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![#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](https://image.slidesharecdn.com/schoolforradicalsou-160719075430/85/OUSR-2-320.jpg)
![#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](https://image.slidesharecdn.com/schoolforradicalsou-160719075430/85/OUSR-3-320.jpg)
![#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](https://image.slidesharecdn.com/schoolforradicalsou-160719075430/85/OUSR-4-320.jpg)
Uploaded byNHS Improving Quality
OUSR
The document discusses factors that contribute to successful change agents or "boat rockers". It identifies four key things: 1) having a strong sense of self-efficacy or belief in one's ability to create change; 2) being able to join forces with others to take action; 3) being able to achieve small wins which build momentum; and 4) viewing obstacles as challenges to overcome rather than barriers. Building self-efficacy involves tactics like starting with small, achievable changes and reframing failures as learning opportunities. Social support and learning from exemplars are also discussed.
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OUSR
- 1. #OUSR 19th July 2016 Schoolfor Radicals
- 2. #OUSR WHO makes changehappen 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 changehappen 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 changehappen 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
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- 7. #OUSR How we makea 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 onTwitter @School4Radicals @HelenBevan @KateSlater2 @OllyBenson
- 10. #OUSR Agenda 1. Being ahealth 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”
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- 13. #OUSR Everyone has giftsand strengths What superpower do you have?
- 14. #OUSR The genesis ofthe 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 YearForward View Mentions “radical” 12 times “transformation/transformational” 13 times “change” 42 times
- 16. #OUSR The OU StudentFirst paper Contains the following words: • Change = 20 • Innovate = 19 • Adapt = 10 • Radical = 0
- 17. #OUSR “New truths beginas heresies” (Huxley, defending Darwin’s theory of natural selection) Source of image: installation by the artist Adam Katz www.thisiscolossal.com Via @NeilPerkin
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- 19. #OUSR People who arehighly connected have twice as much power to influence change as people with hierarchical power Leandro Herrero http://t.co/Du6zCbrDBC
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- 21. #OUSR Kinthi Sturtevant, IBM 13thannual 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
- 22. #OUSR Source: Bromford P(2015), ”What’s the difference between a test and a pilot?”
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- 26. #OUSR How does theNHS improvement community prefer to communicate?
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- 32. #OUSR Change is changing Changefrom the edge
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- 34. #OUSR Why go tothe 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 TEDtalk “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 Secretsof 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 changeprocess a cathedral or a bazaar? http://www.unterstein.net/su/docs/CathBaz.pdf
- 38. #OUSR We have alot of cathedrals Source: Sewell (2015) : Stop training our project managers to be process junkies
- 39. #OUSR “Tomorrow’s management systems willneed 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 willneed 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!
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- 42. #SHCR @HelenBevan What happensto heretics/radicals/rebels/mavericks in organisations?
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- 44. #SHCR @HelenBevan#IQTGOLD#SCHR @HelenBevanSource:Lois Kelly http://www.slideshare.net/Foghound/rocking-the-boat-without-falling-out
- 45. #SHCR @HelenBevan We needrebels! •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 youput fences around people, you get sheep. Give people the room they need William L McKnight
- 47. #SHCR @HelenBevan We needto 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 • Whatare 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
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- 54. #SHCR @HelenBevan Outcomes ofrandomised coffee trials
- 55. #SHCR @HelenBevan Change startswith me Source of image: jasonkeath.com
- 56. #SHCR @HelenBevan "There’s onlyone 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 donot 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. ableto 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 isa 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
- 60. #SHCR @HelenBevan What’s thedifference between self efficacy and self esteem, self belief, self-confidence?
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- 62. #SHCR @HelenBevan Source: @NHSChangeDay Whatis the issue here? “permission” ? (externally generated) or Self efficacy ? (internally generated)
- 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. strongsense 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
- 65. #SCHR @HelenBevanImage copyright:http://13c4.wordpress.com/2007/02/24/50-reasons-not-to-change/
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- 72. #SCHR @HelenBevanSource: http://www.slideshare.net/AndreaWaltz/gfn-slidesharegfnhandling-rejectionpositively Makeit a personal PERFORMANCE target.
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- 74. #SCHR @HelenBevan Research fromthe 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 thatare 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. —
- 76. #SHCR @HelenBevan Being agreat change agent is about knowing, doing, living and being improvement
- 77. #SHCR @HelenBevan Avedis Donabedian “Ultimately,the secret of quality is love. …… If you have love, you can then work backward to monitor and improve the system”.
- 78. #SHCR @HelenBevan Key tactic: Out-love everyone else Source of image: Bradley Burgess
- 79. #SHCR @HelenBevan Questions forreflection 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 capacityand 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
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- 82. #SHCR @HelenBevan Social energy Energyof 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 Energyof 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 Energyof courage, resilience and feeling safe to do things differently Involves feeling supported to make a change and trust in leadership and direction
- 85. #SHCR @HelenBevan Physical energy Energyof action, getting things done and making progress The flexible, responsive drive to make things happen
- 86. #SHCR @HelenBevan Intellectual energy Energyof 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 andlow 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 • Areparticular 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
- 90. #SHCR @HelenBevan#IQTGOLD#SCHR @HelenBevan 1 2 3 4 5 Social Spiritual PsychologicalPhysical Intellectual Team1: what’s your assessment of their energy for change?
- 91. #SHCR @HelenBevan#IQTGOLD#SCHR @HelenBevan 1 2 3 4 5 Social Spiritual PsychologicalPhysical Intellectual Team2: what’s your assessment of their energy for change?
- 92. #SHCR @HelenBevan There hasnever 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 powerof 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? Platformstoday 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
- 96. #SHCR @HelenBevan Evolving kindsof change platforms: They overlap! 1. Connecting platforms 2. Mobilising platforms 3. Learning platforms 4. Knowledge platforms 5. Crowdsourcing platforms
- 97. #SHCR @HelenBevan Example platforms Sourceof image: @JenniferClemo
- 98. #SHCR @HelenBevan What arethe 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
- 99. #SHCR @HelenBevan http://biggerboat.org/exploring-moodocs/ MOODOCs (Massive, Online,Open, Disease Oriented Communities)
- 100. #SHCR @HelenBevan The Academyof 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
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- 102. #SHCR @HelenBevan#IQTGOLD#SCHR @HelenBevan Source:OpenIdeo https://challenges.openideo.com/challenge/end-of-life/refinement
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- 105. #SHCR @HelenBevan Nearly 100,000 connections (defined asa viewing, a download of material or an original tweet) • Latest no-cost solutions • 150 speakers • 28 topics • Live broadcast and on-demand
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- 107. #SHCR @HelenBevan Should weundertake routine radiology investigations overnight for all our inpatients? How to build a change platform in an hour
- 108. #SHCR @HelenBevan • Platformestablished 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
- 109. #SHCR @HelenBevan The ChangeChallenge Tapping the collective brilliance of the NHS
- 110. #SHCR @HelenBevan 14,000 contributionsidentified 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 contributionsidentified 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 NaturalEnvironment Research Council asked the crowd to name its new £200 million polar research vessel
- 115. #SHCR @HelenBevan#IQTGOLD#SCHR @HelenBevan TEN TIMESas many votes as the next most popular answer
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- 117. #SHCR @HelenBevan ”If peoplegive 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 ofimage: outskirtsbattledome.wikispaces.com The easiest way to thrive as an outlier ...is to avoid being one Seth Goodin
- 119. #SHCR @HelenBevanFor moreinformation/explanation visit: http://linkis.com/www.oscarberg.net/20/QwGqW
- 120. #SHCR @HelenBevan Power incommunity “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 knowhow 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 wetalk 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 fromsocial 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
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- 126. #SHCR @HelenBevan Leadership is…. …theart of mobilising others to want to struggle for shared aspirations Jim Kouzes Source of image: environmentvictoria.org.au
- 127. #SHCR @HelenBevan Framing … isthe 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)
- 128. #SHCR @HelenBevan What’s the financialincentive? Who is performance managing? What’s the project plan? Source: @RobertVarnam
- 129. #SHCR @HelenBevan The reality “Whatthe 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. Peoplespeak 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
- 131. #SHCR @HelenBevan#IQTGOLD#SCHR @HelenBevan “Ihave some Key Performance Indicators for you” or “I have a dream” Source: @RobertVarnam
- 132. #SHCR @HelenBevan If wewant people to take action, we have to connect with their emotions through values action values emotion Source: Marshall Ganz
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- 135. #SHCR @HelenBevan#IQTGOLD#SCHR @HelenBevan Butnot 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 mustwake 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
- 137. #SHCR @HelenBevan Effective framing: whatdo we need to do? 1. Tell a story Source of image: woccdoc.org
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- 139. #SHCR @HelenBevan Effective framing: whatdo we need to do? 1. Tell a story 2. Make it personal Source of image: woccdoc.org
- 140. #SHCR @HelenBevan Effective framing: whatdo we need to do? 1. Tell a story 2. Make it personal 3. Be authentic Source of image: woccdoc.org
- 141. #SHCR @HelenBevan Effective framing: whatdo 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: whatdo 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: whatdo 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
- 144. #SHCR @HelenBevan#IQTGOLD#SCHR @HelenBevan Vividdetails Source: Marshall Ganz
- 145. #SHCR @HelenBevan Talk tothe 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
- 146. #SHCR @HelenBevan Harvard researchersput a gorilla image on this lung scan
- 147. #SHCR @HelenBevan Harvard researchersput a gorilla image on this lung scan
- 148. #SHCR @HelenBevan What proportionof the radiologists who reviewed this scan actually saw the gorilla? 90% 25% 17% 80% 9% 60%
- 149. #SHCR @HelenBevan Question: what’sthe 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 dowe create a sense of “us” to build momentum for change? Source of image: www.tannerfriedman.com
- 151. #SHCR @HelenBevan Moving beyondus and them to us and us Source of image: www.delta7.com
- 152. #SHCR @HelenBevan The NetworkSecrets 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 wespread 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 wespread 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
- 156. #SHCR @HelenBevan The prosand cons of strong ties Pros Cons
- 157. #SHCR @HelenBevan When weseek 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 weneed 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 weneed 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 weneed 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
- 161. #SHCR @HelenBevan Sources ofweak ties
- 162. #SHCR @HelenBevan Three componentsof 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 keysto collaboration • Lean into your discomfort • Listen as an ally • State your intent • Share your “street corner” Source: Judith Katz and Fred Miller
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- 166. #SHCR @HelenBevan Source ofimage: http://switchandshift.com/transactional-or- transformational-which-leadership-style-is-best
- 167. #SHCR @HelenBevan#IQTGOLD#SCHR @HelenBevan “Youdon’t need an engine when you have wind in your sails”
- 168. #SHCR @HelenBevan Questions forreflection 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 resistanceis 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 ofpatients 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 asktheir 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 behaviouris 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 ‘‘
- 173. #SHCR @HelenBevan Cultural change isa million subversive acts of resistance Brene Brown Source of image: zazzle.com ‘‘
- 174. #SHCR @HelenBevan “Stages ofchange” Transtheoretical model of behaviour change Prochaska, DiClemente & Norcross (1992)
- 175. #SHCR @HelenBevan • smokingcessation • 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 • smokingcessation • 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 ofchange” Smoking I am not aware my smoking is a problem – I have no intention to quit Prochaska, DiClemente & Norcross (1992)
- 178. #SHCR @HelenBevan “Stages ofchange” 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 amnot 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 amnot 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 amnot 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 amnot 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)
- 183. #SHCR @HelenBevan Prochaska, DiClemente& Norcross (1992) “Stages of change” Transtheoretical model of behaviour change
- 184. #SHCR @HelenBevan • Whichstage do most change activities in health and care focus on? • Which stage are most people actually at? Some questions
- 185. #SHCR @HelenBevan The realityof 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 • Designedfor 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 ANUTSHELL • 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 • Lowerour 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 singlebiggest problem in communication is the illusion that it has taken place George Bernard Shaw ‘‘
- 190. #SHCR @HelenBevan • Listenand 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 • Thefocus 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 onProchaska, 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 yourhorse dies, get off it Cherokee proverb Source of image: fenwickgallery.co.uk ‘‘
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- 195. #SHCR @HelenBevan Traditional event Theagenda 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: 4principles 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 unconferenceprocess • 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 keysto 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 ourapproach 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 waysto 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
- #8 #EdgeTalks WebEx http://theedge.nhsiq.nhs.uk/expert/how-has-the-school-for-health-and-care-radicals-made-a-difference/ Or Google: #EdgeTalks School
- #38 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.
- #94 Why platforms are the new power Old power won’t deliver what we need to
- #97 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
- #99 Thinking about your wish list
- #103 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.
- #126 Examples form the NHS of social movements often called a call to action
- #129 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.
- #132 Link below http://www.bbc.co.uk/news/magazine-23790147 http://www.bbc.co.uk/learningzone/clips/martin-luther-king-i-have-a-dream-pt-1-2/1293.html With the brooding statue of Abraham Lincoln peering down at him, King began by telling protesters that their presence in the symbolic shadow of the "great emancipator" offered proof of the marvellous new militancy sweeping the country. For too long, he complained, black Americans had been exiles in their own land, "crippled by the manacles of segregation and the chains of discrimination". The whirlwinds of revolt would continue to shake the very foundations of the country: "And those who hope that the Negro needed to blow off steam and will now be content will have a rude awakening if the nation returns to business as normal," King said. It would be fatal for the nation "to overlook the urgency of the moment and to underestimate the determination of the Negro". “He's good - he's damned good” Kennedy on King Wearied by the suffocating heat, the crowd's initial response was muted. The speech was not going well. "Tell 'em about the dream, Martin," shouted Mahalia Jackson, referring to a rhetorical riff that King had used several times before, but which had not made it into his prepared speech because aides insisted he needed fresh material. But King decided to cast aside his prepared notes, and launched extemporaneously into the refrain for which he will forever be remembered. "I have a dream that one day this nation will rise up and live out the true meaning of its creed," he shouted, his out-stretched right arm reaching towards the sky. Soon he was hitting his rhythm, invigorated by the chants and cries of the crowd. "Dream on!" they shouted. "Dream on!" With his voice thundering down the Mall, King imagined a future in which his children could "live in a nation where they will not be judged by the colour of their skin but by the content of their character". Then he reached his impassioned finale. King asked the crowd to yell so it was heard the world over Watching at the White House, the president was riveted. Like so many Americans, it was the first time he had heard the 34-year-old preacher deliver a speech in its entirety - the first time he had taken its measure, listened to its cadence. "He's good," Kennedy told one of his advisors. "He's damned good." The aide was struck, however, that the president seemed impressed more by the quality of King's performance rather than the power of his message.
- #133 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.
- #136 LIST some emotions
- #145 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.
- #168 I thank you for being here and doing what you do. Have a wonderful three days in Birmingham.