This module will help us create and sustain the energy we need to make change happen. We will look at a number of practical ideas, tools and resources to help us change the way we do change. We’ll look at why change fails and how you can minimise the risk of it failing by creating a shared purpose and understanding the different energies needed to bring teams with you.
To find out more about the School, please visit the website http://theedge.nhsiq.nhs.uk/school/
Module 3 slides - School for Change Agents NHS Horizons
It is natural to resist change. Rather than seeing resistance as something negative, here we shift our perspective so that we see dissent, diversity and disruption as essential components of effective change. However, we need to build resilience in order to work effectively with resistance. This module offers some tools and techniques to ensure that we remain strong, adaptable and able to continue our work as change agents.
To find otu more about the School, please visit the website http://theedge.nhsiq.nhs.uk/school/module-3/
School for Change Agents 2017 - Module 1NHS Horizons
This first module invites you to continue your journey as a change agent and offers some new ways of thinking about how you work to effect change. The module highlights learning from some of the most effective change agents across the globe, explores the differences between troublemakers and rebels and helps us to understand how to ‘rock the boat and stay in it’.
http://theedge.nhsiq.nhs.uk/school/
Module 2 School for Change Agents - transcriptNHS Horizons
The golden rule for change activists is: ‘You can’t be a rebel on your own’ and will be presented by Kathryn Perera. This module gives us an understanding of the power of working together by exploring communities of practice and social movements. We identify techniques for connecting with our own and others’ values and emotions to create a call for action.
To find out more about the School, please visit the website http://theedge.nhsiq.nhs.uk/school
School for Change Agents 2017 Module 4NHS Horizons
This module will help us create and sustain the energy we need to make change happen. We will look at a number of practical ideas, tools and resources to help us change the way we do change. We’ll look at why change fails and how you can minimise the risk of it failing by creating a shared purpose and understanding the different energies needed to bring teams with you.
School for Change Agents Module 5 slidesNHS Horizons
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. We’ll explore what we mean by ‘the edge’, and what opportunities there are for health and care change activists to be bridge builders and curators.
Module 3 slides - School for Change Agents NHS Horizons
It is natural to resist change. Rather than seeing resistance as something negative, here we shift our perspective so that we see dissent, diversity and disruption as essential components of effective change. However, we need to build resilience in order to work effectively with resistance. This module offers some tools and techniques to ensure that we remain strong, adaptable and able to continue our work as change agents.
To find otu more about the School, please visit the website http://theedge.nhsiq.nhs.uk/school/module-3/
School for Change Agents 2017 - Module 1NHS Horizons
This first module invites you to continue your journey as a change agent and offers some new ways of thinking about how you work to effect change. The module highlights learning from some of the most effective change agents across the globe, explores the differences between troublemakers and rebels and helps us to understand how to ‘rock the boat and stay in it’.
http://theedge.nhsiq.nhs.uk/school/
Module 2 School for Change Agents - transcriptNHS Horizons
The golden rule for change activists is: ‘You can’t be a rebel on your own’ and will be presented by Kathryn Perera. This module gives us an understanding of the power of working together by exploring communities of practice and social movements. We identify techniques for connecting with our own and others’ values and emotions to create a call for action.
To find out more about the School, please visit the website http://theedge.nhsiq.nhs.uk/school
School for Change Agents 2017 Module 4NHS Horizons
This module will help us create and sustain the energy we need to make change happen. We will look at a number of practical ideas, tools and resources to help us change the way we do change. We’ll look at why change fails and how you can minimise the risk of it failing by creating a shared purpose and understanding the different energies needed to bring teams with you.
School for Change Agents Module 5 slidesNHS Horizons
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. We’ll explore what we mean by ‘the edge’, and what opportunities there are for health and care change activists to be bridge builders and curators.
Module 3 study guide - School for Change AgentsNHS Horizons
It is natural to resist change. Rather than seeing resistance as something negative, here we shift our perspective so that we see dissent, diversity and disruption as essential components of effective change. However, we need to build resilience in order to work effectively with resistance. This module offers some tools and techniques to ensure that we remain strong, adaptable and able to continue our work as change agents.
To find out more about the School, please visit the website http://theedge.nhsiq.nhs.uk/school
The golden rule for change activists is: ‘You can’t be a rebel on your own’. This module gives us an understanding of the power of working together by exploring communities of practice and social movements. We identify techniques for connecting with our own and others’ values and emotions to create a call for action.
Module 1 Study Guide - School for Change Agents NHS Horizons
This first module invites you to continue your journey as a change agent and offers some new ways of thinking about how you work to effect change. The module highlights learning from some of the most effective change agents across the globe, explores the differences between troublemakers and rebels and helps us to understand how to ‘rock the boat and stay in it’.
To find out more about the School, please visit the website http://theedge.nhsiq.nhs.uk/school
Module 2 slides - School for Change AgentsNHS Horizons
The golden rule for change activists is: ‘You can’t be a rebel on your own’ and will be presented by Kathryn Perera. This module gives us an understanding of the power of working together by exploring communities of practice and social movements. We identify techniques for connecting with our own and others’ values and emotions to create a call for action.
To find out more about the School, please visit the website http://theedge.nhsiq.nhs.uk/school/
School for change agents - Module 1 transcriptNHS Horizons
This first module invites you to continue your journey as a change agent and offers some new ways of thinking about how you work to effect change. The module highlights learning from some of the most effective change agents across the globe, explores the differences between troublemakers and rebels and helps us to understand how to ‘rock the boat and stay in it’.
http://theedge.nhsiq.nhs.uk/school/
School for Change Agents 2019 - Session 1NHS Horizons
In this session we:
How it can feel to be a change agent in a hierarchical organisation (or challenging a formal system) – why is it so hard?
Understanding the difference between old power and new power (Heimans and Timms) and why change agents need to work with both
Being an influencer for change - why informal influence can be more powerful than formal authority
The nature of agency (the power to make a positive difference) and how we can unleash it
The essence of being a change agent
Change starts with me: self-awareness, reflection, my own mindset about leading and supporting change
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. We’ll explore what we mean by ‘the edge’, and what opportunities there are for health and care change activists to be bridge builders and curators.
The new era of change and transformationHelen Bevan
The slides that Helen Bevan presented at #LIIPSforum2016 25th November 2016. The event is organised by the Leicestershire Improvement, Innovation and Patient Safety Unit of the University of Leicester
Module 3 study guide - School for Change AgentsNHS Horizons
It is natural to resist change. Rather than seeing resistance as something negative, here we shift our perspective so that we see dissent, diversity and disruption as essential components of effective change. However, we need to build resilience in order to work effectively with resistance. This module offers some tools and techniques to ensure that we remain strong, adaptable and able to continue our work as change agents.
To find out more about the School, please visit the website http://theedge.nhsiq.nhs.uk/school
The golden rule for change activists is: ‘You can’t be a rebel on your own’. This module gives us an understanding of the power of working together by exploring communities of practice and social movements. We identify techniques for connecting with our own and others’ values and emotions to create a call for action.
Module 1 Study Guide - School for Change Agents NHS Horizons
This first module invites you to continue your journey as a change agent and offers some new ways of thinking about how you work to effect change. The module highlights learning from some of the most effective change agents across the globe, explores the differences between troublemakers and rebels and helps us to understand how to ‘rock the boat and stay in it’.
To find out more about the School, please visit the website http://theedge.nhsiq.nhs.uk/school
Module 2 slides - School for Change AgentsNHS Horizons
The golden rule for change activists is: ‘You can’t be a rebel on your own’ and will be presented by Kathryn Perera. This module gives us an understanding of the power of working together by exploring communities of practice and social movements. We identify techniques for connecting with our own and others’ values and emotions to create a call for action.
To find out more about the School, please visit the website http://theedge.nhsiq.nhs.uk/school/
School for change agents - Module 1 transcriptNHS Horizons
This first module invites you to continue your journey as a change agent and offers some new ways of thinking about how you work to effect change. The module highlights learning from some of the most effective change agents across the globe, explores the differences between troublemakers and rebels and helps us to understand how to ‘rock the boat and stay in it’.
http://theedge.nhsiq.nhs.uk/school/
School for Change Agents 2019 - Session 1NHS Horizons
In this session we:
How it can feel to be a change agent in a hierarchical organisation (or challenging a formal system) – why is it so hard?
Understanding the difference between old power and new power (Heimans and Timms) and why change agents need to work with both
Being an influencer for change - why informal influence can be more powerful than formal authority
The nature of agency (the power to make a positive difference) and how we can unleash it
The essence of being a change agent
Change starts with me: self-awareness, reflection, my own mindset about leading and supporting change
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. We’ll explore what we mean by ‘the edge’, and what opportunities there are for health and care change activists to be bridge builders and curators.
The new era of change and transformationHelen Bevan
The slides that Helen Bevan presented at #LIIPSforum2016 25th November 2016. The event is organised by the Leicestershire Improvement, Innovation and Patient Safety Unit of the University of Leicester
School for Health and Care radicals - Slides for module fourHorizons NHS
Making change happen: This module will help us create and sustain the energy we need to make change happen. We will look at a number of practical ideas, tools and resources to help us change the way we do change.
This is the presentation that Goran Henriks and Helen Bevan made at the International Forum on Quality and Safety in Healthcare, 23rd April 2015.
Follow us on Twitter:
@HelenBevan
@GoranHenriks
These are the slides from Module 4: Making change happen
This module brings together themes from earlier modules and examines ways of bringing your aspirations for change to fruition. We will look at the NHS Change model and the energy model and consider the importance of balancing different types of energy and recognising the need for both extrinsic and intrinsic motivation.
Agenda:
Why change efforts often fail to achieve their objectives
What happens to large-scale change efforts in reality?
Leaders and their role as ‘signal generators’
10 key principles of large-scale change
Intrinsic vs extrinsic motivation and drivers
What is the NHS Change Model and how does it align with the above?
How can you build both intrinsic and extrinsic motivators of change into your efforts?
How can you managed the tension between the two?
Building energy for change
What is energy for change?
What are the five energies?
Characteristics of the high and low end of the energies
What is an energy for change profile?
Creating shared purpose
What is our approach to change?
What is the value of a shared purpose?
How to avoid de facto purpose?
Questions and call to action
Questions for reflection:
How can I make the most of both intrinsic and extrinsic aspects of change?
How can I build energy for change for the long haul?
How can I ensure shared purpose throughout my change process?
What can I do tomorrow to accelerate change?
Call to action:
Reflect on how you can use both intrinsic and extrinsic motivators in your practice as a leader or agent of change.
Seek to ignite energy for change in everyone involved in your project.
Build commitment to shared purpose in all your change efforts.
These are the slides for Module 4 of The School for Health and Care Radicals, a five week virtual programme, designed to equip people across the health and care system with the core skills to improve their skills as change agents. It supports NHS Change Day 2014, the grassroots movement in which everyone who values the NHS can make a pledge of action to improve things for patients and the health and care system.
Big change only happens in health and care because of heretics and radicals: passionate people who are willing to take responsibility and work with others to make change happen. Being a radical isn't related to hierarchy or position and you don't have to work in the NHS or social care to qualify as one. Registrants to the school so far include patients and carers, students, senior leaders, improvement facilitators and clinical and care staff.
There is also a live weekly web seminar which will be available to 'listen again', supported by a raft of other opportunities, including coaching and mentoring, virtual discussions and tweet chats, and an ever- expanding portal of useful resources.
Programme
The programme focuses on five modules over five weeks, 9:30 to 11:00 am GMT
Friday 31 January 2014: Being a health and care radical: change starts with me
Friday 7 February 2014: Forming communities: building alliances for change
Friday 14 February 2014: Rolling with resistance
Friday 21 February 2014: Making change happen
Friday 28 February 2014: Moving beyond the edge
Tweetchat
We will run a tweetchat each Wednesday from 16:00 to 17:00 GMT, based on the content of the module from the previous Friday. A tweetchat is a facilitated conversation using Twitter. The hashtag we will use for the tweetchats is #SHCRchat. The dates for the tweetchats are:
12 February 2014
19 February 2014
26 February 2014
5 March 2014
There is no charge to join the School of Health and Care Radicals and it is open to all, whatever your role or level, and whether or not you work in the NHS
Resources from all modules can be found at: http://www.nhsiq.nhs.uk/9059.aspx
The presentation was made during the Community Service Public Relations Council's annual Spectrum Conference on May 20, 2014.
Program Description: Are you new to a leadership position? Do you aspire to take on a leadership role in your organization?
Do you want to be a better leader or improve your leadership skills? We will provide a “buffet” of
leadership elements to help you improve your capacity to lead. View the selections and sample small
portions on communicating, resolving conflict, project planning and management, goal setting, and
listening. You might have more of an appetite for some offerings and less for others, but there will be
something to satisfy everyone’s hunger for successfully leading themselves, a team, or organization.
Presentation by Andy Feldman on Bridging Evidence and Innovation made at the ...OECD Governance
This presentation by Andy Feldman was made at the OECD conference on Innovating the Public Sector: From Ideas to Impact (12-13 November 2014). For more information visit the OECD Observatory of Public Sector Innovation: https://www.oecd.org/governance/observatory-public-sector-innovation/events/.
Measuring the Impact of Employee Soft Skills TrainingBizLibrary
Why do organizations struggle with measuring the impact of their soft skills training?
We know that improved communications skills make our colleagues better sales professionals, HR professionals, customer service professionals, etc. But getting to actual proof of this “knowledge” isn’t always easy.
What You’ll Learn:
Common soft skills training and development challenges
How content should be delivered to achieve maximum benefit
How to build a framework for measurement of business benefits of soft skills
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
2. The team today
School Lead:
Helen Bevan
@HelenBevan
Lead
facilitator:
Pip Hardy
@PilgrimPip
Technical Support
Joanna Hemming
@JoannaHemming
Paul Woodley
@PaulWoodley4
Olly Benson
@OllyBenson
Kate Pound
@KateSlater2
Chat Room Monitors
Kathryn Perera
@Kathrynperera
Twitter Monitors
Louis Warner
@LouisWHorizons
Leigh Kendall
@leighakendall
3. • Please use the chat box to contribute continuously during the talk
• Please tweet using hashtag #S4CA and the handle @Sch4Change
• Send a request to join our Facebook group School for Change Agents
https://www.facebook.com/sch4change/
• We will produce summaries of each module discussion using Steller and
put on the website
Joining in today…and beyond
4. 16th February: Being a change agent: change
begins with me
23rd February: From me to we: making
connections and building communities
2nd March: Rolling with resistance
9th March: Making change happen
16th March: Moving beyond the edge
Each week we’ll cover different
change agent capabilities
Source of image: thenounproject.com
5. Nurses, Midwives and Allied Health Professionals
Use the school experience as part of your CPD reflective account
for revalidation
Doctors
We have applied for CPD credits for the school
Certification and Continuing
Professional Development
Everyone
If you watch all five of the talks and
demonstrate you have applied the
learning, you can apply to become a
certificated change agent (and it’s free).
6. • Email to join the RCT england.si-
horizons@nhs.net
• We will randomly match you with
another participant in the School
for Change Agents from
anywhere in the world
• At some time in the next four
weeks, arrange to have a
conversation over Skype (or other
communication system) with a
cup of coffee!
Randomised Coffee Trials
Image source: Pinterest
7. 7
To what extent did the last change
initiative you were engaged with
deliver all its objectives?
1 = delivered very little
10 = delivered all its objectives
8. • understanding why many change efforts fail to
deliver their intended benefits
• considering barriers and building blocks to change
• recognising the need to align intrinsic and extrinsic
motivators for change
• building joy at work
• appreciating energy for change
• avoiding “de facto” purpose
Change agent capabilities in
module 4
Source of image: thenounproject.com
9. Source of image: Whatsthebigideascwartzy.blogspot.com
Why is
often quoted in the field of change
leadership?
11. Most change programmes fail to
deliver their objectives
Source: McKinsey Performance Transformation Survey, 3000 respondents to
global, multi-industry survey
70%
25%
5%
Gets anywhere near
achieving the
change and
delivering the
benefits
12. Most change programmes fail to
deliver their objectives
Source: McKinsey Performance Transformation Survey, 3000 respondents to
global, multi-industry survey
70%
25%
5% Delivers and
sustains the change
15. Source: 2016 Chartered Institute of Management Quality of Working Life study
Across the UK, poorly led change
programmes are damaging morale and the
performance of organisations
16. It is our contention that most change efforts are built upon
the shaky foundation of five flawed assumptions; that
change can be managed, that human beings are objective,
that there are ‘X’ steps to change, that we have a neutral
starting point for change, and that change, itself, is the goal
Peter Fuda
http://www.peterfuda.com/wp-content/themes/peterfuda-
bootstrap/content/Why-Change-Efforts-Fail.pdf
Source of image: Whatsthebigideascwartzy.blogspot.com
17. The old power/new power
framework has been a thread
through every module so far:
Jeremy Heimens, Henry Timms
This is New Power
18. Economic resources
diminish with use
• money
• materials
• technology
Natural resources
grow with use
• relationships
• commitment
• community
Based on principles from Albert
Hirschman and Marshall Ganz
Let’s think about resources for
change inold/new power terms
19. Source: How can asset mapping improve community health?
An asset map from the Institute
for Healthcare Improvement
20. Change is not the goal;
the goal is the goal
Peter Fuda
Source of image:
timemanagementninja.com
21. 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
Source: Health Service Journal, Nursing Times, NHS Improving
Quality, “Change Challenge” March 2015
22. Front line teams get inundated with high priority
messages from leaders each day, making it
difficult for them to know what to focus on
Increasing number of messages
as information cascade through
the organisation
Source: adapted from
http://businessjournal.gallup.com/content/162707/change-initiatives-fail-
don.aspx
23. Front line teams get inundated with high priority
messages from leaders each day, making it
difficult for them to know what to focus on
Increasing number of messages
as information cascade through
the organisation
Source: adapted from
http://businessjournal.gallup.com/content/162707/change-initiatives-fail-
don.aspx
Buy in from front line staff is critical
for improvements in quality and safety
Don’t overload them
http://healthaffairs.org/blog/2014/03/07/the-
dangers-of-quality-improvement-overload-insights-
from-the-field/
24. Poll: Which of these have been blocks
for you in the last 12 months?
Confusing strategies
Over controlling
leadership
Perverse incentivesStifling innovation
Poor workforce
planning
One way
communication
Inhibiting
environment
Undervaluing staff
Poor project
management
Playing it safe
Source: Health Service Journal, Nursing Times, NHS Improving
Quality, “Change Challenge” March 2015
25. 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
14,000 contributions identified
11 building blocks for change:
26. Poll: Which of these factors are
present in your situation now?
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
27. How to make change happen
• Make people feel
something
• Emphasise progress
• Stop bribing
• Start a cult (a group
unified by a provocative
idea)
Source: How to motivate people: four steps backed by science
28. • Teresa Amabile, Harvard
Business School: studied the
"inner work life" diaries of 238
professionals
• Best days were when they were
able to move forward in their
work
• 700 managers were asked to
rank five employee motivators,
including recognition and
incentives. They ranked
progress last
Emphasise progress
Source: The Progress Principle: Using Small Wins to
Ignite Joy, Engagement, and Creativity at Work
30. Tapping into intrinsic motivation
is critical to ongoing, large scale
change
Emilia Wietrak External incentives and internal motivation – a perfect
pairing to boost work performance!
• Works best for straightforward,
repetitive tasks
• Build meaning and understanding
of performance, tie extrinsic
motivators closely to specific
performance and reward teams
• Works best for complex tasks that
need personal investment,
absorption and focus on quality
• Increase intrinsic motivation by
making people feel competent/self-
efficacious (module1) and giving
them more autonomy
Internally motivated people who enjoy what they do RARELY
perform poorly
Joy at work /intrinsic motivation RARELY appear in isolation
34. Drivers
of extrinsic
motivation
create focus &
momentum for
delivery
Intrinsic
motivators
•connecting to
shared purpose
•engaging, mobilising and
calling to action
•motivational leadership
build energy
and creativity
•System drivers &
incentives
•Payment by results
•Performance
management
•Measurement for
accountability
35. Internal
motivators
•connecting to
shared purpose
•engaging, mobilising and
calling to action
•motivational leadership
build energy and
creativity
Drivers of
extrinsic
motivation
•System drivers &
incentives
•Performance
management
•Measurement for
accountability
create & focus
momentum for
delivery
37. Priority area: Reducing inappropriate use of anti-psychotic drugs for people
with Learning Disabilities in our inpatient unit
What outcomes do we seek?
Our Shared Purpose
Is there a sense of shared
purpose amongst our key
stakeholders?
The shared purpose is to
improve the quality of life
for people with learning
disabilities by reducing the
over reliance on
antipsychotic drugs.
Leadership by all
Do all our leaders have the skills
to create transformational
change?
Psychiatrists
Lead commissioner
Clinical Lead
Managers
Clinical staff
Support staff /carers
Therapies
Patients, families, carers,
advocates
Motivate and Mobilise
Are we engaging and mobilising
all the right people?
Patient , carer and family groups,
related charities
Medication group
Psychiatrists
Local improvement group
Local patient advocate group
Therapies staff
Commissioners
Spread and Adoption
Are we designing for the active
spread of innovation?
Medicines Optimisation Toolkit
Induction pack
National campaigns
How to Guides – benefits and
practical application
Project and performance
Management
Do we have an effective
approach for delivery of change
and monitoring of progress
towards our planned objectives?
Inclusion in all team meetings
Risk & Issues Log
System Drivers
Are our processes, incentives
and systems aligned to enable
change?
National Guidance
National Publication
Improvement tools
Are we using an evidence-based
quality improvement
methodology?
YES. Using the Trust’s quality
improvement tools package
Measurement
Are we measuring the outcome
of the change continuously and
transparently?
Baseline data re number on
medication, medication used
and why medication is being
used.
Regular data collection
Regional and national data.
38. “The change model is a structure that helped the
team to understand what we are all trying to
achieve, where we needed to focus more of our
attention and how to achieve it. It helped the team
to work together. I encourage more teams to use
the change model to achieve successful change.”
Parent of James
39. Two kinds of people at work
• Feel connected to a higher
purpose
• Controlled & coordinated
through shared goals & values
• Collaborate
• Embrace change
• Work to who they are
The contributors The compliant
• Feel disconnected from purpose
• Controlled & coordinated through
performance management &
standardised procedures
• Hold back
• Resist change
• Work to a role specification
Adapted from The Emotional Economy
http://emotionaleconomy.com.au/papers-articles/why-the-winners-
in-business-are-taking-the-time-to-build-a-positive-kind-social-
culture/
40. Two kinds of people at work
The compliant
• Feel connected to a higher
purpose
• Controlled & coordinated
through shared goals & values
• Collaborate
• Embrace change
• Work to who they are
The contributors
Gallup global research:
• Only 13% of the workforce are
engaged (contributors)
• Contributors create six times the
value to an organisation
compared to the compliant
http://www.gallup.com/poll/165269/worldwide-
employees-engaged-work.aspx
43. The capacity and drive of a team,
organisation or system to act and
make the difference necessary to
achieve its goals
Energy for change
http://www.institute.nhs.uk/tools/energ
y_for_change/energy_for_change_.html
44. What happens to large scale change
efforts in reality
In order of frequency:
1. the effort effectively “runs out of energy” and simply fades
away
2. the change hits a plateau at some level and no longer
attracts new supporters
3. the change becomes reasonably well established; several
levels across the system have changed to accommodate or
support it in a sustainable way
Why is energy for change important?
Source: http://www.nhsiq.nhs.uk/8530.aspx
45. Typically, around any change effort, there is an
initial spike of tangible energy, and change, but
when leadership loses interest, the momentum
of change slows down drastically.”
Tara Paluck
46. Overall performance - 14% higher
• productivity – 17%
• efficiency – 14%
• customer satisfaction – 6%
• customer loyalty – 12%
Teams and organisations with high energy score
higher on every dimension of performance
Source: Bruch and Vogel
47.
48. Change is most likely to happen
when five energies are high
Psychologic
al
Physical
Spiritual
Social Intellectual
Source: http://www.institute.nhs.uk/tools/
energy_for_change/energy_for_change_.html
49. 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”
Social energy
50. 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
Spiritual energy
51. Energy of courage, resilience and feeling
safe to do things differently
Involves feeling supported to make a change and
trust in leadership and direction
Psychological energy
53. Energy of action, getting things done and
making progress
The flexible, responsive drive to make things
happen
Physical energy
54. 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
55. Social isolated solidarity
Spiritual uncommitted higher purpose
Psychological risky safe
Physical fatigue vitality
Intellectual Illogical reason
High and low ends of each
energy domain
LOW
HIGH
56. Which one of these energies do you
think is disproportionately high
(compared to the other energies) in
senior leadership teams in health
and care?
56
• Social
• Spiritual
• Psychological
• Physical
• Intellectual
57. • Intellectual energy on its own isn’t
transformational
• It keeps leaders in their comfort zone (intellect
to intellect)
The challenge of disproportionately
high intellectual energy
Emotion is the fuel for change;
data and information provide
direction
Dan Heath
(author of Switch)
58. • Which group likely to have
higher spiritual energy
scores:
• clinicians
• non clinicians
• Nearer to CEO in the
structure:
higher or lower overall
energy scores?
Some more questions
Source: Respondents to the energy for change questionnaire NHSIQ/Horizons team
61. Energy analysis of six large scale
transformation plans
Source: energy for change discourse analysis of six STP plans by the Horizons team
62. Energy analysis of six large scale
transformation plans
Source: energy for change discourse analysis of six STP plans by the Horizons team
63. What happens when we don’t build a
proportionate amount of social and
spiritual energy in our change efforts?
64. “As a leader, think of yourself as a “signal generator” whose
words and actions are constantly being scrutinised and
interpreted, especially by those below you” [in the
hierarchy]…..
Signal generators reduce uncertainty and ambiguity about what
is important and how to act”
Charles O’Reilly, Leaders in Difficult Times
As leaders and change agents, we
are “signal generators”
Source of image:
vintage-radio.com
What leaders pay attention to
matters to staff, and
consequently staff pay attention
to that too
65. Avoiding “de facto” purpose
• hitting a target
• reducing costs
• reducing length of stay
• eliminating waste
• completing activities within a
timescale
• complying with regulators
Source: Delivering Public Services That Work: The Vanguard
Method in the Public Sector
If purpose isn’t explicit and shared, then it is very easy for something
else to become a de facto purpose in the minds of the workforce
PURPOSE
The difference between
having a purpose and a shared
purpose is that shared purpose
is owned everyone who has a
stake in the change and
improvement we are seeking
to create
SHARED
PURPOSE
66. [Shared] purpose goes way deeper than vision and mission;
it goes right into your gut and taps some part of your
primal self. I believe that if you can bring people with
similar primal-purposes together and get them all
marching in the same direction, amazing things can be
achieved.
Seth Carguilo
We need to go beyond “buy-in”. We
don’t need buyers, we need
investors
Mark Jaben
We can build shared purpose
through social and spiritual energy
67. ....the last era of management was about how
much performance we could extract from
people
.....the next is all about how much humanity we
can inspire
Dov Seidman
68. • If you pre-registered with your Break out room
number, you will be transferred there
• If you haven’t registered with a room, we are offering
a separate phone conference that you can join:
0800 917 1950
33136606#
What happens next
69. • If you get stuck, ask for help here
• Your facilitator will be in the room.
They can be identified with the
presenter ball next to them.
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In the breakout room