QSIR knowledge exchange - Moira Livingstone presentation
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How do we engage clinicians in transformational change and service improvement? Presented by Moira Livingstone at the QSIR knowledge exchange, 27 January 2015.
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QSIR knowledge exchange - Moira Livingstone presentation
- 1. How do you engage clinicians in transformational change and service improvement? Professor Moira Livingston, NHS Improving Quality
- 2. Everyone Everywhere Every Time • Financial challenges • Quality: safety, outcomes and experience is the focus • Rising expectations • Increasing complex health needs • Unacceptable variation BACKGROUND: THE CURRENT LANDSCAPE We need to do more, for less… and better …. and faster Does not experience the safest and highest quality healthcare
- 5. The landscape we work in “No more nanny state on health”
- 6. 2008 -2013
- 7. staff
- 8. MENTAL MODELS AND SPREAD OF KNOWLEDGE
- 9. Edgar Schein, Professor Emeritus MIT Sloan School You can’t impose anything on anyone and expect them to be committed to it. ‘‘ ’’
- 11. Mental models of change - striking a balance How we think about engagement
- 12. It’s all about
- 13. It is hard but we DO SEE great success and IMPROVED UNDERSTANDING of what HELPS
- 15. Features of success Training is not enough: • Identify the right people who can be leaders of change and improvement • A culture that supports change (time encouragement and recognition) • Mentorship How do we get value from the investment in clinical leaders in improvement and large scale change
- 18. Clear vision: ambitious Collective goal: Shared purpose Transparency of steps to get there Consistency and constancy Commitment Courage Resilience Innovations Small continuous improvements measured to the millisecond Share and Spread Leadership and team work Sky’s mission in 2010 was to win Tour de France with a British rider within five years – they did it in two years
- 19. Consider • The vision and purpose • Leadership: – Behaviours and values – Culture – Courage – Resilience • Seeking commitment not compliance • Focus on: – Why - benefits to patients and clinicians – Strengths more than deficiencies – Everyone getting better • Align the system levers to maximise efforts for improving quality • Data and measurement
Editor's Notes
- Can we get a moving image of scales so they tip from heavy on compliance to heavy on commitment ( above is final position)? NOTES: Change that starts from commitment to a collective goal is much more likely to achieve sustainable results than change that is based on compliance (Walton 2005) It is much easier to ensure compliance at an organisational level when it is based on commitment to change; people who buy into the “why” are more likely to do the “what” (Roffey Park 2013) There is little evidence in the change literature of organisations or systems that have delivered and sustained large scale change largely on the basis of compliance (Bevan 2011)