Apollo 11 Chat Box Music Discussion

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Module 4 Chat Box – School for Change Agents
from Adrian Woodfield to All Participants:
Hello from a sunny Orkney!
yes - I'm early!
from Emily Lau to All Participants:
Yup!
from Emma Hill to All Participants:
yes
not yet.....guessing that you are asking if we can hear something?
is anyone speaking now?
No - just some background music
aah! - music and Apollo 11!
fantastic!
:)
from Helen Bevan to All Participants:
Hi everyone. Great to see so many of you signed on nice and early. Who is joining us today and
where are you?
from Douglas Natusch to All Participants:
Hi, my name is Douglas Natusch and I am joining you from South Devon

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though these normally start at three? but funky apollo music stuff is fine.
from Oliver Benson to All Participants:
We start at 3pm but play some music while people join us.
what album is it from? Anyone know?
from Tom de Salis to All Participants:
I prefer this to last week's music, maybe I should come early every week!
Track is Public Service Broadcasting - Go
PSB!
great! got to get that
from Leigh Kendall to All Participants:
Quite apt really!
it's because we are in mission control today
Orkney - go!
Birmingham - go!
old enough to remember this - wahted it on a COLOUR TV at junior school
from Kate Pound to All Participants:
Hi all great to see so many people today

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they had to rent it - too expensive to buy!
from Paul Woodley to All Participants:
Coventry - go!
from Paula Ward to All Participants:
Nottingham
hi Helen
Hi from sunny Bournemouth
Thunderbirds are go!
er - thanks My Tracey
*Mr
from Tony Longbone to All Participants:
afternoon all, hope we're well
from Fiona Mac to All Participants:
Hello from the Wild Borders of Wales
Can we have a playlist please? My kind of music!
I really liked to Apollo music
from Val Edwards to All Participants:
Hello all from a very sunny Salford, Manchester
from Kathryn Perera to All Participants:

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Hello everyone and welcome!
from Lucy Butler to All Participants:
Morning from Dunedin New Zealand
from Pip Hardy to All Participants:
Hello from sunny Cambridge!
Stunning weather in London, overlooking St James' Park today.
from Stacey Kavanagh to All Participants:
Hello, Stacey Kavanagh, from Advancing Quality Alliance in Manchester
from Heather Callum to All Participants:
Hello from Guelph, Ontario, Canada!
from Kirstie Lawrence to All Participants:
Hi all! Kirstie from Warwickshire here. Im a final year OT student.
from Jennie Huntley to All Participants:
Hello from sunny, springy Ashford in Kent - Jennie from Kent Community Health NHS Trust....yes
loved the Apollo song....please let us know whose tune that is
from Asha Gaines to All Participants:
Hey y'all! I'm from Atlanta, GA, USA Population Health Coordinator
from Sharon Brown to All Participants:
Hello from South Tees Hospitals in sunny, grass cut smelling Middlesbrough!
from Katy McNeil to All Participants:
Hi it's Katy from Scottish Government - sunny spring day in Edinburgh too
Hello my name is Tony, perched with my hand in there practicing one handed typing
from Sajjad Mushtaq to All Participants:
Hi from Birmingham, UK
from patricia wimmer to All Participants:

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Goos afternoon everybody, Patricia Wimmer from a sunny Tilburg, the Netherlands
from Georgina Ritchie to All Participants:
Hi Everyone, Im Georgina Ritchie District Nurse from University of Central Lancashire, not sure baout
the weather I havent seen daylight since early this morning
from Patricia Burns to All Participants:
Hi Patricia Burns from Edinburgh which is crisp and bright today!
from pramod kumar to All Participants:
Hi Dr Pramod Kumar from Wexham Park hospital , Slough
from Michele Young to All Participants:
Hi I'm in OUH anyone else attending?
from Malcolm Cooper to All Participants:
Hello to you all. Malcolm Cooper here enjoying a sunny day in South London.
Typing from Wolverhampton UK with glorious blue skies
from Yvonne Newbold to All Participants:
Hello all, I'm Yvonne Newbold, and I'm doing this from Wallington, which is both Surrey and London.
I'm at home and it must be a nice day because this is the first day in months that the central heating
hasn't had to be turned on!
from Brian Markey to All Participants:
Hi Everyone, I'm Brian Markey, Project Manager for the National ePrescribing Project in Ireland...
lovely day here too!
from Shelley Cornick to All Participants:
Hi from Shelley in Newfoundland Canada. We still have snow on the ground here and a heavy
snowfall forecast for the weekend.
from Lisa Sharrock to All Participants:
Hi everyone, Lisa Sharrock Team Manager RMN / CBT therapist North Staffs Combined Healthcare
Trust North Staffordshire enjoying the beautiful sunshine :)
from Wendy Johnson to All Participants:
Sunny, and blustery near Edinburgh

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from Rose McCaul to All Participants:
Spring has arrived in Dublin. My name is Rose Senior Environmental Health Manager Health &
Wellbeing Division HSE
from Rebecca Tringham to All Participants:
Here in Birmingham we have a beautiful blue sky :-)
from Rebecca Fyffe to All Participants:
Hi everyone, from Rebecca - NHS Fife, Scotland.
from Victoria Hill to All Participants:
Hi, Victoria, Pharmacist from Halifax, West Yorkshire - lovely blue sky here too!
from naomi ledwith to All Participants:
Hi naomi from manchester
I am a pharmacist too
Fab!
I miss having my own window, everyone seems to have their blinds closed!
from James Rawson to All Participants:
Jim Rawson from Augsuta, GA USA joining the call.
from Karen Perkins to All Participants:
Sunny lunchtime run, feeling refreshed!
from Shelley Huffman to All Participants:
Good morning - signing on from Ontario Canada.
from Claire Maggs to All Participants:
Good afternoon, lovely sunshine here in Birmingham, UK
from julie smith to All Participants:
Afternoon

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from Chrysta Mayhew to All Participants:
Sunny day in Toronto, Canada! Hello everyone
from Andrew Blane to All Participants:
Hello everyone from sunny Leeds
from Helen Bevan to All Participants:
Great to see such an outstanding diversity of people on the webex. We will start in 2 minutes
from Ans Luyben to All Participants:
hello everyone from switzerland
from Christine Clarke to All Participants:
Hello from Sunny Worcestershire
from Catherine Fleetwood to All Participants:
Hello from sunny West Yorkshire. Leeds to be precise :)
from Tom O'Sullivan to All Participants:
too nice to be inside! ;-(
lol @tom
from Jonathan Williams to All Participants:
Hello from sunny Lancashire
Hi everyone from Nottingham
from Emma Kelly to All Participants:
Hi from sunny East Kent (Ashford - not quite the seaside but not far!)
from Leigh Morgan-Jones to All Participants:
Thanks to Anthony for the Twitter chat this week
from MADELYN GRIFFITHS to All Participants:
hello from Bristol

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Hi all :-)
from Rachel Volland to All Participants:
@Jonathon Williams where are you in Lancashire? It is high from sunny Salford, Manchester here
from Malanie Greenaway to All Participants:
A group us here from chilly Edmonton Canada
it's sunny in Leeds, Malanie, but definitely still chilly!
from Lori Williamson to All Participants:
Hi from a lovely sunny Buckinghamshire
from Felicity Mitchell to All Participants:
hello all
from Caroline Carswell to All Participants:
Caroline @soundadvice_pro, from spring-time Dublin, Ireland!
from Bonny Johnson to All Participants:
Sunny and cold in the Ottawa Valley Ontario Canada
from Kate Emery to All Participants:
Hello from Gorleston, Great Yarmouth
from eileen sharp to All Participants:
Hi all from sunny Stirling, Beautifu view of the castle
from Tanya Burchell to All Participants:
Hi from a sunny Gloucester
from joanne reay to All Participants:
Lovely and sunny in Fulbourn but slight breeze.... windows open!
from Tracy Clifford to All Participants:
small keen group here in caledon ontario

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from Mel Harrington to All Participants:
Hi all - sunny in Carlisle as well, makes a change!
from Mandy Rudczenko to All Participants:
difficult to apply this to carer experience
from Rob Cockburn to All Participants:
Scored mine high, but that was 3 years ago and I know it has 'fallen back' since then - lack of
sustainability
from Andrew Marsh to All Participants:
yes 6.5!
from Becky Haines to All Participants:
This of course assumes that specific objectives were defined and measured:-)
i scored mine a 10 but, the objectives were not the ones to deliver sustanable change
my thoughts too
@mandy - as a carer, service standards, personalisation of care, TLAP?
the individuals that had to implement the change were not invested in it
from Charlotte Welsh to All Participants:
Becky that is what I was thinking!
I may not have known the objectives ...
from colin Waldron to All Participants:
No change made as business case did not stack up and project stopped:-(
Rate of failure

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from Maya Pajevic to All Participants:
70% fail
numbers that fail
safe zone
So Lean consultants can sell their business to you!
from vicki nash to All Participants:
fail rate
from Nigel Millar to All Participants:
someone made it up
Natural distibution of engagement and drop out?
LSC failure rate
from Hugo Lemay to All Participants:
critical mass
Research from Kotter, Fuda, et al
from Michele Wood to All Participants:
not sure
from Trevor Fossey to All Participants:
%of of failure
natural distribution

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i'd have put it at unsuccessful
from Jane Ansell to All Participants:
Fail rate
historic
from Jane Douthwaite to All Participants:
Total fail or fail to be as effective as they could be
from Avril Washington to All Participants:
But isn't this being challenged?
that is comforting somewhat when i consider my own failures
Often driven from unrealistic goals
Does this depend on how we measure? Surely some objectives would have been met, even if not full
change intended?
so are we asking too much or is the system too rigid?
both?
from jo Palmer to All Participants:
over what time periods?
1 -3 years is a short timescale for major cultural change
so proud to see i could class myself in the 5%

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Is it that people's hearts aren't in it?
Good chart here:
https://www.google.com/amp/s/www.forbes.com/sites/markmurphy/2016/06/05/this-chart-
shows-why-so-many-change-management-efforts-fail/amp/
too many competing priorities
Its that we dont get where peoples hearts are
too many cooks!
from chris malvern to All Participants:
scopecreep a big factor - sometimes objectives change....
Constaqnt organisational changes prevent individuals from following through with projects they
start
Lack of honesty about what the challenges really are
not enough CO-PRODUCTION!!!
5% that maintain change would also have to achieve change in the first place
Inability to openly discuss what's wrong without blame
change is often forced on others without ensuring that this change is wanted

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Often context has changed by the time you are scaling up, so maybe we need to be better at
continual review of change methods
Intersting - was involved in Spinal Collaboration - what learnign was there from those projects in
terms of scaling out from pilots?
human factors - we don't like admitting it didn't work....
No commitment with the goals set
@Becky Haines I cant get that link to work
from Angela Catley to All Participants:
Sometimes scale can be 'scaling out' not just scaling up. The collective impact of lots of small
connected things.
change is hard - until you change yourself first
The passion shown by leaders of change isnt felt by those that are left behind to manage it-
Stakeholder engagement needs to go beyond retoric, it needs to benefit individuals
people moving on to new roles during change programme can be big issue - need to maintain core
team and commitment
www.forbes.com/sites/markmurphy/2016/06/05/this-chart-shows-why-so-many-change-
management-efforts-fail/amp/
Maybe this?
we don't invest enough effort in evaluation to demonstrate benefits....

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individuals need to have ownership of the project too many are done TO them, not WITH them
from Stuart Clough to All Participants:
Coproduction, common goals and taking people with the change is the key for me. Communication
vital.
Vested interests? People wanting things to stay the same for their benefit?
Yes power 'with' and not power 'over'
Expectation is that change will happen in a very short space of time....
Yes Caroline Carswell!
If you havent changed yourself at teh beginning then you will just get people down
Achieving organisational change
through values alignment
Christopher M. Branson
St Francis College, Crestmead, Australia
for change to stick - it needs a gradual, inclusinve process
@Becky Haines, precisely, the magic bullet springs to mind!
Yes! Give up the illusion of control and get on with it.
Silos prevent horizontal processes!

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Why do we expect that everyone will be rational - we only imagine that we are personally - self
reflect to get going
Change needs to go from grassroots level if possible - our experience anyway
Yes - the goal is the goal - agree
Networks of motivated people better than hierarchical 'must-dos'
Read anything from Vanguard Consulting for faiure reasons - John Seddon is a great mentor.
@Victoria - yes, networks of motivated people! Sometimes patients / citizens.
Don't forget the external factors that may be opportunities to deliver the change
Senior managers fear having to hand over control of a project to staff = a sign of weakness in the
manager, not the staff
CHange is about helping people grow - not controlling their path
from Naomi Brook to All Participants:
The change process thinking itself is asset based. i like this framing
@Adrian - Best change is network driven, peer to peer if possible.
Forget who said it but "coach the senior managmeent to get out of the way"

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absolutely Nigel, change grows in my experience
from Linda D'Arpino to All Participants:
And students!
Yes Victoria Hill...Kotetr's premise in Accelerate
Kotter
Loving this asset map...
Asset mapping focuses on passion of community members to be successful
Aligning the change to the organisations values (and our own) should be meaningful
Yup - come across all of these at some time or another...
In the middle of reading Accelerate!
Dont play it safe with change - let the team provide safety by being empowered
it needs to include the barrier of lack of patient/carer involvement????
Tip o' the hat to @Jim_Rawson_MD re asset mapping
Too many strategies.

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https://www.hsj.co.uk/5083572.article link to the HSJ
from Karl Fredrik Westermann to All Participants:
Thanks, Kate! :-)
from James Rawson to All Participants:
Thanks Becky
For change you must have 1. A Vision 2. A strategy 3. People engaged - then they can make a plan
It's the exec that has no strategy, We do. They block it
can they make the vision Nigel?
Conflicting priorities at directorate level - silo working
This is so true! Need for a fewer priorities
Agree Avril.
love this film from Nottingham (NUH) about their Just Do Its! https://www.hsj.co.uk/5083710.article
FOr change do not plan for people - help people make their plan for the agreed vision and stategy
Insightful Avril
from Felicity Mitchell to All Participants:
we don't want buyers, we want investors .... module 3 :-)

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co-design with 'customers' is also critical
from Freya Burns to All Participants:
investment rather than buy in?
Perfect example- Budget announcement & Primary Care Streaming Guidance GPs at the Front Door
is a Must Do. Other NHSE CHannel Shift Guidance published the same week says it snt cost effective
which was backed up by York University Lit Review which agreed. Mixed messages
get the frontline focussed and everything else will fall into place
The priority of public sector policy makers is rarely the same as the priority of local people and vice
versa. The knack is translation and connection
Love this: The knack is translation and connection
I work in Workforce Planning, so probably shouldn't admit to that one!
True for any organization seeking to make change
@Felicity, @Mandy - perfect points!
fair to say, they're all issues!
Also lots of differeent strategies that impact on each other but don't connect
'peverse incentives' - what incentives??
from Muhammad Ali Abid to All Participants:
How does one balance Project management with Complex science of change?

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Try STP for size as a confusing strategy!
Perverse incentives: Make change, but keep doing what you've been doing...with the same
resources
from Bev Matthews to All Participants:
Agree Mandy - Participation, codesign and coproduction are key for creating the conditions for
moving to 'What matters to you' culture
Common themes throughout - quiet shocking really
spot on Becky
Vision and strategy are actually the easiest thing to agree - so start there for effective change
There is some information on our web site at NUH about our Just Do It Scheme please take a look.
Thanks Kate
For inspiring leadership for change try starting with your service users - eg patients
Open culture?? not had that in 17 years of working for the NHS
IMHO we make all of this too big...start small and demonstrate success at grassroots then move it up
in the organization
Interesting to ask this question to people in different roles - a project manager may have a very
different view than perhaps a frontline team member vs senior leader. Need to talk more and keep
folks open and engaged.

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A lot of these mirror the previous set of factors which you woudl expect as the positive side of the
coin
none
none
from Si Chun Lam to All Participants:
Seen cases of perverse incentives in the form of very poorly designed "KPIs"
from Bev Matthews to All Participants:
the #EndPJParalysis is a fab example of just doing the right thing
what does 'thought diversity mean?
differences of opinion
from David Grier to All Participants:
None are present. all are problems by their absence
We're getting there...lots of innovation attempts now that never would have happened before, but
not painless
different ages/levels of seniority/background
@becky i couldn't agree more, started small and was astounded where things ended up
https://www.nuh.nhs.uk/justdoit here is the link to the JDIs at NUH
wheres the option for all or none?

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from Kim Vereijken to All Participants:
Leading by example!
Thx Tony
tick them all! :)
I'm thinking about kingsfund; no more heros. Need to encourage continual improvement, not LSC?
collaborative working vs. too many cooks - how do we balance
from Michele Wood to All Participants:
sadly I have to leave early today, but will catch up with the recording of the rest of today's session.
Yes Tom! No need for heroics...exhausting. Just do a little bit everyday so it becomes the normal way
of working
I ticked them all but would really value someone to challenge that with me..
Dissappointing leadership result
but i only ticked them all by working outside of my organisation !
Also, something about network solutions being difficult given the 'market' environment.
from Angela Rowe to All Participants:
Thought that too Jane....about a third with inspiring, supportive leadership

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If you are looking for passion for improvement which needs change then start talking about how you
feel and help people explore their feelings
@LucyButler: https://www.kingsfund.org.uk/sites/files/kf/Future-of-leadership-and-management-
NHS-May-2011-The-Kings-Fund.pdf
this sounds great
Need to recognise hard work too, even if intended progress not made
from Lucy Butler to All Participants:
Brilliant - thanks Tom
Intersting, the parallels with people learning condition self management skills is strking
thanks lucy
I would suggest reading Daniel Pink "Drive" about motivation
my best days are always the ones where i feel things have been progressed and achieved
happening less recently
I would agree - we are in limbo with a big service provision change at the moment - there is no
progress and it is so demotivating
from Avril Washington to All Panelists:
Ignite joy! Yes!
"Flow"

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ahahahahah!
Making the progress and celebrating that progress, sharing the joy
Have realistic expectations
Maslow!
Lack of progress is so demotivatig - I struggle with resiliance at times when it can feel out of my own
control
is it about change or about reinvigoration?
Another good one: https://hbr.org/2014/06/engaging-doctors-in-the-health-care-revolution
To help with motivation for change talk about what really matters - ask Why are we here - you will
be surprised how much you agree
from Andrea Selley to All Participants:
Intrinsic motivation - so important!
Fun - yes - helps with stress
from Susan Martin to All Participants:
The suggestion about Dan Pink is great - his most recent 'Pinkcast' about finding your purpose (which
is really your organization's purpose) is very fitting for this
discussion.http://www.danpink.com/pinkcast/pinkcast-1-18-a-5-minute-exercise-for-discovering-
your-purpose/

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Sadly I think we loose sight of the intrnsic personal motivators for people sometimes and use a stick
Yes Adrian! Realistic expectations and the sense that we can walk before we run and be successful
thanks @BeckyHaines!
Ask what matters to you rather than what is the matter?
Thanks Susan for gr8 link
from david broomhall to All Participants:
This is what my trust uses for quality improvment
yes rachel
Wow. so many interesting references to go away and read - pots of tabs open!
Public Sector ---reward??? ...
yes me too, need to bookmark these tabs!
Dan Pink is great - 'Drive' particularly good
Can't keep up with them - clicking and nothign doing!
this links to motivating self-care - e.g. Health Coaching

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@Rachel - communicating what matters to you, can lead to finding mobilisers
from Alison Wilson-Shaw to All Participants:
Some intrinsic motivation can be those who work with their head and not their heart because that is
how they are wired and must not be lost in this!
Intrinsic motivators may not be within your current organisation / workplace
Intrinsic motivation means - "What is in your heart?"
Thanks @Nigel
if we relate this to maslows hierarchy of needs, where would intrinsic motivation lie? do they come
before the sense of security and food/belonging
from Ken Hancott to All Participants:
They're subconscious drivers!
Health is easy when it comes to intrinsic motivation - almost everyone will agree that we are here for
the wellbeing of the community and patients
from david broomhall to All Participants:
www.wwl.nhs.uk/News/2014/.../wwl_already_leads_the_way.aspx
How do you deal with a sitution where you have to do something, but neither motivation is there
apart from otherwise you'll get disciplined?
INcentives are a devisive form of primary motivation
Caregivers in US incented to do stuff to patients, but changing to value-based care where we are
working for and with patients

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payment by results??? not happy about that.... smacks of private companies
I wonder if intrinsic motivators find it harder to deal with stagnation/lack of change. Hit hard when
you are so passionate about the cause
Disincentive demoralise because they appear to be amoral and harmful to our community and
patietns
There's a piece missing - CO-PRODUCTION
great point @Emma Kelly
Thank you Mandy
@EmmaKelly - couldnt agree more....
clustering is no different to payment by results, cquins it's all there we just don't hear about them
I think the key is its not all or none! You need a balance !
Agree @Mandy, although if you use this model in collaboration, I guess that works?
Mandy: what about leadership by all = PFCC (Patient and family centered care?)
from Ken Hancott to All Participants:
We all have intrinsic motivation. More empathy with others' motivation is necessary.

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@Mandy encompassed in Shared Purpose?
Avoid being eaten up by others attempts to motivate you - keep to the core - what matters to our
community and patietns
Yes Muhammad!
@Rob - not if we pressume we know best! Professional 'expert' power...
Thanks.....I think it's rife in current enviornment and we need to keep the passion of our teams
*presume
change agents need to have responsiblity AND authority - not just responsibility.....
Adrian - or at least a lever into authority?
How do we get through the curent change fatigue?
Love examples of tools that make this intentional rather than "good ideas" Discipline needed to
review outcomes along the way and adjust as needed
from Fiona McKenzie to All Participants:
@Mandy Good challenge. For me it's encompassed in the first 3 - shared purpose, leadership by all
and motivate and mobilise
from Ejiro Ohare stratton to All Participants:
How do we promote that shared purpose with our leaders?
autonomy more important than authority?

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@naomi - yes, agree
how do we define authority?
So true Adrian - so we must cede the authority to the people
KPIs drive perverse behaviours
could fit Co-Pro into some of the pieces but then can get 'TEA-BAG CO-PRODUCTION' - just dip it in
for a few seconds!!
Responsible is being accountable - authority is being in control (usually an illusion)
@Mandy - lol. So true.
How to balance intrinsic leadership with the top down demands that are part of many leadership
roles? Changes that may not be on our agenda but is the national or organisational agenda
interstingly
From Ejiro More importantly how do we get them to listen to the quite vioces in thier midst?
authority in this context is the "permission" to carry out action
Very true Adrian - so we have to try not to hang on to authority and share it out

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Compliant People can sometimes suffer from Functional Stupidity which basically means they do
their work but don;t think about it!
@Mandy - TEA-BAG COPRODUCTION - Brilliant!
waiting for permission to act isn't always the way to go...
love the LD example template.....dot voting a great democratic tool too....
distributed leadership does rock...
might be waiting a long time for permission
@Naomi- love it!
Dan Pink again... https://www.youtube.com/watch?v=u6XAPnuFjJc
#JFDI :)
Temptation is to see people as one or the other, but really lots of gray here
from Frances Mead to All Participants:
you need both kinds of people the trick is knowing what each needs to motivate and enthuse them
yes @NaomiBrook
I worry in this kind of model that we are demonizing/judging a group much as we have done in the
past with introverts

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thanks @emma :)
Love being a contributor. Far from compliant! Born rebel!
Yes Frances! colleagues who may be perceived as compliant may be actually more thoughtful. Also
valuable
When you run the next trinaing event for improvement - give all participants an authority card - "You
are hereby authorised to change the system" - best if signed by the CEO
Plodders & achievers in 80's speak, turns out we need both.
you can work with employees to change from compliant to contributor. LISTEN to them and give
them responsibility
How are executives measured against this ie mainly contributers or compliant?
seek forgiveness, don't ask permission...
was told many years ago by a director from our trust - if you see something needs changing, just do
it. we need to ask permission once the groundwork has been done and are ready to make the
change
Think we are a (small) organisation of contributors - not sure if that is a good thing or not! Do we
need balance?
@nigel - love that idea - stealing it for next time :)

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Exceutives are emasued by the ctlrue of the organisation and the engagement of the people
lol @tom
i live by that Tom
Yeah - a slide with CO-PRODUCTION on it!!!!
me too @tom!
Harry is correct - cede the power
Even with permission to change, need support
haha @mandy is happy!
generally i find people find it hard to let go
Co-production is key!
public value management...oh no... :-)
We need our managers/executives to be contributers, but the higher structures want them to be
complainents!
energising people is the key to creating effective change - it matters to them

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SO true @AlisonWilson-Shaw
If the focus is on patients, its easier to let go of old ways of working.
'a facilitator of joy' on a job spec - love this !! I'll be going for that job..
LOVE the term Facilitator of Joy!
This is rining bells in my mind making me think of the Mental Health "Recovery" movment...
absolutely @becky - focus on why we are doing this
once the joy is gone- I move to find new joy. "who moved my joy?"
I think I will take hypertension of my job description and add facilitation of joy
@Clare v true, also hello CPD!
Love it Nigel!
Who is this Joy and where does she work
Brill @JulieSmith!!!
Empathy not just for patients but for your staff too :)

33
works really well along side the project I work on that have a 'dream based provision'
i no longer allow others to steal my joy
*projects
BUt I will keep taking the tablets to be on the safe side
We're all going to ACR HR later today and changing our job descriptions:-)
Agent4Change and Joy Faciltator - great!
THe best job description is one you write yourself
lol @adrian
i dont facilitate joy- I spread it
@Nigel so true
i seek it
i seek, facilitate, embody and spread it :)
#1 on this list is so prevalent!!!!!

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Joy is my middle name
To keep energy for change keep recharging your batteries by talking yo your service users - write a
journal and highlight the god days to read again later
Aha! Freya - you are the missing Joy
@Nigel - yes - credit where credit is due!
Ideally the change effort morphs into a new change effort that keeps change a constant
http://pixar.wikia.com/wiki/Joy
Last year, I acheived 3. I was not prepared for the personal impact. im still struggling
Very true @Nigel. Reconnecting with patients or service users recharges the batteries
joy comes from engagement and considering wellbeing...
Build the energy change and keep doing it - go thermonuclear
Finding your 'flock' is so important for joy
What if it just becomes the way you work with engaged and motivated teams and individuals who
are always looking to spread joy and improvement?
Yes @NaomiBrook!

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@NigelMillar - take laughter three times a day, with water. p.s. Joy is 82, low blood pressure and
retired! :-)
Put the 5 together and you reach a critical mass -
but what do you do when the flock moves off and leaves you behind?
create your own flock
from Kate Emery to All Participants:
@Julie Smith - find a new one :)
@Julie Smith: be happy knowing that you are disseminating your work broadly and find a new flock:-
)
https://www.depts.ttu.edu/upwardbound/books/the-7-habits-ofhighly-effective-people.pdf
The Golden Thread of Relationships!
Psychological energy - ask for forgiveness not permission! :-)
Yes @catherine Fleetwood! can be tricky though
@Julie - run with the pack of wolves
http://qualitysafety.bmj.com/content/early/2015/06/02/bmjqs-2015-004160

36
Psychological safety, oh yes...
Love these five energies
absolutely @Naomi - takes courage!
Thanks, Chris! :-)
You can change one step at a time - it helps to achieve 10,000 steps per day
from Ejiro Ohare stratton to All Panelists:
Love these energy domian too
^lol!
oh dear...im on the wrong side of the energy level
'facilitator of courage' @catherine fleetwood?
one for my CV haha
right, thats enough. Flock, where are you
Me and my team too!
Problem is big differnce between energies inn my organsiation vs my department!
from Chris Butler to All Participants:

37
loving the connection between these 5 energies and change
#findyourflock
Love these energy domian too
The difference between Monday and Friday! :)
we're all here @julie smith
....and reason leads to wisdom..
Love this slide!
You also need dark energy
fatigue
intellectual
from Isabella Davis-Fernandez to All Participants:
isolated
intellectual
Physicial
from Shawn Volk to All Participants:

38
Physical
Intellectual
from Adrian Sieff to All Participants:
intellectual
Intellectual
intellectual
intellectual
spiratual
Intellectual
psychological
Intelleculal
Interllectual
Intellectual
from Jen Quinlan to All Participants:
psychological

39
intellectual
from Ann Quinn to All Participants:
physical
Intellectual
intellectual
fatigue
Social
intellectual
intellectual
Intellectual
fatigue
from James Turner to All Participants:
intellectual
from Dawn Plimmer to All Participants:
physical
fatigue
from Ans Luyben to All Participants:

40
intellectual
Intellectual
Psychological
from Keira Azzopardi to All Participants:
intellectual
Intellectual
from Sarah Emery to All Participants:
intellectual
intellectual
Intellectual
Physical
psychological
psychological
from Seonaid Beddows to All Participants:
psychological
oh i misunderstood the q! :)

41
fatigue
from Drew Carr to All Participants:
[ntrllectual
from siobhan bonham to All Participants:
intellectual
Intellectual
intellectual
from Michelle Grouchy to All Participants:
intellectual
from Michelle Lewis to All Participants:
Intellectual
intellectual
intellectual
from Rose McCaul to All Participants:
Intellectual energy
intellectual
only thing that matters is what can be measured
from Gillian Sage to All Participants:
uncommitted
from Judith Thomson to All Participants:

42
Intellectual
Me too! Yes - completely agree with Helen
from jean dipple to All Participants:
intellectual
from Anthony Alleman to All Participants:
anything other than intellectual energy, seems illogical
this reminds me of something i saw today actually
and again..........I have a dream! (not a 10 point management plan and extensive evidence base
non!
non
non
from Christine Clarke to All Participants:
Non clinicians
Excellent point @Rob!
non
from Cathy caple to All Participants:
clinicians

43
non
non
clincians
non
clinician
non
clinians
from Keira Azzopardi to All Participants:
non clinicians
from Marie Parish to All Participants:
clinicians
clinicians
non
non (sadly)
non

44
non clinicians
non clinicians
non
non
non
non
clinicans
ckinicans
@anthony Alleman - live long and prosper
clinicians
non
from Steven Amrhein to All Participants:
no
non

45
clinicians
Non clinicians
Clinicians
clinicians
clinicians
non clinicians
clinicians
non
Non
non clinicains
from Shawn Volk to All Participants:
Clinicians
no
clinicians

46
Clinicians
clinicians
from Sorrel Talbot to All Participants:
clincians
clinicians
from Anthony Alleman to All Participants:
non
non
non-clinicians
clinicians
yes
clinicians
Non
from Aoife Gallagher to All Participants:
clinicains
clinicians
from Jocelyn Bennett to All Participants:

47
clinicians
non
non
from siobhan bonham to All Participants:
clinicans
from Sharon Kelly to All Participants:
clinicians
non clinicians
from Amy Newbery to All Participants:
clinicians
non clinicians
clinicians
from Asha Gaines to All Participants:
clinicians
from Cathy caple to All Participants:
higher
wow
vocation!!

48
lower
https://twitter.com/Lukejones03/status/839820715587141632/photo/1
lower
lower
lower
lower
from Sorrel Talbot to All Participants:
lower
higher
lower
higher
lower
lower
from Marie Parish to All Participants:
higher

49
lower
lower
lower
lower
lower
lower
lower
lower
Lower
lower
lower
lower
higher

50
higher
from Ashley Burton to All Participants:
higher
CEO closer: lower
from Hugo Lemay to All Participants:
hjigher
lower
higher
higher
higher
higher
higher
higher
high
from Cheryl Mudge to All Participants:
lower
from Mubashir Arain to All Participants:

51
higher
higher
lower
higher
from Rachel Volland to Joanna Hemming (privately):
higher
lower
higher
higher
lower
higher
higher
higher
higher

52
higher
from Jennie Huntley to All Participants:
higher
higher
!
higher
higher
higher
higher
My work is my vocation
no...really.
higher
higher
higher

53
The nearer you are to the sun the greater the risk of burning up
from Chris Bungoni to All Participants:
higher
feel connected to the top
higher ... and oblivious to reality !
power is sucked out of them......
might be to do wih autonomy
and a higher extrinsic income / opportunities ...
id like to measure this
so skewed
ha look at those intellectual scores
back to results again
thats no surprise
and the reason why it feels bumpy is the wheel aint round

54
so, no selfcare?
ideas that remain on paper or in the mind
And of STPs - that's a worry
well they arent going to get off the ground are they?
Thats because the plans were done by one person and not shared
They will try to impose
STPs are being done for the wrong reason - money not better care provision.....that's sapping energy
from everyone!
Co-Creation
fantastic Red Team - go CoPro
Let's face it, we can't know everything. > focus on intellectual is to reduce risk inherent in change
activities
re: intellect https://twitter.com/Lukejones03/status/839820715587141632/photo/1
codesigning
Bet the red plan was a story not a narrative

55
@avril - yes - the "old" power
i woldnt want to be in the purple one
THe balanced place is where and equal number of people complain that there is no plan or that
there plan is too far ahead
from Hazel Murgatroyd to All Participants:
theyll get off the ground bu be draging folk with them ..... creative logic. Its a better combination
from Elizabeth Bleu to All Participants:
Interesting that intellect and physical are "external" compared to spiritual and psychological that
require a deeper level personally of commitment and energy
but what if your whole workplace is so lopsided - never mind plans for change?
Need quite a team to achieve all that
thats ok
Love the Luke Jones
gotta go sorry!
Also exposing social and spiritual and psychological energy requires trust in other members of team
Yes Elizabeth Bleu!

56
One person can have high psychological energy and benefit from rising social & spiritual energy in
the right contexts.
quite agree with you Becky TRUST is key
Great session & brilliant contributions from Participants thx
leaders are teflon-coated
Agree 100% Adrian...resilience
shared purpose = transformation
leaders have to be teflon coated or they don't have enough resiliance to do their job!
i never want to be so thick skinned though that i lose my ability to feel
A shared porpoise adds to the fun - they are so smart
that's an individual task for me!
But we are sold things with shared purpse disguise but really defacto
@tom - agree - but means that they aren't accountable as well
Remember we are all leaders. Beware reinforcing them and us. We are all signal generators.
Change starts with me!

57
Co-creation should lead to shared purpose and then co-production
STP - defacto puporse in our organisation.
Thanks for reminder Hazel!
The social movement tenets!
Seth Carguilo my hero!
@hazel - you are right - my bad
love the Seth quote
@adrian... Not bad. Full of potential to make and shape great choices :-)
from Hazel Runyararo Murwisi to All Participants:
shared purpose is key
Mind the Gap Coventry :)
yes @angela!
Shared purpose- so important to sustain energy
totally resonates and we've recently agreed we need to do more

58
Perfect quote to end on
Jaben - yes investment is two-way
@Adrian - so much accountability in the system is self serving, this is where it comes full circle and
back to patients.
Good visual
great visual!
I lied! Dov Seidman is my new hero!
from Marjolein Don to All Participants:
Question: Do you think you can get a shared purpose whilst having defacto purpose(s)?
lol @avril
love the last slide
#offthehook
quite a challenging session today
agree @adrian
from Lisa Saminaden to All Participants:
An excellent session love the last quote

59
like it!
Great session thanks
Last slide makes me verklempt (sp?)
Great thank you
Great session - many thanks
A very good session - thank you everyone
love the quote!
Good for thought...Much to think about
good change is messy - coproduction is messy
thanks for today
thank you for another challenging and inspiring hour
Two roads diverged in a wood, and I - took the one less travelled by; And that has made all the
difference (Robert Frost) #boatrocker
from Angela Rowe to All Participants:
Brilliant session - thank you!

60
from Lisa Sharrock to All Participants:
Amazing session thank you so much Helen
thank yoo
Another great session..
Thank you
Brilliant module - lots to reflect on
Great session - I love the fact that we are looking to change the way we change.
Marjolein: htink we need both or no action
Really enjoyed the session with inspiring things to think about thank you
Disrupting ourselves - love it
'be the change you want to see' - ghandi! :)
thank you again for an enlightening session
Thanks all & @Sch4Change
I'm off to spread some joy....thank you!
from Ruth Nelson to All Participants:
Still reminded on being the change I want to see...

61
from Tami Rich to All Participants:
Helen YOU'RE inspiring! As a medical mom I may be solo out here but the energy you speak of -
which I get from the patient community - is what refuels me. I turn to that when I feel down. At this
moment I see a mic drop #BeTheChange
Utterly brilliant session. Thanks all!
from Marjolein Don to All Participants:
Thanks Becky - it seemed during the session that shared is better than defacto...
Loved the session and particularly like Dov seidman quote. Thank you :)
Many thanks Helen and Team. I feel like I have had an injection of hope. Sorry not to be able to
participate in the chat room.
from Lisa Stewart to All Participants:
Thank you!
Great presentation! Thank you!
thanks, great session
Thanks for a great session from your pals at the American College of Radiology
Great inspiring session, thank you
Thanks Helen, et al
Thanks everyone - I hope you can stay for the breakouts shortly...

62
Thanks!
Thanks Helen -- great as usual.
sorry can't stay for the breakout session
Tschüss
Thanks a lot
Thanks Helen
Thank you so much Helen. So much energy. It's contagious!
many thanks - have to go now
Thank you
Each session buillds on and is more inspiring than the last ! Thanks
many thanks :)
Many thanks for another great session, lots to think about. I'm unable to stay for the break out
session, hope you all have some fab convos.
Thanks, #Stay Well

63
0800 917 1950
33136606#
Great session, sorry have to go!
OK all just finished breakout session. Interest in further info on Energy for Change and the
assessment tool behind it. I did note that it is normally carried out by a trained facilitator (did
training several years ago with Rosanna). Happy to follow up.
Thanks for a great session
END OF CHAT BOX

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