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.

Rocking the boat and staying in it - Helen Bevan

5,205 views

Published on

Helen Bevan explains the concept of 'boat rockers' - one of the core principles at the heart of NHS Change Day

Published in: Sports, Technology

Rocking the boat and staying in it - Helen Bevan

  1. 1. Rocking  the  boat  and     staying  in  it:   respiratory  leader     as  organisa3onal  radical     Helen  Bevan   Delivery  team   NHS  Improving  Quality   @helenbevan   @NHSIQ               @helenbevan      
  2. 2. @helenbevan  
  3. 3. How  does  it  feel  to  be  a    here0c/ radical/rebel/maverick  in  our   organisa0on?   @helenbevan  
  4. 4. @helenbevan  
  5. 5. What  happens  to  here0cs/radicals/ rebels/mavericks  in  organisa0ons?   @helenbevan  
  6. 6. @helenbevan  
  7. 7. Are  you  a  boat  rocker?   •  One  who  challenges  the  status   quo  when  they  see  that  there   could  be  a  be@er  way   •  Energise  their  organisa0on  by   working  from  their  true  self   •  Capable  of  working  with  others   to  create  success  NOT  a   destruc0ve  troublemaker   •  Walk  the  fine  line  between   difference  and  fit,  inside  and   outside,  rock  the  boat  but   manage  to  stay  in  it   @helenbevan  
  8. 8. Some3mes  people  see  us  radicals  as   troublemakers   Troublemaker   Radical   Complain   Me-­‐focused   Anger   Pessimist   Energy-­‐sapping   Alienate   Problems   Alone   Create   Mission-­‐focused   Passion   Op0mist   Energy-­‐genera0ng   A@ract   Possibili0es   Together   @helenbevan   Source  :  Lois  Kelly    www.foghound.com
  9. 9. Task   •  Talk  to  others  at  your  table  about  your   experiences  around  “rebels”  and   “troublemakers”   •  Which  have  you  been  and  why?   •  What  moves  people  from  being  “good”  to   “bad”?   •  How  do  we  protect  against  this?   @helenbevan  
  10. 10.        First  they  ignore  you,  then  they  laugh  at  you,   then  they  fight  you,  then  you  win                                                                                                                                              Gandhi   @helenbevan  
  11. 11. Valuing  radicals   •  “New  truths  begin  as  heresies”  (Huxley,  defending   Darwin’s  theory  of  natural  selec0on)   •  big  things  only  happen  in  organisa0ons  because  of   here0cs  and  radicals   @helenbevan  
  12. 12. @helenbevan  
  13. 13. @helenbevan   Source:  Foghound  
  14. 14. Four  tac3cs  for  organisa3onal  radicals   1.  Start  with  myself   2.  Build  alliances   3.  Work  out  what  might  help  others  to   change   4.  Don't  be  a  martyr   @helenbevan  
  15. 15. Four  tac3cs  for  organisa3onal  radicals   1.  Start  with  myself   2.  Build  alliances   3.  Work  out  what  might  help  others  to   change   4.  Don't  be  a  martyr   @helenbevan  
  16. 16.        “There  is  nothing  more   difficult  to  carry  out,  nor   more  doub9ul  of  success,   nor  more  dangerous  to   handle,  than  to  ini;ate  a   new  order  of  things.  For  the   reformer  has  enemies  in  all   those  who  profit  by  the  old   order,  and  only  lukewarm   defenders  in  all  those  who   profit  by  the  new”     Niccolo  Machiavelli  15th  century   @helenbevan    
  17. 17. "There’s  only  one  corner  of  the   universe  you  can  be  certain  of   improving,  and  that’s  your  own   self."  Aldous  Huxley     @helenbevan  
  18. 18. @helenbevan  
  19. 19. What  are  the  risks  for  a  boat  rocker?   1.  Our  experiences  of  “being  different”  can  be   fundamentally  disempowering.  This  can  lead  us  to   conform  because  we  see  no  other  choice   @helenbevan  
  20. 20. What  are  the  risks  for  a  boat  rocker?   1.  Our  experiences  of  “being  different”  can  be   fundamentally  disempowering.  This  can  lead  us  to   conform  because  we  see  no  other  choice   §  we  surrender  a  part  of  ourselves,  and  silence   our  commitment,  in  order  to  survive   @helenbevan  
  21. 21. @helenbevan   Source:  Foghound  
  22. 22. @helenbevan  
  23. 23. What  are  the  risks  for  a  boat  rocker?   1.  Our  experiences  of  “being  different”  can  be   fundamentally  disempowering.  This  can  lead  us  to   conform  because  we  see  no  other  choice   §  we  surrender  a  part  of  ourselves,  and  silence   our  commitment,  in  order  to  survive   2.  leave  the  organisa0on   @helenbevan  
  24. 24. What  are  the  risks  for  a  boat  rocker?   1.  Our  experiences  of  “being  different”  can  be   fundamentally  disempowering.  This  can  lead  us  to   conform  because  we  see  no  other  choice   §  we  surrender  a  part  of  ourselves,  and  silence   our  commitment,  in  order  to  survive   2.  leave  the  organisa0on   §  we  cannot  find  a  way  to  be  true  to  our  values   and  commitments  and  s0ll  survive   @helenbevan  
  25. 25. What  are  the  risks  for  a  boat  rocker?   1.  Our  experiences  of  “being  different”  can  be   fundamentally  disempowering.  This  can  lead  us  to   conform  because  we  see  no  other  choice   §  we  surrender  a  part  of  ourselves,  and  silence   our  commitment,  in  order  to  survive   2.  leave  the  organisa0on   §  we  cannot  find  a  way  to  be  true  to  our  values   and  commitments  and  s0ll  survive   3.  stridently  challenge  the  status  quo  in  a  manner   which  is  increasingly  radical  and  self-­‐defea0ng   @helenbevan  
  26. 26. What  are  the  risks  for  a  boat  rocker?   1.  Our  experiences  of  “being  different”  can  be   fundamentally  disempowering.  This  can  lead  us  to   conform  because  we  see  no  other  choice   §  we  surrender  a  part  of  ourselves,  and  silence   our  commitment,  in  order  to  survive   2.  leave  the  organisa0on   §  we  cannot  find  a  way  to  be  true  to  our  values   and  commitments  and  s0ll  survive   3.  stridently  challenge  the  status  quo  in  a  manner   which  is  increasingly  radical  and  self-­‐defea0ng   §  this  just  confirms  what  we  already  know  –  that   we  don’t  belong   @helenbevan  
  27. 27. What do we know about successful boat rockers? 1.  convic0ons  and  values  –  driven   2.  strong  sense  of  “self-­‐efficacy”   §  §  belief  that  I  am  personally  able  to  create  change   belief  in  others   3.  ac0on  orientated   §  §   ignite  collec0ve  ac0on   mobilising  others,  inspiring  change   4.  able  to  join  forces  with  others   §  work  as  a  collec0ve  body  for  commonly  valued  changes   5.  able  to  achieve  small  wins  which  create  a  sense  of  hope,  self-­‐ efficacy  and  confidence   6.  op0mis0c  in  the  face  of  challenge   §  §  see  opportuni0es   take  account  of  obstacles   @helenbevan  
  28. 28. Three  assump3ons  for  organisa3onal   radicals   1.  Assume  that  everyone  has  a  noble  inten0on   2.  Mo0va0on  and  behaviour  in  a  change   process  are  due  to  interpersonal  interac;on   (not  just  innate  character  trait)   3.  My  role  as  a  change  agent  is  about   alignment,  not  judgement   @helenbevan  
  29. 29. Four  tac3cs  for  organisa3onal  radicals   1.  Start  with  myself   2.  Build  alliances   3.  Work  out  what  might  help  others  to   change   4.  Don't  be  a  martyr   @helenbevan  
  30. 30. The  easiest  way  to  thrive  as  an  outlier   ...is  to  avoid  being  one   Seth  Goodin   @helenbevan  
  31. 31. “if  you  want  to  go  fast,  go  alone.  If  you  want  to   go  far,  go  together”   African  proverb  quoted  by  Al  Gore     @helenbevan  
  32. 32. Framing           Is  the  process  by  which  leaders  construct,  ar3culate   and  put  across  their  message  in  a  powerful  and   compelling  way  in  order  to  win  people  to  their  cause   and  call  them  to  ac3on       Snow  D  A  and  Benford  R  D  (1992)             @helenbevan  
  33. 33. What  do  we  need  to  do?   1.  Tell  a  story   @helenbevan  
  34. 34. What  do  we  need  to  do?   1.  Tell  a  story   2.  Make  it  personal   @helenbevan  
  35. 35. What  do  we  need  to  do?   1.  Tell  a  story   2.  Make  it  personal   3.  Be  authen0c   @helenbevan  
  36. 36. 1.  2.  3.  4.  What  do  we  need  to  do?   Tell  a  story   Make  it  personal   Be  authen0c   Create  a  sense  of  “us”  (and  be  clear  who  the  “us”   is)   @helenbevan  
  37. 37. 1.  2.  3.  4.  What  do  we  need  to  do?   Tell  a  story   Make  it  personal   Be  authen0c   Create  a  sense  of  “us”  (and  be  clear  who  the  “us”   is)   5.  Build  in  a  call  for  urgent  ac0on   @helenbevan  
  38. 38. @helenbevan  
  39. 39. @helenbevan  
  40. 40. @helenbevan  
  41. 41. @helenbevan  
  42. 42. Four  tac3cs  for  organisa3onal  radicals   1.  Start  with  myself   2.  Build  alliances   3.  Work  out  what  might  help  others  to   change   4.  Don't  be  a  martyr   @helenbevan  
  43. 43. @helenbevan  
  44. 44. “Stages  of  change”     Transtheore0cal  model  of  behaviour  change           @helenbevan   Prochaska,  DiClemente  &  Norcross  (1992)    
  45. 45. The  model  is  mostly  used  around     health-­‐related  behaviours   •  •  •  •  •  •  •  •  •  •  smoking  cessa0on     exercise  adop0on   alcohol  and  drug  use   weight  control     fruit  and  vegetable  intake   domes0c  violence   HIV  preven0on   use  of  sunscreens  to  prevent  skin  cancer     medica0on  compliance     mammography  screening   @helenbevan  
  46. 46. The  model  is  mostly  used  around     health-­‐related  behaviours   •  •  •  •  •  •  •  •  •  •  smoking  cessa0on     exercise  adop0on   alcohol  and  drug  use   weight  control     fruit  and  vegetable  intake   It  works  for   organisa3onal  and   domes0c  violence   HIV  preven0on   service  change  too!   use  of  sunscreens  to  prevent  skin  cancer     medica0on  compliance     mammography  screening   @helenbevan  
  47. 47. “Stages  of  change”     Smoking         I  am  not  aware  my   smoking  is  a   problem  –  I  have  no   inten0on  to  quit   Prochaska,  DiClemente  &  Norcross  (1992)     @helenbevan  
  48. 48. “Stages  of  change”     Smoking         @helenbevan   I  am  not  aware  my   smoking  is  a   problem  –  I  have  no   inten0on  to  quit   I  know  my  smoking   is  a  problem  –  I   want  to  stop  but  no   plans  yet   Prochaska,  DiClemente  &  Norcross  (1992)    
  49. 49. “Stages  of  change”     Smoking         I  am  not  aware  my   smoking  is  a   problem  –  I  have  no   inten0on  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   prepara0on.     @helenbevan   Prochaska,  DiClemente  &  Norcross  (1992)    
  50. 50. “Stages  of  change”     Smoking         I  have   stopped   smoking!     @helenbevan   I  am  not  aware  my   smoking  is  a   problem  –  I  have  no   inten0on  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   prepara0on.     Prochaska,  DiClemente  &  Norcross  (1992)    
  51. 51. “Stages  of  change”     Smoking       I  am  con0nuing  to   not  smoke.       I  some0mes  miss  it   –  but  I  am  s0ll  not   smoking   I  have   stopped   smoking!     I  am  not  aware  my   smoking  is  a   problem  –  I  have  no   inten0on  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   prepara0on.     Prochaska,  DiClemente  &  Norcross  (1992)     @helenbevan  
  52. 52. “Stages  of  change”     Smoking       I  am  con0nuing  to   not  smoke.       I  some0mes  miss  it   –  but  I  am  s0ll  not   smoking   I  have   stopped   smoking!     @helenbevan   I  am  not  aware  my   smoking  is  a   problem  –  I  have  no   inten0on  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   prepara0on.     Prochaska,  DiClemente  &  Norcross  (1992)    
  53. 53. “Stages  of  change”     Transtheore0cal  model  of  behaviour  change           @helenbevan   Prochaska,  DiClemente  &  Norcross  (1992)    
  54. 54. 90%  of  the  tools  available  for  healthcare  change   agents  are  designed  for  the  “ac3on”  stage   The  reality  of  our  change  situa3on   •  Our  tools  are  oken  not  effec0ve  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,  irra0onal   •  We  feel  powerless  in  our  ability  to  lead  or   facilitate  the  change   @helenbevan  
  55. 55. Example  -­‐  Surgical  Checklist   •  Designed  for  Stage  4   –  ACTION!   •  Mandated  it  through   targets   •  Despite  compelling   case  for  change  –   people  resisted  it  –   no  values  connec0on   •  People  did  the  task   and  missed  the  point     @helenbevan  
  56. 56. “One  key  issue  is  that  many  doctors  already  feel   that  they  are  delivering  pa;ent  centred  care  –   unfortunately  that  is  not  what  pa;ents  report.”   Dr  Nigel  Mathers,  Vice  Chair,  Royal  College  of   General  Prac0ce   @helenbevan  
  57. 57. So  what  do  we  TEND  to  do?   •  Lower  our  ambi0ons  for  improvement   •  Focus  our  energies  on  those  who  are  already  in   the  “ac0on”  stage   •  Put  nega0ve  labels  on  those  who  are  not  yet  at   the  ac0on  stage  such  as  “blocker”  or  “resister”  or   “laggard”   •  Blame  the  leadership  for  not  enforcing  change   •  Overes0mate  the  mo0va0on  of  those  who  say   they’re  ready  to  change  and  underes0mate  the   mo0va0on  of  those  who  indicate  no  interest  in   change  (Lundberg)   @helenbevan  
  58. 58. So  what  SHOULD  we  do   •  Listen  and  understand   •  appreciate  the  star0ng  point   •  elaborate  interests   •  Build  meaning  and  convic0on  in  the  change   •  Roll  with  resistance  (Singh)     •  Don’t  argue  against  it   •  Encourage  elabora0on  of  resistance   •  What  makes  it  so  hard?   •  What  would  help?   •  Build  shared  purpose   @helenbevan  
  59. 59. OutwiPed        He  drew  a  circle  that  shut  me  out  -­‐   Here0c,  rebel,  a  thing  to  flout.   But  Love  and  I  had  the  wit  to  win:   We  drew  a  circle  that  took  him  in.                Edward  Markham   @helenbevan  
  60. 60. Discussion   What  might  you  do  to:   •  enhance  your  own  role  as  a  respiratory   maverick,  radical  or  here0c?   •  Support  other  mavericks,  radicals  or  rebels  in   your  organisa0on  or  system?   @helenbevan  
  61. 61. ....the  last  era  of  management  was  about  how   much  performance  we  could  extract  from   people    .....the  next  is  all  about  how  much  humanity  we   can  inspire   Dov  Seidman   @helenbevan  
  62. 62. We  have  a  choice   “This  is  the  true  joy  of  life,  the  being  used  up  for  a   purpose  recognised  by  yourself  as  a  mighty  one,   being  a  force  of  nature  instead  of  a  feverish,  selfish   li@le  clot  of  ailments  and  grievances,  complaining   that  the  world  will  not  devote  itself  to  making  you   happy”                                                                          George  Bernard  Shaw   @helenbevan  

×