Module 1 change starts with me upload

#SHCR @School4Radicals
http://www.theedge.nhsiq.nhs.uk/school/
Module 1:
Being a health and care radical:
Change starts with me
Supported by

Welcome to the School for Health and Care
Radicals – a global community of change agents
• 1,643 registrants for The School for Health and Care
Radicals (as of 29th January)
• From 36 countries, including:
Argentina, Australia, Austria, Belgium, Brazil, Canada,
Denmark, England, France, Georgia, Germany, Greece,
India, Ireland (Republic), Italy, Netherlands, New Zealand,
Nigeria, Norway, Northern Ireland, Pakistan, Qatar, Russian
Federation, Saudi Arabia, Scotland, Singapore, Slovenia,
South Africa, Spain, Sweden, Switzerland, Thailand, Tunisia,
Ukraine, USA, Wales

Make your mark!

Where on earth are you?

Where in the UK are you?

How are you feeling today?
(choose one)
I’m ready to be
radical
I’m cautiously
optimistic
I remain
unconvinced or
sceptical
I’m feeling
positive, let’s see
how I can make
this work

Joining in today and beyond
• Please use the chat box to contribute continuously during the
web seminar
• Please tweet using hashtag #SHCR and the handle
@School4Radicals
• Join our Facebook group School for Health and Care Radicals
• We will produce summaries of the discussions on each
module using Storify and Pinterest and put on the website
• Join in the Tweetchat each Wednesday at 4-5pm (GMT) using
the hashtag #SHCR

Study guides
Programme Study Guide:
http://www.slideshare.net/NHSIQ/shc
r-ii-study-guide-20150120-final-2
Module 1 Study Guide:
http://www.slideshare.net/NHSI
Q/shcr-module-1-study-guide

The team today
Session lead:
Helen Bevan
@HelenBevan
Learning lead:
Pip Hardy
@PilgrimPip
Case study alumnus:
Daniel Walsh
@dwalsh811
Chat monitor:
Dominic Cushman
@domcushnan
Twitter monitor:
and alumna:
Jodi Brown
@jodimolden
Case study alumna:
Kate Pound
@kateslater2

30th January: Being a health and care radical:
change starts with me
6th February: Building alliances for change
13th February: Rolling with resistance
20th February: Making change happen
27th February: Moving beyond the edge
Modules

• 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 rock the boat AND stay in it
• How to thrive and survive as a radical
• Questions and call to action
Source of image: www.freshnessmag.com
for
today

The genesis of the
School
2002
2014
2013
2010 2012
2003
NHS Change Day
2013
“A school for
healthcare
radicals”
Applying
social movement
thinking to
healthcare
improvement
“The School for
Health and Care
Radicals”
“A one day school
for organisational
radicals”
Applying
community organising
principles to
healthcare
improvement
2015

Source: @NHSChangeDay

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: John Wenger https://medium.com/corporate-learning/3deb1bb2e865

“New truths begin as heresies.”
(Huxley, defending Darwin’s theory of natural selection)
Source of image:
installation by the
artist Adam Katz
www.thisiscolossal.com
Via @NeilPerkin

Starts on the fringe
(at the edge)
Starts with the activists
Gary Hamel
always

So why do we keep reinventing the past
and calling it the future?
Image used under Creative Commons licence: Kicki

‘Tomorrow belongs to those
who can hear it coming.’
David Bowie

SEISMIC SHIFTS

SEISMIC SHIFTS
Change from the edge

Leading change in a new era
Dominant approach Emerging direction

Leading change in a new era
Dominant approach Emerging direction
Most healthcare
transformation
efforts are driven
from this side

Source: Gary Hamel

Source:@Alfacarlo

John Kotter, the most influential thought leader
globally, recognises new approaches are needed
FROM

John Kotter: ‘Accelerate!’
• We won’t create big change
through hierarchy on its own
• We need hierarchy AND network
• Many change agents, not just a
few, with many acts of leadership
• At least 50% buy-in required
• Changing our mindset
• From ‘have to’ to ‘want to’
TO

From ‘have to’ to ‘want to’
Source of image s:www.slideshare.net/mexicanwave/champions-trolls-10-years-
of-the-cipd-online-community

Managers know how to command obedience
and diligence, but most are clueless when it
comes to galvanizing the sort of volunteerism
that animates life on the social web.
Initiative, imagination and passion can’t be
commanded—they’re gifts.
Gary Hamel
http://www.mixmashup.org/blog/reinventing-
management-mashup-architecture-ideology
‘ ‘

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

People who are highly connected
have twice as much power to
influence change as people with
hierarchical power.
Leandro Herrero
http://t.co/Du6zCbrDBC

Discussion
What are the implications of the
“emerging direction” for the way
change agents work?

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 neilperkin.typepad.com

We need rebels!
• The principal champion of a change initiative,
cause or action
• Rebels don’t wait for permission to lead, innovate,
strategise
• They are responsible; they do what is right
• They name things that others
don’t see yet
• They point to new horizons
• Without rebels, the storyline never
changes
Source : @PeterVan http://t.co/6CQtA4wUv1

@helenbevan
What happens to
heretics/radicals/rebels/mavericks
in organisations?

@helenbevan #IQTGOLD#NHSChangeDaySource: Lois Kelly http://www.slideshare.net/Foghound/rocking-the-boat-without-falling-out

@HelenBevan
Ostracism is experienced in the brain as
deeply as physical pain

@helenbevan
We need to be boat rockers!
• 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
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
1. Our experiences of “being different” can be
 we surrender a part of ourselves, and silence
our commitment, in order to survive

@helenbevan
1. Our experiences of ‘being different’ can be
2. leave the organisation

@helenbevan
 we cannot find a way to be true to our values
and commitments and still survive

@helenbevan
3. stridently challenge the status quo in a manner
which is increasingly radical and self-defeating

@helenbevan
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
Source : Lois Kelly www.foghound.com
There’s a big difference between a rebel
and a troublemaker
Rebel

@helenbevan
Reflection
• What are your insights around ‘rebels’ and
‘troublemakers’?
• What moves people from being ‘rebel’ to
‘troublemaker’?
• How do we protect against this?

@helenbevan
Case study 1:
troublemaker, rebel or radical?
Introducing Daniel Walsh

@helenbevan#NHSChangeDay #SHCRchat
Source : Lois Kelly www.rebelsatwork.com
There’s a big difference between a
rebel and a troublemaker
Rebel

@helenbevan
Change starts with me
Source of image: jasonkeath.com

@helenbevan#SHCR @School4Radicals
‘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
‘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
Source of image: fistfuloftalent.com

@helenbevan
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
http://blogs.bmj.com/quality/2013/08/19/a-call-to-action-helen-bevans-blog-2/
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.
Image from novamagazine.com

@helenbevan
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
boat rockers
CHANGE
me
BEGINS WITH

@helenbevan
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 image:www.h3daily.com

@helenbevan
What’s the difference between
self efficacy
and
self esteem,
self belief,
self-confidence?

@helenbevan

@helenbevan
What is the issue here?
“permission” ?
(externally generated)
or
Self efficacy ?
(internally generated)

@HelenBevan
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

@HelenBevan
Case study 2: building self-efficacy
Introducing Jodi Brown

@HelenBevan
Case study 3: building self-efficacy
Introducing Kate Pound

@helenbevan
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
Being a great change agent is about knowing, doing, living
and being improvement

@helenbevan
Avedis Donabedian
‘Ultimately, the secret of
quality is love.
…… If you have love, you
can then work backward
to monitor and improve
the system.’
The secret of quality

@helenbevan
Tactic for radicals:
Out-love everyone else
Source of image: Bradley Burgess

@helenbevan
Calls to action from this module
• Take part in a RCT (Randomised Coffee Trial).
• 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
Randomised Coffee
Trial!

@helenbevan
Outcomes of randomised coffee trials

@helenbevan
Randomized Coffee Trial!
• Instructions in News from Jo later today
• Send an email to say you want to take part in the RCT to
radicals@nhsiq.nhs.uk
• We will randomly match you with another participant in the
School for Health and Care Radicals from anywhere in the world
• At some time in the next four weeks, arrange to have a
conversation over Skype (or other communication system) with
a cup of coffee!

@helenbevan
Next opportunities for learning
• Next Wednesday 4th February
16:00-17:00 GMT: Tweet chat #SHCR
• Next Friday morning 6th February
9.30-11;00 GMT: Module 2:
Building alliances for change

@helenbevan#SHCR @School4Radicals
Next issue due out on
Tuesday, 3rd February!

@helenbevan
Celebration, certification and CPD!
Become a certificated change agent.
Put your learning into action.
Gain CPD points.

@helenbevan
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
Goodbye and good luck!
‘Be the change you want to see in the world.’

Module 1 change starts with me upload

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