITH
  61. 61. @LynneMaher1 @helenbevan #qfm5 #quality2016 Ways to build resilience as a leader of change 1. Get social support 2. Look after yourself 3. Try not to see crisis as insurmountable problems 4. Accept that change is part of living and alter the things you can alter 4. Find ways to move towards your goals 5. Keep a hopeful outlook 6. Build your own self efficacy Source: adapted from The road to resilience, American Psychological Society
  62. 62. @LynneMaher1 @helenbevan #qfm5 #quality2016 We can make ourselves more or less vulnerable by how we think about things George Bonanno Loss, Trauma, and Emotion Lab, Columbia University
  63. 63. @LynneMaher1 @helenbevan #qfm5 #quality2016Image copyright: http://13c4.wordpress.com/2007/02/24/50-reasons-not-to-change/
  64. 64. @LynneMaher1 @helenbevan #qfm5 #quality2016
  65. 65. @LynneMaher1 @helenbevan #qfm5 #quality2016 C http://www.slideshare.net/AndreaWaltz/gfn-slidesharegfnhandling-rejectionpositively
  66. 66. @LynneMaher1 @helenbevan #qfm5 #quality2016Source: http://www.slideshare.net/AndreaWaltz/gfn-slidesharegfnhandling-rejectionpositively
  67. 67. @LynneMaher1 @helenbevan #qfm5 #quality2016Source: http://www.slideshare.net/AndreaWaltz/gfn-slidesharegfnhandling-rejectionpositively
  68. 68. @LynneMaher1 @helenbevan #qfm5 #quality2016Source: http://www.slideshare.net/AndreaWaltz/gfn-slidesharegfnhandling-rejectionpositively
  69. 69. @LynneMaher1 @helenbevan #qfm5 #quality2016Source: http://www.slideshare.net/AndreaWaltz/gfn-slidesharegfnhandling-rejectionpositively
  70. 70. @LynneMaher1 @helenbevan #qfm5 #quality2016Source: http://www.slideshare.net/AndreaWaltz/gfn-slidesharegfnhandling-rejectionpositively Make it a personal PERFORMANCE target.
  71. 71. @LynneMaher1 @helenbevan #qfm5 #quality2016Source: http://www.slideshare.net/AndreaWaltz/gfn-slidesharegfnhandling-rejectionpositively
  72. 72. @LynneMaher1 @helenbevan #qfm5 #quality2016 You don’t know you’re going to get a “No” until you ask, and if you don’t ask, you’ve given yourself the “No” Jack Canfield Source of image: blog.mindjet.com
  73. 73. @LynneMaher1 @helenbevan #qfm5 #quality2016 Research from the sales industry: How many NOs should we be seeking to get? • 2% of sales are made on the first contact • 3% of sales are made on the second contact • 5% of sales are made on the third contact • 10% of sales are made on the fourth contact • 80% of sales are made on the fifth to twelfth contact Source: http://www.slideshare.net/bryandaly/go-for-no
  74. 74. @LynneMaher1 @helenbevan #qfm5 #quality2016 “Papers that are more likely to contend against the status quo are more likely to find an opponent in the review system—and thus be rejected —but those papers are also more likely to have an impact on people across the system, earning them more citations when finally published” V. Calcagno et al., “Flows of research manuscripts among scientific journals reveal hidden submission patterns,” Science, doi:10.1126/science.1227833, 2012. —
  75. 75. @LynneMaher1 @helenbevan #qfm5 #quality2016 Rolling with resistance
  76. 76. @LynneMaher1 @helenbevan #qfm5 #quality2016 Employee resistance is the most common reason executives cite for the failure of big organizational-change efforts Scott Keller and Colin Price (2011), Beyond Performance: How Great Organizations Build Ultimate Competitive Advantage Source of image: Businessconjunctions.com
  77. 77. @LynneMaher1 @helenbevan #qfm5 #quality2016 Resistant behaviour is a good indicator of missing relevance Harald Schirmer http://de.slideshare.net/haraldschirmer/strategies-for-corporate-change-the-new- role-of-hr-driving-social-adoption-and-change-in-the-enterprise Source of image: driverlayer.com ‘‘
  78. 78. @LynneMaher1 @helenbevan #qfm5 #quality2016
  79. 79. @LynneMaher1 @helenbevan #qfm5 #quality2016 “Stages of change” Transtheoretical model of behaviour change Prochaska, DiClemente & Norcross (1992)
  80. 80. @LynneMaher1 @helenbevan #qfm5 #quality2016 • smoking cessation • exercise adoption • alcohol and drug use • weight control • fruit and vegetable intake • domestic violence • HIV prevention • use of sunscreens to prevent skin cancer • medication compliance • mammography screening The model is mostly used around health-related behaviours
  81. 81. @LynneMaher1 @helenbevan #qfm5 #quality2016 • smoking cessation • exercise adoption • alcohol and drug use • weight control • fruit and vegetable intake • domestic violence • HIV prevention • use of sunscreens to prevent skin cancer • medication compliance • mammography screening It works for organisational and service change too! The model is mostly used around health-related behaviours
  82. 82. @LynneMaher1 @helenbevan #qfm5 #quality2016 “Stages of change” Smoking I am not aware my smoking is a problem – I have no intention to quit Prochaska, DiClemente & Norcross (1992)
  83. 83. @LynneMaher1 @helenbevan #qfm5 #quality2016 “Stages of change” Smoking I am not aware my smoking is a problem – I have no intention to quit I know my smoking is a problem – I want to stop but no plans yet Prochaska, DiClemente & Norcross (1992)
  84. 84. @LynneMaher1 @helenbevan #qfm5 #quality2016 I am not aware my smoking is a problem – I have no intention to quit I know my smoking is a problem – I want to stop but no plans yet I am making plans & changing things I do in preparation. “Stages of change” Smoking Prochaska, DiClemente & Norcross (1992)
  85. 85. @LynneMaher1 @helenbevan #qfm5 #quality2016 I am not aware my smoking is a problem – I have no intention to quit I know my smoking is a problem – I want to stop but no plans yet I am making plans & changing things I do in preparation. I have stopped smoking! “Stages of change” Smoking Prochaska, DiClemente & Norcross (1992)
  86. 86. @LynneMaher1 @helenbevan #qfm5 #quality2016 I am not aware my smoking is a problem – I have no intention to quit I know my smoking is a problem – I want to stop but no plans yet I am making plans & changing things I do in preparation. I have stopped smoking! I am continuing to not smoke. I sometimes miss it – but I am still not smoking “Stages of change” Smoking Prochaska, DiClemente & Norcross (1992)
  87. 87. @LynneMaher1 @helenbevan #qfm5 #quality2016 I am not aware my smoking is a problem – I have no intention to quit I know my smoking is a problem – I want to stop but no plans yet I am making plans & changing things I do in preparation. I have stopped smoking! I am continuing to not smoke. I sometimes miss it – but I am still not smoking “Stages of change” Smoking Prochaska, DiClemente & Norcross (1992)
  88. 88. @LynneMaher1 @helenbevan #qfm5 #quality2016 Prochaska, DiClemente & Norcross (1992) “Stages of change” Transtheoretical model of behaviour change
  89. 89. @LynneMaher1 @helenbevan #qfm5 #quality2016 • Which stage do most change activities in health and care focus on? • Which stage are most people actually at? Some questions
  90. 90. @LynneMaher1 @helenbevan #qfm5 #quality2016 The reality of our change situation • Our tools are often not effective at the stage of change that most people we work with are at • It’s hard to engage people in change • It’s hard to get people to make the changes we want them to make • People get irritated, defensive, irrational • We feel powerless in our ability to lead or facilitate the change 90% of the tools available for health and care change agents are designed for the “action” stage
  91. 91. @LynneMaher1 @helenbevan #qfm5 #quality2016 • Designed for Stage 4 – ACTION! • Mandated it through targets • Despite compelling case for change – people often resisted it • People did the task and missed the point Example – WHO Surgical Safety Checklist
  92. 92. @LynneMaher1 @helenbevan #qfm5 #quality2016 Source: Russ et al (2015) A Qualitative Evaluation of the Barriers and Facilitators Toward Implementation of the WHO Surgical Safety Checklist Across Hospitals in England: Lessons From the “Surgical Checklist Implementation Project” Ann Surg Source of infographic here
  93. 93. @LynneMaher1 @helenbevan #qfm5 #quality2016 “In hospitals without adequate resources and efficient systems, simply requiring the checklist to be used might not only fail to improve patient safety but might also introduce new risks for staff and patients. This is the exact opposite of what the checklist was designed to achieve”.
  94. 94. @LynneMaher1 @helenbevan #qfm5 #quality2016 • Lower our ambitions for improvement • Focus our energies on those who are already in the “action” stage • Put negative labels on those who are not yet at the action stage such as “blocker” or “resister” or “laggard” • Blame “the management” for not enforcing change So what do we TEND to do when people resist?
  95. 95. @LynneMaher1 @helenbevan #qfm5 #quality2016 The single biggest problem in communication is the illusion that it has taken place George Bernard Shaw ‘‘
  96. 96. @LynneMaher1 @helenbevan #qfm5 #quality2016 • Listen and understand • appreciate the starting point • elaborate interests • Roll with resistance • Don’t argue against it • Be curious and accepting • Encourage elaboration of resistance • What makes it so hard? • What would help? • Build meaning and conviction in the change So what SHOULD we do? See Motivational interviewing as a change management strategy
  97. 97. @LynneMaher1 @helenbevan #qfm5 #quality2016 If your horse dies, get off it Cherokee proverb Source of image: fenwickgallery.co.uk ‘‘
  98. 98. @LynneMaher1 @helenbevan #qfm5 #quality2016 Focussing on Prochaska, DiClemente and Norcross’s Stages of Change model: • What stage of change are some of the key people that you need to influence for your change initiative at? • What actions can you take to help them move to the next stage? Thinking about your own situation- Discussion
  99. 99. @LynneMaher1 @helenbevan #qfm5 #quality2016 How to make change happen • Stop bribing • Make people feel something • Emphasise progress • Start a cult (a group unified by a provocative idea) Source: How to motivate people: four steps backed by science
  100. 100. @LynneMaher1 @helenbevan #qfm5 #quality2016 What will you do now?
  101. 101. @LynneMaher1 @helenbevan #qfm5 #quality2016 Study guides Programme Study Guide: http://www.slideshare.net/TheEdgeNHS/school-for-health-and-care-radicals-iii- study-guide-2016?related=2 Module 1 Study Guide: http://www.slideshare.net/TheEdgeNHS/the-school-for-health-and- care-radical-2016-module-1-study-guide?related=1
  102. 102. @LynneMaher1 @helenbevan #qfm5 #quality2016 The School has been formally evaluated by the Chartered Institute for Personnel & Development http://theedge.nhsiq. nhs.uk/school/school- evaluation/ How has the School for Health and Care Radicals made a difference?
  103. 103. @LynneMaher1 @helenbevan #qfm5 #quality2016 Goodbye and good luck! ‘Be the change you want to see in the world.’ Goodbye and good luck!

Editor's Notes

  • Link below http://www.bbc.co.uk/news/magazine-23790147 http://www.bbc.co.uk/learningzone/clips/martin-luther-king-i-have-a-dream-pt-1-2/1293.html
    With the brooding statue of Abraham Lincoln peering down at him, King began by telling protesters that their presence in the symbolic shadow of the "great emancipator" offered proof of the marvellous new militancy sweeping the country. For too long, he complained, black Americans had been exiles in their own land, "crippled by the manacles of segregation and the chains of discrimination".
    The whirlwinds of revolt would continue to shake the very foundations of the country: "And those who hope that the Negro needed to blow off steam and will now be content will have a rude awakening if the nation returns to business as normal," King said. It would be fatal for the nation "to overlook the urgency of the moment and to underestimate the determination of the Negro".
    “He's good - he's damned good”
    Kennedy on King
    Wearied by the suffocating heat, the crowd's initial response was muted. The speech was not going well. "Tell 'em about the dream, Martin," shouted Mahalia Jackson, referring to a rhetorical riff that King had used several times before, but which had not made it into his prepared speech because aides insisted he needed fresh material. But King decided to cast aside his prepared notes, and launched extemporaneously into the refrain for which he will forever be remembered.
    "I have a dream that one day this nation will rise up and live out the true meaning of its creed," he shouted, his out-stretched right arm reaching towards the sky. Soon he was hitting his rhythm, invigorated by the chants and cries of the crowd. "Dream on!" they shouted. "Dream on!"
    With his voice thundering down the Mall, King imagined a future in which his children could "live in a nation where they will not be judged by the colour of their skin but by the content of their character". Then he reached his impassioned finale.
    King asked the crowd to yell so it was heard the world over
    Watching at the White House, the president was riveted. Like so many Americans, it was the first time he had heard the 34-year-old preacher deliver a speech in its entirety - the first time he had taken its measure, listened to its cadence. "He's good," Kennedy told one of his advisors. "He's damned good." The aide was struck, however, that the president seemed impressed more by the quality of King's performance rather than the power of his message.
  • So Emotions help us understand what we value in the world.
    Why did the story of Alice work ?
    So why was this story powerful?
    Why do we respond differently when we hear about Alice rather than when we see the policy data and financial balance sheet?
    So public narrative when used intentionally for a purpose to connect with others to move to action is a powerful skills set and leadership gift. When we hear stories that make us feel a certain way those stories remind us of our core values. We experience our values through emotions. Then we are prepared to take action on those values. Through our emotions we are more likely to take action

    Research by Martha Nussbaum a Moral philosopher, tells us that people who have a damaged (a-mig-da- la) Amygadla the part of the brain which controls emotions, when faced with decisions can come up with many options from which to choose but cannot make a decision because the decision rests upon judgements of value. If we cannot feel emotion we cannot experience values that orient us to the choices we must make


    Shortly we will be thinking about the lived experiences that have moved you to action…we’ll be drawing on those a few minutes as you start to craft your own stories.
  • Remember the power of “Killer Facts”

    Have one that really illustrates this for you.

    JG – I often use one from Kath Evans. If we had the health care system in England that matched the best in Europe 1500 children a year, would not die in our care.

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