"Where is change going?" Slides from Helen Bevan's first talk at the NHS Tran...Helen Bevan
The NHS Transformathon was a 24 hour virtual event to connect people from all over the world who are leading the way in transforming the health and care system. It took place on 27/28 January 2016. The aim of this first talk "Where is chaneg going?" was to set the scene for the following 24 hours and to identify the principles that underpinned many of the talk to come during the Transformathon.
The entire event was a live broadcast on Google hangout. You can watch all of the sessions. Go to http://theedge.nhsiq.nhs.uk/transformathon/ and click on the title of the session you would like to view. The content is free and available to all.
If you tweet about the content of the Transformathon, please use the hashtag #NHSTform
"Where is change going?" Slides from Helen Bevan's first talk at the NHS Tran...Helen Bevan
The NHS Transformathon was a 24 hour virtual event to connect people from all over the world who are leading the way in transforming the health and care system. It took place on 27/28 January 2016. The aim of this first talk "Where is chaneg going?" was to set the scene for the following 24 hours and to identify the principles that underpinned many of the talk to come during the Transformathon.
The entire event was a live broadcast on Google hangout. You can watch all of the sessions. Go to http://theedge.nhsiq.nhs.uk/transformathon/ and click on the title of the session you would like to view. The content is free and available to all.
If you tweet about the content of the Transformathon, please use the hashtag #NHSTform
It's the era of the improvement platformHelen Bevan
Slides from the presentation Helen Bevan made at 2nd International Symposium on Healthcare Improvement and Innovation, Monash University, 29th June 2016
"Signed, Sealed Delivered": leading improvement in a new eraHelen Bevan
The slides from the workshop that Helen Bevan and Goran Henriks presented at the Clinical Microsystems Festival, Jonkoping, Sweden on 2nd March 2016. References and resources have been added at the end
This is the presentation on “health and care radicals for large scale improvement” that Helen Bevan made at the University of Jönköping on 17th January 2014. The occasion was a mini-symposium on improvement science to celebrate Jönköping Academy’s first 5 years.
Helen Bevan is Chief of Service Transformation, working in the Horizons Group at NHS Improving Quality, the national improvement body that supports the NHS in England. Follow her on Twitter @HelenBevan
Stopping over-medication of People with Learning Disabilities
(STOMPLD) 2016.
Reducing Inappropriate Psychotropic Drugs in People with a Learning Disability in General Practice and Hospitals in 2016.
Communication using the SBAR tool, Patient Safety Team, NHS Improving Quality,
more at http://www.nhsiq.nhs.uk/improvement-programmes/patient-safety.aspx
It's the era of the improvement platformHelen Bevan
Slides from the presentation Helen Bevan made at 2nd International Symposium on Healthcare Improvement and Innovation, Monash University, 29th June 2016
"Signed, Sealed Delivered": leading improvement in a new eraHelen Bevan
The slides from the workshop that Helen Bevan and Goran Henriks presented at the Clinical Microsystems Festival, Jonkoping, Sweden on 2nd March 2016. References and resources have been added at the end
This is the presentation on “health and care radicals for large scale improvement” that Helen Bevan made at the University of Jönköping on 17th January 2014. The occasion was a mini-symposium on improvement science to celebrate Jönköping Academy’s first 5 years.
Helen Bevan is Chief of Service Transformation, working in the Horizons Group at NHS Improving Quality, the national improvement body that supports the NHS in England. Follow her on Twitter @HelenBevan
Stopping over-medication of People with Learning Disabilities
(STOMPLD) 2016.
Reducing Inappropriate Psychotropic Drugs in People with a Learning Disability in General Practice and Hospitals in 2016.
Communication using the SBAR tool, Patient Safety Team, NHS Improving Quality,
more at http://www.nhsiq.nhs.uk/improvement-programmes/patient-safety.aspx
Integrated data to support service redesign decision making 19 01 2016 finalNHS Improving Quality
Integrated data to support service redesign decision making
Leeds LTC Year of Care Commissioning Early Implementer Site
Tricia Cable, Year of Care Lead
Alison Phiri, Business Intelligence Manager
Mohini Chauhan, Year of Care Commissioning Manager
Implementing Transition - Ready Steady Go
Dr Arvind Nagra, Consultant Paediatric Nephrologist, Southampton Children's Hospital, University Hospitals of Southampton
NHS Improving Quality held an event in London on 31 July 2013 to progress the children and young people transition to adult services work with a focus on turning the rhetoric into practice entitled “Working to Define a Generic Service Specification for Transition”
Transition to adult services - Gill Levitt
NHS Improving Quality held an event in London on 31 July 2013 to progress the children and young people transition to adult services work with a focus on turning the rhetoric into practice entitled “Working to Define a Generic Service Specification for Transition”
Pre work for minicourse M1 at the IHI National Forum 7th December 2015NHS Improving Quality
This is the "flipped classroom" pre-reading for minicourse M1 "a one day school for health and care radicals" at the Institute for Healthcare Improvement National Forum 7th December 2015
The School for Healthcare Radicals Institute for Healthcare Improvement Natio...NHS Improving Quality
The slides that Helen Bevan, Steve Fairman and Hannah wall will be using at the School for Healthcare Radicals minicourse at the IHI National Forum on 7th December 2015
School for Health and Care Radicals - Module 5 slides 2016Horizons NHS
Module 5 of the School for Health and Care Radicals ran on Thursday 3 March 2016 from 14:30-16:00 GMT and was led by Helen Bevan, Chief Transformation Officer, Horizons Group, NHS England.
As change agents we are aware that most effective change starts at ‘the edge’. This module will help us equip ourselves for our journey to the edge and beyond.
To find out more about the School for Health and Care Radicals, click and paste this link into your address bar: http://theedge.nhsiq.nhs.uk/school
7 day services practical tips for achieving consultant review of patients wit...NHS England
Sue Cottle, Programme Lead, 7 Day Services, Sustainable Improvement, NHS England South
Celia Ingham Clark, MBE, Medical Director for Clinical Effectiveness, NHS England
Claire Gorzanski, Head of Clinical Effectiveness, Salisbury NHS Foundation Trust
Sam Burrows, Director of Strategy, NHS Wokingham CCG
This webinar aims to provide you with:
An overview of the updated guidance for the priority clinical standards and timing of the forthcoming self-assessment survey
Practical examples of how commissioners and acute providers are working together to support delivery of timely Consultant assessment (clinical standard 2) – their successes, challenges and opportunities
An opportunity to ask questions of your colleagues and identify key areas of support required
Endoscopy - conducting a start and stop time auditNHS Improvement
Presentation from NHS Improvement endoscopy workshop held at Ambassadors Hotel, London on 29 January 2013
http://www.improvement.nhs.uk/diagnostics/EndoscopyImprovement/Events.aspx
Conducting a start and stop time audit
Janet Bates, Endoscopy Department Digestive Diseases Centre
Brighton and Sussex University Hospitals NHS Trust
Presentation at the RCGP East Anglia Faculty practice team awards event, Newmarket 20 Sept.
Reflections on the strengths of general practice, the daily realities for most of us right now and ideas about how we can realise more of the potential in primary care.
A rapid introduction to the evidence base of what works on getting large scale change started, with valuable insights from senior leaders on the successful progression of transformation. Hear from NHS IQ’s Transforming Care team and take away learning and tips from their work with over half the country’s local health and care systems.
Improving quality, safety and lives - the Patient Safety Collaborative Programme 2014-2019
Presentation from Chief Nursing Officer for England's Summit 2014
26 November 2014
Bringing Lean to Life" provides a basic introduction and overview of Lean; the culture, principles and tools to understand, tackle and resolve issues within healthcare. It is not intended as a complete guide to implementing Lean as a management system. (May 2010).
EdgeTalks, March 3 2017, The DNA of Care: the importance of listening to staf...Horizons NHS
The DNA of Care: the importance of listening to staff stories
Presented by Dr Karen Deeny, Staff Experience Programme Lead at NHS England (@karendeeny1), and Dr Pip Hardy (@PilgrimPip), Co-founder of the Patient Voices Programme (@PatientVoicesUK).
The intertwined relationship between patient care and staff well-being has been likened to the double helix. And so the stories we tell each other are like the DNA of care, transmitting information and shaping cultures, offering learning opportunities and, sometimes, healing.
These are the presentation slides from Helen Bevan at the Health and Care Innovation Expo 2014, Manchester #Expo14NHS
Learn how to be a health and care radical who can challenge the status quo when you see there could be a better way. We want to change existing thinking and practice and improve care for patients, families and people who use care services
These are the slides for the one day School for Health and Care Radicals that Helen Bevan ran in Vancouver on 18th February as part of the British Columbia Quality Forum, organised by the BC Patient Safety and Quality Council
"It's time to rewrite the rules of change in healthcare" - a presentation that Helen Beven, Chief Transformation Officer with the Horizons group, NHS Improving Quality, made at Yale on 10 June 2014.
This is the summary of the talk:
As leaders of health and care, we are seeking to create change in a world where the power of hierarchy is diminishing and change is happening faster and becoming more disruptive. Many of the ways we have traditionally gone about improving health and care were designed in a different mindset for a different set of circumstances and increasingly, they won't work. This means a fundamental rethink about what organisational change means; who does it (many change agents, not just a few) where it happens (increasingly 'at the edge' of organisations and the skills and mindsets that change agents need. This also means embracing disruption and 'disruptors' in our health and care organisations so that innovation happens; no longer seeking to 'overcome resistance to change' but welcoming difference, diversity and dissent as core operating principles in our approach to change. The slides end with a call to action: join the movement of health and care leaders across the world who are rewriting the rules of change and leading change from the future for different results.
Full slide deck for Minicourse M5 "Leading radical change a day of transforma...NHS Improving Quality
These are the slides from the Minicourse M5 that Helen Bevan led at the Institute for Healthcare Improvement National Forum, 8th December 2014
The aims of the day were to:
- Identify major themes and trends in the global world of change and transformation that are likely to shake the world of health care improvement
- Consider the opportunities and implications of these for their own practice as a leader of change and improvement
- Model new forms of collective learning, collaboration, and community building
You can follow Helen on Twittter at @HelenBevan
You can also sign up for The Edge, our free knowledge hub for change activists in health and care at TheEdge.nhsiq.nhs.uk
Fab Change Day Activists School (Newcastle)NHS Horizons
Slides used during the Fab Change Day Activists School (Newcastle) on Tuesday 13 September 2016 and delivered by the Horizons team. If you have any comments or questions about these slides, please email england.si-horizons@nhs.net.
This year, NHS Change Day is joining forces with The Academy of Fabulous Stuff to create Fabulous Change Day on Wednesday 19 October 2016. We hope that you will be able to take action on this date (and all year round) to improve things for patients, service users, families and colleagues.
Ahead of Fab Change Day, we’re running one-day training events at six venues round the country to build your skills in leading change and help you make a real difference to patients and staff.
Fab Change Day Activists School (Leeds)NHS Horizons
Slides used during the Fab Change Day Activists School (Newcastle) on Wednesday 14 September 2016 and delivered by the Horizons team. If you have any comments or questions about these slides, please email england.si-horizons@nhs.net.
This year, NHS Change Day is joining forces with The Academy of Fabulous Stuff to create Fabulous Change Day on Wednesday 19 October 2016. We hope that you will be able to take action on this date (and all year round) to improve things for patients, service users, families and colleagues.
Ahead of Fab Change Day, we’re running one-day training events at six venues round the country to build your skills in leading change and help you make a real difference to patients and staff.
Helen Bevan's presentation to the Surgical Quality Action Network NHS Improving Quality
This is Helen Bevan's presentation to the Surgical Quality Action network of British Columbia, 18th February 2015. The topic is "How to be a great change agent"
Rocking the boat and staying in it: a presentation for Healthcare Improvement...NHS Improving Quality
This is the presentation that Helen Bevan, Chief of Service Transformation at NHS Improving Quality, England made for Healthcare Improvement Scotland on 23rd September 2014
These are the slides from Helen Bevan’s talk “ It’s time to rewrite the rules of change in health and care” to be given on 3rd September 2014 at the APAC Forum, Melbourne Australia.
The APAC Forum (1st to 3rd September 2014) is the premier healthcare conference in the Asia Pacific region. It offers innovative ideas and leading-edge solutions for clinicians, managers, policy-makers and academics seeking to deliver the highest quality healthcare with finite resources and seemingly infinite demand. More details at http://apacforum.com/
These are the slides for SHCR II Module 3: Rolling with Resistance.
This module looks at the issue of 'resistance to change’: 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; it’s 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 and call to action
Questions for reflection:
What does resistance mean to you?
Think about the things you resist as well as your responses to others’ 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?
….. do not create dependency?
….. 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 others’ views, engage others in change and help others through the stages of change.
Module 1: Being a health and care radical - change starts with meNHS Improving Quality
These are the slides for module one 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.
Starting on 31 January, there will be 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: Being a health and care radical: change starts with me
• Friday 7 February: Forming communities: building alliances for change
• Friday 14 February: Rolling with resistance
• Friday 21 February: Making change happen
• Friday 28 February: 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:
• 5 February
• 12 February
• 19 February
• 26 February
• 5 March
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. There will be additional learning materials and opportunities in addition to the web seminars but there is no set syllabus for learners to work through - you can join for as much or as little as you want.
More information: http://changeday.nhs.uk/healthcareradicals
School for Health and Care Radicals one day school Bolton 26 May 2016Horizons NHS
The Horizons team from NHS England delivered a one day School for Health and Care Radicals for the North West Centre for Professional Workforce Development.
Date: 26th May 2016
Presenters: Kate Pound and Olly Benson
To find out more information about School for Health and Care Radicals follow this link http://theedge.nhsiq.nhs.uk/school/
Presentation slides Frailty: building understanding, empathy and the skills t...NHS Improving Quality
Frailty: building understanding, empathy and the skills to support self-care
Guest speaker:Dr Dawn Moody, Director - Fusion48
An opportunity to learn about some innovative approaches to making the health and care workforce 'Fit for Frailty'* (*British Geriatrics Society 2015).
Learning outcomes:
To explore the Frailty Fulcrum as a tool for holistic assessment and management of frailty
To hear how Virtual Reality is being used to build empathy for older people living with frailty
To learn about the impact of a county-wide, multi-agency, multi-professional training an toolkit for care professionals working with older people
Resources:www.fusion48.net
Self-management in the community and on the Internet - Presentation 22nd Marc...NHS Improving Quality
LTC Lunch & Learn webinar:- 22nd March 2016
Presenter:- Pete Moore, Educator, Author & Pain Toolkit Trainer
As pain is the most daily health problem reported to a GP-
Developing a national pain strategy- reviews from around the world
Electronic Palliative Care Coordination Systems (EPaCCS): Improving Patient C...NHS Improving Quality
Speaker slides from the national conference, 'Electronic Palliative Care Coordination Systems (EPaCCS): Improving Patient Care at End of Life', 17 March 2016
Fire service as an asset: providing telecare support in the community Webinar...NHS Improving Quality
Guest speaker: Steve Vincent - West Midlands Fire Service & Simon Brake from Coventry Council
Hosted by: Bev Matthews, Long Term Conditions Programme Lead, NHS England
Learning Outcomes:-
To better understand the role that the Fire and Rescue service can provide as a community asset to support health needs Enhancing the quality of life for people by supporting them to stay in their own home, even in a crisis
An overview of the work carried out by NHS England and NHS Improving Quality's Long Term Conditions Sustainable Improvement Team. It puts the case for why person-centred care has to be at the heart of healthcare.
Commissioning Integrated models of care
Kent LTC Year of Care Commissioning Early Implementer Site
Alison Davis, Integration Programme Health and Social Care, Working on behalf of Kent County Council and South Kent Coast and Thanet CCG's
Slides from a lunch and learn webinar hosted by NHS England's Long Term Conditions Team, on the topic of health coaching by lay professionals.
The speakers and Anya de Longh and Jim Phillips.
The final poll for the person centred care images captured at the LTC Midlands and East learning event in November 2015. Which captures person centred care the most to you? Access to records or quality for everyone?
Improving the physical health of patients with severe mental health illness ...NHS Improving Quality
Improving the physical health of patients with severe mental health illness in primary care, by Rhiannon England, GP Clinical Lead, City and Hackney CCG
We all have good and bad thoughts from time to time and situation to situation. We are bombarded daily with spiraling thoughts(both negative and positive) creating all-consuming feel , making us difficult to manage with associated suffering. Good thoughts are like our Mob Signal (Positive thought) amidst noise(negative thought) in the atmosphere. Negative thoughts like noise outweigh positive thoughts. These thoughts often create unwanted confusion, trouble, stress and frustration in our mind as well as chaos in our physical world. Negative thoughts are also known as “distorted thinking”.
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
This is a presentation by Dada Robert in a Your Skill Boost masterclass organised by the Excellence Foundation for South Sudan (EFSS) on Saturday, the 25th and Sunday, the 26th of May 2024.
He discussed the concept of quality improvement, emphasizing its applicability to various aspects of life, including personal, project, and program improvements. He defined quality as doing the right thing at the right time in the right way to achieve the best possible results and discussed the concept of the "gap" between what we know and what we do, and how this gap represents the areas we need to improve. He explained the scientific approach to quality improvement, which involves systematic performance analysis, testing and learning, and implementing change ideas. He also highlighted the importance of client focus and a team approach to quality improvement.
Welcome to TechSoup New Member Orientation and Q&A (May 2024).pdfTechSoup
In this webinar you will learn how your organization can access TechSoup's wide variety of product discount and donation programs. From hardware to software, we'll give you a tour of the tools available to help your nonprofit with productivity, collaboration, financial management, donor tracking, security, and more.
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
Palestine last event orientationfvgnh .pptxRaedMohamed3
An EFL lesson about the current events in Palestine. It is intended to be for intermediate students who wish to increase their listening skills through a short lesson in power point.
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
The Indian economy is classified into different sectors to simplify the analysis and understanding of economic activities. For Class 10, it's essential to grasp the sectors of the Indian economy, understand their characteristics, and recognize their importance. This guide will provide detailed notes on the Sectors of the Indian Economy Class 10, using specific long-tail keywords to enhance comprehension.
For more information, visit-www.vavaclasses.com
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
How to Split Bills in the Odoo 17 POS ModuleCeline George
Bills have a main role in point of sale procedure. It will help to track sales, handling payments and giving receipts to customers. Bill splitting also has an important role in POS. For example, If some friends come together for dinner and if they want to divide the bill then it is possible by POS bill splitting. This slide will show how to split bills in odoo 17 POS.
2. #OUSR
WHO makes change happen in your organisation?
Source: adapted by Helen Bevan
from Leandro Herrera
List A
• The Transformation Programme
Board [or alternative title]
• The programme sponsor
• The Programme Management
Office
• The leads of the [insert number]
transformation work streams
• The Project Manager
• The Team Leader /Unit Manager
• The Change Facilitator
3. #OUSR
WHO makes change happen in your organisation?
List A
• The Transformation
Programme Board
• The programme sponsor
• The Programme Management
Office
• The leads of the [insert
number] transformation work
streams
• The Project Manager
• The Team Leader /Unit
Manager
• The Change Facilitator
List B
• The mavericks and rebels
• The deviants (positive). Who do
things differently and succeed
• The contrarians, because they can
• The nonconformists who see
things through glasses no one else
has
• The hyper-connected. Good or
bad, they spread behaviours, role
model at a scale, set mountains
on fire and multiply anything they
get their hands on
• The hyper-trusted. Multiple
reasons, doesn’t matter which
ones Source: adapted by Helen Bevan
from Leandro Herrera
4. #OUSR
WHO makes change happen in your organisation?
List A
• The Transformation
Programme Board
• The programme sponsor
• The Programme Management
Office
• The leads of the [insert
number] transformation work
streams
• The Project Manager
• The Team Leader /Unit
Manager
• The Change Facilitator
List B
• The mavericks and rebels
• The deviants (positive). Who do
things differently and succeed
• The contrarians, because they can
• The nonconformists who see
things through glasses no one else
has
• The hyper-connected. Good or
bad, they spread behaviours, role
model at a scale, set mountains
on fire and multiply anything they
get their hands on
• The hyper-trusted. Multiple
reasons, doesn’t matter which
ones Source: adapted by Helen Bevan
from Leandro Herrera
7. #OUSR
How we make a difference
The School formally evaluated by
the Chartered Institute for Personnel
& Development
Statistically significant positive effect on EVERY
dimension of impact at both individual and
organisational level
• Change knowledge
• Sense of purpose & motivation to improve practice
• Ability to challenge the status quo
• Rocking the boat & staying in it
• Connecting with others to build support for change
8. #OUSR
The Horizons team
• A small team of people within the
NHS who support improvement
and change.
• We tune into and engage with the best change
thinking and practice in healthcare and other
industries around the world and seek to translate
this learning into practical approaches to change.
• The team has emerged through years of
supporting change in the NHS and wider health
and care system
9. #OUSR
Follow us on Twitter
@School4Radicals
@HelenBevan
@KateSlater2
@OllyBenson
10. #OUSR
Agenda
1. Being a health and care radical: change starts with
me
2. Building energy for change
3. Forming communities and connecting emotionally
with change
4. Change programmes versus change platforms
5. Rolling with resistance
6. An “unconference”
14. #OUSR
The genesis of the School
2002
2014
2013
2010 2012
2003
NHS Change Day
2013
“A school for
healthcare
radicals”
Applying
social movement
thinking to
healthcare
improvement
“The School for
Health and Care
Radicals”
Applying
community organising
principles to
healthcare
improvement
2016
“A one day school for
organisational
radicals”
15. #OUSR
The Five Year Forward View
Mentions
“radical”
12 times
“transformation/transformational”
13 times
“change”
42 times
16. #OUSR
The OU Student First paper
Contains the following words:
• Change = 20
• Innovate = 19
• Adapt = 10
• Radical = 0
17. #OUSR
“New truths begin as heresies”
(Huxley, defending Darwin’s theory of natural selection)
Source of image:
installation by the
artist Adam Katz
www.thisiscolossal.com
Via @NeilPerkin
19. #OUSR
People who are highly connected
have twice as much power to
influence change as people with
hierarchical power
Leandro Herrero
http://t.co/Du6zCbrDBC
21. #OUSR
Kinthi Sturtevant, IBM
13th annual Change Management
Conference June 2015
We rarely see two, three or four
year change projects anymore.
Now it’s 30-60-90 day change
projects
34. #OUSR
Why go to the edge?
“ Leading from the edge brings us
into contact with a far wider range
of relationships, and in turn, this
increases our potential for diversity
in terms of thought, experience
and background. Diversity leads to
more disruptive thinking, faster
change and better outcomes
Aylet Baron
35. #OUSR
Jeremy Heimens TED talk “What new power looks like”
https://www.youtube.com/watch?v=j-S03JfgHEA
old power new power
Currency
Held by a few
Pushed down
Commanded
Closed
Transaction
Current
Made by many
Pulled in
Shared
Open
Relationship
36. #OUSR
The Network Secrets of Great Change Agents
Julie Battilana &Tiziana Casciaro
As a change agent, my centrality in the
informal network is more important
than my position in the formal
hierarchy
37. #OUSR
Is your change process a cathedral or a bazaar?
http://www.unterstein.net/su/docs/CathBaz.pdf
38. #OUSR
We have a lot of cathedrals
Source: Sewell (2015) : Stop training our project managers to be process junkies
39. #OUSR
“Tomorrow’s management systems
will need to value diversity, dissent
and divergence as highly as
conformance, consensus and
cohesion.”
Gary Hamel
Image by neilperkin.typepad.com
is the new normal!
40. #OUSR
“Tomorrow’s management systems
will need to value diversity, dissent
and divergence as highly as
conformance, consensus and
cohesion.”
Gary Hamel
Image by neilperkin.typepad.com
“The single biggest mistake to
avoid? Creating disruption at work.
Focus on developing relationships,
not disrupting and alienating
people. Peter Vander Awera on
learning from setbacks and failures
is the new normal!
45. #SHCR @HelenBevan
We need rebels!
•The principal champion of a change initiative, cause
or action
•Rebels don’t wait for permission to lead, innovate,
strategise
•They are responsible; they do what is right
•They name things that others don’t
see yet
•They point to new horizons
•Without rebels, the storyline never
changes
Source : @PeterVan http://t.co/6CQtA4wUv1
46. #SHCR @HelenBevan
If you put fences around people, you
get sheep. Give people the room they
need
William L McKnight
47. #SHCR @HelenBevan
We need to create more boat rockers!
• Rock the boat but manage to
stay in it
• Walk the fine line between
difference and fit, inside and
outside
• Conform AND rebel
• Capable of working with
others to create success NOT
a destructive troublemaker
Source: Debra Meyerson
48. #SHCR @HelenBevan
Source : Lois Kelly www.foghound.com
There’s a big difference between a rebel and
a troublemaker
Rebel
49. #SHCR @HelenBevan
Reflection
• What are your insights around “rebels” and
“troublemakers”?
• What moves people from being “rebel” to
“troublemaker”?
• How do we protect against this?
50. #SHCR @HelenBevan
Source : Lois Kelly www.rebelsatwork.com
There’s a big difference between a
rebel and a troublemaker
Rebel
56. #SHCR @HelenBevan
"There’s only one
corner of the
universe you can
be certain of
improving, and
that’s your own
self."
Aldous Huxley
Source of image: timcoffeyart.wordpress.com
57. #SHCR @HelenBevan
‘I do not think you can really deal with
change without a person asking real
questions about who they are and how they
belong in the world’
David Whyte, The Heart Aroused 1994
Source of image: fistfuloftalent.com
58. #SHCR @HelenBevan
1. able to join forces with others to create action
2. able to achieve small wins which create a sense
of hope, possibility and confidence
3. More likely to view obstacles as challenges to
overcome
4. strong sense of “self-efficacy”
belief that I am personally able to create the change
Four things we know about successful
boat rockers
Source: adapted from Debra E Meyerson
CHANGE
me
BEGINS WITH
59. #SHCR @HelenBevan
Self-efficacy
There is a positive, significant
relationship between the
self-efficacy beliefs of a
change agent and her/his
ability to facilitate change
and get good outcomes
Source of image:www.h3daily.com
63. #SCHR @HelenBevan
Building self-efficacy: some tactics
1. Create change one small step at a time
2. Reframe your thinking:
• failed attempts are learning opportunities
• uncertainty becomes curiousity
3. Make change routine rather than an exceptional
activity
4. Get social support
5. Learn from the best
64. #SHCR @HelenBevan
1. strong sense of “self-efficacy”
belief that I am personally able to create the change
2. able to join forces with others to create action
3. able to achieve small wins which create a sense
of hope, possibility and confidence
4. More likely to view obstacles as challenges to
overcome
Four things we know about successful
boat rockers
Source: adapted from Debra E Meyerson
CHANGE
me
BEGINS WITH
74. #SCHR @HelenBevan
Research from the sales industry:
How many NOs should we be seeking to get?
• 2% of sales are made on the first contact
• 3% of sales are made on the second contact
• 5% of sales are made on the third contact
• 10% of sales are made on the fourth contact
• 80% of sales are made on the fifth to twelfth
contact
Source: http://www.slideshare.net/bryandaly/go-for-no
75. #SCHR @HelenBevan
“Papers that are more likely to contend against
the status quo are more likely to find an
opponent in the review system—and thus be
rejected —but those papers are also more
likely to have an impact on people across the
system, earning them more citations when
finally published”
V. Calcagno et al., “Flows of research manuscripts among
scientific journals reveal hidden submission patterns,”
Science, doi:10.1126/science.1227833, 2012.
—
79. #SHCR @HelenBevan
Questions for reflection
1. What are the opportunities for me to build my
perspectives and skills as an agent of change?
2. How can I build self efficacy as a change agent?
3. How do I move beyond skills and knowledge of
change to live and be change?
4. Who can help and support me as a change
agent?
5. What are the implications for the way I work?
80. #SHCR @HelenBevan
The capacity and drive of a team,
organisation or system to act and
make the difference necessary to
achieve its goals
http://www.institute.nhs.uk/tools/energ
y_for_change/energy_for_change_.html
We need to focus on a different kind of
energy for change
82. #SHCR @HelenBevan
Social energy
Energy of personal
engagement, relationships and
connections between people
It’s where people feel a sense of
“us and us”
rather than
“us and them”
83. #SHCR @HelenBevan
Spiritual energy
Energy of commitment to a common
vision for the future, driven by shared
values and a higher purpose
Gives people the confidence to move towards a
different future that is more compelling than
the status quo
84. #SHCR @HelenBevan
Psychological energy
Energy of courage, resilience and feeling
safe to do things differently
Involves feeling supported to make a change and
trust in leadership and direction
86. #SHCR @HelenBevan
Intellectual energy
Energy of analysis, planning and thinking
Involves gaining insight as well as planning and
supporting processes, evaluation, and arguing a
case on the basis of logic/ evidence
87. #SHCR @HelenBevan
High and low ends of each energy domain
Low High
Social isolated solidarity
Spiritual uncommitted higher purpose
Psychological risky safe
Physical fatigue vitality
Intellectual Illogical reason
88. #SHCR @HelenBevan
Some questions
• Which group likely to have
higher spiritual energy
scores (clinicians/non
clinicians?)
• Nearer to CEO, higher or
lower energy scores?
89. #SHCR @HelenBevan
• Are particular
energy domains
more dominant
than others for
our team at the
moment?
• Is this the
optimal energy
profile to help
us achieve our
improvement
goals?
Energy for change profile
1
2
3
4
5
Social
Spiritual
PsychologicalPhysical
Intellectual
92. #SHCR @HelenBevan
There has never been a time in the history of health
and care when this advice has been more pertinent
“Leadership is not about
making clever decisions
and doing bigger deals.
It is about helping
release the positive
energy that exists
naturally within
people”
Henry Mintzberg
93. #SHCR @HelenBevan
The power of the platform
“Facebook, YouTube, Twitter and their lesser cousins have
proved the power of the platform. They have shown that if
your average 21st century citizen is given the tools to
connect and the freedom to create, they will do so with
enthusiasm, and often with an originality that blindsides
the so-called creative industries. …..
Good leadership is no longer about ‘taking charge’ or
imposing a strategic vision but about creating the
platforms that allow others to flourish and create”
Ashoka
http://www.virgin.com/unite/entrepreneurship/what-does-leadership-mean-in-
the-21st-century
94. #SHCR @HelenBevan
• systematic “change
management”
• too often, leaders
prescribe outcome
and method of change
in a top-down way
• change is experienced
by people at the front
line as “have to”
(imposed) rather than
“want to” (embraced)
Change
Programmes
• everyone (including
service users and families)
can help tackle the most
challenging issues
• value diversity of thought
• connect people, ideas and
learning
• Role of formal leaders is to
create the conditions and
get out of the way
Change
Platforms
“Tear down the walls”
95. #SHCR @HelenBevan
Why platforms?
Platforms today power learning and innovation
at the speed of change by providing
collaborative and sometimes exponentially
productive spaces for people to create value
John Hagel
Source of image: Pinipa
98. #SHCR @HelenBevan
What are the features of your ideal change platform?
Resource bank
Library
Crowdsourcing
Social media feed
Blog
CURATION
- Resource bank
- Library
- Best practice
- News feeds
- Guidelines and policy
- Webinars
- FAQs
COMMUNITY
- Social media feed
- Blogs - Vlogs
- Personal profiles
- Forums
- Chat function
- Communities of Practice
- Topic of the month
- Stories
COMMUNICATION
- Bulletins
- Press releases
- Notice board
- Diary / calendar
- Document share
- Project Management
CREATION
- Crowdsourcing
- Challenges
- Innovation
- Prizes / funds
Collaboration
100. #SHCR @HelenBevan
The Academy of Fabulous Stuff
• Half a million page views
• Over 700 fab shares
• 1,500 to 4,000 page views
a day
• Nottingham Safe staffing
app: 2,500 views
• Dovetailing vaccinations
Scheme: 160 direct queries
107. #SHCR @HelenBevan
Should we undertake routine radiology
investigations overnight for all our inpatients?
How to build a
change
platform in an
hour
108. #SHCR @HelenBevan
• Platform established and presented to global audience in
less than three days
• 60 minute sprint followed by a two week window for
further ideas and discussion
• 3,000+ connections
• good level of support for a 24/7 service for inpatients
• consensus that the decision to receive a scan during
unsocial hours was patient led
• yet many participants commented that it should be a
joint decision between clinician and patient
• Panel at Nottingham University Hospitals is reviewing
findings, ideas and agreeing next steps for
implementation
elp create a change platform in an hourRather than a consultation exercise that can take weeks,
we set up a crowdsourcing platform to get an answer in
an hour
110. #SHCR @HelenBevan
14,000 contributions identified
10 barriers to change:
Confusing strategies
Over controlling
leadership
Perverse incentivesStifling innovation
Poor workforce
planning
One way
communication
Inhibiting
environment
Undervaluing staff
Poor project
management
Playing it safe
111. #SHCR @HelenBevan
14,000 contributions identified
11 building blocks for change:
Inspiring & supportive
leadership
Collaborative working
Thought diversityAutonomy & trust
Smart use of resources
Flexibility &
adaptability
Long term thinking
Nurturing our people
Fostering an open
culture
A call to action
Source: Health Service Journal, Nursing Times, NHS Improving
Quality, “Change Challenge” March 2015
Challenging the
status quo
112. #SHCR @HelenBevan
Project Aristotle: http://qz.com/625870/after-years-of-intensive-
analysis-google-discovers-the-key-to-good-teamwork-is-being-nice/
After years of intensive analysis, Google
discovers that the key to high performing,
innovative teams is psychological safety
113. #SHCR @HelenBevan
Some lessons
1. You can’t control the outputs of the crowd
2. People want a relationship
3. Always, always, follow up
114. #SHCR @HelenBevan
The Natural Environment Research Council asked the
crowd to name its new £200 million polar research vessel
117. #SHCR @HelenBevan
”If people give to a cause,
they expect a relationship,
not a transaction”
Nilofer Merchant
Once you start down this path, you
have to follow up and continue
118. #SHCR @HelenBevanSource of image: outskirtsbattledome.wikispaces.com
The easiest way to thrive as an
outlier
...is to avoid being one
Seth Goodin
119. #SHCR @HelenBevanFor more information/explanation visit: http://linkis.com/www.oscarberg.net/20/QwGqW
120. #SHCR @HelenBevan
Power in community
“Power used to come largely through and from big
institutions.
Today power can and does come from connected individuals
in community.
When community invests in an idea, it co-owns its success.
Source of image: orton.org
Instead of trying to
achieve scale all by
ourselves, we have a new
way to have scale. Scale
can be in, with and
through community.”
Nilofer Merchant
121. #SHCR @HelenBevan
Managers know how to command
obedience and diligence, but most are
clueless when it comes to galvanizing the
sort of volunteerism that animates life on
the social web. Initiative, imagination and
passion can’t be commanded—they’re gifts.
Gary Hamel
http://www.mixmashup.org/blog/reinventing-
management-mashup-architecture-ideology
‘
122. #SHCR @HelenBevan
“When we talk of social change, we talk of
movements, a word that suggest vast
groups of people walking together, leaving
behind one way and travelling towards
another”
Rebecca Solnit
123. #SHCR @HelenBevan
Learning from social movement leaders
http://www.slideshare.net/NHSIQ/the-power-of-one-the-power-of-
many?qid=97bb3464-07c2-4883-9531-c3d436a66aa1&v=qf1&b=&from_search=2
126. #SHCR @HelenBevan
Leadership is….
…the art of mobilising others
to want to struggle for shared
aspirations
Jim Kouzes
Source of image: environmentvictoria.org.au
127. #SHCR @HelenBevan
Framing
… is the process by which leaders construct,
articulate and put across their message in a powerful
and compelling way in order to win people to their
cause and call them to action.
Snow D A and Benford R D (1992)
129. #SHCR @HelenBevan
The reality
“What the leader cares about (and typically bases at
least 80% of his or her message to others on) does
not tap into roughly 80% of the workforce’s primary
motivators for putting extra energy into the change
programme”
Scott Keller and Carolyn Aiken (2009)
The Inconvenient Truth about Change Management
Source of image: swedenbourg-openlearning.org.uk
130. #SHCR @HelenBevan
1. People speak intellectually but engage
emotionally
2. Facts are hard to remember and easy to
challenge
3. If we only talk about our success people won’t
believe us
4. People don’t want more communication; they
want meaningful communication
http://www.peterfuda.com/2014/10/30/traditional-comms-fail-engage/
Four gaps between
how we
communicate
change
how people
engage with that
communication
132. #SHCR @HelenBevan
If we want people to take action, we have to
connect with their emotions through values
action
values
emotion
Source: Marshall Ganz
135. #SHCR @HelenBevan#IQTGOLD#SCHR @HelenBevan
But not all emotions are equal.........
inertiaurgency
anger apathy
solidarity isolation
you can make a
difference
Self-doubt
hope fear
Overcomes
Action motivators Action inhibitors
Source: Marshall Ganz
136. #SHCR @HelenBevan
‘‘Leaders must wake people out of
inertia. They must get people excited
about something they’ve never seen
before, something that does not yet
exist”
Rosa Beth Moss Kanter
Source of image: www.linkedin.com/company/activate-brand-agency
141. #SHCR @HelenBevan
Effective framing:
what do we need to do?
1. Tell a story
2. Make it personal
3. Be authentic
4. Create a sense of “us” (and be clear who the “us”
is)
Source of image: woccdoc.org
142. #SHCR @HelenBevan
Effective framing:
what do we need to do?
1. Tell a story
2. Make it personal
3. Be authentic
4. Create a sense of “us” (and be clear who the “us”
is)
5. Build in a call for urgent action
Source of image: woccdoc.org
143. #SHCR @HelenBevan
Effective framing:
what do we need to do?
1. Tell a story
2. Make it personal
3. Be authentic
4. Create a sense of “us” (and be clear who the “us”
is)
5. Build in a call for urgent action
Source of image: woccdoc.org
145. #SHCR @HelenBevan
Talk to the person next to you
• Tell your story about why the change you are
involved in now is so important to you
• Relate it to a personal experience
You have:
• 2 minutes to prepare your story
• 3 minutes each to tell your story
149. #SHCR @HelenBevan
Question: what’s the most reliable way to
predict the future effectiveness of a team?
Source:
http://www.fastcompany.com/3049524/know-it-all/the-
science-behind-team-intelligence
150. #SHCR @HelenBevan
How do we create a sense of
“us” to build momentum for
change?
Source of image: www.tannerfriedman.com
152. #SHCR @HelenBevan
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
153. #SHCR @HelenBevan
strong ties (cohesive)
v.
weak ties (disconnected)
Source of image: http://www.forbes.com/fdc/welcome_mjx.shtml
154. #SHCR @HelenBevan
When we spread change through strong ties:
• we interact with “people like us”, with
the same life experiences, beliefs and
values
• Change is “peer to peer”; GP to GP,
social worker to social worker, nurse to
nurse, community leader to
community leader
• Influence is spread through people
who are strongly connected to each
other, like and trust each other
155. #SHCR @HelenBevan
When we spread change through strong ties:
• we interact with “people like us”, with
the same life experiences, beliefs and
values
• Change is “peer to peer”; GP to GP,
social worker to social worker, nurse to
nurse, community leader to
community leader
• Influence is spread through people
who are strongly connected to each
other, like and trust each other
IT WORKS BECAUSE: people are far
more likely to be influenced to
adopt new behaviours or ways of
working from those with whom they
are most strongly tied
157. #SHCR @HelenBevan
When we seek to spread change through weak
ties
• we build bridges between groups and
individuals who were previously different and
separate
• we create relationships based not on pre-
existing similarities but on common purpose
and commitments that people make to each
other to take action
• We can mobilise all the resources in our
organisation, system or community to help
achieve our goals
158. #SHCR @HelenBevan
Why we need to build weak ties AS WELL AS
strong ties
• Weak ties are more likely to lead to change at scale
because they enable us to access more people with
fewer barriers
More on weak ties: https://www.youtube.com/watch?v=w7AzRVxhEXA#t=45
159. #SHCR @HelenBevan
Why we need to build weak ties AS WELL AS
strong ties
• Weak ties are more likely to lead to change at scale
because they enable us to access more people with
fewer barriers
• In situations of uncertainty, we have a tendency to
revert to our strong tie relationships
yet the evidence tells us that weak ties are
much more important than strong ties when it
comes to searching out resources in times of
scarcity
160. #SHCR @HelenBevan
Why we need to build weak ties AS WELL AS strong
ties
• Weak ties are more likely to lead to change at scale
because they enable us to access more people with
fewer barriers
• In situations of uncertainty, we have a tendency to
revert to our strong tie relationships
yet the evidence tells us that weak ties are much
more important than strong ties when it comes
to searching out resources in times of scarcity
• The most breakthrough innovations and most radical
change will come when we tap into our weak ties
162. #SHCR @HelenBevan
Three components of a great narrative
• Diagnostic – what is the problem that
we are addressing? What is the extent
of the problem? What is the specific
source or sources?
• Prognostic – what could the future look
like? What is our “plan of attack” and
our strategy for carrying out the plan?
• Motivational – why is this urgent?
What is our call for action that
connects with the motivational and
emotional drivers of our audience?
Source: Benford and Snow
Source of image: www.ecommercedefense.com
163. #SHCR @HelenBevan
Four keys to collaboration
• Lean into your discomfort
• Listen as an ally
• State your intent
• Share your “street corner”
Source: Judith Katz and Fred Miller
168. #SHCR @HelenBevan
Questions for reflection
1. 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?
2. How will you attract the attention of the people
you want to call to action?
3. 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 “us” with them?
169. #SHCR @HelenBevan
Employee resistance is the
most common reason
executives cite for the
failure of big
organizational-change
efforts
Scott Keller and Colin Price
(2011), Beyond Performance: How
Great Organizations Build Ultimate
Competitive Advantage
Source of image:
Businessconjunctions.com
170. #SHCR @HelenBevan
“
Thousands of patients have died
needlessly because of a
damaging reluctance amongst
doctors and the public to accept
changes in the NHS, according to
the country’s top emergency
doctor
“
171. #SHCR @HelenBevan
Leaders ask their staff to be ready for change,
but do not engage enough in
sensemaking........
Sensemaking is not done via marketing...or
slogans but by emotional connection with
employees
Ron Weil
172. #SHCR @HelenBevan
Resistant behaviour is a good
indicator of missing relevance
Harald Schirmer
http://de.slideshare.net/haraldschirmer/strategies-for-corporate-change-the-new-
role-of-hr-driving-social-adoption-and-change-in-the-enterprise
Source of image: driverlayer.com
‘‘
174. #SHCR @HelenBevan
“Stages of change”
Transtheoretical model of behaviour change
Prochaska, DiClemente & Norcross (1992)
175. #SHCR @HelenBevan
• smoking cessation
• exercise adoption
• alcohol and drug use
• weight control
• fruit and vegetable intake
• domestic violence
• HIV prevention
• use of sunscreens to prevent skin cancer
• medication compliance
• mammography screening
The model is mostly used around
health-related behaviours
176. #SHCR @HelenBevan
• smoking cessation
• exercise adoption
• alcohol and drug use
• weight control
• fruit and vegetable intake
• domestic violence
• HIV prevention
• use of sunscreens to prevent skin cancer
• medication compliance
• mammography screening
It works for
organisational and
service change too!
The model is mostly used around
health-related behaviours
177. #SHCR @HelenBevan
“Stages of change”
Smoking
I am not aware my
smoking is a
problem – I have no
intention to quit
Prochaska, DiClemente & Norcross (1992)
178. #SHCR @HelenBevan
“Stages of change”
Smoking
I am not aware my
smoking is a
problem – I have no
intention to quit
I know my smoking
is a problem – I
want to stop but no
plans yet
Prochaska, DiClemente & Norcross (1992)
179. #SHCR @HelenBevan
I am not aware my
smoking is a
problem – I have no
intention to quit
I know my smoking
is a problem – I
want to stop but no
plans yet
I am making plans
& changing things
I do in
preparation.
“Stages of change”
Smoking
Prochaska, DiClemente & Norcross (1992)
180. #SHCR @HelenBevan
I am not aware my
smoking is a
problem – I have no
intention to quit
I know my smoking
is a problem – I
want to stop but no
plans yet
I am making plans
& changing things
I do in
preparation.
I have
stopped
smoking!
“Stages of change”
Smoking
Prochaska, DiClemente & Norcross (1992)
181. #SHCR @HelenBevan
I am not aware my
smoking is a
problem – I have no
intention to quit
I know my smoking
is a problem – I
want to stop but no
plans yet
I am making plans
& changing things
I do in
preparation.
I have
stopped
smoking!
I am continuing to
not smoke.
I sometimes miss it
– but I am still not
smoking
“Stages of change”
Smoking
Prochaska, DiClemente & Norcross (1992)
182. #SHCR @HelenBevan
I am not aware my
smoking is a
problem – I have no
intention to quit
I know my smoking
is a problem – I
want to stop but no
plans yet
I am making plans
& changing things
I do in
preparation.
I have
stopped
smoking!
I am continuing to
not smoke.
I sometimes miss it
– but I am still not
smoking
“Stages of change”
Smoking
Prochaska, DiClemente & Norcross (1992)
184. #SHCR @HelenBevan
• Which stage do most change activities in
health and care focus on?
• Which stage are most people actually at?
Some questions
185. #SHCR @HelenBevan
The reality of our change situation
• Our tools are often not effective at the stage of change
that most people we work with are at
• It’s hard to engage people in change
• It’s hard to get people to make the changes we want
them to make
• People get irritated, defensive, irrational
• We feel powerless in our ability to lead or facilitate the
change
90% of the tools available for health and care change
agents are designed for the “action” stage
186. #SHCR @HelenBevan
• Designed for Stage 4 –
ACTION!
• Mandated it through
targets
• Despite compelling
case for change –
people resisted it – no
values connection
• People did the task
and missed the point
Example – WHO Surgical Safety Checklist
187. #SHCR @HelenBevan
IN A NUTSHELL
• Evidence from observational studies that the use of surgical safety
checklists results in striking improvements in outcomes
• Led to rapid adoption of such checklists worldwide
• Researchers studied effect of mandatory adoption of checklists in
Ontario, Canada
• Use of checklists not associated with significant reductions in
operative mortality or complications
188. #SHCR @HelenBevan
• Lower our ambitions for improvement
• Focus our energies on those who are
already in the “action” stage
• Put negative labels on those who are
not yet at the action stage such as
“blocker” or “resister” or “laggard”
• Blame “the management” for not
enforcing change
So what do we TEND to do when people
resist?
189. #SHCR @HelenBevan
The single biggest problem
in communication is the
illusion that it has taken
place
George Bernard Shaw
‘‘
190. #SHCR @HelenBevan
• Listen and understand
• appreciate the starting point
• elaborate interests
• Roll with resistance (Singh)
• Don’t argue against it
• Encourage elaboration of resistance
•What makes it so hard?
•What would help?
• Build meaning and conviction in the change
So what SHOULD we do?
191. #SHCR @HelenBevan
• The focus should be on
creating awareness for me of
the need to change
• Remember the goal is not to
make me (as a
precontemplator) change
immediately, but to help me
move to contemplation
• 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
192. #SHCR @HelenBevan
Focussing on Prochaska, DiClemente and
Norcross’s Stages of Change model:
• What stage of change are some of the key
people that you need to influence for your
change initiative at?
• What actions can you take to help them move
to the next stage?
Thinking about your own situation
193. #SHCR @HelenBevan
If your horse dies,
get off it
Cherokee proverb
Source of image: fenwickgallery.co.uk
‘‘
195. #SHCR @HelenBevan
Traditional event
The agenda is pre-set
One way learning style
with Q&A
People sit in rows or round
tables
Networking between
sessions
Hard to leave the session
once it starts
Absorbing information
Unconference
People set the agenda
Based on discussion
People sit in a circle
Networking the whole
time
Encouraged to find the
right session
Connecting to action
Source: adapted from @BCPSQC
196. #SHCR @HelenBevan
The unconference:
4 principles and a law
Principles:
1. Whoever comes 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."
197. #SHCR @HelenBevan
Our unconference process
• Having heard all the content so far, think
about a topic that you would like to explore
with other people
• It should be a topic that you want to take
action on over the next twelve months
• Raise your hand and we will bring you a sheet
198. #SHCR @HelenBevan
Four keys to collaboration
• Lean into discomfort
• Listen as an ally
• State your intent
• Share your “street corner”
Source: Judith Katz and Fred Miller
199. #SHCR @HelenBevan
What’s our approach to change?
Deficit based
• what is wrong?
• solve problems
• identify what we
need to improve
• fill gaps and
deficiencies
Strength based
• what is strong?
• work with our
existing assets and
resources
• amplify what works
• “positive deviants”
200. #SHCR @HelenBevan
Four ways to connect!
1. Follow us on Twitter
@HelenBevan @KateSlater2 @Ollybenson
@School4Radicals
2. Subscribe to
theedge.nhsiq.nhs.uk
3. Get materials from
theedge.nhsiq.nhs.uk/school
…and sign up for our monthly #EdgeTalks
theedge.nhsiq.nhs.uk/edgetalks
Editor's Notes
#EdgeTalks WebEx
http://theedge.nhsiq.nhs.uk/expert/how-has-the-school-for-health-and-care-radicals-made-a-difference/
Or Google: #EdgeTalks School
Cathedral and Bazaar is an essay, then book, by Eric S. Raymond on software engineering methods
Illustrates the struggle between top-down and bottom-up design
The Cathedral model: restricted access to code, code only available with each software release – controlled / limited / restricted / closed
The Bazaar model, in which the code is developed over the Internet in view of the public
Raymond's proposition that "given enough eyeballs, all bugs are shallow" - the more openly and widely available the source code is for public testing, scrutiny, and experimentation, the more rapidly all forms of bugs will be discovered.
Raymond claims that an inordinate amount of time and energy must be spent hunting for bugs in the Cathedral model, since the working version of the code is available only to a few developers.
Why platforms are the new power
Old power won’t deliver what we need to
Social platforms
Social platforms include more tightly defined communities of interest that come together around specific shared interests like certain genres of music, types of sports or academic disciplines like history or economics.
They tend to foster mesh networks of relationships rather than hub and spoke interactions
E.g. Facebook, Twitter,
2. Mobilisation platforms
Mobilization platforms ultimately focus on mobilising participants to engage in some kind of collaborative effort that will take considerable time to accomplish
Because of the need for collaborative action over time, these platforms tend to foster longer-term relationships rather than focusing on isolated and short-term transactions or tasks
3. Learning platforms
Explicit goal to create environments where participants can learn faster and individually achieve higher and higher levels of performance as more and more participants join the platform
E.g. School for Health and Care Radicals, World of Warcraft
4. Aggregation platforms
The basic focus of these platforms is to bring together a broad array of relevant resources and help users of the platform to connect with the most appropriate resources.
E.g. EBay
Transactional & task focussed (Need > response > deal > move on)
Hub & spoke model – all transactions are brokered by platform owner/organiser
Thinking about your wish list
OpenIdeo’s challenges and programs are modeled on IDEO's human-centered design methodology. This means that they enable their community to develop solutions rooted in people's needs and lifestyles.
Examples form the NHS of social movements often called a call to action
Large scale action - Not requiring large leadership team or compliance framework
Definition used in “The Power of One, the Power of Many” = a voluntary collective of individuals committed to promoting or resisting change through co-ordinated activity.
Link belowhttp://www.bbc.co.uk/news/magazine-23790147http://www.bbc.co.uk/learningzone/clips/martin-luther-king-i-have-a-dream-pt-1-2/1293.html
With the brooding statue of Abraham Lincoln peering down at him, King began by telling protesters that their presence in the symbolic shadow of the "great emancipator" offered proof of the marvellous new militancy sweeping the country. For too long, he complained, black Americans had been exiles in their own land, "crippled by the manacles of segregation and the chains of discrimination".
The whirlwinds of revolt would continue to shake the very foundations of the country: "And those who hope that the Negro needed to blow off steam and will now be content will have a rude awakening if the nation returns to business as normal," King said. It would be fatal for the nation "to overlook the urgency of the moment and to underestimate the determination of the Negro".
“He's good - he's damned good”
Kennedy on King
Wearied by the suffocating heat, the crowd's initial response was muted. The speech was not going well. "Tell 'em about the dream, Martin," shouted Mahalia Jackson, referring to a rhetorical riff that King had used several times before, but which had not made it into his prepared speech because aides insisted he needed fresh material. But King decided to cast aside his prepared notes, and launched extemporaneously into the refrain for which he will forever be remembered.
"I have a dream that one day this nation will rise up and live out the true meaning of its creed," he shouted, his out-stretched right arm reaching towards the sky. Soon he was hitting his rhythm, invigorated by the chants and cries of the crowd. "Dream on!" they shouted. "Dream on!"
With his voice thundering down the Mall, King imagined a future in which his children could "live in a nation where they will not be judged by the colour of their skin but by the content of their character". Then he reached his impassioned finale.
King asked the crowd to yell so it was heard the world over
Watching at the White House, the president was riveted. Like so many Americans, it was the first time he had heard the 34-year-old preacher deliver a speech in its entirety - the first time he had taken its measure, listened to its cadence. "He's good," Kennedy told one of his advisors. "He's damned good." The aide was struck, however, that the president seemed impressed more by the quality of King's performance rather than the power of his message.
So Emotions help us understand what we value in the world.
Why did the story of Alice work ?
So why was this story powerful?
Why do we respond differently when we hear about Alice rather than when we see the policy data and financial balance sheet?
So public narrative when used intentionally for a purpose to connect with others to move to action is a powerful skills set and leadership gift. When we hear stories that make us feel a certain way those stories remind us of our core values. We experience our values through emotions. Then we are prepared to take action on those values. Through our emotions we are more likely to take action
Research by Martha Nussbaum a Moral philosopher, tells us that people who have a damaged (a-mig-da- la) Amygadla the part of the brain which controls emotions, when faced with decisions can come up with many options from which to choose but cannot make a decision because the decision rests upon judgements of value. If we cannot feel emotion we cannot experience values that orient us to the choices we must make
Shortly we will be thinking about the lived experiences that have moved you to action…we’ll be drawing on those a few minutes as you start to craft your own stories.
LIST some emotions
Remember the power of “Killer Facts”
Have one that really illustrates this for you.
JG – I often use one from Kath Evans. If we had the health care system in England that matched the best in Europe 1500 children a year, would not die in our care.
I thank you for being here and doing what you do.
Have a wonderful three days in Birmingham.