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Transformational change: it's time to rewrite the rules of change in health and care


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This is the updated slide deck from the presentation I made at the APEC Forum, Melbourne on 3rd September 2014

Published in: Healthcare
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Transformational change: it's time to rewrite the rules of change in health and care

  1. 1. It’s time to rewrite the rules of change in health and care Source of image: Helen Bevan APAC Forum Wednesday 3rd September 2014 @HelenBevan #APACForum
  2. 2. @HelenBevan #APACForum “New truths begin as heresies” (Huxley, defending Darwin’s theory of natural selection) Source of image: installation by the artist Adam Katz Via @NeilPerkin
  3. 3. @HelenBevan #APACForum The ideas in this talk come from our White Paper •Examines leading trends in change and transformation globally •How to make change happen at a faster rate and be more disruptive •Join the new breed of leaders of health and care globally, rewriting the rules of change and leading change from the future for different results
  4. 4. What is the single biggest thing that is happening in the world now that impacts on our ability to deliver? Source:
  5. 5. @HelenBevan @HelenBevan #APACForum SEISMIC SHIFTS
  6. 6. @HelenBevan @HelenBevan #APACForum SEISMIC SHIFTS
  7. 7. @HelenBevan @HelenBevan #APACForum Facebook didn’t exist, Twitter was still a sound, the cloud was still in the sky, 4G was a parking place, LinkedIn was a prison, applications were what you sent to college, Skype was a typo Thomas Friedman, World Economic Forum, Quoted by
  8. 8. @HelenBevan @HelenBevan #APACForum SEISMIC SHIFTS
  9. 9. @HelenBevan @HelenBevan #APACForum SEISMIC SHIFTS
  10. 10. @HelenBevan @HelenBevan #APACForum SEISMIC SHIFTS Change from the edge
  11. 11. @HelenBevan @HelenBevan #APACForum Many of the ways we go about improving health and care were designed in a different mindset for a different set of circumstances We are operating with 20th century change practice in a 21st century world : Source of images : gray-the-connected-company
  12. 12. @HelenBevan
  13. 13. @HelenBevan @HelenBevan #APACForum Leading change in a new era Dominant approach Emerging direction
  14. 14. @HelenBevan @HelenBevan #APACForum The essential flaw of quality improvement methods The essential flaw of [quality improvement methodology] is that, when implemented, it tends to reinforce the mechanistic and hierarchical models that are consistent with the mental maps of most managers Chris Argyris, Flawed advice and the management trap Source of image: Read more at:
  15. 15. @HelenBevan @HelenBevan #APACForum Leading change in a new era Dominant approach Emerging direction Most healthcare transformation efforts are driven from this side
  16. 16. @HelenBevan @HelenBevan #APACForum John Kotter, the most influential thought leader globally, recognises new approaches are needed FROM
  17. 17. @HelenBevan @HelenBevan #APACForum 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
  18. 18. @HelenBevan @HelenBevan #APACForum From “have to” to “want to” Source of image of-the-cipd-online-community
  19. 19. @HelenBevan @HelenBevan #APACForum Unleashing the spirit of the volunteer You may be able to ‘buy’ a person’s back with a paycheck, position, power or fear but a human being’s genius, loyalty and tenacious creativity are volunteered only. The world’s greatest problems will be solved by passionate, unleashed ‘volunteers’ Stephen Covey, Turn the ship around, via @MarkGraban Source of image: ‘ ‘ ’ ’
  20. 20. @HelenBevan 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
  21. 21. @HelenBevan @HelenBevan #APACForum What’s your theory of change? Source of cartoon:
  22. 22. @HelenBevan @HelenBevan #APACForum Five enabling themes
  23. 23. @HelenBevan @HelenBevan #APACForum 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
  24. 24. @HelenBevan @corprebels Across the world, the change agent movement Is exploding! @rebelsatwork
  25. 25. @HelenBevan @HelenBevan #APACForum What happens to heretics/radicals/rebels/mavericks in organisations? Source of image:
  26. 26. @HelenBevan @HelenBevan #APACForum
  27. 27. @HelenBevan @HelenBevan #APACForum What is a rebel? •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 •Rebels aim for greatness, healthy fire, worthiness •They name things that others don’t see yet •They point to new horizons •Without rebels, the storyline never changes Source : @PeterVan
  28. 28. @HelenBevan @HelenBevan #APACForum The 90/30 conundrum of senior leaders say that to create more innovation, they need to activate the radicals/ disruptive innovators in their organisations or systems of senior leaders are very satisfied that radicals/innovators can provide this value in their organisations or systems Source:
  29. 29. @HelenBevan @HelenBevan #APACForum We need boatrockers! •Rock the boat but manage to stay in it •Walk the fine line between difference and fit, inside and outside •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
  30. 30. @HelenBevan Source : Lois Kelly There’s a big difference between a rebel and a troublemaker Rebel
  31. 31. @HelenBevan @HelenBevan #APACForum Reflection •What are your insights around “rebels” and “troublemakers”? •What moves people from being “rebel” to “troublemaker”? •How do we protect against this?
  32. 32. @HelenBevan @HelenBevan #APACForum Probably the largest simultaneous improvement initiative in the history of healthcare A disruptive case study @HelenBevan #Quality2014 #f1
  33. 33. @HelenBevan @HelenBevan #APACForum NHS Change Day Aim: to create a mass movement of grass roots NHS staff and people who work with and use the NHS to pledge a simple act that can contribute to better patient care
  34. 34. @HelenBevan @HelenBevan #APACForum NHS Change Day 2014 More than 700,000 pledges to take action •81 separate Campaigns •86 million twitter impressions •35,400 video views •95,000 daily reach on Facebook •More than 98% of the activity through volunteers
  35. 35. @HelenBevan @HelenBevan #APACForum It started with a tweet in June 2012! Young clinical leaders and improvement leaders decided to start a social movement to improve care Damian Roland Stuart Sutton Helen Bevan @HelenBevan #Quality2014 #f1
  36. 36. @HelenBevan @HelenBevan #APACForum Probably the only winner of a global challenge to develop leaders in the corporate world that names Saul Alinsky and Marshall Ganz as major influencers @HelenBevan #Quality2014 #f1
  37. 37. @HelenBevan
  38. 38. @HelenBevan @HelenBevan #APACForum Evaluating NHS Change Day •We’re evaluating intention (pledging), initiation (doing) and outcomes (delivering) •We’re developing and testing new methods to show impact •We want to build new theory of large scale change
  39. 39. @HelenBevan @HelenBevan #APACForum Change Day is spreading……. Australia Sweden N Ireland Denmark Canada Netherlands Saudi Arabia USA Finland …….and many more
  40. 40. @HelenBevan @HelenBevan #APACForum Source: @NHSChangeDay Can I, dare I?
  41. 41. @HelenBevan @HelenBevan #APACForum •A virtual school •Anyone can join •All the resources are completely open •Five weeks of virtual lectures, study guides, materials, tweetchats •Demonstrate learning to earn a virtual badge The School for Health and Care Radicals
  42. 42. @HelenBevan @HelenBevan #APACForum The School for Health and Care Radicals More than 1,600 enrollees from 40 countries 90 volunteer mentors Average weekly twitter reach 2.6 million Over 25,000 shares of the slides on SlideShare More than 10,000 shares of the study guides More than 10,000 tweets using #SCHRchat Storify has been viewed 2,000 times 150 people achieved full graduation
  43. 43. @HelenBevan @HelenBevan #APACForum
  44. 44. @HelenBevan @HelenBevan #APACForum
  45. 45. @HelenBevan @HelenBevan #APACForum We learnt... 1.The core audience is different to that which we anticipated 2.The most important need is for connection and community 3.How to build the relationship between tacit and explicit knowledge 4.There is a massive untapped reservoir of energy and talent out there and the potential is outstanding
  46. 46. @HelenBevan @HelenBevan #APACForum Underpinning theme: “Tomorrow’s management systems will need to value diversity, dissent and divergence as highly as conformance, consensus and cohesion.” Gary Hamel Source of image: Paul Wearing
  47. 47. @HelenBevan Leading change from the edges Go out to your edges. Explore the possibilities. Because you will find more opportunity in the edges, where you will be able to imagine, invent and thrive Ayelet Baron
  48. 48. @HelenBevan @HelenBevan #APACForum Watch the four minute film here:
  49. 49. @HelenBevan @HelenBevan #APACForum •Identify your own opportunities to move to the edge •Think about how to ignite the disruptive innovators in your midst •Consider how you can enable change at a faster rate than the outside world
  50. 50. @HelenBevan @HelenBevan #APACForum As you create your roadmap for the future, make sure you are part of the steamroller, not part of the road Saavik Wilcox-Hamilton Source of quote: “ “
  51. 51. @HelenBevan @HelenBevan #APACForum References Baron A (2014) Preparing for a changing world: the power of relationships Bate P, Robert G, Bevan H. The next phase of healthcare improvement: what can we learn from social movements? Quality and Safety in Health Care. 2004 Feb;13(1):62-6. Battilano J, Casciaro T (2013) The network secrets of the great change agents Harvard Business Review, July-August Bevan H, Plsek P, Winstanley (2011) Leading Large Scale Change - Part 1, A Practical Guide Bevan H (2011) Leading Large Scale Change - Part 2, The Postscript Bevan H, Fairman S (2014) The new era of thinking and practice in change and transformation, NHS Improving Quality Change Agents Worldwide (2013) Moving forward with social collaboration SlideShare Diaz-Uda A, Medina C, Schill E (2013) Diversity’s new frontier Fuda P (2012) 15 qualities of a transformational change agent Hamel G (2014)Why bureaucracy must die Jarche, H (2013) Rebels on the edges
  52. 52. @HelenBevan @HelenBevan #APACForum References Jarche H (2014) Moving to the edges Kotter J (2014) Accelerate! Harvard Business Review Press Merchant N (2013) eleven rules for creating value in the social era Llopis G (2014) Every leader must be a change agent or face extinction Meyerson D (2001) Tempered Radicals: how people use differences to inspire change at work Harvard Meyerson D (2008) Rocking the boat: how to effect change without making trouble Harvard BP Perkins N (2014) Bats and pizzas (agility and organisational change) Schillinger C (2014) Top-Down is a Serious Disease. But It Can Be Treated Shinners C (2014) New Mindsets for the Workplace Web Stoddard J (2014)The future of leadership Williams B (2014) Working Out Loud: When You Do That… I Do This Weber Shandwick (2014) Employees rising: seizing the opportunity in employee activism Verjans S (2013) How social media changes the way we work together