Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.
@HelenBevan #Quality2016
@HelenBevan #Quality2016
Joining in this session
• The theme of the session is
connectivity and platforms
for change
• Ple...
@HelenBevan #Quality2016
What is happening in the field of change and
transformation in the wider world?
@HelenBevan #Quality2016
Change is changing
@HelenBevan #Quality2016
What approaches to change are needed in
this environment?
@HelenBevan #Quality2016
Kinthi Sturtevant, IBM
13th annual Change Management
Conference June 2015
We rarely see two, thre...
@HelenBevan #Quality2016
Source: Bromford P (2015), ”What’s the difference between a test and a pilot?”
@HelenBevan #Quality2016
Change is changing
@HelenBevan #Quality2016
@HelenBevan #Quality2016
@HelenBevan #Quality2016
How does the NHS improvement community
prefer to communicate?
Digital
Reactive
@HelenBevan #Quality2016
Change is changing
@HelenBevan #Quality2016
@HelenBevan #Quality2016
Change is changing
@HelenBevan #Quality2016
@HelenBevan #Quality2016
@HelenBevan #Quality2016
Change is changing
Change is moving to
the edge
@HelenBevan #Quality2016
http://www.slideshare.net/Openpolicymaking/policy-lab-slide-
share-introduction-final
@HelenBevan #Quality2016
Why go to the edge?
“ Leading from the edge brings us into
contact with a far wider range of
rela...
@HelenBevan #Quality2016
Starts on the fringe
(at the edge)
Starts with the activists
Gary Hamel
always
@HelenBevan #Quality2016
Jeremy Heimens TED talk “What new power looks like”
https://www.youtube.com/watch?v=j-S03JfgHEA
o...
@HelenBevan #Quality2016
The Network Secrets of Great Change Agents
Julie Battilana &Tiziana Casciaro
As a change agent, m...
@HelenBevan #Quality2016
“People who are highly
connected have twice
as much power to
influence change as
people with
hier...
@HelenBevan #ngdpcohort17
“I have some Key
Performance
Indicators
for you”
or
“I have a
dream”
Source: @RobertVarnam
@HelenBevan
WHO makes change happen in healthcare?
Source: adapted by Helen Bevan from Leandro Herrera
List A
• The Transf...
@HelenBevan
WHO makes change happen in healthcare?
Source: adapted by Helen Bevan from Leandro Herrera
List A
• The Transf...
@HelenBevan
WHO makes change happen in healthcare?
List B
• The mavericks and rebels
• The deviants (positive). Who do
thi...
@HelenBevan
What’s the evidence?
The failure of strategic change
projects is rarely due to the content
or structure of the...
@HelenBevan #Quality2016
The essential flaw of quality improvement
approaches
The essential flaw of [quality
improvement ]...
@HelenBevan #Quality2016
Is your change process a cathedral or a bazaar?
http://www.unterstein.net/su/docs/CathBaz.pdf
@HelenBevan #Quality2016
We have a lot of cathedrals
Source: Sewell (2015) : Stop training our project managers to be proc...
@HelenBevan #Quality2016
The power of the platform
“Facebook, YouTube, Twitter and their lesser cousins have
proved the po...
@HelenBevan #Quality2016
“Change comes
naturally when
individuals have a
platform that allows
them to identify
shared inte...
@HelenBevan #Quality2016
• systematic “change
management”
• too often, leaders
prescribe outcome and
method of change in a...
@HelenBevan #Quality2016
Why platforms?
“Platforms today power learning and innovation
at the speed of change by providing...
@HelenBevan #Quality2016
Evolving kinds of change platforms:
They overlap!
1. Connecting platforms
2. Mobilising platforms...
@HelenBevan #Quality2016
Example platforms
Source of image: @JenniferClemo
@HelenBevan #Quality2016
http://biggerboat.org/exploring-moodocs/
MOODOCs
(Massive, Online, Open, Disease Oriented Communi...
@HelenBevan #Quality2016
The Academy of Fabulous Stuff
• Half a million page views
• Over 700 fab shares
• 1,500 to 4,000 ...
@HelenBevan #Quality2016
https://youtu.be/eUApgJBZU8M
@HelenBevan #Quality2016
Source: OpenIdeo https://challenges.openideo.com/challenge/end-of-life/refinement
Diane Smith
diane.smith2@swyt.nhs.uk
@DianeCS9
Sue Barton
sue.barton@swyt.nhs.uk
@barnsleybart
www.southwestyorkshire.nhs....
@HelenBevan #Quality2016
Source: @NHSChangeDay
@HelenBevan #Quality2016
@HelenBevan #Quality2016
Source: http://www.slideshare.net/alwynlau/learning-theories-learner-needs
@HelenBevan #Quality2016
10,000
Nearly
@HelenBevan #Quality2016
The School was formally evaluated by the Chartered
Institute for Personnel & Development
#EdgeTal...
@HelenBevan #Quality2016
The School was formally evaluated by the Chartered
Institute for Personnel & Development
• Change...
@HelenBevan #Quality2016
Nearly
100,000
connections
(defined as a viewing, a
download of material or an
original tweet)
• ...
@HelenBevan #Quality2016
@HelenBevan #Quality2016
Should we undertake routine radiology investigations
overnight for all our inpatients?
How to bui...
@HelenBevan #Quality2016
The Change Challenge
Tapping the collective brilliance
of the NHS
@HelenBevan #Quality2016
14,000 contributions identified
10 barriers to change:
Confusing strategies
Over controlling
lead...
@HelenBevan #Quality2016
14,000 contributions identified
11 building blocks for change:
Inspiring & supportive
leadership
...
@HelenBevan #Quality2016
Project Aristotle: http://qz.com/625870/after-years-of-intensive-
analysis-google-discovers-the-k...
@HelenBevan #Quality2016
Some lessons
1. You can’t control the outputs of the crowd
2. People want a relationship
3. Alway...
@HelenBevan #Quality2016
The Natural Environment Research Council asked the crowd to
name its new £200 million polar resea...
@HelenBevan #Quality2016
TEN TIMES
as many
votes as the
next most
popular
answer
@HelenBevan #Quality2016
@HelenBevan #Quality2016
”If people give to a cause,
they expect a relationship,
not a transaction”
Nilofer Merchant
Once ...
@HelenBevan #Quality2016
1. Frame the issues in ways that
will engage and mobilise the
imagination, energy and will of
div...
@HelenBevan #Quality2016
This talk is bought to you by the
Horizons team
We tune into and engage with the best change thin...
@HelenBevan #Quality2016
1. Follow us on Twitter
@HelenBevan @TheEdgeNHS @School4Radicals
2. Subscribe to
theedge.nhsiq.nh...
@HelenBevan #Quality2016
Ashoka (2014) What does leadership mean in the 21st century?
Berg O (2014) The Collaboration Pyra...
@HelenBevan #Quality2016
Heimens J, Timms J (2014) Understanding “New Power”
Innovations- Kontor Väst (2013) Open innovati...
Upcoming SlideShare
Loading in …5
×

"It's time to rewrite the rules of change in healthcare"

859 views

Published on

Slides from Helen Bevan's talk at #quality2016 on 28th September

Published in: Healthcare
  • Be the first to comment

"It's time to rewrite the rules of change in healthcare"

  1. 1. @HelenBevan #Quality2016
  2. 2. @HelenBevan #Quality2016 Joining in this session • The theme of the session is connectivity and platforms for change • Please tweet using hashtag #Quality2016 • A challenge: make our Twitter conversational • We will get some feedback on Twitter activity during the session
  3. 3. @HelenBevan #Quality2016 What is happening in the field of change and transformation in the wider world?
  4. 4. @HelenBevan #Quality2016 Change is changing
  5. 5. @HelenBevan #Quality2016 What approaches to change are needed in this environment?
  6. 6. @HelenBevan #Quality2016 Kinthi Sturtevant, IBM 13th annual Change Management Conference June 2015 We rarely see two, three or four year change projects anymore. Now it’s 30-60-90 day change projects
  7. 7. @HelenBevan #Quality2016 Source: Bromford P (2015), ”What’s the difference between a test and a pilot?”
  8. 8. @HelenBevan #Quality2016 Change is changing
  9. 9. @HelenBevan #Quality2016
  10. 10. @HelenBevan #Quality2016
  11. 11. @HelenBevan #Quality2016 How does the NHS improvement community prefer to communicate? Digital Reactive
  12. 12. @HelenBevan #Quality2016 Change is changing
  13. 13. @HelenBevan #Quality2016
  14. 14. @HelenBevan #Quality2016 Change is changing
  15. 15. @HelenBevan #Quality2016
  16. 16. @HelenBevan #Quality2016
  17. 17. @HelenBevan #Quality2016 Change is changing Change is moving to the edge
  18. 18. @HelenBevan #Quality2016 http://www.slideshare.net/Openpolicymaking/policy-lab-slide- share-introduction-final
  19. 19. @HelenBevan #Quality2016 Why go to the edge? “ Leading from the edge brings us into contact with a far wider range of relationships, and in turn, this increases our potential for diversity in terms of thought, experience and background. Diversity leads to more disruptive thinking, faster change and better outcomes Aylet Baron
  20. 20. @HelenBevan #Quality2016 Starts on the fringe (at the edge) Starts with the activists Gary Hamel always
  21. 21. @HelenBevan #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
  22. 22. @HelenBevan #Quality2016 The Network Secrets of Great Change Agents Julie Battilana &Tiziana Casciaro As a change agent, my centrality in the informal network is more important than my position in the formal hierarchy
  23. 23. @HelenBevan #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
  24. 24. @HelenBevan #ngdpcohort17 “I have some Key Performance Indicators for you” or “I have a dream” Source: @RobertVarnam
  25. 25. @HelenBevan WHO makes change happen in healthcare? Source: adapted by Helen Bevan from Leandro Herrera List A • The Transformation Programme Board [or equivalent] • The programme sponsors • The Programme Management Office • The [insert number] work streams • The Clinical Director • The Quality Improvement team
  26. 26. @HelenBevan WHO makes change happen in healthcare? Source: adapted by Helen Bevan from Leandro Herrera List A • The Transformation Programme Board [or equivalent] • The programme sponsors • The Programme Management Office • The [insert number] work streams • The Clinical Director • The Quality Improvement team List B • The mavericks and rebels • The deviants (positive). Who do things differently and succeed • The contrarians, because they can • The nonconformists who see things through glasses no one else has • The hyper-connected. Good or bad, they spread behaviours, role model at a scale, set mountains on fire and multiply anything they get their hands on • The hyper-trusted. Multiple reasons, doesn’t matter which ones
  27. 27. @HelenBevan WHO makes change happen in healthcare? List B • The mavericks and rebels • The deviants (positive). Who do things differently and succeed • The contrarians, because they can • The nonconformists who see things through glasses no one else has • The hyper-connected. Good or bad, they spread behaviours, role model at a scale, set mountains on fire and multiply anything they get their hands on • The hyper-trusted. Multiple reasons, doesn’t matter which ones Source: adapted by Helen Bevan from Leandro Herrera List A • The Transformation Programme Board [or equivalent] • The programme sponsors • The Programme Management Office • The [insert number] STP transformation work streams • The Clinical Leads of workstreams • The Directors of participating organisations • The Change Facilitators
  28. 28. @HelenBevan What’s the evidence? The failure of strategic change projects is rarely due to the content or structure of the plans that are put into action It’s much more about the role of informal networks in the organisations/systems affected by change To make transformational change happen we need to connect networks of people who ‘want’ to contribute http://iedp.com/articles/vertical-leadership/?utm_source=Sign-Up.to&utm_medium=email&utm_campaign=13787- 257163-Campaign+-+01%2F09%2F2016 Source: David Dinwoodie (2015)
  29. 29. @HelenBevan #Quality2016 The essential flaw of quality improvement approaches The essential flaw of [quality improvement ] 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 trap Source of image: www.biblicalcreation.org.uk Read more at: http://www.slideshare.net/jurgenappelo/management-30-workout
  30. 30. @HelenBevan #Quality2016 Is your change process a cathedral or a bazaar? http://www.unterstein.net/su/docs/CathBaz.pdf
  31. 31. @HelenBevan #Quality2016 We have a lot of cathedrals Source: Sewell (2015) : Stop training our project managers to be process junkies
  32. 32. @HelenBevan #Quality2016 The power of the platform “Facebook, YouTube, Twitter and their lesser cousins have proved the power of the platform. They have shown that if your average 21st century citizen is given the tools to connect and the freedom to create, they will do so with enthusiasm, and often with an originality that blindsides the so-called creative industries. ….. Good leadership is no longer about ‘taking charge’ or imposing a strategic vision but about creating the platforms that allow others to flourish and create” Ashoka http://www.virgin.com/unite/entrepreneurship/what-does-leadership-mean-in-the- 21st-century
  33. 33. @HelenBevan #Quality2016 “Change comes naturally when individuals have a platform that allows them to identify shared interests and to brainstorm solutions.” Gary Hamel & Michele Zanini, 2014 Build a change platform not a change program
  34. 34. @HelenBevan #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”
  35. 35. @HelenBevan #Quality2016 Why platforms? “Platforms today power learning and innovation at the speed of change by providing collaborative and sometimes exponentially productive spaces for people to create value” John Hagel Source of image: Pinipa
  36. 36. @HelenBevan #Quality2016 Evolving kinds of change platforms: They overlap! 1. Connecting platforms 2. Mobilising platforms 3. Learning platforms 4. Knowledge platforms 5. Crowdsourcing platforms
  37. 37. @HelenBevan #Quality2016 Example platforms Source of image: @JenniferClemo
  38. 38. @HelenBevan #Quality2016 http://biggerboat.org/exploring-moodocs/ MOODOCs (Massive, Online, Open, Disease Oriented Communities)
  39. 39. @HelenBevan #Quality2016 The Academy of Fabulous Stuff • Half a million page views • Over 700 fab shares • 1,500 to 4,000 page views a day • Nottingham Safe staffing app: 2,500 views • Dovetailing vaccinations Scheme: 160 direct queries
  40. 40. @HelenBevan #Quality2016 https://youtu.be/eUApgJBZU8M
  41. 41. @HelenBevan #Quality2016 Source: OpenIdeo https://challenges.openideo.com/challenge/end-of-life/refinement
  42. 42. Diane Smith diane.smith2@swyt.nhs.uk @DianeCS9 Sue Barton sue.barton@swyt.nhs.uk @barnsleybart www.southwestyorkshire.nhs.uk Paula Rylatt Paula.Rylatt@swyt.nhs.uk @rylatt_paula
  43. 43. @HelenBevan #Quality2016 Source: @NHSChangeDay
  44. 44. @HelenBevan #Quality2016
  45. 45. @HelenBevan #Quality2016 Source: http://www.slideshare.net/alwynlau/learning-theories-learner-needs
  46. 46. @HelenBevan #Quality2016 10,000 Nearly
  47. 47. @HelenBevan #Quality2016 The School was formally evaluated by the Chartered Institute for Personnel & Development #EdgeTalks WebEx http://theedge.nhsiq.nhs.uk/expert /how-has-the-school-for-health- and-care-radicals-made-a- difference/ How has the School for Health and Care Radicals made a difference?
  48. 48. @HelenBevan #Quality2016 The School was formally evaluated by the Chartered Institute for Personnel & Development • Change knowledge • Sense of purpose & motivation to improve practice • Ability to challenge the status quo • Rocking the boat & staying in it • Connecting with others to build support for change Statistically significant positive effect on at both individual and organisational level
  49. 49. @HelenBevan #Quality2016 Nearly 100,000 connections (defined as a viewing, a download of material or an original tweet) • Latest no-cost solutions • 150 speakers • 28 topics • Live broadcast and on-demand
  50. 50. @HelenBevan #Quality2016
  51. 51. @HelenBevan #Quality2016 Should we undertake routine radiology investigations overnight for all our inpatients? How to build a change platform in an hour
  52. 52. @HelenBevan #Quality2016 The Change Challenge Tapping the collective brilliance of the NHS
  53. 53. @HelenBevan #Quality2016 14,000 contributions identified 10 barriers to change: Confusing strategies Over controlling leadership Perverse incentivesStifling innovation Poor workforce planning One way communication Inhibiting environment Undervaluing staff Poor project management Playing it safe
  54. 54. @HelenBevan #Quality2016 14,000 contributions identified 11 building blocks for change: Inspiring & supportive leadership Collaborative working Thought diversityAutonomy & trust Smart use of resources Flexibility & adaptability Long term thinking Nurturing our people Fostering an open culture A call to action Source: Health Service Journal, Nursing Times, NHS Improving Quality, “Change Challenge” March 2015 Challenging the status quo
  55. 55. @HelenBevan #Quality2016 Project Aristotle: http://qz.com/625870/after-years-of-intensive- analysis-google-discovers-the-key-to-good-teamwork-is-being-nice/ After years of intensive analysis, Google discovers that the key to high performing, innovative teams is psychological safety
  56. 56. @HelenBevan #Quality2016 Some lessons 1. You can’t control the outputs of the crowd 2. People want a relationship 3. Always, always, follow up
  57. 57. @HelenBevan #Quality2016 The Natural Environment Research Council asked the crowd to name its new £200 million polar research vessel
  58. 58. @HelenBevan #Quality2016 TEN TIMES as many votes as the next most popular answer
  59. 59. @HelenBevan #Quality2016
  60. 60. @HelenBevan #Quality2016 ”If people give to a cause, they expect a relationship, not a transaction” Nilofer Merchant Once you start down this path, you have to follow up and continue
  61. 61. @HelenBevan #Quality2016 1. Frame the issues in ways that will engage and mobilise the imagination, energy and will of diverse stakeholders 2. Take steps to be more social leaders, invest in digital skills & social connections & lead through networks as well as formal leadership systems 3. Find your B-list people & give them important tasks 4. Consider what/where your equivalent of ‘the edge’ is, so that you incubate radical & disruptive ideas & lead healthcare from the future 5. Build change platforms for important issues – create bazaars alongside the cathedrals 6. Adopt emergent approaches to planning & design, based on monitoring progress, learning & adapting as you go
  62. 62. @HelenBevan #Quality2016 This talk is bought to you by the Horizons team We tune into and engage with the best change thinking and practice in healthcare and other industries around the world and seek to translate this learning into practical approaches to change The team has emerged through years of supporting change in the NHS and wider health and care system A small team of people within the English NHS who support improvement and change
  63. 63. @HelenBevan #Quality2016 1. Follow us on Twitter @HelenBevan @TheEdgeNHS @School4Radicals 2. Subscribe to theedge.nhsiq.nhs.uk 3. Get materials from theedge.nhsiq.nhs.uk/school …and sign up for our monthly #EdgeTalks theedge.nhsiq.nhs.uk/edgetalks Or email me at helen.bevan2@nhs.net Ways to connect!
  64. 64. @HelenBevan #Quality2016 Ashoka (2014) What does leadership mean in the 21st century? Berg O (2014) The Collaboration Pyramid revisited Bevan H (2015) From change programmes to platforms Briggs D (2015) The elements of council as a platform Bromford P (2015) What’s the difference between a test and a pilot? Chesbrough H et al (2016) Why does open innovation work? Choudray P (2015) The platform manifesto: 16 principles for digital transformation Dawson R (2015) The future of work and organisations Deloitte University Press (2014) A movement in the making Deloitte University Press (2015) Business ecosystems come of age Hagel J (2015) The power of platforms Hagel J (2015) John Hagel at SXSW 2015: Narratives, platforms and movements Hagel J (2014) Platforms are not created equal: harnessing the full potential of platforms Hamel G, Zanini J (2014) Build a change platform not a change program Health Services Journal, Nursing Times, NHS Improving Quality (2015) ‘Change Challenge’ interactive toolkit Heimans J (2014) What new power looks like [YouTube] References cited in the slide deck (1/2)
  65. 65. @HelenBevan #Quality2016 Heimens J, Timms J (2014) Understanding “New Power” Innovations- Kontor Väst (2013) Open innovation – a handbook for Researchers Little J (2016) Change management is dead Milton N (2014) Why knowledge transfer through discussion is 14 times more effective than writing O’Reilly T (2010) Government as a platform Pearce D (2013) Social business discussions are the new documentation Raymond E S (2001) The Cathedral and the Bazaar Satell G (2015) 4 things you should know about platforms Satell G (2012) How power is shifting from corporations to platforms Satell G (2015) Leaders must do more than inspire – we must shape networks Schillinger C (2015) Forget social networks, think social impact [YouTube] Scrivens J (2015) Enabling the experience of wholeness within enterprise social networks Sewell S (2015) Stop training our project managers to be process junkies Shaw K (2015) Placing a digital platform at the heart of organisational change with Oxfam Simon P (2011) The Age of the Platform Van Alstyne et al (2016) Pipelines, platforms, and the new rules of strategy References cited in the slide deck (2/2)

×