It is natural to resist change. Rather than seeing resistance as something negative, here we shift our perspective so that we see dissent, diversity and disruption as essential components of effective change. However, we need to build resilience in order to work effectively with resistance. This module offers some tools and techniques to ensure that we remain strong, adaptable and able to continue our work as change agents.
To find out more about the School, please visit the website http://theedge.nhsiq.nhs.uk/school
As change agents we are aware that most effective change starts at âthe edgeâ. This module will help us equip ourselves for our journey to the edge and beyond. Weâll explore what we mean by âthe edgeâ, and what opportunities there are for health and care change activists to be bridge builders and curators.
Module 2 School for Change Agents - transcriptNHS Horizons
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The golden rule for change activists is: âYou canât be a rebel on your ownâ and will be presented by Kathryn Perera. This module gives us an understanding of the power of working together by exploring communities of practice and social movements. We identify techniques for connecting with our own and othersâ values and emotions to create a call for action.
To find out more about the School, please visit the website http://theedge.nhsiq.nhs.uk/school
School for Change Agents 2017 Module 4NHS Horizons
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This module will help us create and sustain the energy we need to make change happen. We will look at a number of practical ideas, tools and resources to help us change the way we do change. Weâll look at why change fails and how you can minimise the risk of it failing by creating a shared purpose and understanding the different energies needed to bring teams with you.
School for change agents - Module 1 transcriptNHS Horizons
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This first module invites you to continue your journey as a change agent and offers some new ways of thinking about how you work to effect change. The module highlights learning from some of the most effective change agents across the globe, explores the differences between troublemakers and rebels and helps us to understand how to ârock the boat and stay in itâ.
http://theedge.nhsiq.nhs.uk/school/
School for Change Agents 2017 - Module 1NHS Horizons
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This first module invites you to continue your journey as a change agent and offers some new ways of thinking about how you work to effect change. The module highlights learning from some of the most effective change agents across the globe, explores the differences between troublemakers and rebels and helps us to understand how to ârock the boat and stay in itâ.
http://theedge.nhsiq.nhs.uk/school/
Module 1 Study Guide - School for Change Agents NHS Horizons
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This first module invites you to continue your journey as a change agent and offers some new ways of thinking about how you work to effect change. The module highlights learning from some of the most effective change agents across the globe, explores the differences between troublemakers and rebels and helps us to understand how to ârock the boat and stay in itâ.
To find out more about the School, please visit the website http://theedge.nhsiq.nhs.uk/school
The golden rule for change activists is: âYou canât be a rebel on your ownâ. This module gives us an understanding of the power of working together by exploring communities of practice and social movements. We identify techniques for connecting with our own and othersâ values and emotions to create a call for action.
As change agents we are aware that most effective change starts at âthe edgeâ. This module will help us equip ourselves for our journey to the edge and beyond. Weâll explore what we mean by âthe edgeâ, and what opportunities there are for health and care change activists to be bridge builders and curators.
Module 2 School for Change Agents - transcriptNHS Horizons
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The golden rule for change activists is: âYou canât be a rebel on your ownâ and will be presented by Kathryn Perera. This module gives us an understanding of the power of working together by exploring communities of practice and social movements. We identify techniques for connecting with our own and othersâ values and emotions to create a call for action.
To find out more about the School, please visit the website http://theedge.nhsiq.nhs.uk/school
School for Change Agents 2017 Module 4NHS Horizons
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This module will help us create and sustain the energy we need to make change happen. We will look at a number of practical ideas, tools and resources to help us change the way we do change. Weâll look at why change fails and how you can minimise the risk of it failing by creating a shared purpose and understanding the different energies needed to bring teams with you.
School for change agents - Module 1 transcriptNHS Horizons
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This first module invites you to continue your journey as a change agent and offers some new ways of thinking about how you work to effect change. The module highlights learning from some of the most effective change agents across the globe, explores the differences between troublemakers and rebels and helps us to understand how to ârock the boat and stay in itâ.
http://theedge.nhsiq.nhs.uk/school/
School for Change Agents 2017 - Module 1NHS Horizons
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This first module invites you to continue your journey as a change agent and offers some new ways of thinking about how you work to effect change. The module highlights learning from some of the most effective change agents across the globe, explores the differences between troublemakers and rebels and helps us to understand how to ârock the boat and stay in itâ.
http://theedge.nhsiq.nhs.uk/school/
Module 1 Study Guide - School for Change Agents NHS Horizons
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This first module invites you to continue your journey as a change agent and offers some new ways of thinking about how you work to effect change. The module highlights learning from some of the most effective change agents across the globe, explores the differences between troublemakers and rebels and helps us to understand how to ârock the boat and stay in itâ.
To find out more about the School, please visit the website http://theedge.nhsiq.nhs.uk/school
The golden rule for change activists is: âYou canât be a rebel on your ownâ. This module gives us an understanding of the power of working together by exploring communities of practice and social movements. We identify techniques for connecting with our own and othersâ values and emotions to create a call for action.
School for Change Agents Module 5 slidesNHS Horizons
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As change agents we are aware that most effective change starts at âthe edgeâ. This module will help us equip ourselves for our journey to the edge and beyond. Weâll explore what we mean by âthe edgeâ, and what opportunities there are for health and care change activists to be bridge builders and curators.
School for Change Agents - Module 4 SlidesNHS Horizons
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This module will help us create and sustain the energy we need to make change happen. We will look at a number of practical ideas, tools and resources to help us change the way we do change. Weâll look at why change fails and how you can minimise the risk of it failing by creating a shared purpose and understanding the different energies needed to bring teams with you.
To find out more about the School, please visit the website http://theedge.nhsiq.nhs.uk/school/
Module 2 slides - School for Change AgentsNHS Horizons
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The golden rule for change activists is: âYou canât be a rebel on your ownâ and will be presented by Kathryn Perera. This module gives us an understanding of the power of working together by exploring communities of practice and social movements. We identify techniques for connecting with our own and othersâ values and emotions to create a call for action.
To find out more about the School, please visit the website http://theedge.nhsiq.nhs.uk/school/
Module 3 slides - School for Change Agents NHS Horizons
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It is natural to resist change. Rather than seeing resistance as something negative, here we shift our perspective so that we see dissent, diversity and disruption as essential components of effective change. However, we need to build resilience in order to work effectively with resistance. This module offers some tools and techniques to ensure that we remain strong, adaptable and able to continue our work as change agents.
To find otu more about the School, please visit the website http://theedge.nhsiq.nhs.uk/school/module-3/
Module 4 Transcript - School for Change AgentsNHS Horizons
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This module will help us create and sustain the energy we need to make change happen. We will look at a number of practical ideas, tools and resources to help us change the way we do change. Weâll look at why change fails and how you can minimise the risk of it failing by creating a shared purpose and understanding the different energies needed to bring teams with you.
To find out more about the School, please visit the website http://theedge.nhsiq.nhs.uk/school.
Module 3 transcript - School for Change AgentsNHS Horizons
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Transcript from Module 3 - Thursday 2 March 2017.
It is natural to resist change. Rather than seeing resistance as something negative, here we shift our perspective so that we see dissent, diversity and disruption as essential components of effective change. However, we need to build resilience in order to work effectively with resistance. This module offers some tools and techniques to ensure that we remain strong, adaptable and able to continue our work as change agents.
To find out more about the School, please visit the website http://theedge.nhsiq.nhs.uk/school
Module 3 chat box contents - School for Change AgentsNHS Horizons
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Chat box contents from Module 3 held on Thursday 2 March 2017.
It is natural to resist change. Rather than seeing resistance as something negative, here we shift our perspective so that we see dissent, diversity and disruption as essential components of effective change. However, we need to build resilience in order to work effectively with resistance. This module offers some tools and techniques to ensure that we remain strong, adaptable and able to continue our work as change agents.
To find out more about the School, please visit the website http://theedge.nhsiq.nhs.uk/school
School for Change Agents Module 5 slidesNHS Horizons
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As change agents we are aware that most effective change starts at âthe edgeâ. This module will help us equip ourselves for our journey to the edge and beyond. Weâll explore what we mean by âthe edgeâ, and what opportunities there are for health and care change activists to be bridge builders and curators.
School for Change Agents - Module 4 SlidesNHS Horizons
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This module will help us create and sustain the energy we need to make change happen. We will look at a number of practical ideas, tools and resources to help us change the way we do change. Weâll look at why change fails and how you can minimise the risk of it failing by creating a shared purpose and understanding the different energies needed to bring teams with you.
To find out more about the School, please visit the website http://theedge.nhsiq.nhs.uk/school/
Module 2 slides - School for Change AgentsNHS Horizons
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The golden rule for change activists is: âYou canât be a rebel on your ownâ and will be presented by Kathryn Perera. This module gives us an understanding of the power of working together by exploring communities of practice and social movements. We identify techniques for connecting with our own and othersâ values and emotions to create a call for action.
To find out more about the School, please visit the website http://theedge.nhsiq.nhs.uk/school/
Module 3 slides - School for Change Agents NHS Horizons
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It is natural to resist change. Rather than seeing resistance as something negative, here we shift our perspective so that we see dissent, diversity and disruption as essential components of effective change. However, we need to build resilience in order to work effectively with resistance. This module offers some tools and techniques to ensure that we remain strong, adaptable and able to continue our work as change agents.
To find otu more about the School, please visit the website http://theedge.nhsiq.nhs.uk/school/module-3/
Module 4 Transcript - School for Change AgentsNHS Horizons
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This module will help us create and sustain the energy we need to make change happen. We will look at a number of practical ideas, tools and resources to help us change the way we do change. Weâll look at why change fails and how you can minimise the risk of it failing by creating a shared purpose and understanding the different energies needed to bring teams with you.
To find out more about the School, please visit the website http://theedge.nhsiq.nhs.uk/school.
Module 3 transcript - School for Change AgentsNHS Horizons
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Transcript from Module 3 - Thursday 2 March 2017.
It is natural to resist change. Rather than seeing resistance as something negative, here we shift our perspective so that we see dissent, diversity and disruption as essential components of effective change. However, we need to build resilience in order to work effectively with resistance. This module offers some tools and techniques to ensure that we remain strong, adaptable and able to continue our work as change agents.
To find out more about the School, please visit the website http://theedge.nhsiq.nhs.uk/school
Module 3 chat box contents - School for Change AgentsNHS Horizons
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Chat box contents from Module 3 held on Thursday 2 March 2017.
It is natural to resist change. Rather than seeing resistance as something negative, here we shift our perspective so that we see dissent, diversity and disruption as essential components of effective change. However, we need to build resilience in order to work effectively with resistance. This module offers some tools and techniques to ensure that we remain strong, adaptable and able to continue our work as change agents.
To find out more about the School, please visit the website http://theedge.nhsiq.nhs.uk/school
Module 2 chat box - School for Change Agents NHS Horizons
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The golden rule for change activists is: âYou canât be a rebel on your ownâ and will be presented by Kathryn Perera. This module gives us an understanding of the power of working together by exploring communities of practice and social movements. We identify techniques for connecting with our own and othersâ values and emotions to create a call for action.
To find out more about the School, please visit our website http://theedge.nhsiq.nhs.uk/school
Module 4 chat box school for change agentsNHS Horizons
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This module will help us create and sustain the energy we need to make change happen. We will look at a number of practical ideas, tools and resources to help us change the way we do change. Weâll look at why change fails and how you can minimise the risk of it failing by creating a shared purpose and understanding the different energies needed to bring teams with you.
To find out more about the School, please visit the website http://theedge.nhsiq.nhs.uk/school
Module 1 chat box - School for Change AgentsNHS Horizons
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This first module invites you to continue your journey as a change agent and offers some new ways of thinking about how you work to effect change. The module highlights learning from some of the most effective change agents across the globe, explores the differences between troublemakers and rebels and helps us to understand how to ârock the boat and stay in itâ.
http://theedge.nhsiq.nhs.uk/school/
Mod 5 Chat Box - School for Change AgentsNHS Horizons
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Chat box contents - 16 March 2017
As change agents we are aware that most effective change starts at âthe edgeâ. This module will help us equip ourselves for our journey to the edge and beyond. Weâll explore what we mean by âthe edgeâ, and what opportunities there are for health and care change activists to be bridge builders and curators.
To find out more about the School, please visit the website http://theedge.nhsiq.nhs.uk/school
Slides from the talk that Helen Bevan gave at London Women's Leadership Network on 8th March 2017 on the occasion of International Women's Day #womenlead
Leading Large Scale Change: A Practical Guide - Part 1
What the NHS Academy for Large Scale Change learnt and how you can apply these principles within your own
health and healthcare setting
Written by:
Helen Bevan
Paul Plsek
Lynne Winstanley
On behalf of the
NHS Academy for Large Scale Change
Our industrial experience enables us to understand the needs of our clients in a better manner thus offering a precision engineered range of power control systems, electric power control systems.
School for Health and Care Radicals Module 3 Study Guide 2016Horizons NHS
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Rolling with Resistance:
It is natural to resist change. Rather than seeing resistance as something negative, here we shift our perspective so that we see dissent, diversity and disruption as essential components of effective change. However, we need to build resilience in order to work effectively with resistance. This module offers some tools and techniques to ensure that we remain strong, adaptable and able to continue our work as change agents.
Module 3 takes place on Thursday 18 February 14.30-16.00 GMT
To find out more about the School for Health and Care Radicals, copy and paste this link into your address bar http://theedge.nhsiq.nhs.uk/school/
This is the study guide for Module 3 of the School for Health and Care Radicals: Rolling with Resistance.
This module looks at the issue of 'resistance to changeâ: rather than seeing resistance as a negative thing, we shift our perspective so that we see dissent, diversity and disruption as essential components of effective change.
Agenda:
What do we mean by resistance to change?
What are some of the ways to look at resistance to change?
Importance of diversity in leading change and its implications in terms of resistance
Diversity is critical to innovation and change
Being a champion for diversity
Impact and intent
The effectiveness of a change agent is not a matter of intention; itâs a matter of impact
How to stop talking at someone and start talking to them
What you can do to build impact and intent
Using the Stages of Change model to help people through change
Why do people resist change?
What is the transtheoretical model of behaviour change?
An example of the model in practice
What we tend to do when dealing with resistance and what we should do
Questions for reflection:
What does resistance mean to you?
Think about the things you resist as well as your responses to othersâ resistance
How do you work with resistance as a change leader?
How can you make sure that the changes you make achieve the impact you desire and are sustainable?
âŚ.. do not create dependency?
âŚ.. generate self-efficacy in others?
Who are you interacting with and where they are on the Stages of Change model?
Call to action:
Reflect deeply on how you operate as an agent for change.
Consider the impact of your communication and behaviour beyond your intent.
Listen to othersâ views, engage others in change and help others through the stages of change.
This is the Study Guide for Module 4 of the School for Health and Care Radicals. This module brings together themes from earlier modules and examines ways of bringing your aspirations for change to fruition. We will look at the NHS Change model and the energy model and consider the importance of balancing different types of energy and recognising the need for both extrinsic and intrinsic motivation.
Agenda:
Why change efforts often fail to achieve their objectives
What happens to large-scale change efforts in reality?
Leaders and their role as âsignal generatorsâ
10 key principles of large-scale change
Intrinsic vs extrinsic motivation and drivers
What is the NHS Change Model and how does it align with the above?
How can you build both intrinsic and extrinsic motivators of change into your efforts?
How can you managed the tension between the two?
Building energy for change
What is energy for change?
What are the five energies?
Characteristics of the high and low end of the energies
What is an energy for change profile?
Creating shared purpose
What is our approach to change?
What is the value of a shared purpose?
How to avoid de facto purpose?
Questions and call to action
Questions for reflection:
How can I make the most of both intrinsic and extrinsic aspects of change?
How can I build energy for change for the long haul?
How can I ensure shared purpose throughout my change process?
What can I do tomorrow to accelerate change?
Call to action:
Reflect on how you can use both intrinsic and extrinsic motivators in your practice as a leader or agent of change.
Seek to ignite energy for change in everyone involved in your project.
Build commitment to shared purpose in all your change efforts.Â
School for Health and Care Radicals Module 5 Study Guide 2016Horizons NHS
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As change agents we are aware that most effective change starts at âthe edgeâ. This module will help us equip ourselves for our journey to the edge and beyond.
Module 5 takes place on Thursday 3 March 2016, 14.30-16.00 GMT
To find out more about the School for Health and Care Radicals, copy and paste this link into your address bar http://theedge.nhsiq.nhs.uk/school/
Module 5 Moving beyond the edge
This is the study guide for Module 5 of The School for Health and Care Radicals, a five week virtual programme, designed to equip people across the health and care system with the core skills to improve their skills as change agents.
Change always starts at the edge and always starts with the activists. This module looks at ways we can move towards the edge and towards sustainable change.
Agenda:
⢠Review of what we have learnt so far; characteristics of a transformational change agent
â Peter Fudaâs Transformation Change Agent framework
â âBeingâ a health and care radical â going back to âchange starts with meâ
â âSeeingâ as a health and care radical
â âDoingâ as a health and care radical
â Quick review of some models and theories
⢠'Fromâ the edge â views about emerging directions for change and change agents
â What do we mean when we say 'from the edge?'
â What is happening with change?
â What is the difference between tacit and explicit knowledge?
â Opportunities for health and care radicals â being bridge-builders and curators
⢠Reflections and key messages about The School
â Some things we have learned from delivering The School
⢠What next for The School?
â Gaining a certificate as a health and care change agent and claiming continuing professional development (CPD) points
⢠Questions and call to action
Questions for reflection:
⢠How can I move in the direction of change in ways that will help me bring about the changes I want to see?
⢠How will I build on my experiences of the School for Health and Care Radicals?
⢠How will I build networks and communities in support of the changes I want to see?
Call to action:
⢠Consider why it would be beneficial for you to be a certified change agent.
⢠Identify people who might help you with this process.
⢠Take action and, if your change action is something that could be shared for Change Day, please add it on www.changeday.nhs.uk
⢠Complete the follow-up work for certification.
This is the study guide for Module 2 of the 2015 School for Health and Care Radicals: Building alliances for change
A golden rule for change activists: You canât be a radical on your own. This module gives you an understanding of the power of working together by exploring communities of practice and social movements. We identify techniques for connecting with our own and others values and emotions to create a call for action.
Agenda:
â˘Why we canât be radicals on our own: building communities for change
âWhat is a community and how can you find power within communities?
â˘What can we learn from leaders of social movements?
âThe power of one, the power of many
âCalls to action â what are they and how are they powerful?
âWhat are the characteristics of people or groups within effective social movements?
âHow to create change at scale
âWhat is strategy in this context and how can we define resources?
â˘Effective framing: telling our stories
âWhat is framing?
âHow to connect with people to take action â connecting with emotions through values
âCreating your narrative and the power of telling stories
â˘Bridging disconnected groups
âStrong vs. weak ties
â˘Building your own community
âWho are your communities?
âHow to build new communities
Questions for reflection from this module:
â˘What learning and inspiration can you take from social movement leaders to help you in your role as an agent of change in health and care?
â˘How will you attract the attention of the people you want to call to action?
â˘Who are the people who are currently disconnected that you want to unite in order to achieve your goal for change? How can you build a sense of âusâ with them?
Call to action from this module:
⢠Identify which communities you are currently part of and how you can utilise your existing communities for change.
⢠Reflect on who else you would like to be part of your community for change and take action to connect with them.
⢠Create your narrative or âcall to actionâ to win other people to your cause.
This is the study guide for Module 4 of The School for Health and Care Radicals, a five week virtual programme, designed to equip people across the health and care system with the core skills to improve their skills as change agents. It supports NHS Change Day 2014, the grassroots movement in which everyone who values the NHS can make a pledge of action to improve things for patients and the health and care system.
Big change only happens in health and care because of heretics and radicals: passionate people who are willing to take responsibility and work with others to make change happen. Being a radical isn't related to hierarchy or position and you don't have to work in the NHS or social care to qualify as one. Registrants to the school so far include patients and carers, students, senior leaders, improvement facilitators and clinical and care staff.
There is also a live weekly web seminar which will be available to 'listen again', supported by a raft of other opportunities, including coaching and mentoring, virtual discussions and tweet chats, and an ever- expanding portal of useful resources.
Programme
The programme focuses on five modules over five weeks, 9:30 to 11:00 am GMT
Friday 31 January 2014: Being a health and care radical: change starts with me
Friday 7 February 2014: Forming communities: building alliances for change
Friday 14 February 2014: Rolling with resistance
Friday 21 February 2014: Making change happen
Friday 28 February 2014: Moving beyond the edge
Tweetchat
We will run a tweetchat each Wednesday from 16:00 to 17:00 GMT, based on the content of the module from the previous Friday. A tweetchat is a facilitated conversation using Twitter. The hashtag we will use for the tweetchats is #SHCRchat. The dates for the tweetchats are:
12 February 2014
19 February 2014
26 February 2014
5 March 2014
There is no charge to join the School of Health and Care Radicals and it is open to all, whatever your role or level, and whether or not you work in the NHS
Resources from all modules can be found at: http://www.nhsiq.nhs.uk/9059.aspx
The School for Health and Care Radical 2016 Module 1 Study GuideHorizons NHS
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This first module invites you to continue your journey as a change agent and offers some new ways of thinking about how you work to effect change. The module highlights learning from some of the most effective change agents across the globe, explores the differences between troublemakers and rebels and helps us to understand how to ârock the boat and stay in itâ.
The âCourse Topicsâ series from Manage Train Learn and Slide Topics is a collection of over 4000 slides that will help you master a wide range of management and personal development skills. The 202 PowerPoints in this series offer you a complete and in-depth study of each topic. This presentation is on "Managing Learning in Times of Change".
HRM3120
Individual and Organisational Change
2013 - 2014
Reflective Journal
Name and Family Name
Student ID
Table of Contents
IntroductionâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚ..4
What is Reflection? âŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚ 6
Tools for Reflection âŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚ.7
Wk 1: Introduction to the Module âŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚ...8
Wk 2: A Changing World âŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚ.11
Wk 3: What does this mean for Employability?................................................................14
Wk 4: Marketing Yourself 1âŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚ......17
Wk 5: Understanding Yourself 1........................................................................................20
Wk 6: Marketing Yourself 2..............................................................................................23
Wk 7: Understanding Yourself 2âŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚ26
Wk 8: The Individual and Change.....................................................................................29
Wk 9: Tutorial 1âŚâŚâŚâŚ.................................................................................................31
Wk 10: Tutorial 2âŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚ..âŚâŚ.33
Wk 11: Taking Stock and Creative Management..............................................................35
Wk 12: Understanding Organisations................................................................................38
Wk 13 Leadership of ChangeâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚâŚ.40
Wk 14: Models of Change 1âŚâŚ.......................................................................................43
Wk 15: Models of Change 2âŚâŚ.......................................................................................46
Wk 16: Systems Diagramming 1........................................................................................49
Wk 17: Systems Diagramming 2âŚ....................................................................................52
Wk 18: Working with Case Studies...................................................................................55
Wk 19: Taking Stock through Reflective Practice.............................................................57
Wk 20: Tutorial 3...............................................................................................................60
Wk 21: Tutorial 4âŚâŚ.......................................................................................................63
Wk 22: Theatre of Change Production...............................................................................66
Wk 23: Self-directed Study: Reflecting on your Learning Journey...................................69
Wk 24: Self-directed Study: Completion of Reflective Journals.......................................71
Introduction
Throughout your time at university, a lot of emphasis has been placed on supporting you to develop your skills in using reflection as a tool for learning from experience. The main reason for this is to provide you with a way of thinking a ...
Leading the Way in Nephrology: Dr. David Greene's Work with Stem Cells for Ki...Dr. David Greene Arizona
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As we watch Dr. Greene's continued efforts and research in Arizona, it's clear that stem cell therapy holds a promising key to unlocking new doors in the treatment of kidney disease. With each study and trial, we step closer to a world where kidney disease is no longer a life sentence but a treatable condition, thanks to pioneers like Dr. David Greene.
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
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M Capital Group (âMCGâ) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, âDespite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.â
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (âMTIâ) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
The Importance of Community Nursing Care.pdfAD Healthcare
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NDIS and Community 24/7 Nursing Care is a specific type of support that may be provided under the NDIS for individuals with complex medical needs who require ongoing nursing care in a community setting, such as their home or a supported accommodation facility.
Explore our infographic on 'Essential Metrics for Palliative Care Management' which highlights key performance indicators crucial for enhancing the quality and efficiency of palliative care services.
This visual guide breaks down important metrics across four categories: Patient-Centered Metrics, Care Efficiency Metrics, Quality of Life Metrics, and Staff Metrics. Each section is designed to help healthcare professionals monitor and improve care delivery for patients facing serious illnesses. Understand how to implement these metrics in your palliative care practices for better outcomes and higher satisfaction levels.
ICH Guidelines for Pharmacovigilance.pdfNEHA GUPTA
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The "ICH Guidelines for Pharmacovigilance" PDF provides a comprehensive overview of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) guidelines related to pharmacovigilance. These guidelines aim to ensure that drugs are safe and effective for patients by monitoring and assessing adverse effects, ensuring proper reporting systems, and improving risk management practices. The document is essential for professionals in the pharmaceutical industry, regulatory authorities, and healthcare providers, offering detailed procedures and standards for pharmacovigilance activities to enhance drug safety and protect public health.
Empowering ACOs: Leveraging Quality Management Tools for MIPS and BeyondHealth Catalyst
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Join us as we delve into the crucial realm of quality reporting for MSSP (Medicare Shared Savings Program) Accountable Care Organizations (ACOs).
In this session, we will explore how a robust quality management solution can empower your organization to meet regulatory requirements and improve processes for MIPS reporting and internal quality programs. Learn how our MeasureAble application enables compliance and fosters continuous improvement.
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
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This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
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Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patientâs body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
1. MODULE 3 STUDY GUIDE
Rolling with resistance
âEvery creative person, and I think probably every other person, faces
resistance when they are trying to create something good...The harder
the resistance, the more important the task must be.â
Donald Miller
http://www.theedge.nhsiq.nhs.uk/school/
@Sch4change #S4CA
www.facebook.com/sch4change/
2. Module 3 Study Guide
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Contents
Introduction ..................................................................................................................................................3
This study guide ........................................................................................................................................3
The overall goals [learning outcomes] for this module............................................................................4
What are YOUR goals for this module? ....................................................................................................4
What do we mean by resistance to change?................................................................................................5
What is our mindset about resistance?....................................................................................................5
An old power versus new power view of change and resistance.............................................................6
The power of resistance................................................................................................................................8
Diversity ....................................................................................................................................................8
Intent and impact..........................................................................................................................................9
Go for no!............................................................................................................................................... 10
Embracing resistance and surviving....................................................................................................... 10
Resistance and cream paint or shades of grey ..........................................Error! Bookmark not defined.
Understanding why people resist and what to do about it....................................................................... 11
Where am I in the change cycle and what will help me to progress to the next stage?....................... 11
The Stages of Change (or Transtheoretical Change) model .................................................................. 11
Building resilience...................................................................................................................................... 15
What is resilience?................................................................................................................................. 16
Get your five a day................................................................................................................................. 17
Call to action .............................................................................................................................................. 17
Questions for reflection............................................................................................................................. 18
Bringing it all together ........................................................................................................................... 18
Reference list for Module 3 ....................................................................................................................... 19
Additional resources.............................................................................................................................. 20
If you have ten minutes⌠...................................................................................................................... 20
If you have more than ten minutesâŚ..................................................................................................... 20
This Study Guide was prepared for the School for Change Agents by Pip Hardy, Pilgrim Projects Limited and updated by Helen
Bevan.
3. School for Change Agents
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Module 3
Rolling with resistance
Introduction
âLearning is in the relationships between people.â McDermott 1999
Welcome to Module 3 from the School for Change Agents.
In Module 1, we considered what it means to be a health and care change agent; we looked at the
differences between rebels and troublemakers, and thought about some of the risks inherent in being a
change agent. We talked about the importance of living and being the change you want to see in the
world and identified some useful ways of building self-efficacy in order to help you be an effective
change agent. We hope that you have continued to reflect on the content of Module 1 and on the
various conversations that have continued via Twitter @Sch4change and #S4CA and the School for
Change Agents Facebook group.
In Module 2, we shifted the focus from ourselves as individual agents of change to the importance of
community, networks and the power of working together. We looked at lessons from great social
movement leaders and community organisers and discussed techniques for connecting with our own
and othersâ values and emotions to create a call for action through the practice of effective framing and
storytelling.
In Module 3 we will turn to a phenomenon that will be familiar to everyone who has tried to make
changes: resistance. It is common to perceive resistance as a negative force, something to be battled
with in order to win ground. Here we will explore different ways of approaching resistance and offer
some tools that will help you to harness the energy of resistance.
This study guide
This study guide is intended to enhance and complement the webinar and help deepen your thinking
and reflection. It is not compulsory, but it may give you some ideas of things to think about and
questions to ask and you may take some inspiration from some of the examples and quotations. If you
would find it helpful, please feel free to use this guide as a place to keep track of your own thoughts and
ideas so you will have a record of your work on the module and the overall programme.
Every week, we will make a study guide available one week before the next live webinar. You can
download the study guide from the website and use it to record your reflections during and after the
seminar. You can also use the study guide in the discussions you have with your coach, mentor or
learning group after the webinar.
Throughout this study guide there are shaded sections for you to reflect on your own experiences or
respond to key questions related to the content of the module. We hope that you will feel free to use
these questions as prompts to your own thinking, and the space provided to record your ideas.
The schedule for the release of the study guides is as follows:
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Module Date of study guide release Date of webinar
4 Making change happen 3rd
March 2017 9th
March 2017
5 Moving beyond the edge 10th
March 2017 16th
March 2017
The overall goals [learning outcomes] for this module
By the time you have worked through this module, we hope that you will be able to:
⢠understand what is meant by resistance to change and why people resist
⢠explore different approaches to resistance
⢠discover the difference between impact and intent, and learn how to utilise both
⢠explore different ways of meeting the challenge of resistance
⢠harness the power of resistance
⢠use the Stages of Change model to help you identify where people are at on the cycle of change
and what to do about it
⢠build resilience to help you deal with resistance.
What are YOUR goals for this module?
In order to make the most of this module and of the
overall programme, you may find it helpful to give some
thought to your own personal goals â what do you hope
to achieve by engaging with The School for Change
Agents? What do you hope to take away from this
module?
If you have engaged with Modules 1 and 2, please
reflect briefly on what you have learned so far, and
begin to connect where you are now in your thinking
with your goals for this module, carrying forward what
you have already learned to inform your future
intentions.
In Module 1, you were encouraged to think about being the change you want to see and you will have
begun to realise that you are unlikely to accomplish your goal single-handedly. In Module 2, our focus
was on the importance of sharing both power and responsibility and of working with others to
accomplish your goals. We hope you have thought about your own networks and communities. In
Module 3, we will turn to the challenge that all change agents will meet: that is, the challenge of
resistance. We will be looking at some of the reasons why people â including you â resist change.
ACTIVITY: THE STORY CONTINUES
1 What do you hope to achieve from this module?
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2 Have you ever given any thought to how you deal with resistance?
3 Have you considered the ways in which you may able to use resistance to help you achieve your
goals?
4 What would you like to change as a result of engaging with this module?
Perhaps one of the best outcomes from studying this module is the recognition of your patterns of - and
responses to - resistance!
What do we mean by resistance to change?
Resistance means any force that stops or slows movement.
Resistance is inevitable⌠learn to expect it, welcome it.
What is our mindset about resistance?
How we deal with âresistance to changeâ depends on how we perceive the resistance. Is resistance
something negative that will get in the way of the changes that we are seeking to implement, something
that we need to overcome if we are to deliver the change? Or is it something to welcome that ensures a
diversity of perspective and builds better change?
REFLECTION: YOUR APPROACH TO RESISTANCE
Think of a time when you were seeking to lead or make a change and other people were resistant.
1 What was the situation?
2 What was your response to the resistance?
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3 How did your feelings manifest themselves?
4 Why did you react this way?
5 What was the outcome?
6. What might you do differently if faced with the same situation now?
Itâs clear that we need to be thinking differently about change and resistance if we are going to be
successful in our change efforts. Some of our work in Module 1 can help us here.
An old power versus new power view of change and resistance
You may remember this diagram from
Module 1, helping us to recognise changes
in power structures, guiding us from the
traditional, dominant approach to change
to the emerging direction for change, from
âold powerâ to ânew powerâ. Old power
approaches tended to be hierarchical,
diagnostic and transactional. Problems
were identified by a few people, solutions
sought by other people and then imposed
by those in power, while all actions and
behaviours were viewed as transactions.
As new power replaces old power, the
future will be characterised more by solutions that arise from improved and open communication, more
creative dialogue, stronger connections and better relationships.
We can also contrast these two ways of thinking about change when it comes to how we think about
resistance. The change we want isnât going to happen all at once, and it canât always be easily managed.
Acknowledging that change is often emergent and hard to predict; sharing power, valuing diversity and
nurturing relationships all make- it more likely that we will succeed in creating capability in establishing
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and maintaining connections, stimulating different perspectives and shaping how people think about
things.
Adopting these different approaches that rely more on connection, communication and dialogue than
on diagnosis, equips us to create better conditions for positive outcomes from our change efforts; part
of that is the realisation that resistance is natural but that it can lend strength and power to our change
efforts.
ACTIVITY: OLD POWER / NEW POWER APPROACHES TO CHANGE
Reflecting on my current activities in leading change:
1 Who are the âresistersâ and how would I manage them from an âold powerâ perspective?
2 How might I work with a ânew powerâ approach in my own setting?
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You have already begun to make connections and strengthen your weak and strong ties â we have seen
this via the Twitter and Facebook groups, as well as the learning groups that have been established.
Weâll go on now to look at some of the different approaches to resistance and ways of harnessing its
power.
The power of resistance
Resistance is powerful. If unharnessed, it can be harmful,
much like lightning. But, when the power of electricity is
harnessed, it is immensely useful.
Find ways of harnessing the power of resistance to help
you achieve your goals. Go with the energy rather than
against it.
Diversity
Research studies show that teams of people with diverse backgrounds, experiences and views of the
world will consistently outperform groups of more talented but homogenous individuals.
Diverse teams have better insights, they are more effective as problem solvers and they make fewer
mistakes.
The âbest peopleâ for our change projects are not necessarily the people who are most like us. As health
and care change agents, we want to embrace diversity and bring people into our change teams who
think differently to us or who have had different experiences of life. This may include patients and
families, community leaders, people from other industries and organisations. By deliberately seeking
diversity we create the risk of greater resistance, challenge and disagreement within the group, even
though the outcome is likely to be better.
As change agents, we need to embrace and value the differences.
ACTIVITY: DIVERSITY - VALUING THE DIFFERENCE
1 In the context of ârolling with resistanceâ, what are the implications of embracing diversity of
thought, experience and background in my change initiative?
2 What skills and perspectives do I need to develop to work effectively with diverse groups of people
for change?
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Intent and impact
âThe road to hell is paved with good intentions.â Proverb
What do we mean by intent and impact? If we assume that
everyone starts from a position of good intent then we
need to reflect on why we sometimes react to others in the
way that we do. A good intention can nevertheless have a
negative impact upon us; by the same token, our good
intentions may not always have the impact we hope for.
Why is this?
The deeper our knowledge of self, the more able we are to
understand WHY someone's well-intended actions cause us
anger, frustration, pain or leave us feeling disempowered.
Remember the model in Module 2 of how we overcome
negative feelings, how hope overcomes fear, how rage and
outrage can overcome apathy? When we find ourselves
reacting to the words or actions of another person, we can
step back and think about what emotion is being stirred
within us and how then to overcome it. This is not an easy
thing to do! It requires considerable self-awareness, including the awareness that we are reacting,
rather than responding appropriately to a given situation. It takes considerable strength and a degree of
mindful awareness to be aware of these reactions so that we can examine them and, hopefully, learn
from them.
REFLECTION: NEGATIVE REACTIONS
1 Think of a time when you reacted negatively to someone else's actions. What happened?
2 What do you believe their intention was?
3 Was it to cause a negative reaction in you?
4 What frame did you use to interpret their intention?
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5 If you were advising your change agent self today, how would you (re)frame the same story?
Go for no!
In the Module 3 webinar, we will look at
one very practical but not entirely
intuitive way of rolling with resistance:
Going for No!
It is only natural to seek out those who
are in sympathy with and who will
support our cause and our desire for
change. However, one of the most
effective ways of working with diversity
is to embrace other viewpoints, listen
carefully to objections and then figure out how to turn a ânoâ into a âyesâ. Going through this process will
often result in a better ultimate outcome while at the same time enabling you to realise your own
strength and become more resilient.
Source:www.goforno.com/think-of-rejection-differently/
Embracing resistance and surviving
Maxine Craig, an organisational development professional and graduate of the 2014 School, shared an
important story about resistance with the first School cohort. She begins by talking about âusâ and
âthemâ â the âgood guysâ (us) and the âbad guysâ (them).
Then she relates the story of her grandfather who was taken prisoner by the Japanese in World War 2
and interned in a POW camp. Conditions, as you may imagine, were terrible and men were starving.
Some guards took pity on her father and some
of the other men and gave them extra food.
Clearly this was a risky action for those guards
to take: they were breaking the rules and
would undoubtedly have been severely
punished had they been found out.
So who was resisting and what were they
resisting? The guards were showing
compassion and humanity to their prisoners.
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And yet, they were breaking the rules: they were rebels, agents of change.
The realisation for Maxine was that resistance is all about perspective, a matter of where you stand.
She describes her growing awareness that the world isnât always black and white and there are many
ways to accomplish the same goals. Often, those who appear to be resistors are simply seeing things
differently and doing things differently. Resistance can be more about where you stand than an inbuilt
desire to maintain the status quo. Maxine also talks about her work with a team in difficulties,
describing the anguish and frustration she and others felt when things werenât changing and the power
of the teamâs resistance to change, even when they knew, in some way, that change was necessary for
them and for their patients.
Eventually, a listening and storytelling approach was adopted and, from the pain and truths revealed in
the stories that were told, an intervention was agreed which resulted in the desired change.
If you are interested in watching some of the stories that eventually emerged from Ward 14, they can
be seen at www.patientvoices.org.uk/ht.htm
Understanding why people resist and what to do about it
There are a number of models and frameworks that can give us insight into why people are resisting
change and suggest actions to take as a change agent to roll with resistance. Many health and care
change agents use the âStages of Changeâ or âTranstheoretical Model of Behaviour Changeâ from
Prochaska, DiClemente and Norcross to support their change effort. It is a model of health-related
behaviour change that many clinicians are already familiar with through their clinical practice; it can also
be used for improving service quality and patient safety.
Where am I in the change cycle and what will help me to progress to the next
stage?
The basic model consists of five stages of change that individuals go through in changing their
behaviours. By working out where on the cycle an individual is, we can plan some appropriate actions to
help that person embrace and contribute to the change. In health and care, when people âresistâ
change, it is much more likely to be a result of their interpersonal interaction with the change process
than their innate character traits. This means that people are more likely to be resisting because of a
bad change process rather than because they are difficult people. The Stages of Change model helps us
to understand this and work out where the person is at.
The Stages of Change (or Transtheoretical Change) model
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Prochaska, DiClemente and Norcross offer us a framework that we can use to work out which stage of
change a particular individual is at and plan actions to help the person get to the next stage. We unpack
the model on the next couple of pages.
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Stage Where am I in the change cycle? What will help me move to the next stage of
change?
Whatâs a good
outcome from
efforts at this
stage?
PRECONTEMPLATION
I am not thinking about changing my
behaviours, actions or work processes. The
problem or issue is outside my frame of
awareness or my perceived need.
Therefore, there is no problem because I am
not aware of the situation as it might affect
me. Obviously, I have no intention to change
at this stage and my defences may be raised
if you push me to change. I often get
labelled as âresistantâ, âblockerâ or âin denial.â
The focus should be on creating awareness for
me of the need to change.
ďˇ Use strategies to raise my awareness and
lower my doubt.
ďˇ Increase my perception of risks and
problems with current ways of working
ďˇ Emphasise the consequences and costs
associated with maintaining the existing
system.
ďˇ Emphasise the benefits that I and others
will get from the change.
ďˇ Use basic communication skills such as
reflective listening and open-ended
questions.
ďˇ Function as my collaborator not my
educator.
Remember, the goal is not to make me (as a
pre-contemplator) change immediately, but to
help me move to contemplation.
I begin to recognise
that there might be
a problem that I
need to do
something about.
CONTEMPLATION
I am aware a problem exists and I am
seriously considering action, but I have not
yet made a commitment to an action. I have
some level of awareness of the problem. I
might not want to admit it but I also have a
large degree of fear of the unknown and of
the amount of effort I may need to make for
the change. If you force me to change at this
stage, there is a risk that my defences will
remain in place. This means that I might be
compliant with the change but not
committed to it. As a result, the change may
not be sustained.
The focus should shift to increasing the
perceived benefits of the change and reducing
the expected or perceived negative
consequences of changing for me. You will
want to create a âtipping pointâ where the
expected benefits outweigh the expected costs
of the change. To get me to this point it may be
necessary for you to help further clarify both
the benefits (which may be unknown) and
costs (which may be unrecognised). You need
to try to step into my shoes, considering the
pros and cons of change from my perspective.
I have made a
tentative
commitment to
changing the way I
currently do things
but it is fragile.
PREPARATION
I have made a decision to take future action,
but I am not yet actually prepared to take
the action now. I need to do some more
thinking about the individual steps that I
need to take prior to attempting the new
behaviour or new way of working. There is a
strong likelihood that my peers will still be
at the precontemplation and contemplation
stages (80% of others in many research
samples). As a result, I may be discouraged
or question my decision to take action.
Help me to build my skills, knowledge and
confidence in the new way of working:
⢠Build an action plan for change.
⢠Include others in the plan.
⢠Examine barriers to change and help me
work through potential solutions (what will
the first week be like?).
⢠Encourage me to take part in formal
training sessions and workshops.
⢠Give me interesting articles to read that
include robust evidence.
⢠Agree how the change will be evaluated.
Iâm making clear
statements about
the change and I
have an action plan
in place.
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ACTION
I am aware a problem exists and have
actively modified my behaviour, work
process and/or environment in order to
overcome the problem. Iâve actually made
the changes and Iâm working in a new way.
However, some of my old habits and
tendencies toward the old behaviour are
still in place and it is quite likely that I will
revert to the old way of working. The good
news is that my commitment is clear and I
am making a big effort to change.
Reinforce the changes I have made by coaching
and mentoring me:
ďˇ Recognise and acknowledge the success of
the change even if the success is only the
attempt with results not yet evident.
ďˇ Reaffirm your own commitment to the
change and engage in active problem
solving with me and my colleagues.
Iâm working in the
new way. The risk
of relapse is
diminishing as my
new
behaviours/ways of
operating replace
the old ones.
MAINTENANCE
I have made a sustained change. My new
ways of working have become firmly
established and the threat of relapse is
becoming less intense. Itâs no longer
necessary for me to think consciously about
and plan the new way of working as it has
become more automatic. I (and my patients
and colleagues) are realising the benefits of
the change and my confidence that it was
the right thing to do is growing. However, in
times of stress there is still a risk that I might
revert to the old ways of doing things.
Understand that even though I am well
established in the âmaintenanceâ phase, I still
need ongoing support and encouragement. Be
there for me if I relapse. If this happens, help
me to:
⢠Reaffirm the original reasons for the
change.
⢠Explore the factors that precipitated the
crisis.
⢠Get back on track.
Hopefully, I
successfully exit the
final stage of
change cycle and
move into a new
cycle for a new
change. If I relapse,
I will re-enter the
contemplation or
preparation stage.
Adapted from DiClemente, 1991; Prochaska and Norcross, 1994 and Wirth 2004 by Robert Ferris-Rogers and Helen Bevan
REFLECTION: STAGES OF CHANGE
1 At what stage of change are some of the key people that you need to influence for your change
initiative?
2 What actions can you take to help them move to the next stage?
When you are trying to help people through change, you might find it useful to look at the Bridges
Transition model. William Bridges realised that people need time to make the transition from one state
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to another, to adjust to the loss of something known, to acknowledge and possibly even mourn the end
of one state before accepting and becoming comfortable with a new state.
Giving yourself time and allowing time for others to adjust to change will make your change efforts
more likely to succeed and will also go a long way towards building the capacity for resilience in yourself
and those with whom you are working.
Building resilience
âEvery great personal story you have to tell involves overcoming adversity.
If you shy away from adversity, you take away your ability to tell new stories.â
Farrell Drake
In Module 2 we explored the importance of building communities and forming alliances. We gain our
strength from these alliances and this is a way in which we can overcome feelings of isolation. Within
these alliances and communities there are always critical friends: people who can connect with us at an
individual level and whom we trust. In Module 1 we looked at self-efficacy. Teachings on emotional
intelligence show us how to develop our own support mechanisms from within. We can do this through
building our self-efficacy and taking time to be kind to ourselves. Sometimes this is simply in sitting
quietly and breathing, in practising some mindfulness techniques, in sitting still to eat our lunch, in
going for a walk. By taking time simply to be, we are building our reservoirs of self-support.
REFLECTION: TAKING CARE
1 How do you take time to take care of your own physical and emotional well-being?
2 Please note down three things/activities that help to build your emotional reserves rather than
deplete your energy.
William Bridges Transition model
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3 What do you do for fun and/or to relax?
4 How can you build activities like this into your daily routine?
One change agent of our acquaintance has adopted a pragmatic approach to looking after herself. She
says:
âI only ever have three things on my âTo doâ list each day. And one of them is always
âeat lunchâ.â
Another, slightly more dramatic response was:
âThe decision to leave my job was the biggest act of self-care in the whole of my 34-year
career â I needed to make sure that I thrived, rather than the job.â
And still another:
âItâs the hardest thing! Iâve been trying to do that for 26 years! Reading, family history,
paintingâŚ. I have to schedule fun and ease into my life. Itâs usually alone time â
I go for a walk.â
Caring for ourselves is particularly important if we want to care for others. In Module 5, we will look
more deeply at the importance of being compassionate to yourself. But, if we are to âbe the change we
want to seeâ and remain committed to being an agent of change, we may have to become even more
resilient in order to roll with resistance.
What is resilience?
Resilience can be defined as âthe ability of an individual to adjust to adversity, maintain equilibrium,
retain some sense of control over their environment and continue to move on in a positive mannerâ
(Jackson et al 2007). Resilient individuals tend to:
⢠have an optimistic style
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⢠operate in their circle of influence
⢠be aware of and use their strengths
⢠set goals
⢠stay connected to others
⢠have a âcan doâ mindset
⢠exercise self-care.
Get your five a day
If you find that you are not bouncing back from
adversity quite as quickly as you would like, here are
five things you can do in order to improve your mental
health and well-being, which will, in turn, make you more resilient: www.happiness-wellbeing.org
Connect ⌠with friends, family and colleagues, building connections and investing time to maintain
them. Itâs also useful to think about connecting â or reconnecting â with purpose and your passion for
change.
Be active⌠Walk, run, cycle, dance, swim, workout in the gym, or whatever other physical activity
makes you feel good.
Take notice⌠find time to be curious, notice beautiful sights, comment on unusual ones, appreciate
your surroundings and the people you are with.
Keep learning ⌠Try something new or rediscover an old interest, learn to knit or play a musical
instrument or change a tyre, challenge yourself to something new.
Give ⌠do something nice for someone: say thank you, help an elderly person with their shopping, pick
up a childâs toy. You might try volunteering or joining a community group, but find ways to connect with
others in your community.
Call to action
Try to keep the momentum and enthusiasm going by taking some concrete actions. Here are our
suggestions:
ďˇ Look after myself: commit to doing one thing every day that gives me joy/makes me feel good.
ďˇ Identify three things I can do to support colleagues through the âStages of Changeâ.
Make time to watch The Edge talk on resilience here:
http://theedge.nhsiq.nhs.uk/edge-talk-practical-skills-resilience/
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Questions for reflection
Each webinar ends with some questions for you to reflect on during the week. Here are the questions
for this week.
REFLECTION: WHAT DOES RESISTANCE MEAN TO YOU?
1 How do I experience resistance?
2 How can I make sure that the changes I make achieve the impact I desire andâŚ
- are sustainable?
- do not create dependency?
- generate self-efficacy in others?
3 How can I make sure that my intentions actually result in the impact I want?
4 What do I need to do to develop resilience so that I can roll with resistance?
Bringing it all together
Make a note of the things that stand out for you from this module and then give some thought to how
you will use your new learning to make a difference.
REFLECTION: MAKING IT REAL
1 What have you learned?
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2 How do you know youâve learned it?
3 How will you take your learning forward? What will you do differently?
Reference list for Module 3
These are the references that we have referred to in the webinar and/or that we have used to help
shape the content. Click on the reference to get the link.
Anderson L (2014) âCollective wisdom: are we making the most of interprofessional education?â Lecture
presented at University of Leicester, 6th
February 2014
Boyd S (2014) Is cultural fit a cop-out?
Bushe G (2009) Dialogic OD Turning Away from Diagnosis
Bushe G, Marshak R (2010) Revisioning Organization Development: Diagnostic and Dialogic Premises
and Patterns of Practice
Bridges W (2009) Managing transitions: Making the most of change (3rd
edition)
Cancer Prevention Research Centre Detailed Overview of the Transtheoretical Model
Diaz-Uda A, Medina C and Schill E (2013) Diversityâs new frontier
Farquhar K (2013) NTLâs âConference on the New ODâ: Turning Thought into Action
Holman P (2013) A Call to Engage: Realizing the Potential of Dialogic Organization Development
Jaben M (2016a) The science behind resistance: Slide deck from British Columbia Patient Safety and
Quality Council
Jaben M (2016b) The science behind resistance II: now what? Slide deck from British Columbia Patient
Safety and Quality Council
Johnson S (2010) Where good ideas come from A four-minute video that explains how a truly innovative
environment encourages diversity of thought and experience.
Kegan R and Lahey L (2009) Immunity to change. Boston, Mass: Harvard Business School Press
Kotter J and Cohen D (2011) The heart of change: real-life stories of how people change their
organisations. Boston, Mass: Harvard Business Review Press
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Miller D (2011) A million miles in a thousand years
Mootee I (2013) Diversity is the short cut to building an innovation culture
NHS Institute for Innovation and Improvement (2010) Resistance â working with it
Page S (2007) Making the difference: applying a logic of diversity Academy of Management Perspectives
Prochaska J, DiClemente C, Norcross JC (1992). In search of how people change. Applications to
addictive behaviours Am Psychol 47:1102
Waltz A (2014) Handle rejection positively to succeed SlideShare
Additional resources
Here are some additional resources that you might find helpful if you would like to learn more about
resistance and how it can be harnessed to bring about constructive change.
If you have ten minutesâŚ
The power of two: how listening shapes storytelling TED talk by Paul Browde & Murray Nossel
Three myths of behaviour change â what you think you know that you donât TED talk by Jeni Cross
If you have more than ten minutesâŚ
The science behind resistance by Mark Jaben
A webinar presented to the British Columbia Patient Safety and Quality Council
The science behind resistance II: by Mark Jaben
Practical example and strategies on recognising resistance; a further webinar presented to the British
Columbia Patient Safety and Quality Council
rEvolution How to Thrive in Crazy Times by Bill Lucas
Look especially at Rule 3: Slow down and Rule 7: Sometimes itâs smart to resist.
The New Leaders by Daniel Goleman
The author of many books on emotional intelligence and personality; this book reviews the emotional
component of leadership, and discusses its role in modern leadership.
Switch: how to change things when change is hard by Chip and Dan Heath
Well-written, engaging and insightful book about why we insist on seeing the obstacles rather than the
goal and explaining how we can unlock shortcuts to switches in behaviour
Hesperian Health Guides
Resources on health and community empowerment
Useful websites for resilience, health and happiness
www.wellbeinginfo.org
www.mindapples.org
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www.mind.org.uk
www.mentalhealth.org.uk
www.moodgym.anu.edu.au
Please do contact us with your ideas and contribute to the growing collection. We look forward to
seeing you in School â and please keep in touch!
Email: england.si-horizons@nhs.net Telephone: +44 2476 627543
Facebook: www.facebook.com/sch4change/ Twitter: @Sch4change #S4CA