Module 1: Being a health and care radical - change starts with me

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These are the slides for module one of The School for Health and Care Radicals, a five week virtual programme, designed to equip people across the health and care system with the core skills to improve their skills as change agents. It supports NHS Change Day 2014, the grassroots movement in which everyone who values the NHS can make a pledge of action to improve things for patients and the health and care system.
Big change only happens in health and care because of heretics and radicals: passionate people who are willing to take responsibility and work with others to make change happen. Being a radical isn't related to hierarchy or position and you don't have to work in the NHS or social care to qualify as one. Registrants to the school so far include patients and carers, students, senior leaders, improvement facilitators and clinical and care staff.

Starting on 31 January, there will be a live weekly web seminar which will be available to 'listen again', supported by a raft of other opportunities, including coaching and mentoring, virtual discussions and tweet chats, and an ever- expanding portal of useful resources.
Programme
The programme focuses on five modules over five weeks, 9:30 to 11:00 am GMT
• Friday 31 January: Being a health and care radical: change starts with me
• Friday 7 February: Forming communities: building alliances for change
• Friday 14 February: Rolling with resistance
• Friday 21 February: Making change happen
• Friday 28 February: Moving beyond the edge
Tweetchat
We will run a tweetchat each Wednesday from 16:00 to 17:00 GMT, based on the content of the module from the previous Friday. A tweetchat is a facilitated conversation using Twitter. The hashtag we will use for the tweetchats is #SHCRchat. The dates for the tweetchats are:
• 5 February
• 12 February
• 19 February
• 26 February
• 5 March
There is no charge to join the School of Health and Care Radicals and it is open to all, whatever your role or level, and whether or not you work in the NHS. There will be additional learning materials and opportunities in addition to the web seminars but there is no set syllabus for learners to work through - you can join for as much or as little as you want.
More information: http://changeday.nhs.uk/healthcareradicals

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  • @davidhurrell @davidhurrell Hi David. It's great to get your feedback about the content of the modules for The School for Health and Care Radicals. We have completed three of the five modules for this term. However, you can still register and take part in the last two. Just sign up at www.changeday.nhs.uk/healthcareradicals



    You can view the slides and recordings of the previous three modules:

    Module 1 recording:https://haelo.webex.com/haelo/lsr.php?RCID=cb2534865578962fe574b5ec859da810

    Module 1 slides:http://www.slideshare.net/NHSIQ/module-1-being-a-health-and-care-radical-change-starts-with-me

    Module 2 recording:https://haelo.webex.com/haelo/lsr.php?RCID=0d5862c43c9aec2747f37540b45c8730

    Module 2 slides:http://www.slideshare.net/NHSIQ/module-2-forming-communities-building-alliances

    Module 3 recording:https://haelo.webex.com/haelo/lsr.php?RCID=7f4eed6bed82f6aeecb3d7e82af162d0

    module 3 slides:http://www.slideshare.net/NHSIQ/module-3-rolling-with-resistance



    It will be very easy to catch up.



    I hope you can join us for module 4 'making change happen' at 9.30am next Friday, 21st February.

    Best wishes

    Helen
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  • Hi! This is great stuff - I'd love to be involved in the live webinars that are left - is this possible?
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  • @EmanKhairyRadwan Hi Eman. In terms of a specific study of the use of community organising principles for health and care improvement, I suggest http://www.nhsiq.nhs.uk/media/2414209/dementia_report_nov_2013.pdf This is a paper from the University of Manchester on the England-wide call to action on people with dementia and antipsychotic drugs. To see the impact of this campaign in a local area, go to http://www.pjonline.com/news/reducing_antipsychotics_in_dementia?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed:+pjonline/news+(PJ+Online+news+feed)

    In addition, there is an excellent case study on the use of community organising and social mobilisation approach to improve the health of Pacific youth in Auckland, New Zealand. This is a link which shows work in progress http://leadingchangenetwork.com/2013/05/31/new-zealand-organizing-project/ I haven't got a link for the final version of the report on this project which was published in December 2013. However, this is called 'Handle the Jandle: A Report Assessing
    Social Mobilisation and Community Organising
    in the Counties Manukua District Health Board
    with Ko Awatea, Health System Innovation and Improvement'. it is written by Hahrie Han, Wellesey College
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  • I was impressed by the fact that the school has been using the community organising methodology since 2002. I wonder if there is any published literature on particular pieces of work that were conducted since then, the areas tackled and how you evaluated the success.
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  • @EmanKhairyRadwan Thanks Eman. It's great to get your comment. The School for Health and Care Radicals is an experiment to create a community of people who are change agents in health and care and who can gain support, skills and confidence by connecting with each other virtually. It's still early days but it's wonderful to see the way in which people are connecting and building their own communities. I hope you will continue to find the school useful
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Module 1: Being a health and care radical - change starts with me

  1. 1. The School for Health and Care Radicals www.changeday.nhs.uk/healthcareradicals Module 1: Being a health and care radical: Change starts with me Supported by #NHSChangeDay #SHCRchat
  2. 2. Welcome to the School for Health and Care Radicals – a global community of change agents • Nearly 1000 registrants for The School for Health and Care Radicals • Nearly 90 volunteer coach and mentor volunteers • From 22 countries, including: Australia, Belgium, Canada, Czech Republic, Denmark, England, France, Germany, Ireland, Netherlands, New Zealand, Norway, Northern Ireland, Philippines, Saudi Arabia, Scotland, Spain, Sweden, Ukraine, United Arab Emirates, USA, Wales #NHSChangeDay #SHCRchat
  3. 3. Why the School for Health & Care Radicals? It’s tough being a change agent in health and care, particularly when other people don’t always get it or want to change. Yet big change happens in health and care only because of heretics and radicals: passionate people who are willing to take responsibility for change. We are people who support the goals of our health and care systems, but also want to change existing thinking and practice and improve care for patients and people who use services. The School for Health and Care Radicals provides tools, ideas and connections with a community of radicals to help us thrive and survive as agents of positive change #NHSChangeDay #SHCRchat
  4. 4. Pledge today! http://changeday.nhs.uk #NHSChangeDay #SHCRchat
  5. 5. Joining in today and beyond • Please use the chat box to contribute continuously during the web seminar • Please tweet using hashtags #NHSChangeDay and #SHCRchat • We will produce summaries of the discussions on each module using Storify.com and put on the website • The conversation continues on the live chat forum at www.changeday.nhs.uk/healthcareradicalsforum #NHSChangeDay #SHCRchat
  6. 6. for today • Background to The School for Health and Care Radicals • Learning processes • Context: emerging directions in transformation and change • Some challenges for health and care radicals • The difference between a radical and a troublemaker • How to thrive and survive as a radical • Questions and call to action #NHSChangeDay #SHCRchat Source of image: www.freshnessmag.com
  7. 7. Why are we here? Why are you here? #NHSChangeDay #SHCRchat
  8. 8. Why did you join the school? ‘I want to: • be part of changing the NHS and to learn how to be more effective as a change maker’ • learn how to implement change effectively and encourage others to join the vision’ • help others realise they're able to make changes without seeking permission first’ • network with other healthcare radicals #NHSChangeDay #SHCRchat
  9. 9. Why did you join the school? ‘I want to: • learn, gain more inspiration and courage to continue what I started’ • share the joy of participating in NHS Change Day • share, be inspired and inspire others to support and coach others to be the best they can with the aim of improving the NHS we love and cherish • drive quality improvement, promote harm free care, make the improvement sustainable, remember patients are at the centre of everything we do • spread change in a stealthy way!’ #NHSChangeDay #SHCRchat
  10. 10. Modules 31st January: Being a health and care radical: change starts with me 7th February: Forming communities: building alliances for change 14th February: Rolling with resistance 21st February: Making change happen 28th February: Moving beyond the edge #NHSChangeDay #SHCRchat
  11. 11. The genesis of the School NHS Change Day 2013 2013 Applying community organising principles to healthcare 2010 improvement “A one day school for organisational radicals” #NHSChangeDay #SHCRchat 2014 “The School for Health and Care Radicals” 2012 “A school for healthcare radicals” 2003 2002 Applying social movement thinking to healthcare improvement
  12. 12. Source: @NHSChangeDay #NHSChangeDay #SHCRchat
  13. 13. The school is based on two kinds of learning Transactional learning Transformational learning A “toolkit” of ideas & approaches Learning through motivation, practice & feedback Seeks to transfer useful knowledge Seeks to transform beliefs & underlying assumptions Learning events, presentations & materials Experiential, interactive & action-based Generates understanding of “what to do” Generates increased capacity in “how to do it” Source: #SHCRchat #NHSChangeDayJohn Wenger https://medium.com/corporate-learning/3deb1bb2e865
  14. 14. What the school can offer What you might do  Take part in the programme at  Five learning modules, live on whatever level of engagement Friday mornings and available 24/7 you want  Materials, inc a weekly study guide  Encourage others in your to back up the modules organisation or locality to join changeday.nhs.uk/healthcareradicals the school  A weekly telephone discussion 7 Create your own local learning 8pm on Sunday evenings (if set or group demand)  Join the Change Day  A weekly tweetchat, 4-5pm on movement and mobilise Wednesdays #SCHRchat others  A chat forum  Keep a learning log, complete www.changeday.nhs.uk/healthcareradicalsforum all modules and action your  Potential to link you and/or your Change Day pledges to gain group with a mentor certification #NHSChangeDay #SHCRchat
  15. 15. Emerging themes in change and transformation Dominant approach Organisation Power through hierarchy Mission and vision Making sense through rational argument Leadership-driven (top down) innovation Tried and tested, based on experience Transactions #NHSChangeDay #SHCRchat Emerging direction Community Power through connection Shared purpose Making sense through emotional connection Viral (grass-roots driven) creativity “ Open” approaches , sharing ideas & data, co-creating change Relationships Source: @HelenBevan
  16. 16. John Kotter: “Accelerate!” • We won’t create big change through hierarchy on its own • We need hierarchy AND network • Many change agents, not just the usual few • Changing our mindset Source of • From “have to” to “want to” • Head and heart, not just head #NHSChangeDay #SHCRchat image:www.slideshare.net/m exicanwave/champions-trolls10-years-of-the-cipd-onlinecommunity
  17. 17. The Network Secrets of Great Change Agents Julie Battilana &Tiziana Casciaro 1. As a change agent, my centrality in the informal network is more important than my position in the formal hierarchy 2. If you want to create small scale change, work through a cohesive network If you want to create big change, create bridge networks between disconnected groups #NHSChangeDay #SHCRchat
  18. 18. Discussion What are the implications of the “emerging direction” for the way change agents work? Dominant approach Organisation Power through hierarchy Mission and vision Emerging direction Community Power through connection Shared purpose Making sense through rational argument Making sense through emotional connection Leadership-driven (top down) innovation Viral (grass-roots driven) creativity Tried and tested, based on experience Transactions #NHSChangeDay #SHCRchat “ Open” approaches , sharing ideas & data, co-creating change Relationships
  19. 19. 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 #NHSChangeDay #SHCRchat Image by neilperkin.typepad.com
  20. 20. Across the world, the change agent movement is exploding! @chagww Changeagentsworldwide.com @rebelsatwork rebelsatwork.com @corprebels Corporaterebelsunited.com #NHSChangeDay #SHCRchat
  21. 21. Image copyright: http://13c4.wordpress.com/2007/02/24/50-reasons-not-to-change/ @helenbevan #1000LivesPlus
  22. 22. What happens to heretics/radicals/rebels/mavericks in organisations? @helenbevan #NHSChangeDay #SHCRchat
  23. 23. @helenbevan #NHSChangeDay #SHCRchat
  24. 24. “There is nothing more difficult to carry out, nor more doubtful of success, nor more dangerous to handle, than to initiate 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 #NHSChangeDay #SHCRchat
  25. 25. We need to be boatrockers! • Walk the fine line between difference and fit, inside and outside, rock the boat but manage to stay in it • Able to challenge the status quo when we see that there could be a better way • Conform AND rebel • Capable of working with others to create success NOT a destructive troublemaker Source: Debra Meyerson @helenbevan #NHSChangeDay #SHCRchat
  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 Source: adapted from Debra E Meyerson @helenbevan #NHSChangeDay #SHCRchat
  27. 27. 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 Source: adapted from Debra E Meyerson @helenbevan #NHSChangeDay #SHCRchat
  28. 28. @helenbevan #NHSChangeDay #SHCRchat Source: Foghound
  29. 29. @helenbevan #NHSChangeDay #SHCRchat Source of image: quote.lifehack.org
  30. 30. 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 organisation Source: adapted from Debra E Meyerson @helenbevan #NHSChangeDay #SHCRchat
  31. 31. 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 organisation  we cannot find a way to be true to our values and commitments and still survive Source: adapted from Debra E Meyerson @helenbevan #NHSChangeDay #SHCRchat
  32. 32. 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 organisation  we cannot find a way to be true to our values and commitments and still survive 3. stridently challenge the status quo in a manner which is increasingly radical and self-defeating Source: adapted from Debra E Meyerson @helenbevan #NHSChangeDay #SHCRchat
  33. 33. 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 organisation  we cannot find a way to be true to our values and commitments and still survive 3. stridently challenge the status quo in a manner which is increasingly radical and self-defeating  this just confirms what we already know – that we don’t belong Source: adapted from Debra E Meyerson @helenbevan #NHSChangeDay #SHCRchat
  34. 34. Sometimes people see us radicals as troublemakers Rebel @helenbevan #NHSChangeDay #SHCRchat Source : Lois Kelly www.foghound.com
  35. 35. Discussion • What are your insights around “radicals” and “troublemakers”? • What moves people from being “radical” to “troublemaker”? • How do we protect against this? @helenbevan #NHSChangeDay #SHCRchat
  36. 36. Valuing radicals • “New truths begin as heresies” (Huxley, defending Darwin’s theory of natural selection) • Big things only happen in organisations because of heretics and radicals. GALILEO DESCRIBES HIS DISCOVERIES TO THE CHURCH ESTABLISHMENT @helenbevan #NHSChangeDay #SHCRchat
  37. 37. "There’s only one corner of the universe you can be certain of improving, and that’s your own self." Aldous Huxley Source of image: timcoffeyart.wordpress.com @helenbevan @HelenBevan @RobertVarnam #IHI25Forum #ChangeAgents
  38. 38. ‘I do not think you can really deal with change without a person asking real questions about who they are and how they belong in the world’ David Whyte, The Heart Aroused 1994 @helenbevan #NHSChangeDay #SHCRchat Source of image: fistfuloftalent.com
  39. 39. History tells us that personal transformation comes before organisational or system transformation If we want to play our role, we have to focus deeply on our own perspective and the ways we interact with and influence others. The more that we can unleash that powerful reservoir of energy for change, the more our influence and impact will grow. http://blogs.bmj.com/quality/2013/08/19/a-call-to-action-helen-bevans-blog-2/ @helenbevan #NHSChangeDay #SHCRchat Image from novamagazine.com
  40. 40. Five things we know about successful boat rockers CHANGE BEGINS WITH 1. Driven by conviction and values me 2. strong sense of “self-efficacy”  belief that I am personally able to create the change 3. able to join forces with others to create action 4. able to achieve small wins which create a sense of hope, self-efficacy and confidence 5. More likely to view obstacles as challenges to overcome @helenbevan #NHSChangeDay #SHCRchat Source: adapted from Debra E Meyerson
  41. 41. 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 @helenbevan #NHSChangeDay #SHCRchat Source of image:www.h3daily.com
  42. 42. What’s the difference between self efficacy and self esteem, self belief, self-confidence? @helenbevan #NHSChangeDay #SHCRchat
  43. 43. Source: @NHSChangeDay @helenbevan #NHSChangeDay #SHCRchat
  44. 44. Source: @NHSChangeDay What is the issue here? “permission” ? (externally generated) or Self efficacy ? @helenbevan #NHSChangeDay #SHCRchat (internally generated)
  45. 45. Brainstorm What are some ways that health and care radicals can build self-efficacy? @helenbevan #NHSChangeDay #SHCRchat
  46. 46. Building self-efficacy: some tactics 1. Invest in your own change agent development (modules 2-5) • create the conditions where success is more likely to happen 2. Create change one small step at a time 3. Reframe your thinking: • failed attempts are learning opportunities • uncertainty becomes curiousity 4. Make change (and learning cycles from change) routine rather than an exceptional activity 5. Get social support 6. Learn from the best 7. Get people whose opinions you value to encourage you (mentor?) @helenbevan #NHSChangeDay #SHCRchat
  47. 47. @helenbevan #NHSChangeDay #SHCRchat
  48. 48. Five things we know about successful boat rockers CHANGE BEGINS WITH 1. Driven by conviction and values me 2. strong sense of “self-efficacy”  belief that I am personally able to create the change 3. able to join forces with others to create action 4. able to achieve small wins which create a sense of hope, self-efficacy and confidence 5. More likely to view obstacles as challenges to overcome @helenbevan #NHSChangeDay #SHCRchat Source: adapted from Debra E Meyerson
  49. 49. The most effective change agents: • don’t waste their time and energy blaming and complaining • take calculated risks to achieve the outcomes they sought Now is the time to plan steps to keep moving myself forward, with positive momentum, as a health and care radical @helenbevan #NHSChangeDay #SHCRchat
  50. 50. Three assumptions for health and care radicals 1. Assume that everyone has a noble intention. 2. When people “resist” change is it more likely to be a result of their interpersonal interaction with the change process than their innate character traits (“a bad change process not a difficult person”). 3. My role as a change agent is about alignment, not judgement. @helenbevan #NHSChangeDay #SHCRchat Source of image:help.adobe.com
  51. 51. Being a great change agent is about knowing, doing, living and being improvement @helenbevan #NHSChangeDay #SHCRchat
  52. 52. Being a great change agent is about knowing, doing, living and being improvement @helenbevan #NHSChangeDay #SHCRchat
  53. 53. 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 little clot of ailments and grievances, complaining that the world will not devote itself to making you happy.” George Bernard Shaw @helenbevan #NHSChangeDay #SHCRchat
  54. 54. Outwitted He drew a circle that shut me out Heretic, 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 #NHSChangeDay #SHCRchat
  55. 55. Calls to action campaigns for this week Post these or similar actions as a pledge on the NHS Change Day pledge wall http://changeday.nhs.uk/wall • Reflect on your own role/knowledge/skills as a health and care radical and create an action plan to “start with me” • Discuss tactics for rocking the boat and staying in it with other radicals • Identify and support others who are at risk of crossing the line from “radical” to “troublemaker” @helenbevan #NHSChangeDay #SHCRchat
  56. 56. Next opportunities for learning • Sunday 2nd February 19:00-20:00 conference call discussion of module one • Wednesday 5th February 16:00-17:00 Tweet chat #SHCRchat • Next Friday morning module 2: Building alliances: forming communities for change @helenbevan #NHSChangeDay #SHCRchat
  57. 57. Questions for reflection 1. What are the opportunities for me to build my perspectives and skills as an agent of change? 2. How can I build self efficacy as a change agent? 3. How do I move beyond skills and knowledge of change to live and be change? 4. Who can help and support me as a change agent? 5. What are the implications for the way I work? @helenbevan #NHSChangeDay #SHCRchat

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