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Patient advisors as change agents

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Patient advisors as change agents

  1. 1. How to be an effective change agent! October 16, 2015 Marlies van Dijk Alberta Health Services @tweetvandijk #PFAC2015
  2. 2. What is a Change Agent? • Champion for change • They name things that others don’t see yet • Point to new horizons • A person who acts as a catalyst for change • One who resist status quo when they see there could be a better way
  3. 3. “The people who are crazy enough to think that they can change the world are the ones who do”
  4. 4. What are your top three challenges in leading change? 1. Afraid I might hurt my reputation/career 2. The lead on the project resists most new ideas 3. Hate dealing with conflict and controversy 4. Working through approval processes makes me crazy 5. My ideas go against the culture of my organization 6. Don’t know enough about how to lead change 10
  5. 5. Which one of the following best characterizes your change efforts? 1. Influencing people resistant to change 2. Trying to get complacent people to care 3. People agree with me but I see no or little action as a result of this 4. Leading a group of committed change agents 11
  6. 6. What problem are you trying to solve?12
  7. 7. Change Agent Value… 33.7% Source: Lois Kelly, Organizational Radicals, Foghound Study
  8. 8. Troublemaker Vs Radical (Change Agent) “Troublemaker” “Radical” Break Rules Change Rules Complain Create Assertions Questions Me-Focused Mission-Focused Anger Passion Pessimist Optimist Energy-Sapping Energy-Generating Alienate Attract Problems Possibilities Worry That Wonder If Doubt Believe Social Loner Social Source: Lois Kelly, Organizational Radicals, Foghound Study
  9. 9. Where do you fit? Have you shifted between the two? Table Discussions
  10. 10. Constructive Conversations • Constructive what/if conversations examine assumptions, open up possibilities, invite everyone to contribute and value all points of view Lois Kelly, Foghound #WhatifAB
  11. 11. Possibilities • Ask questions that highlight possibilities vs. damn the problems • Problems create energy, problem dissing saps it Lois Kelly, Foghound
  12. 12. Christina Costello, Babson Entrepreneur Experience Lab
  13. 13. Create Clarity • Communicate in ways that creates clarity from complexity • Define context, relevancy, value Lois Kelly, Foghound
  14. 14. Let It Breathe • Velocity scares people • If we go to fast, we can mow over people, hurting our chances to affect change • People often need time to absorb a new way Lois Kelly, Foghound
  15. 15. Listen • Ask good questions • Become a keen listener • Curiosity Lois Kelly, Foghound
  16. 16. 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 Change agents Source: adapted from Debra E Meyerson CHANGE me BEGINS WITH
  17. 17. What is something that has worked for you? Table Discussion
  18. 18. Framing “People change what they do less because they are given analysis that shifts their thinking than because they are shown a truth that influences their feelings.” (John P Kotter (2002), The Heart of Change)
  19. 19. Framing • Connect with people’s hearts and minds • Turning opportunity into action • Hooks to pull people in • Springboards for mobilizing support • Need to be authentic and connect with reality
  20. 20. h?v=CNhYbJbqg-Y
  21. 21. #SCHR #Quality2015 @HelenBevan @BoelGare @jackielynton 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:
  22. 22. Source of image: installation by the artist Adam Katz Via @NeilPerkin
  23. 23.
  24. 24. #SCHR #Quality2015 @HelenBevan @BoelGare @jackielyntonImage copyright:
  25. 25. is the new normal! “By questioning existing ideas, by opening new fields for action, change agents actually help organisations survive and adapt to the 21st Century.” Céline Schillinger Image by
  26. 26. Source: Lois Kelly
  27. 27. What are you trying to change and how is it going? Are people changing things or behaviors? Do you see movement? how did it go over?
  28. 28. Assumption s Fears Love way it wasCertaintyDiscomfort Why is change so hard? Time That which we’re afraid or unable to admit 40
  29. 29. • If you’re not part of the solution, you’re part of the problem. • If you’re not part of the problem, you can’t be part of the solution. 41
  30. 30. #SCHR #Quality2015 @HelenBevan @BoelGare @jackielynton#SCHR #Quality2015 @HelenBevan @BoelGare @jackielynton 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
  31. 31. #SCHR #Quality2015 @HelenBevan @BoelGare @jackielynton 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
  32. 32. C
  33. 33. Source:
  34. 34. Source:
  35. 35. Source:
  36. 36. Source:
  37. 37. Source: Make it a personal PERFORMANCE target.
  38. 38. Source:
  39. 39. 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:
  40. 40. How have you handled “no” before? Any other strategies to cope with it positively? Table Discussion
  41. 41. Patients are our best business consultants as they provide an outside view to providers
  42. 42. Imagining and leading change may be the most important professional competency you can practice.56
  43. 43. The Action @pts4chg @epatientdave @reginaholliday #ChangeDayAB
  44. 44. Marlies van Dijk @tweetvandijk #ChangeDayAB

Editor's Notes

  • Why is change so hard? Organizations that destroy the statut quo win. Individuals who push their organizations, who inspire other individuals to change the rules, thrive.

    On average, it takes 17 years for research to translate into practice
    Big change only happens in healthcare organizations because of radicals
    The passionate people who are willing to take responsibility for change!!
  • opinion profoundly at odds with what is generally accepted.
  • Colleen
    Yet, what happens to radicals??????????

    Let’s think about Heretics….Heresy is any provocative belief or theory that is strongly at variance with established beliefs or customs. A heretic is a proponent of such claims or beliefs.[1]

    The end results for people who challenge established ideas/conventions isn’t always pretty!
  • Ignaz Philipp Semmelweis[Note 1] (July 1, 1818 – August 13, 1865)

    a Hungarian physician known as an early pioneer of antiseptic procedures.
    Described as the "savior of mothers", Semmelweis discovered that the incidence of puerperal fever could be drastically cut by the use of hand disinfection in obstetrical clinics. Puerperal fever was common in mid-19th-century hospitals and often fatal, with mortality at 10%–35%. Semmelweis proposed the practice of washing with chlorinated lime solutions in 1847 while working in Vienna General Hospital's First Obstetrical Clinic, where doctors' wards had three times the mortality of midwives' wards.[3] He published a book of his findings in Etiology, Concept and Prophylaxis of Childbed Fever.
    Despite various publications of results where hand-washing reduced mortality to below 1%, Semmelweis's observations conflicted with the established scientific and medical opinions of the time and his ideas were rejected by the medical community.
    Some doctors were offended at the suggestion that they should wash their hands and Semmelweis could offer no acceptable scientific explanation for his findings. Semmelweis's practice earned widespread acceptance only years after his death, when Louis Pasteur confirmed the germ theory and Joseph Lister, acting on the French microbiologist's research, practiced and operated, using hygienic methods, with great success.
    In 1865, Semmelweis was committed to an asylum, where he died at age 47 after being beaten by the guards, only 14 days after he was committed.
  • On December 1, 1955, in Montgomery, Alabama, Parks refused to obey bus driver James F. Blake's order that she give up her seat in the colored section to a white passenger, after the white section was filled. Parks was not the first person to resist bus segregation. Others had taken similar steps, including Irene Morgan in 1946, Sarah Louise Keys in 1955, and the members of the Browder v. Gayle lawsuit (Claudette Colvin, Aurelia Browder, Susie McDonald, and Mary Louise Smith) were arrested months before Parks. NAACP organizers believed that Parks was the best candidate for seeing through a court challenge after her arrest for civil disobedience in violating Alabama segregation laws though eventually her case became bogged down in the state courts.[2][3]
    Parks' act of defiance and the Montgomery Bus Boycott became important symbols of the modern Civil Rights Movement. She became an international icon of resistance to racial segregation. She organized and collaborated with civil rights leaders, including Edgar Nixon, president of the local chapter of the NAACP; and Martin Luther King, Jr., a new minister in town who gained national prominence in the civil rights movement.
  • Colleen
    Steve Jobs challenged things to be different
    Had a vision for a different world
    Can we imagine a world right now with out our iPads, iMacs, iPhones, Apple TV?

    “The ones who are crazy enough to think that they can change the world are the ones who do” - Jack Kerouac
  • Marlies
  • Marlies
  • Marlies

    Live in a state of “manage discomfort’ – there might be an unease as they are entrepeneurs – or even to find space to be entrepreneurial

    Act entrepreurial outside of their job description. “capable of squeezing through the smallest of opportunity to build evidence that my idea is good”

    Official job title “change agent” – operate off the org chart – seek out places in nook and crannies in the organzation -then develop truth of the value of their idea

    Octopus – she says I can squeeze through the smallest opportunity to get my idea out there – or it would get killed

    Another guy: project manager – he showed value through other side projects and through a community of practice. Although his company thought he should do that through his day job

    Day it is broken out – one hour meetings not condusive to entrepreneurial thinking.

    Meeting culture – what can happen and not happen. Entrepreneurs get bigger blocks of time to do creative work

    Hour long meetings – not contusive to entrepreneurial behaviour. They look for ways to structure their days differently – larger blocs of time.

    An organization can have strong or weak entrepreneurial cultures

  • Marlies
  • Marlies
    Ppt “what and how” – story telling – powerful to mobilize others to act. Through stories. Through a new outcome or new reality.

    Notice that there is meager support to how to develop good story telling. Entrepreuners know this skill – through trial and error.

    Two practices 1) recognize what the language gap is between stakeholders – ie,., trying telling stories about new idea at several levels – really needed to understand the concept the idea – she thought everyone was on the same page but she was missing the mark. 2)technique: progressive disclosure (from interaction and design field)– essence: sequencing information and action across several groups of people. Start with small disclosure and reveal more and more. Ie,. Progressively disclosed more in his story – and added on that as people were caught up. New idea later broadly socialized to get resources.

    Important element piece

  • Marlies
  • Marlies
  • Colleen
    How can we start to build alliances??? How can we link ideas for change/improvements….
    “Frame It!”
  • Colleen
    To connect with people’s hearts and minds
    Emotional heart tug
    Intrinsic motivation and values
    Key to turning opportunity into action
    Hooks to pull people in
    Springboards for mobilizing support
    Frames need to be authentic and connect with reality
  • Why is change so hard? I want to talk about organizational radicals!!!

    On average, it takes 17 years for research to translate into practice
    Big change only happens in healthcare organizations because of radicals
    The passionate people who are willing to take responsibility for change!!