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Thinking differently in the NHS - Zoe Lord - Change Management Institute


Published on

How and why we're thinking differently in the NHS.
Crowdsourcing and Hackathons.
NHS Change Model.

Published in: Healthcare

Thinking differently in the NHS - Zoe Lord - Change Management Institute

  1. 1. @ZoeLord1 #cmiDisrupt Zoe Lord National Improvement Manager NHS England @ZoeLord1 How and why we’re thinking differently in the NHS…
  2. 2. @ZoeLord1 #cmiDisrupt@HelenBevan@ZoeLord1 #cmiDisrupt Overview… • Why we’re using new thinking… • Concepts into practice: • Crowdsourcing • Hackathons
  3. 3. @ZoeLord1 #cmiDisrupt@HelenBevan@ZoeLord1 #cmiDisrupt Why new methods? • Patient need & expect high quality safe care, right first time at the right cost.
  4. 4. @ZoeLord1 #cmiDisrupt@HelenBevan@ZoeLord1 #cmiDisrupt Why new methods?
  5. 5. @ZoeLord1 #cmiDisrupt@HelenBevan@ZoeLord1 #cmiDisrupt Why new methods? • People need high quality safe care, right first time at the right cost. • Traditional methods… • We’re not getting the results we desire • 70% change programmes fail • Needs to be quicker • We know there are new methods • Constantly learning…
  6. 6. @ZoeLord1 #cmiDisrupt@HelenBevan@ZoeLord1 #cmiDisrupt Jeremy Heimens TED talk “What new power looks like” old power new power Currency Held by a few Pushed down Commanded Closed Transaction Current Made by many Pulled in Shared Open Relationship
  7. 7. @ZoeLord1 #cmiDisrupt Source : Ross Dawson (2015)
  8. 8. @ZoeLord1 #cmiDisrupt@HelenBevan@ZoeLord1 #cmiDisrupt The power of co-creation
  9. 9. @ZoeLord1 #cmiDisrupt Crowdsourcing… @ZoeLord1
  10. 10. @ZoeLord1 #cmiDisrupt
  11. 11. @ZoeLord1 #cmiDisrupt The Change Challenge Tapping the collective brilliance of the NHS
  12. 12. @ZoeLord1 #cmiDisrupt@HelenBevan@ZoeLord1 #cmiDisrupt The process: Step 1 : The build-up Setting the right foundation for campaign launch Step 2: Launch campaign, explore barriers and enablers Weeks 1-4 Launch the campaign for bottom up change and questions to the crowd to develop the barriers and building blocks for change. Step 3 Propose solutions Weeks 5-6 Crowd invited to share, build and validate list of potential solutions Step 4 Develop toolkit Week 7 best ideas selected by crowd and panel selects Weeks 8-9 crowd develops best ideas into tools Weeks 9-11 works on key outputs Step 5: Spread and Embed Week 12 Publication of interactive guide / ‘new era’ toolkit / manifesto for change / celebrated cases Development of the process, questions, objectives and communicatio n plan Questions:- What things block or help you from delivering bottom-up change: · inside your organisation, to improve or transform services, and · across organisations to improve the health and wellbeing of a local population? Questions:- What solutions work? What approaches have you used or observed that others could learn from and copy? Please share your stories and learning about what did and didn't work. What solutions should we test? What ideas do you have that we could test out? Share ideas (these can be completely new) that you believe could support bottom- up change in the NHS, if we gave them a chance. 47 ideas selected for the crowd to develop. Crowd asked to develop these into workable tools; tangible and practical enough to be used widely across health and care organisations to deliver bottom up change for patients, staff and the public. To do this, please tell us: - what steps need to be taken, - who needs to be involved, and - what commitments… The HSJ and Nursing Times share outputs : • project overview, • ‘how to’ guides for application of crowdsourcing • ‘how to’ toolkit of prioritised ‘hacks’/ solutions Result: a foundation for a social movement of bottom up change Project over 12 weeks
  13. 13. @ZoeLord1 #cmiDisrupt What does the NHS workforce think? 14,000 contributors recently identified 10 barriers to change: Confusing strategies Over controlling leadership Perverse incentivesStifling innovation Poor workforce planning One way communication Inhibiting environment Undervaluing staff Poor project management Playing it safe Source: Health Service Journal, Nursing Times, NHS Improving Quality, “Change Challenge” March 2015
  14. 14. @ZoeLord1 #cmiDisrupt What does the NHS workforce think? 14,000 contributors recently identified 11 building blocks for change: Inspiring & supportive leadership Collaborative working Thought diversityAutonomy & trust Smart use of resources Flexibility & adaptability Long term thinking Nurturing our people Fostering an open culture A call to action Source: Health Service Journal, Nursing Times, NHS Improving Quality, “Change Challenge” March 2015 Challenging the status quo
  15. 15. @ZoeLord1 #cmiDisrupt Help us to capture redesign principles for care models to get better, quicker outcomes from change CARE DESIGN 2016 System redesign principles for care models #CareDesignJoin in:
  16. 16. @ZoeLord1 #cmiDisrupt@HelenBevan@ZoeLord1 #cmiDisrupt Platform methodology for our redesign principles Pre-sprint Sprint 1 Sprint 2 Sprint 3 Expert group sense- check of redesign principles & crowdsourcing process “Have we got the right redesign principles?” “Tell us about the redesign principles in action” “How do we make the redesign principles happen?” V1.0 of redesign principles paper “Starter-for-ten” shared with expert group of “systems engineers” both from within and outside the NHS The ten redesign principles will be presented via the crowdsourcing platform to our collaborators (widespread engagement) Invite practical examples and case studies that demonstrate the refined ten redesign principles working and in action Invite collaborators to signpost us to tools, methods, resources and methodologies that can help in the implementation of the redesign principles Output from each sprint becomes a new version of the paper. The socially derived redesign principles are then open for the next sprint and round of crowdsourcing
  17. 17. @ZoeLord1 #cmiDisrupt@HelenBevan@ZoeLord1 #cmiDisrupt Learning from crowdsourcing 1. Explicit about the purpose 2. Right question! 3. The right question takes time! 4. Test first 5. Right crowd 6. Keep it simple 7. Keep timeframe flexible 8. Respond to comments 9. Right platform 10. Warm up act!
  18. 18. @ZoeLord1 #cmiDisrupt Hackathon…
  19. 19. @ZoeLord1 #cmiDisrupt@HelenBevan@ZoeLord1 #cmiDisrupt Hackathon Break down and rebuild Energised Collaborate Energised Prototype Event / space Action Focused
  20. 20. @ZoeLord1 #cmiDisrupt Our NHS Change Model
  21. 21. @ZoeLord1 #cmiDisrupt@HelenBevan@ZoeLord1 #cmiDisrupt NHS Change Model Developed in 2012 with inputs from hundreds of people, to distil twenty years of learning from change in the NHS into a useable model to accelerate and get better outcomes from improvement
  22. 22. @ZoeLord1 #cmiDisrupt@HelenBevan@ZoeLord1 #cmiDisrupt Purpose of the refresh • Strengthen the model • To ensure it is fit for purpose to support organisations facing significant improvement challenges • To turn from conceptual to enabling • To enable other areas of the health and care system (ie social care, care homes) to embrace the model by considering a change of branding
  23. 23. @ZoeLord1 #cmiDisrupt@HelenBevan@ZoeLord1 #cmiDisrupt Our first hackathon… • Why? • Conversation with Perry Timms! • Move away from traditional methods • How?
  24. 24. @ZoeLord1 #cmiDisrupt@HelenBevan@ZoeLord1 #cmiDisrupt Pre event • Online hack packs • Diversity • Event planning • Insights
  25. 25. @ZoeLord1 #cmiDisrupt@HelenBevan@ZoeLord1 #cmiDisrupt Insights • Interviewed and surveyed 200 + people • Survey Monkey
  26. 26. @ZoeLord1 #cmiDisrupt@HelenBevan@ZoeLord1 #cmiDisrupt Insights • Use: • It is used for many different purposes -Projects, events, meetings • Knowledge: • The more people know, the more they find it useful • Easy accessible information on practical application is required • Language: • Some of the language is inhibiting • Name: • NHS brand brings prestige • NHS brand is hindering the uptake from other care providers • Is it a model or framework?
  27. 27. @ZoeLord1 #cmiDisrupt@HelenBevan@ZoeLord1 #cmiDisrupt The event • 80 people • 1 day • Series of hacks to explore design a proof of concept to support and enable change across health and care
  28. 28. @ZoeLord1 #cmiDisrupt@HelenBevan@ZoeLord1 #cmiDisrupt Remit of the changes • Bring on board the people who don’t like it and keep hold of the people who do like it • Enhance the positives – rather than change for change sake • Address what ‘it’ should be called • Think about spread and implementation
  29. 29. @ZoeLord1 #cmiDisrupt@HelenBevan@ZoeLord1 #cmiDisrupt
  30. 30. @ZoeLord1 #cmiDisrupt@HelenBevan@ZoeLord1 #cmiDisrupt Work in progress….
  31. 31. @ZoeLord1 #cmiDisrupt@HelenBevan@ZoeLord1 #cmiDisrupt
  32. 32. @ZoeLord1 #cmiDisrupt@HelenBevan@ZoeLord1 #cmiDisrupt Learning • Outputs… more than we’d ever imagined! • You cant second guess! • Letting go of control… • Frame and reframing is so important • Balance between divergence and convergence • Scope – In and out of scope • People – diversity in the room • Unconference • Trust the process • Go with the flow! Everyone wants to do it!
  33. 33. @ZoeLord1 4pm - 4pm, 27-28th January 2016
  34. 34. @ZoeLord1 Four ways to connect! 1. Follow us on Twitter @ZoeLord1 @HelenBevan @SteveFairman @TheEdgeNHS @School4Radicals 2. Subscribe to 3. Get materials from …and sign up for our monthly #EdgeTalks 4. Save the date for