Leading large scale change Helen Bevan

@HelenBevan #Expo14NHS
Leading large scale change
Helen Bevan
@HelenBevan
4th
March 2014

• What is happening in the wider world of transformation and
change?
• Where are the big opportunities for innovation and
improvement?
• The Horizons group: a new initiative from NHS Improving Quality
• Sharing on a massive scale
• NHS Change Day and The School for Health and Care Radicals
• How we work
Source of image: www.freshnessmag.com
For
today

1. Change is happening at a faster rate and is becoming more disruptive
2. New digital tools enable us to be in constant, direct contact with nearly everyone in the
developed world at little cost or effort
3. Hierarchical management styles are diminishing in the face of the inherent complexity
and scale of the current work environment
4. Complex work is getting more complex and that makes it difficult to replicate and copy;
creative work is changing more quickly
 both require more tacit knowledge which is best developed through conversation and social
relationships rather than guidelines and best practice databases
1. Creative processes are moving to the edges of our organisations
Many of the ways we go about change were designed in a different mindset for a
different set of circumstances
5 things that are happening in the world of change:
Sources: Change Agents Worldwide, Harold Jarche, Steven Verjans

In the near future, the edges will be where almost all high-value
work will be done in organizations…….
Organizational development and change management need to
move to the edges, and quickly.
Harold Jarche (2014)

Tensions that change agents must live with
Dominant
approach
Emerging
direction
Source: @HelenBevan

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

@rebelsatwork rebelsatwork.com
Across the world, the change agent
movement is exploding!
@chagww
Changeagentsworldwide.com
@corprebels
Corporaterebelsunited.com

A big challenge for innovation/improvement teams
Tacit knowledge is where the action is….
•It’s the people with tacit knowledge who deliver the results
•Tacit knowledge is critical for large scale change
But
The only way tacit knowledge can be
broadly shared…
…is to turn it into explicit knowledge
VERY difficult
Few organisations succeed
Gray D (2012) The Connected Company
Source: Harold Jarche

“Tacit knowledge is best developed
through conversations and social
relationships”
Harold Jarche
Source of image: northcentralcollege.edu

What are the biggest opportunities for change agents?
• As bridge builders between disconnected
groups
• As curators and sharers of knowledge

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

Curation:
Source: DaVinci Institute
From
disruptive
chaos
To
creative
clusters
Finding things out and determining what’s valid from what’s just noise
………It’s about identifying networks and communities and seeing where the
nodes and ampliﬁers sit
……………..It’s about quality and coherence, not volume and mass
Julian Stodd

@HelenBevan #Expo14NHS Source of quote: Harold Jarche; source of image:http://gotcll.com/about-2/
Getting information off
the internet is like
taking a drink from a
fire hydrant
Mitchell Kapor

Potential on a massive scale
Finding things out and keeping up to date
•“pulling” information, but also having it
“pushed” to us by trusted sources
Making sense and meaning of information
•Reflecting and putting into practice what we have
learned
•Plugging information into our own mental models
and turning it into knowledge
Connecting and collaborating
•Sharing complex knowledge with our own
work teams
•Testing new ideas with our own networks
•Increasing connections through social
networks
Source: Harold Jarche

Role of the Horizons Group
To stimulate new and ‘disruptive’ approaches in support of
healthcare transformation, operating at the edge of current
thinking and practice:
•skip a generation of thinking about how to create large scale
change
•skip a generation in who we largely connect with: emerging
leaders, clinical trainees, students
•Skip a generation of methods for change: open innovation,
social media, crowdsourcing, hackathons

Horizons Group: what we do
• Connections and collaboration
• Thought leadership in large scale change
 Tacit and explicit knowledge
 Webinars, publications, films, social media connections
 Virtual summit
 Mobilising for improvement - NHS Change Day
 The School for Health and Care Radicals - supporting the next
generation of change agents

 Supporting NHS Improving Quality programmes,
helping to keep NHS IQ thinking and practice fresh,
relevant and in line with the leading edge
 Inclusion and diversity: key principles for
transformational change
 Building the movement for radically different thinking
and action (“actionable knowledge”) in health and care
that makes a difference
Horizons Group: what we do

“The most basic not-so-secret formula for building an innovation
culture is pretty simple - embrace diversity and start to attract,
retain and promote a diverse workforce that looks differently,
works differently, dress differently, speaks differently and is
inclusive of the full spectrum of human sexual orientation and
gender identities. Do this before you start hiring consultants and
rethinking your innovation process; there is no process that
works without true diversity.”
Idris Moore
Source of image: idsgn.org
Diversity is critical to innovation and change

Case study: NHS Change Day

Its started with a tweet!
Young clinical leaders &
improvement leaders
started to talk about how
they could improve care
Damian Roland
Stuart Sutton
Helen Bevan

NHS Change Day
@NHSChangeDay #NHSChangeDay
• More than 5 million twitter impressions a day
• 4,000 video views a month across YouTube, Vimeo, Podbean
and iTunes
• Over 2,500 active audience reach a week on Facebook
• Daily Blipfoto photo journal getting 7,500 views a week
• Active picture showcases on Instagram, Pinterest, Flickr
• New 'how to' films uploaded onto YouTube...28

We work with multiple social
media platforms
@NHSChangeDay #NHSChangeDay
Join the conversation on:
Twitter
Facebook
Instagram
Blogs
Google+
YouTube
LinkedIn
Vimeo
Tumblr
Vine
Pinterest
Care Opinion
Patient Opinion
Flickr
Podcasts
Forums

Source: @NHSChangeDay

www.changeday.nhs.uk/healthcareradicals

The School for Health and
Care Radicals
Promoted through social media
More than 1,300 enrollees from 26 countries
90 volunteer mentors
Average weekly twitter reach 2.6 million
Over 10,000 shares of the slides on SlideShare
Over 1,800 shares of the study guides on SlideShare
More than 5,000 tweets using #SCHRchat
Storify has been viewed nearly 1,000 times

Feedback

Source: @NHSChangeDay
Permissionlessinnovation!

5 things we learnt from the experience of
The School for Health and Care Radicals
1. There is a massive untapped reservoir of energy and talent out
there and the potential is outstanding
2. The core audience is different to what we anticipated
3. The most important need is for connection and community
4. How to build the relationship between tacit and explicit
knowledge
5. All teach, all learn

The Horizons Group
• Working out loud
• Collaborating on a massive
scale
• Embracing diversity
• Operating at the edge of knowledge and
practice
• Beyond hierarchy

I want to stand as close to the edge as I can without going over;
on the edge you find things you can’t see from the centre
Kurt Vonnegut
Image and quote from Harold Jarche

References
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
Change Agents Worldwide (2013) Moving forward with social collaboration SlideShare
Fuda P (2012) 15 qualities of a transformational change agent
Gray D (2012) The Connected Company
Jarche, H (2013) Rebels on the edges
Jarche H (2014) Moving to the edges
Moore I (2013) Diversity is the short cut to building an innovation culture
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
Verjans S (2013) How social media changes the way we work together SlideShare

Leading large scale change Helen Bevan

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