SlideShare a Scribd company logo
1 of 52
Leading big
change: what
does it take to
deliver at large
scale?
Session M1
9.30-16.30
“Tomorrow belongs to those
who can hear it coming”
David Bowie
Heroes
Leading big change: what does it take to
deliver at large scale?
Our learning objectives for today
•Appreciate the thinking, behaviours and practices of
other leaders who deliver big change.
•Be part of a unique collective learning system to distil
practical wisdom for large scale change.
•Take home knowledge, approaches, models and
frameworks for change.
Today’s minicourse is part of the “Change”
theme at the International Forum
The “Change Rebels Salon” each day
16:45-17:45 M14 today
12.30- 1300 L5 Thursday
12.30- 1300 L12 Friday
Thursday
1100-1215: Nuka – 25 years of community-driven transformation: remarkable clinical, cost, and
happiness achievements A1
1100-1215: Enabling change across a whole system A2
1315-1430: Breaking the rules and co-developing better care systems from the inside out B2
1500-1600: Creating a culture that fosters creativity and new approaches to quality improvement C2
Friday
1100-1215: Change happens one person at a time D2
1315-1430: Creating change together E2
1500-1600: The future of change F2
0930 Welcome and aims for the day:
• being explorers rather than experts
• the process of inquiry and the opportunity of large scale change
• who is in the room?
0945 Table task with image cards: my journey of change, past, present & future (identification of key themes with online voting system (OVS)
1005 A plenary provocation:
• Approach, model, framework and method for large scale change
• How do we get to a different future?
1025 Table hosts pitch for their world café sessions
1035 World café with 10 tables (4 rounds of 12 minutes)
1130 Tea and coffee break
1145 Table discussion: NOISE analysis and identification of themes; feedback via OVS
1230 Lunch
1330 After lunch: the Grand Prix energiser
1340 Tee up for open space - key themes that emerged from the morning: action planning for horizons two
1400 Open space discussion
1500 Tea and coffee break
1515 Creating some simple rules for large scale change
1600 Making our own commitments for the next two days
1615 Reflections
1630 Close and participate in the Change Rebels Salon
A hand vote: Which country are you from?
Scotland
Wales
Northern Ireland
Republic of Ireland
Singapore
Belgium
Sweden
Ghana
Denmark
England
Denmark
USA
Canada
Australia
New Zealand
Jamaica
Brazil
Qatar
Netherlands
Sweden
Other countries?
A hand vote
Who do you know at your table?
1. The person to my left only
2. The person to my right only
3. Both people next to me
4. Neither of the people next to me
5. Everyone on the table
How an
expert
thinks
How an
explorer
thinks
EXPERTISE
How an
expert
thinks
How an
explorer
thinks
EXPERTISE
Today’s session is an INQUIRY
process
Source of image: John Spencer
Inquiry: a process of addressing
key questions that seeks to:
1. discover information and
develop our understanding
2. create movement towards
our goals and aspirations for
improvement
3. build relationships
4. allow for emergence
Today we
want to be
less “expert”
and more
“explorer”
My journey of change: past, present &
future
1. Pick three images:
• Past: An image that represents how you felt when you
first saw yourself as a leader of change
• Present: An image that represents where you are now in
your journey as a leader of change
• Future: An image that represents where you want to be in
the future as a leader of change
Time available: 3 minutes
My journey of change: past, present &
future
2. Use the images to tell your story to the others on your
table.
3. As a table group, create a shared sentence about your
future ambitions for change
4. Someone on your table should add the sentence to
Menti when instructed at the end of this activity.​
• You can choose more than
three images if you like​
• Keep your “future” image for
later​
• Put the unused cards in a tidy
pile when you’ve finished the
task
Time available: 15 minutes
1. Pick three images:
• Past: An image that represents how you felt when you
first saw yourself as a leader of change
• Present: An image that represents where you are now in
your journey as a leader of change
• Future: An image that represents where you want to be in
the future as a leader of change
How can people work together to create transformational
change in the face of an uncertain future?
There are two main sorts of change:
• Continue the pattern of how we are doing things today
• Start a new pattern for the future we want and need
Three Horizons
Bill Sharpe
Source: Sharpe, Bill. [Book]. Three Horizons: The Patterning of Hope.
From: Three horizons: a pathways practice for transformation Bill Sharpe and colleagues
Thinking about our future direction using Bill Sharpe’s “Three
Horizons” model
• Horizon 1: What are our current
ways of working (context, focus,
methods, patterns, structures etc)?
What is viable/not viable for the
future?
Time
Prevalence
From: Three horizons: a pathways practice for transformation Bill Sharpe and colleagues
Thinking about our future direction using Bill Sharpe’s “Three
Horizons” model
• Horizon 1: What are our current
ways of working (context, focus,
methods, patterns, structures etc)?
What is viable/not viable for the
future?
• Horizon 3: What could we do
differently in the future in radically
different ways to achieve our
ambitious goals? Where are the
emerging opportunities?
Time
Prevalence
From: Three horizons: a pathways practice for transformation Bill Sharpe and colleagues
Thinking about our future direction using Bill Sharpe’s “Three
Horizons” model
• Horizons 2: How can we build a path between where we are now and where
we would like to be in future? What actions should we take?
• Horizon 1: What are our current
ways of working (context, focus,
methods, patterns, structures etc)?
What is viable/not viable for the
future?
• Horizon 3: What could we do
differently in the future in radically
different ways to achieve our
ambitious goals? Where are the
emerging opportunities?
Time
Prevalence
WORLDEXPANDING
Much of our current change practice is designed for
“change-in-degree” when we are also seeking “change-in-kind”
Source: Emergent Futures Lab (2024) The new cannot be seen or thought
What level should we be thinking at for large scale change?
Approach
Model
Framework
Method
• a simplified representation of a system, phenomenon or process.
• helps us understand how something works or a path to change or make predictions
about how it might behave in the future.
• created by identifying the key components of the system or concept and then
simplifying them to make them more manageable.
• NOT used to represent a specific system or concept (like a model does)
• provides a structured approach or set of guidelines for addressing particular tasks,
problems or complexities.
• offers tools, methods and methodologies for taking things forward.
• an orderly, logical arrangement of processes that we use to attain an
improvement goal.
• it’s organised, step-by-step, and systematic.
• the actual techniques or steps that make up the practical implementation of an
approach.
• a strategic orientation or way of thinking that can guide how we deal
with issues or problems.
• an underpinning theoretical, philosophical or value outlook and/or
theory of change that can be developed into practical applications.
• broader and more flexible than frameworks and methods.
Source of definitions: adapted by Helen Bevan
Practice
Way
of
thinking
Recurring (& interconnected) themes in
approaches to making large scale change
happen
Moving together
towards a shared
direction
Co-producing
change: “with” &
“by”, not “to” or
“for”
Setting up systems
for experimental
learning &
unlearning: “doing
the right next
thing”
Creating the
conditions for
emergent
change
Developing
leaders
everywhere:
sustainable
systems of
distributed
leadership Building
power: a spectrum
of allies AND
working through
pillars of formal
power
Changing
yourself as a
resource for
change
Changing
yourself as a
resource for
change
Shaping
networks to
shape opinions
Source: Concept review by Helen Bevan and Goran Henriks
A recap: four concepts for leading big
change
1. Three Horizons:
• Horizon 1 - What are our current ways of working?
• Horizon 3 - What could we do differently in the future in
radically different ways?
• Horizon 2 - How can we build a path between where we
are now and where we would like to be in future?
2. Change-in-degree vs. change-in-kind
3. Consistent definitions:
• approach, model, framework, method
4. Eight recurring (& interconnected) themes
in approaches to making large scale change
happen
Sharing and connecting the strength and
knowledge of the community in the room
World café
•Our goal is to facilitate open discussion and collective
learning
•There are 10 tables to choose between
•There are four rounds, each of 12 mins
•Helen will time and call the rounds
•If the table you want to go to is full,
go to another table
World Café: 10 tables to choose from
No Host Topic
1 Goran Henriks, Sweden “Together for a good life for all”: how Jonkoping Region, Sweden gets outstanding
health outcomes
2 Kris Vanhaecht, Belgium The Flanders quality model: thinking, doing and learning in collaboration with
Flemish hospitals
3 Joan Borstrom, Sweden Facilitating transformational change in Swedish healthcare: using designed action
sampling
4 Marie, O’Haire, Ireland Creating communities of practice to build capacity and competency for change
across Ireland
5 Ben Allen, England Key principles for improving care through developing team culture and
performance: learning from primary care
6 Shay Bluemer Miroite, USA
& Georgia Simmonds,
Jamaica
Building a culture of improvement: A decade of sustainability lessons in Jamaica
7 Zoe Lord, England Using Liberating Structures for energising and engaging large groups of people in
change
8 Jodeme Goldhar, Canada Collective impact to enable transformative action: connection is the correction
9 Jen Rodgers, Scotland How Greater Glasgow & Clyde, the biggest health board in Europe, is co-creating its
quality strategy
10 Kathryn Grayling, England Building a thriving learning and improvement community (6,000+ members) for
large scale change
Listen together for
patterns, insights
and deeper
connections
• Do our initial eight
themes resonate?
• What other themes
are you hearing?
• What other insights
about making big
change happen?
Moving together towards a
shared direction
Creating the conditions for
emergent change
Co-producing change: “with” &
“by”, not “to” or “for”
Shaping
networks to
shape opinions
Changing yourself as a
resource for change
Developing leaders everywhere:
sustainable systems of distributed
leadership
Setting up systems for
experimental learning & unlearning:
“doing the right next thing”
Building power: a spectrum of allies
AND working through pillars of
formal power
Other potential themes Additional insights
World Café: 10 tables to choose from
No Host Topic
1 Goran Henriks, Sweden “Together for a good life for all”: how Jonkoping Region, Sweden gets outstanding
health outcomes
2 Kris Vanhaecht, Belgium The Flanders quality model: thinking, doing and learning in collaboration with
Flemish hospitals
3 Joan Borstrom, Sweden Facilitating transformational change in Swedish healthcare: using designed action
sampling
4 Marie, O’Haire, Ireland Creating communities of practice to build capacity and competency for change
across Ireland
5 Ben Allen, England Key principles for improving care through developing team culture and
performance: learning from primary care
6 Shay Bluemer Miroite, USA
& Georgia Simmonds,
Jamaica
Building a culture of improvement: A decade of sustainability lessons in Jamaica
7 Zoe Lord, England Using Liberating Structures for energising and engaging large groups of people in
change
8 Jodeme Goldhar, Canada Collective impact to enable transformative action: connection is the correction
9 Jen Rodgers, Scotland How Greater Glasgow & Clyde, the biggest health board in Europe, is co-creating its
quality strategy
10 Kathryn Grayling, England Building a thriving learning and improvement community (6,000+ members) for
large scale change
28
Coffee break
Back at 11.45
Table task - NOISE: what do we need
to do to enable large scale change?
In terms of what we heard and our own experiences:
• Needs — what’s missing?
• Opportunities — what could be developed further in future?
• Improvements — what could be changed immediately?
• Strengths — what’s working well?
• Exceptions — where are the
examples of where the future is
already happening?
Time available: 40 minutes
Table no.
In terms of what we heard in the world café and our own experiences
Improvements
what could be changed immediately?
Needs
what’s missing?
Strengths
what’s working well?
Opportunities
what could be developed further in future?
Exceptions:
Where is the future
already happening?
31
Back at 13.30
32
After lunch energiser
“The Grand Prix”
Open space table
conversations
4 principles and a law for this open space
session
Principles:
1. Whoever comes to the discussion are the right people
2. Whatever happens is the only thing that could have
happened.
3. When it starts is the right time
4. When it's over it's over
The Law is known as the Law of Two Feet:
"If you find yourself in a situation where you are not
contributing or learning, move somewhere where you can."
Table no.
Open space discussion
1. What approaches, principles and examples did we discuss?
3. Our one big idea for leading big change to deliver in Horizon two
2. What tools and methods could we use?
Topic on this table:
Gallery and “dotmocracy”
• Each person has five dots to vote
• You are voting about the top box on the template: “Our one
big idea for leading big change to deliver in Horizon two”
•Review the templates and place your dots
- Only one dot per template
- You can vote for your own
Tea and coffee break
Back at 3.15
‘Dotmocracy’ results
Creating some simple
rules for large scale
change
Learning from Jönköping: “Transformations in
leadership development in a high performing
public system”
From a system for business-specific learning to
one for system-wide learning
From a system for personal development to one for
people-focused collective improvement
From development programmes to
integration into daily work & use of
simple rules
Leadership
impact
Time
Fabisch et al (2024) Transformations towards an integrated leadership development system – a longitudinal
study in a high-performing public organization. Leadership
If we want to get a group of people to behave
differently, with everyone moving in a similar
direction, there are at least two approaches we
can follow
Complex rules
Change-in-degree
Simple rules
Change-in-kind
Simple rules
Effective simple
rules are:
• Few (5-7)
• Generalisable
• Positive
• Active
“A set of simple rules lead to intelligent behaviour in complex
situations”
Michael Dubakov
Oldham’s simple rules for managing
COVID
7 simple rules for designing the future of
healthcare
1. Name the problem
2. Build on successes
3. Take leaps of faith
4. Look outside medicine
5. Set aims and show constancy of purpose
6. Understand systems
7. Never, ever lose sight of the person we
serve as the central figure
Source: Frank Davidoff:
summarising the underlying
principles in the book “escape
Fire: designs for the future of
healthcare” by Don Berwick
Creating some “simple rules”
As a table, create a set of five “simple rules” for leading
big change and delivering at scale
• Few (5-7)
• Generalisable
• Positive
• Active
What we have done today
1. Thought
about our own
journeys of
change using
image cards
2. Explored
four core concepts:
• Three Horizons
• Change-in-degree vs.
change-in-kind
• Approach. Model,
framework, method
• Eight themes in large
scale change
3. Discussed the
work of others &
identified themes
through world
cafe
5. Energised
with
Eurovision
5. Looked at
key topics in
depth with
open space
6. Created
some simple
rules for large
scale change
4. Used NOISE
analysis to
identify what do
we need to do
to enable large
scale change
Making a commitment as a result of
today’s minicourse
• Write it on the back of one of your
images from earlier
• Add a summary to Menti
Change Rebels
ceremony
Change rebels: people who are passionate
about and committed to transformational
change for better health and care
Closing remarks and next steps
Our contacts
Helen Bevan helen@helenbevan.uk
X/Twitter: @HelenBevan
LinkedIn: Helen Bevan
Goran Henriks goran.henriks@rjl.se
X/Twitter: @GoranHenriks
LinkedIn: Goran Henriks
1.
2. 3.
4. 5.
6.
Source: based on the Three Horizons model and Griffith Centre for System Innovation
1. Understanding our journey story
so far: our history, embedded ways
of working and lessons learnt;
2. Making visible and
supporting/nurturing the
activities that are already
moving us towards a
different future in the current
system;
3. Creating possibilities for
a different/better future:
how the future could be
and how we could get
there;
4. Letting go
of the things
in the current
system that
are no longer
taking us
forward nor fit
for purpose;
5. Developing the
conditions for collective
action for
experimentation and
learning;
6. Building deep roots for system change.
Building our way forward

More Related Content

Similar to Leading big change: what does it take to deliver at large scale?

Time to do things differently event 1
Time to do things differently event 1Time to do things differently event 1
Time to do things differently event 1Iriss
 
SLC Culture fall 2016
SLC Culture fall 2016SLC Culture fall 2016
SLC Culture fall 2016Aleexsan Adal
 
Multi-strand initiatives: using theory of change evaluations
Multi-strand initiatives: using theory of change evaluationsMulti-strand initiatives: using theory of change evaluations
Multi-strand initiatives: using theory of change evaluationsfairnesseducation
 
Innovation, creativity and change: utilising appreciative inquiry and reflec...
 Innovation, creativity and change: utilising appreciative inquiry and reflec... Innovation, creativity and change: utilising appreciative inquiry and reflec...
Innovation, creativity and change: utilising appreciative inquiry and reflec...IL Group (CILIP Information Literacy Group)
 
Future of Healthcare - Delivery Teams
Future of Healthcare - Delivery TeamsFuture of Healthcare - Delivery Teams
Future of Healthcare - Delivery Teamsusffw
 
Cultivating Pedagogical Innovation Through Emerging Leaders
Cultivating Pedagogical Innovation Through Emerging LeadersCultivating Pedagogical Innovation Through Emerging Leaders
Cultivating Pedagogical Innovation Through Emerging LeadersAndrea Tejedor
 
Change Management-new ppt.ppt
Change Management-new ppt.pptChange Management-new ppt.ppt
Change Management-new ppt.pptAradhitaDeb2
 
Implementation Day PPT 2013
Implementation Day PPT 2013Implementation Day PPT 2013
Implementation Day PPT 2013peterjory
 
Leading Change in Times of Change
Leading Change in Times of ChangeLeading Change in Times of Change
Leading Change in Times of ChangeDerek Wenmoth
 
Advancing sustainability leaders
Advancing sustainability leadersAdvancing sustainability leaders
Advancing sustainability leadersMetroWater
 
Centre for ageing better theory of change slides b (1)
Centre for ageing better theory of change slides b (1)Centre for ageing better theory of change slides b (1)
Centre for ageing better theory of change slides b (1)Centre for Ageing Better
 
How to set up an improvement platform in less than one hour - revised slides ...
How to set up an improvement platform in less than one hour - revised slides ...How to set up an improvement platform in less than one hour - revised slides ...
How to set up an improvement platform in less than one hour - revised slides ...Helen Bevan
 
Making change happen at the sharp end. The role of GPs and the primary care ...
Making change happen at the sharp end.The role of GPs and the primary care ...Making change happen at the sharp end.The role of GPs and the primary care ...
Making change happen at the sharp end. The role of GPs and the primary care ...NHS Improving Quality
 
Third Teacher Project Meeting 3 06.08.14
Third Teacher Project Meeting 3 06.08.14Third Teacher Project Meeting 3 06.08.14
Third Teacher Project Meeting 3 06.08.14mrdeshylton
 
Impact and celebration event - developing a strategy for GP services in Halto...
Impact and celebration event - developing a strategy for GP services in Halto...Impact and celebration event - developing a strategy for GP services in Halto...
Impact and celebration event - developing a strategy for GP services in Halto...NHS Improving Quality
 
Project p4 english trans copy
Project p4 english trans copyProject p4 english trans copy
Project p4 english trans copyFredrik Birath
 
Project ENRICH Year 2 Online - Synchronous Session 1
Project ENRICH Year 2 Online - Synchronous Session 1 Project ENRICH Year 2 Online - Synchronous Session 1
Project ENRICH Year 2 Online - Synchronous Session 1 Uncgsoe123
 
Performance Assessment Shells and Globally Significant Issues
Performance Assessment Shells and Globally Significant IssuesPerformance Assessment Shells and Globally Significant Issues
Performance Assessment Shells and Globally Significant IssuesHonor Moorman
 
Presentation IB Conference Barcelona
Presentation IB Conference BarcelonaPresentation IB Conference Barcelona
Presentation IB Conference BarcelonaFrancis McGuigan
 

Similar to Leading big change: what does it take to deliver at large scale? (20)

Time to do things differently event 1
Time to do things differently event 1Time to do things differently event 1
Time to do things differently event 1
 
SLC Culture fall 2016
SLC Culture fall 2016SLC Culture fall 2016
SLC Culture fall 2016
 
Multi-strand initiatives: using theory of change evaluations
Multi-strand initiatives: using theory of change evaluationsMulti-strand initiatives: using theory of change evaluations
Multi-strand initiatives: using theory of change evaluations
 
Innovation, creativity and change: utilising appreciative inquiry and reflec...
 Innovation, creativity and change: utilising appreciative inquiry and reflec... Innovation, creativity and change: utilising appreciative inquiry and reflec...
Innovation, creativity and change: utilising appreciative inquiry and reflec...
 
Future of Healthcare - Delivery Teams
Future of Healthcare - Delivery TeamsFuture of Healthcare - Delivery Teams
Future of Healthcare - Delivery Teams
 
Cultivating Pedagogical Innovation Through Emerging Leaders
Cultivating Pedagogical Innovation Through Emerging LeadersCultivating Pedagogical Innovation Through Emerging Leaders
Cultivating Pedagogical Innovation Through Emerging Leaders
 
Change Management-new ppt.ppt
Change Management-new ppt.pptChange Management-new ppt.ppt
Change Management-new ppt.ppt
 
Implementation Day PPT 2013
Implementation Day PPT 2013Implementation Day PPT 2013
Implementation Day PPT 2013
 
Leading Change in Times of Change
Leading Change in Times of ChangeLeading Change in Times of Change
Leading Change in Times of Change
 
Advancing sustainability leaders
Advancing sustainability leadersAdvancing sustainability leaders
Advancing sustainability leaders
 
Centre for ageing better theory of change slides b (1)
Centre for ageing better theory of change slides b (1)Centre for ageing better theory of change slides b (1)
Centre for ageing better theory of change slides b (1)
 
How to set up an improvement platform in less than one hour - revised slides ...
How to set up an improvement platform in less than one hour - revised slides ...How to set up an improvement platform in less than one hour - revised slides ...
How to set up an improvement platform in less than one hour - revised slides ...
 
Making change happen at the sharp end. The role of GPs and the primary care ...
Making change happen at the sharp end.The role of GPs and the primary care ...Making change happen at the sharp end.The role of GPs and the primary care ...
Making change happen at the sharp end. The role of GPs and the primary care ...
 
Co-producing quality improvement
Co-producing quality improvementCo-producing quality improvement
Co-producing quality improvement
 
Third Teacher Project Meeting 3 06.08.14
Third Teacher Project Meeting 3 06.08.14Third Teacher Project Meeting 3 06.08.14
Third Teacher Project Meeting 3 06.08.14
 
Impact and celebration event - developing a strategy for GP services in Halto...
Impact and celebration event - developing a strategy for GP services in Halto...Impact and celebration event - developing a strategy for GP services in Halto...
Impact and celebration event - developing a strategy for GP services in Halto...
 
Project p4 english trans copy
Project p4 english trans copyProject p4 english trans copy
Project p4 english trans copy
 
Project ENRICH Year 2 Online - Synchronous Session 1
Project ENRICH Year 2 Online - Synchronous Session 1 Project ENRICH Year 2 Online - Synchronous Session 1
Project ENRICH Year 2 Online - Synchronous Session 1
 
Performance Assessment Shells and Globally Significant Issues
Performance Assessment Shells and Globally Significant IssuesPerformance Assessment Shells and Globally Significant Issues
Performance Assessment Shells and Globally Significant Issues
 
Presentation IB Conference Barcelona
Presentation IB Conference BarcelonaPresentation IB Conference Barcelona
Presentation IB Conference Barcelona
 

Recently uploaded

Botulism/ Clostridium botulinum.ppt prepared by Dr PRINCE C P.
Botulism/ Clostridium botulinum.ppt prepared by Dr PRINCE C P.Botulism/ Clostridium botulinum.ppt prepared by Dr PRINCE C P.
Botulism/ Clostridium botulinum.ppt prepared by Dr PRINCE C P.DR.PRINCE C P
 
تقرير منظمة الصحة العالمية الخاص بالغذاء د حاتم البيطار.pdf
تقرير منظمة الصحة العالمية الخاص بالغذاء د حاتم البيطار.pdfتقرير منظمة الصحة العالمية الخاص بالغذاء د حاتم البيطار.pdf
تقرير منظمة الصحة العالمية الخاص بالغذاء د حاتم البيطار.pdfد حاتم البيطار
 
Technology transfer documentation and strategies
Technology transfer documentation and strategiesTechnology transfer documentation and strategies
Technology transfer documentation and strategiesNidhi Joshi
 
Top^Clinic ^%[+27785538335__Safe*Abortion Pills For Sale In Soweto
Top^Clinic ^%[+27785538335__Safe*Abortion Pills For Sale In SowetoTop^Clinic ^%[+27785538335__Safe*Abortion Pills For Sale In Soweto
Top^Clinic ^%[+27785538335__Safe*Abortion Pills For Sale In Sowetodoctorjoe1984
 
INTERNATIONAL HEALTH AGENCIES BY ANUSHRI SRIVASTAV.pptx
INTERNATIONAL HEALTH AGENCIES BY ANUSHRI SRIVASTAV.pptxINTERNATIONAL HEALTH AGENCIES BY ANUSHRI SRIVASTAV.pptx
INTERNATIONAL HEALTH AGENCIES BY ANUSHRI SRIVASTAV.pptxAnushriSrivastav
 
Adrenal Function Tests-3.pptxwhfbdqbfwwfjgwngnegenhndngssfb
Adrenal Function Tests-3.pptxwhfbdqbfwwfjgwngnegenhndngssfbAdrenal Function Tests-3.pptxwhfbdqbfwwfjgwngnegenhndngssfb
Adrenal Function Tests-3.pptxwhfbdqbfwwfjgwngnegenhndngssfbKritikaMishra43
 
Antiepileptic-Drugs-and-Congenital-Anomalies copy.pptx
Antiepileptic-Drugs-and-Congenital-Anomalies copy.pptxAntiepileptic-Drugs-and-Congenital-Anomalies copy.pptx
Antiepileptic-Drugs-and-Congenital-Anomalies copy.pptxdrdeepikaj
 
Tortora PRINCIPLES OF ANATOMY AND PHYSIOLOGY - Tortora - 14th Ed.pdf
Tortora PRINCIPLES OF ANATOMY AND PHYSIOLOGY - Tortora - 14th Ed.pdfTortora PRINCIPLES OF ANATOMY AND PHYSIOLOGY - Tortora - 14th Ed.pdf
Tortora PRINCIPLES OF ANATOMY AND PHYSIOLOGY - Tortora - 14th Ed.pdfDr. Afreen Nasir
 
ℂall Girls South Delhi ℂall Now Chhaya ☎ 9899900591 WhatsApp Number 24/7
ℂall Girls South Delhi ℂall Now Chhaya ☎ 9899900591 WhatsApp  Number 24/7ℂall Girls South Delhi ℂall Now Chhaya ☎ 9899900591 WhatsApp  Number 24/7
ℂall Girls South Delhi ℂall Now Chhaya ☎ 9899900591 WhatsApp Number 24/7joyagarg064
 
I urgently need a love spell caster to bring back my ex. +27834335081 How can...
I urgently need a love spell caster to bring back my ex. +27834335081 How can...I urgently need a love spell caster to bring back my ex. +27834335081 How can...
I urgently need a love spell caster to bring back my ex. +27834335081 How can...BabaJohn3
 
Healthcare Market Overview, May 2024: Funding, Financing and M&A, from Oppenh...
Healthcare Market Overview, May 2024: Funding, Financing and M&A, from Oppenh...Healthcare Market Overview, May 2024: Funding, Financing and M&A, from Oppenh...
Healthcare Market Overview, May 2024: Funding, Financing and M&A, from Oppenh...Levi Shapiro
 
Organisation and Management of Eye Care Programme Service Delivery Models
Organisation and Management of Eye Care Programme Service Delivery ModelsOrganisation and Management of Eye Care Programme Service Delivery Models
Organisation and Management of Eye Care Programme Service Delivery ModelsHarsh Rastogi
 
Session-1-MBFHI-A-part-of-the-Global-Strategy.ppt
Session-1-MBFHI-A-part-of-the-Global-Strategy.pptSession-1-MBFHI-A-part-of-the-Global-Strategy.ppt
Session-1-MBFHI-A-part-of-the-Global-Strategy.pptMedidas Medical Center INC
 
Australia,USA,UK #Online psychic ,"£ +27834335081 Canada Lost Love Spell Cast...
Australia,USA,UK #Online psychic ,"£ +27834335081 Canada Lost Love Spell Cast...Australia,USA,UK #Online psychic ,"£ +27834335081 Canada Lost Love Spell Cast...
Australia,USA,UK #Online psychic ,"£ +27834335081 Canada Lost Love Spell Cast...BabaJohn3
 
Jual obat aborsi Cilacap Wa 081225888346 obat aborsi Cytotec asli Di Cilacap
Jual obat aborsi Cilacap Wa 081225888346 obat aborsi Cytotec asli Di CilacapJual obat aborsi Cilacap Wa 081225888346 obat aborsi Cytotec asli Di Cilacap
Jual obat aborsi Cilacap Wa 081225888346 obat aborsi Cytotec asli Di Cilacapaureliamarcelin589
 

Recently uploaded (20)

Botulism/ Clostridium botulinum.ppt prepared by Dr PRINCE C P.
Botulism/ Clostridium botulinum.ppt prepared by Dr PRINCE C P.Botulism/ Clostridium botulinum.ppt prepared by Dr PRINCE C P.
Botulism/ Clostridium botulinum.ppt prepared by Dr PRINCE C P.
 
تقرير منظمة الصحة العالمية الخاص بالغذاء د حاتم البيطار.pdf
تقرير منظمة الصحة العالمية الخاص بالغذاء د حاتم البيطار.pdfتقرير منظمة الصحة العالمية الخاص بالغذاء د حاتم البيطار.pdf
تقرير منظمة الصحة العالمية الخاص بالغذاء د حاتم البيطار.pdf
 
LTM Session-8-Practices-that-assist-BF..ppt
LTM Session-8-Practices-that-assist-BF..pptLTM Session-8-Practices-that-assist-BF..ppt
LTM Session-8-Practices-that-assist-BF..ppt
 
Technology transfer documentation and strategies
Technology transfer documentation and strategiesTechnology transfer documentation and strategies
Technology transfer documentation and strategies
 
Abortion pills in Kuwait (+918133066128) Abortion clinic pills in Kuwait
Abortion pills in Kuwait (+918133066128) Abortion clinic pills in KuwaitAbortion pills in Kuwait (+918133066128) Abortion clinic pills in Kuwait
Abortion pills in Kuwait (+918133066128) Abortion clinic pills in Kuwait
 
Top^Clinic ^%[+27785538335__Safe*Abortion Pills For Sale In Soweto
Top^Clinic ^%[+27785538335__Safe*Abortion Pills For Sale In SowetoTop^Clinic ^%[+27785538335__Safe*Abortion Pills For Sale In Soweto
Top^Clinic ^%[+27785538335__Safe*Abortion Pills For Sale In Soweto
 
INTERNATIONAL HEALTH AGENCIES BY ANUSHRI SRIVASTAV.pptx
INTERNATIONAL HEALTH AGENCIES BY ANUSHRI SRIVASTAV.pptxINTERNATIONAL HEALTH AGENCIES BY ANUSHRI SRIVASTAV.pptx
INTERNATIONAL HEALTH AGENCIES BY ANUSHRI SRIVASTAV.pptx
 
Adrenal Function Tests-3.pptxwhfbdqbfwwfjgwngnegenhndngssfb
Adrenal Function Tests-3.pptxwhfbdqbfwwfjgwngnegenhndngssfbAdrenal Function Tests-3.pptxwhfbdqbfwwfjgwngnegenhndngssfb
Adrenal Function Tests-3.pptxwhfbdqbfwwfjgwngnegenhndngssfb
 
Antiepileptic-Drugs-and-Congenital-Anomalies copy.pptx
Antiepileptic-Drugs-and-Congenital-Anomalies copy.pptxAntiepileptic-Drugs-and-Congenital-Anomalies copy.pptx
Antiepileptic-Drugs-and-Congenital-Anomalies copy.pptx
 
Tortora PRINCIPLES OF ANATOMY AND PHYSIOLOGY - Tortora - 14th Ed.pdf
Tortora PRINCIPLES OF ANATOMY AND PHYSIOLOGY - Tortora - 14th Ed.pdfTortora PRINCIPLES OF ANATOMY AND PHYSIOLOGY - Tortora - 14th Ed.pdf
Tortora PRINCIPLES OF ANATOMY AND PHYSIOLOGY - Tortora - 14th Ed.pdf
 
ℂall Girls South Delhi ℂall Now Chhaya ☎ 9899900591 WhatsApp Number 24/7
ℂall Girls South Delhi ℂall Now Chhaya ☎ 9899900591 WhatsApp  Number 24/7ℂall Girls South Delhi ℂall Now Chhaya ☎ 9899900591 WhatsApp  Number 24/7
ℂall Girls South Delhi ℂall Now Chhaya ☎ 9899900591 WhatsApp Number 24/7
 
Abortion pills in Abu Dhabi ௵+918133066128௹Un_wandted Pregnancy Kit in Dubai UAE
Abortion pills in Abu Dhabi ௵+918133066128௹Un_wandted Pregnancy Kit in Dubai UAEAbortion pills in Abu Dhabi ௵+918133066128௹Un_wandted Pregnancy Kit in Dubai UAE
Abortion pills in Abu Dhabi ௵+918133066128௹Un_wandted Pregnancy Kit in Dubai UAE
 
I urgently need a love spell caster to bring back my ex. +27834335081 How can...
I urgently need a love spell caster to bring back my ex. +27834335081 How can...I urgently need a love spell caster to bring back my ex. +27834335081 How can...
I urgently need a love spell caster to bring back my ex. +27834335081 How can...
 
Healthcare Market Overview, May 2024: Funding, Financing and M&A, from Oppenh...
Healthcare Market Overview, May 2024: Funding, Financing and M&A, from Oppenh...Healthcare Market Overview, May 2024: Funding, Financing and M&A, from Oppenh...
Healthcare Market Overview, May 2024: Funding, Financing and M&A, from Oppenh...
 
Abortion pills in Qatar (+919707208804) Get Cytotec Pills IN Doha
Abortion pills in Qatar (+919707208804) Get Cytotec Pills IN DohaAbortion pills in Qatar (+919707208804) Get Cytotec Pills IN Doha
Abortion pills in Qatar (+919707208804) Get Cytotec Pills IN Doha
 
Organisation and Management of Eye Care Programme Service Delivery Models
Organisation and Management of Eye Care Programme Service Delivery ModelsOrganisation and Management of Eye Care Programme Service Delivery Models
Organisation and Management of Eye Care Programme Service Delivery Models
 
Session-1-MBFHI-A-part-of-the-Global-Strategy.ppt
Session-1-MBFHI-A-part-of-the-Global-Strategy.pptSession-1-MBFHI-A-part-of-the-Global-Strategy.ppt
Session-1-MBFHI-A-part-of-the-Global-Strategy.ppt
 
Cara menggugurkan kandungan paling ampuh 08561234742
Cara menggugurkan kandungan paling ampuh 08561234742Cara menggugurkan kandungan paling ampuh 08561234742
Cara menggugurkan kandungan paling ampuh 08561234742
 
Australia,USA,UK #Online psychic ,"£ +27834335081 Canada Lost Love Spell Cast...
Australia,USA,UK #Online psychic ,"£ +27834335081 Canada Lost Love Spell Cast...Australia,USA,UK #Online psychic ,"£ +27834335081 Canada Lost Love Spell Cast...
Australia,USA,UK #Online psychic ,"£ +27834335081 Canada Lost Love Spell Cast...
 
Jual obat aborsi Cilacap Wa 081225888346 obat aborsi Cytotec asli Di Cilacap
Jual obat aborsi Cilacap Wa 081225888346 obat aborsi Cytotec asli Di CilacapJual obat aborsi Cilacap Wa 081225888346 obat aborsi Cytotec asli Di Cilacap
Jual obat aborsi Cilacap Wa 081225888346 obat aborsi Cytotec asli Di Cilacap
 

Leading big change: what does it take to deliver at large scale?

  • 1. Leading big change: what does it take to deliver at large scale? Session M1 9.30-16.30 “Tomorrow belongs to those who can hear it coming” David Bowie Heroes
  • 2. Leading big change: what does it take to deliver at large scale? Our learning objectives for today •Appreciate the thinking, behaviours and practices of other leaders who deliver big change. •Be part of a unique collective learning system to distil practical wisdom for large scale change. •Take home knowledge, approaches, models and frameworks for change.
  • 3. Today’s minicourse is part of the “Change” theme at the International Forum The “Change Rebels Salon” each day 16:45-17:45 M14 today 12.30- 1300 L5 Thursday 12.30- 1300 L12 Friday Thursday 1100-1215: Nuka – 25 years of community-driven transformation: remarkable clinical, cost, and happiness achievements A1 1100-1215: Enabling change across a whole system A2 1315-1430: Breaking the rules and co-developing better care systems from the inside out B2 1500-1600: Creating a culture that fosters creativity and new approaches to quality improvement C2 Friday 1100-1215: Change happens one person at a time D2 1315-1430: Creating change together E2 1500-1600: The future of change F2
  • 4. 0930 Welcome and aims for the day: • being explorers rather than experts • the process of inquiry and the opportunity of large scale change • who is in the room? 0945 Table task with image cards: my journey of change, past, present & future (identification of key themes with online voting system (OVS) 1005 A plenary provocation: • Approach, model, framework and method for large scale change • How do we get to a different future? 1025 Table hosts pitch for their world café sessions 1035 World café with 10 tables (4 rounds of 12 minutes) 1130 Tea and coffee break 1145 Table discussion: NOISE analysis and identification of themes; feedback via OVS 1230 Lunch 1330 After lunch: the Grand Prix energiser 1340 Tee up for open space - key themes that emerged from the morning: action planning for horizons two 1400 Open space discussion 1500 Tea and coffee break 1515 Creating some simple rules for large scale change 1600 Making our own commitments for the next two days 1615 Reflections 1630 Close and participate in the Change Rebels Salon
  • 5. A hand vote: Which country are you from? Scotland Wales Northern Ireland Republic of Ireland Singapore Belgium Sweden Ghana Denmark England Denmark USA Canada Australia New Zealand Jamaica Brazil Qatar Netherlands Sweden Other countries?
  • 6. A hand vote Who do you know at your table? 1. The person to my left only 2. The person to my right only 3. Both people next to me 4. Neither of the people next to me 5. Everyone on the table
  • 9. Today’s session is an INQUIRY process Source of image: John Spencer Inquiry: a process of addressing key questions that seeks to: 1. discover information and develop our understanding 2. create movement towards our goals and aspirations for improvement 3. build relationships 4. allow for emergence
  • 10. Today we want to be less “expert” and more “explorer”
  • 11. My journey of change: past, present & future 1. Pick three images: • Past: An image that represents how you felt when you first saw yourself as a leader of change • Present: An image that represents where you are now in your journey as a leader of change • Future: An image that represents where you want to be in the future as a leader of change Time available: 3 minutes
  • 12. My journey of change: past, present & future 2. Use the images to tell your story to the others on your table. 3. As a table group, create a shared sentence about your future ambitions for change 4. Someone on your table should add the sentence to Menti when instructed at the end of this activity.​ • You can choose more than three images if you like​ • Keep your “future” image for later​ • Put the unused cards in a tidy pile when you’ve finished the task Time available: 15 minutes 1. Pick three images: • Past: An image that represents how you felt when you first saw yourself as a leader of change • Present: An image that represents where you are now in your journey as a leader of change • Future: An image that represents where you want to be in the future as a leader of change
  • 13. How can people work together to create transformational change in the face of an uncertain future? There are two main sorts of change: • Continue the pattern of how we are doing things today • Start a new pattern for the future we want and need Three Horizons Bill Sharpe Source: Sharpe, Bill. [Book]. Three Horizons: The Patterning of Hope.
  • 14. From: Three horizons: a pathways practice for transformation Bill Sharpe and colleagues Thinking about our future direction using Bill Sharpe’s “Three Horizons” model • Horizon 1: What are our current ways of working (context, focus, methods, patterns, structures etc)? What is viable/not viable for the future? Time Prevalence
  • 15. From: Three horizons: a pathways practice for transformation Bill Sharpe and colleagues Thinking about our future direction using Bill Sharpe’s “Three Horizons” model • Horizon 1: What are our current ways of working (context, focus, methods, patterns, structures etc)? What is viable/not viable for the future? • Horizon 3: What could we do differently in the future in radically different ways to achieve our ambitious goals? Where are the emerging opportunities? Time Prevalence
  • 16. From: Three horizons: a pathways practice for transformation Bill Sharpe and colleagues Thinking about our future direction using Bill Sharpe’s “Three Horizons” model • Horizons 2: How can we build a path between where we are now and where we would like to be in future? What actions should we take? • Horizon 1: What are our current ways of working (context, focus, methods, patterns, structures etc)? What is viable/not viable for the future? • Horizon 3: What could we do differently in the future in radically different ways to achieve our ambitious goals? Where are the emerging opportunities? Time Prevalence
  • 17. WORLDEXPANDING Much of our current change practice is designed for “change-in-degree” when we are also seeking “change-in-kind” Source: Emergent Futures Lab (2024) The new cannot be seen or thought
  • 18. What level should we be thinking at for large scale change? Approach Model Framework Method • a simplified representation of a system, phenomenon or process. • helps us understand how something works or a path to change or make predictions about how it might behave in the future. • created by identifying the key components of the system or concept and then simplifying them to make them more manageable. • NOT used to represent a specific system or concept (like a model does) • provides a structured approach or set of guidelines for addressing particular tasks, problems or complexities. • offers tools, methods and methodologies for taking things forward. • an orderly, logical arrangement of processes that we use to attain an improvement goal. • it’s organised, step-by-step, and systematic. • the actual techniques or steps that make up the practical implementation of an approach. • a strategic orientation or way of thinking that can guide how we deal with issues or problems. • an underpinning theoretical, philosophical or value outlook and/or theory of change that can be developed into practical applications. • broader and more flexible than frameworks and methods. Source of definitions: adapted by Helen Bevan Practice Way of thinking
  • 19. Recurring (& interconnected) themes in approaches to making large scale change happen Moving together towards a shared direction Co-producing change: “with” & “by”, not “to” or “for” Setting up systems for experimental learning & unlearning: “doing the right next thing” Creating the conditions for emergent change Developing leaders everywhere: sustainable systems of distributed leadership Building power: a spectrum of allies AND working through pillars of formal power Changing yourself as a resource for change Changing yourself as a resource for change Shaping networks to shape opinions Source: Concept review by Helen Bevan and Goran Henriks
  • 20. A recap: four concepts for leading big change 1. Three Horizons: • Horizon 1 - What are our current ways of working? • Horizon 3 - What could we do differently in the future in radically different ways? • Horizon 2 - How can we build a path between where we are now and where we would like to be in future? 2. Change-in-degree vs. change-in-kind 3. Consistent definitions: • approach, model, framework, method 4. Eight recurring (& interconnected) themes in approaches to making large scale change happen
  • 21. Sharing and connecting the strength and knowledge of the community in the room World café •Our goal is to facilitate open discussion and collective learning •There are 10 tables to choose between •There are four rounds, each of 12 mins •Helen will time and call the rounds •If the table you want to go to is full, go to another table
  • 22. World Café: 10 tables to choose from No Host Topic 1 Goran Henriks, Sweden “Together for a good life for all”: how Jonkoping Region, Sweden gets outstanding health outcomes 2 Kris Vanhaecht, Belgium The Flanders quality model: thinking, doing and learning in collaboration with Flemish hospitals 3 Joan Borstrom, Sweden Facilitating transformational change in Swedish healthcare: using designed action sampling 4 Marie, O’Haire, Ireland Creating communities of practice to build capacity and competency for change across Ireland 5 Ben Allen, England Key principles for improving care through developing team culture and performance: learning from primary care 6 Shay Bluemer Miroite, USA & Georgia Simmonds, Jamaica Building a culture of improvement: A decade of sustainability lessons in Jamaica 7 Zoe Lord, England Using Liberating Structures for energising and engaging large groups of people in change 8 Jodeme Goldhar, Canada Collective impact to enable transformative action: connection is the correction 9 Jen Rodgers, Scotland How Greater Glasgow & Clyde, the biggest health board in Europe, is co-creating its quality strategy 10 Kathryn Grayling, England Building a thriving learning and improvement community (6,000+ members) for large scale change
  • 23. Listen together for patterns, insights and deeper connections • Do our initial eight themes resonate? • What other themes are you hearing? • What other insights about making big change happen?
  • 24. Moving together towards a shared direction Creating the conditions for emergent change Co-producing change: “with” & “by”, not “to” or “for” Shaping networks to shape opinions Changing yourself as a resource for change Developing leaders everywhere: sustainable systems of distributed leadership Setting up systems for experimental learning & unlearning: “doing the right next thing” Building power: a spectrum of allies AND working through pillars of formal power
  • 25. Other potential themes Additional insights
  • 26.
  • 27. World Café: 10 tables to choose from No Host Topic 1 Goran Henriks, Sweden “Together for a good life for all”: how Jonkoping Region, Sweden gets outstanding health outcomes 2 Kris Vanhaecht, Belgium The Flanders quality model: thinking, doing and learning in collaboration with Flemish hospitals 3 Joan Borstrom, Sweden Facilitating transformational change in Swedish healthcare: using designed action sampling 4 Marie, O’Haire, Ireland Creating communities of practice to build capacity and competency for change across Ireland 5 Ben Allen, England Key principles for improving care through developing team culture and performance: learning from primary care 6 Shay Bluemer Miroite, USA & Georgia Simmonds, Jamaica Building a culture of improvement: A decade of sustainability lessons in Jamaica 7 Zoe Lord, England Using Liberating Structures for energising and engaging large groups of people in change 8 Jodeme Goldhar, Canada Collective impact to enable transformative action: connection is the correction 9 Jen Rodgers, Scotland How Greater Glasgow & Clyde, the biggest health board in Europe, is co-creating its quality strategy 10 Kathryn Grayling, England Building a thriving learning and improvement community (6,000+ members) for large scale change
  • 29. Table task - NOISE: what do we need to do to enable large scale change? In terms of what we heard and our own experiences: • Needs — what’s missing? • Opportunities — what could be developed further in future? • Improvements — what could be changed immediately? • Strengths — what’s working well? • Exceptions — where are the examples of where the future is already happening? Time available: 40 minutes
  • 30. Table no. In terms of what we heard in the world café and our own experiences Improvements what could be changed immediately? Needs what’s missing? Strengths what’s working well? Opportunities what could be developed further in future? Exceptions: Where is the future already happening?
  • 34. 4 principles and a law for this open space session Principles: 1. Whoever comes to the discussion are the right people 2. Whatever happens is the only thing that could have happened. 3. When it starts is the right time 4. When it's over it's over The Law is known as the Law of Two Feet: "If you find yourself in a situation where you are not contributing or learning, move somewhere where you can."
  • 35. Table no. Open space discussion 1. What approaches, principles and examples did we discuss? 3. Our one big idea for leading big change to deliver in Horizon two 2. What tools and methods could we use? Topic on this table:
  • 36. Gallery and “dotmocracy” • Each person has five dots to vote • You are voting about the top box on the template: “Our one big idea for leading big change to deliver in Horizon two” •Review the templates and place your dots - Only one dot per template - You can vote for your own
  • 37. Tea and coffee break Back at 3.15
  • 39. Creating some simple rules for large scale change
  • 40.
  • 41. Learning from Jönköping: “Transformations in leadership development in a high performing public system” From a system for business-specific learning to one for system-wide learning From a system for personal development to one for people-focused collective improvement From development programmes to integration into daily work & use of simple rules Leadership impact Time Fabisch et al (2024) Transformations towards an integrated leadership development system – a longitudinal study in a high-performing public organization. Leadership
  • 42. If we want to get a group of people to behave differently, with everyone moving in a similar direction, there are at least two approaches we can follow Complex rules Change-in-degree Simple rules Change-in-kind
  • 43. Simple rules Effective simple rules are: • Few (5-7) • Generalisable • Positive • Active “A set of simple rules lead to intelligent behaviour in complex situations” Michael Dubakov
  • 44. Oldham’s simple rules for managing COVID
  • 45. 7 simple rules for designing the future of healthcare 1. Name the problem 2. Build on successes 3. Take leaps of faith 4. Look outside medicine 5. Set aims and show constancy of purpose 6. Understand systems 7. Never, ever lose sight of the person we serve as the central figure Source: Frank Davidoff: summarising the underlying principles in the book “escape Fire: designs for the future of healthcare” by Don Berwick
  • 46. Creating some “simple rules” As a table, create a set of five “simple rules” for leading big change and delivering at scale • Few (5-7) • Generalisable • Positive • Active
  • 47. What we have done today 1. Thought about our own journeys of change using image cards 2. Explored four core concepts: • Three Horizons • Change-in-degree vs. change-in-kind • Approach. Model, framework, method • Eight themes in large scale change 3. Discussed the work of others & identified themes through world cafe 5. Energised with Eurovision 5. Looked at key topics in depth with open space 6. Created some simple rules for large scale change 4. Used NOISE analysis to identify what do we need to do to enable large scale change
  • 48. Making a commitment as a result of today’s minicourse • Write it on the back of one of your images from earlier • Add a summary to Menti
  • 49. Change Rebels ceremony Change rebels: people who are passionate about and committed to transformational change for better health and care
  • 50. Closing remarks and next steps
  • 51. Our contacts Helen Bevan helen@helenbevan.uk X/Twitter: @HelenBevan LinkedIn: Helen Bevan Goran Henriks goran.henriks@rjl.se X/Twitter: @GoranHenriks LinkedIn: Goran Henriks
  • 52. 1. 2. 3. 4. 5. 6. Source: based on the Three Horizons model and Griffith Centre for System Innovation 1. Understanding our journey story so far: our history, embedded ways of working and lessons learnt; 2. Making visible and supporting/nurturing the activities that are already moving us towards a different future in the current system; 3. Creating possibilities for a different/better future: how the future could be and how we could get there; 4. Letting go of the things in the current system that are no longer taking us forward nor fit for purpose; 5. Developing the conditions for collective action for experimentation and learning; 6. Building deep roots for system change. Building our way forward

Editor's Notes

  1. 1.7.2013