If the Criteria Based Discharge Collaborative was a social movement.......
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The slide deck from my talk at the NHS Improvement masterclass linked to the new national collaborative programme on Criteria Based Discharge
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If the Criteria Based Discharge Collaborative was a social movement.......
- 1. @HelenBevan #improvedischarge If the Criteria Based Discharge Collaborative was a social movement….. Helen Bevan @HelenBevan #improvedischarge
- 2. @HelenBevan #improvedischarge “When we talk of social change, we talk of movements, a word that suggest vast groups of people walking together, leaving behind one way and travelling towards another” Rebecca Solnit
- 3. @HelenBevan #improvedischarge What do successful social movements do? • Define the change they want to see • Identify the pillars of power • Create a spectrum of allies • Seek to attract not overpower • Build a plan to survive victory Source: Satell G (2017) How to create transformational change, according to the world’s most successful social movements
- 4. @HelenBevan #improvedischarge If we want people to take action, we have to connect with their emotions through values action values emotion Source: Marshall Ganz
- 5. @HelenBevan #improvedischarge “I have some winter pressure Performance Indicators for you” or “I have a dream” Source: @RobertVarnam
- 6. @HelenBevan #improvedischarge “Because we want to, not because we have to”
- 7. @HelenBevan #improvedischarge “We must act with all due alacrity [speed/swiftness], yet also with the thoughtfulness and seriousness of purpose appropriate to meaningful action” Dr Martin Luther King Jr.
- 8. 14,000 contributions 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”
- 9. @HelenBevan #improvedischarge Front line teams get inundated with high priority messages from leaders each day, making it difficult for them to know what to focus on Increasing number of messages as information cascade through the organisation Source: adapted from http://businessjournal.gallup.com/content/162707/change-initiatives-fail- don.aspx
- 10. @HelenBevan #improvedischarge Identify the pillars of power
- 11. @HelenBevan #improvedischarge Jeremy Heimens, Henry Timms This is New Power old power new power Currency Held by a few Pushed down Commanded Closed Transaction Current Made by many Pulled in Shared Open Relationship
- 12. @HelenBevan #improvedischarge The Network Secrets of Great Change Agents Julie Battilana &Tiziana Casciaro As a change agent, my centrality in the informal network is more important than my position in the formal hierarchy
- 13. @HelenBevan #improvedischarge Create a spectrum of allies Source of image: Greg Satell
- 14. @HelenBevan #improvedischarge WHO will make the change happen? List A • The winter pressures action team • Silver and gold command • The Programme Management Office • The bed managers • The Clinical Leads • The Directors group • The Change Facilitators Source: adapted by Helen Bevan from Leandro Herrera
- 15. @HelenBevan #improvedischarge WHO will make the change happen? List B • The mavericks and rebels • The deviants (positive). Who do things differently and succeed • The nonconformists who see things through glasses no one else has • The hyper-connected who spread behaviours, role model at a scale, set mountains on fire and multiply anything they get their hands on • The hyper-trusted. Multiple reasons, doesn’t matter which ones Source: adapted by Helen Bevan from Leandro Herrera List A • The winter pressures action team • Silver and gold command • The Programme Management Office • The bed managers • The Clinical Leads • The Directors group • The Change Facilitators
- 16. @HelenBevan #improvedischarge List A • The winter pressures action team • Silver and gold command • The Programme Management Office • The bed managers • The Clinical Leads • The Directors group • The Change Facilitators WHO will make the change happen? List B • The mavericks and rebels • The deviants (positive). Who do things differently and succeed • The nonconformists who see things through glasses no one else has • The hyper-connected who spread behaviours, role model at a scale, set mountains on fire and multiply anything they get their hands on • The hyper-trusted. Multiple reasons, doesn’t matter which ones Source: adapted by Helen Bevan from Leandro Herrera
- 17. @HelenBevan #improvedischarge What’s the evidence? The failure of large scale transformational change projects is rarely due to the content or structure of the plans that are put into action http://iedp.com/articles/vertical-leadership/?utm_source=Sign- Up.to&utm_medium=email&utm_campaign=13787-257163-Campaign+-+01%2F09%2F2016 Source: David Dinwoodie (2015) It’s much more about the role of informal networks in the organisations and systems affected by change To make large scale change happen we should connect networks of people who ‘want’ to contribute
- 18. @HelenBevan #improvedischarge Mark Jaben on the science behind resistance What NOT to do But what we do do Engage people here
- 19. @HelenBevan #improvedischarge Mark Jaben on the science behind resistance to change What NOT to do (but what we usually do) We don’t need buyers (who “buy-in” to change) We need investors What TO do Engage people here Engage people here
- 20. @HelenBevan #improvedischarge Seek to attract not overpower
- 21. @HelenBevan #improvedischarge To enable change, connect with the 3% Just 3% of people in the organisation or system typically drive conversations with 90% of the other people Source: research by Innovisor
- 22. @HelenBevan #improvedischarge The problem: leaders want integration/cross-collaboration but the system operates through deep silos The solution: find the connectors and integrate them The result: 22% more system agilitySource: Innovisor
- 23. @HelenBevan #improvedischarge As leaders, we are “signal generators” “As a leader, think of yourself as a “signal generator” whose words and actions are constantly being scrutinised and interpreted, especially by those below you” [in the hierarchy]….. Charles O’Reilly, Leaders in Difficult Times Source of image: vintage-radio.com What leaders pay attention to matters to staff, and consequently staff pay attention to that too
- 24. @HelenBevan #improvedischarge Shared purpose Owned by everyone who has a stake in the change and improvement we are seeking to create OUR SHARED PURPOSE At the end of the day, it is about looking after people in the way they want to be looked after Director of Urgent Care
- 25. @HelenBevan #improvedischarge Shared purpose or “de facto” purpose? • hitting the four hour target • discharging patients before noon • freeing up bed capacity • avoiding the negative consequences of winter pressures • saving money • reducing delayed transfers of care • complying with regulators PURPOSE Owned by everyone who has a stake in the change and improvement we are seeking to create OUR SHARED PURPOSE
- 26. @HelenBevan #improvedischarge Shared purpose or “de facto” purpose? • hitting the four hour target • freeing up bed capacity • managing demand • reducing costs • Managing winter pressures • complying with regulators Source: Delivering Public Services That Work: The Vanguard Method in the Public Sector If purpose isn’t explicit and shared, then it is very easy for something else to become a de facto purpose in the minds of the workforce PURPOSE Owned by everyone who has a stake in the change and improvement we are seeking to create OUR SHARED PURPOSE
- 27. @HelenBevan #improvedischarge Change is not the goal; the goal is the goal Peter Fuda Source of image: timemanagementninja.com
- 29. @HelenBevan #improvedischarge New Public Passion: a growing global movement
- 30. @HelenBevan #improvedischarge • Did we accomplish the goal we were trying to accomplish? • Did our community grow stronger? (create capacity; new power – power we didn’t have before) • Did individuals involved in the whole effort learn, grow and develop their capacity to organise with others? How would we know if the CBD collaborative was successful from a social movement perspective?
- 31. @HelenBevan #improvedischarge Leadership beyond silos can only progress at the speed of trust
- 32. @HelenBevan #improvedischarge After years of intensive analysis, Google discovered that the key to high performing teams that deliver change is being nice Project Aristotle: https://www.youtube.com/watch?v=UfGiCnhdU78&feature=youtu.be&list=PLHEw3ja- xoaZybvz9f0b1_6bJyG7zZO6L
- 33. @HelenBevan #improvedischarge “If we take care of the relationships, the results will follow” Chip Bell Bridge building leaders
Editor's Notes
- So Emotions help us understand what we value in the world. Why did the story of Alice work ? So why was this story powerful? Why do we respond differently when we hear about Alice rather than when we see the policy data and financial balance sheet? So public narrative when used intentionally for a purpose to connect with others to move to action is a powerful skills set and leadership gift. When we hear stories that make us feel a certain way those stories remind us of our core values. We experience our values through emotions. Then we are prepared to take action on those values. Through our emotions we are more likely to take action Research by Martha Nussbaum a Moral philosopher, tells us that people who have a damaged (a-mig-da- la) Amygadla the part of the brain which controls emotions, when faced with decisions can come up with many options from which to choose but cannot make a decision because the decision rests upon judgements of value. If we cannot feel emotion we cannot experience values that orient us to the choices we must make Shortly we will be thinking about the lived experiences that have moved you to action…we’ll be drawing on those a few minutes as you start to craft your own stories.
- Link below http://www.bbc.co.uk/news/magazine-23790147 http://www.bbc.co.uk/learningzone/clips/martin-luther-king-i-have-a-dream-pt-1-2/1293.html With the brooding statue of Abraham Lincoln peering down at him, King began by telling protesters that their presence in the symbolic shadow of the "great emancipator" offered proof of the marvellous new militancy sweeping the country. For too long, he complained, black Americans had been exiles in their own land, "crippled by the manacles of segregation and the chains of discrimination". The whirlwinds of revolt would continue to shake the very foundations of the country: "And those who hope that the Negro needed to blow off steam and will now be content will have a rude awakening if the nation returns to business as normal," King said. It would be fatal for the nation "to overlook the urgency of the moment and to underestimate the determination of the Negro". “He's good - he's damned good” Kennedy on King Wearied by the suffocating heat, the crowd's initial response was muted. The speech was not going well. "Tell 'em about the dream, Martin," shouted Mahalia Jackson, referring to a rhetorical riff that King had used several times before, but which had not made it into his prepared speech because aides insisted he needed fresh material. But King decided to cast aside his prepared notes, and launched extemporaneously into the refrain for which he will forever be remembered. "I have a dream that one day this nation will rise up and live out the true meaning of its creed," he shouted, his out-stretched right arm reaching towards the sky. Soon he was hitting his rhythm, invigorated by the chants and cries of the crowd. "Dream on!" they shouted. "Dream on!" With his voice thundering down the Mall, King imagined a future in which his children could "live in a nation where they will not be judged by the colour of their skin but by the content of their character". Then he reached his impassioned finale. King asked the crowd to yell so it was heard the world over Watching at the White House, the president was riveted. Like so many Americans, it was the first time he had heard the 34-year-old preacher deliver a speech in its entirety - the first time he had taken its measure, listened to its cadence. "He's good," Kennedy told one of his advisors. "He's damned good." The aide was struck, however, that the president seemed impressed more by the quality of King's performance rather than the power of his message.