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Leading big
change: what does
it take to deliver at
large scale?
Strategic
Translation
Strategic Translation
Emergence over three days
Created By: Helen Bevan, Goran Henrick, Jodeme Goldhar,
Sasha Karakusevic
“Tomorrow belongs to those
who can hear it coming”
David Bowie
X/Twitter: #Qualityforum
500 people over 3 days
Today’s session is the culmination of the
“Change” theme at the International Forum
The “Change Rebels Salon” each day
16:45-17:45 M14 today
12.30- 1300 L5 Thursday Capital Suite 14-16
12.30- 1300 L12 Friday Capital Suite 6 & 13
Thursday
1100-1215: Nuka – 25 years of community-driven transformation: remarkable clinical, cost, and
happiness achievements A1
1100-1215: Enabling change across a whole system A2
1315-1430: Breaking the rules and co-developing better care systems from the inside out B2
1500-1600: Creating a culture that fosters creativity and new approaches to quality improvement C2
Friday
1100-1215: Change happens one person at a time D2
1315-1430: Creating change together E2
1500-1600: The future of change F2
Our process over 8 sessions in three days
1. Thought
about our own
journeys of
change using
image cards
2. Explored
four core concepts:
• Three Horizons
• Change-in-degree vs.
change-in-kind
• Approach. Model,
framework, method
• Eight themes in large
scale change
3. Discussed the
work of others &
identified themes
through world
cafe
5. Energised
with
Eurovision
5. Looked at
key topics in
depth with
open space
6. Created the
strategic
translation
4. Used NOISE
analysis to
identify what do
we need to do
to enable large
scale change
WORLDEXPANDING
Much of our current change practice is designed for
“change-in-degree” when we also need “change-in-kind”
Source: Emergent Futures Lab (2024) The new cannot be seen or thought
X/Twitter: #Qualityforum
From: Three horizons: a pathways practice for transformation Bill Sharpe and colleagues
Thinking about our future direction using Bill Sharpe’s “Three
Horizons” model
• Horizons 2: How can we build a path between where we are now and where
we would like to be in future? What actions should we take?
• Horizon 1: What are our current
ways of working (context, focus,
methods, patterns, structures etc)?
What is viable/not viable for the
future?
• Horizon 3: What could we do
differently in the future in radically
different ways to achieve our
ambitious goals? Where are the
emerging opportunities?
Time
Prevalence
Recurring (& interconnected) themes in
approaches to making large scale change
happen
Moving together
towards a shared
direction
Co-producing
change: “with” &
“by”, not “to” or
“for”
Setting up systems
for experimental
learning &
unlearning: “doing
the right next
thing”
Creating the
conditions for
emergent
change
Developing
leaders
everywhere:
sustainable
systems of
distributed
leadership Building
power: a spectrum
of allies AND
working through
pillars of formal
power
Changing
yourself as a
resource for
change
Changing
yourself as a
resource for
change
Shaping
networks to
shape opinions
Source: Concept review by Helen Bevan and Goran Henriks
Leading
transitions
through
uncertainty
Recurring (& interconnected) themes in
approaches to making large scale change
happen
Design Components and Questions Showing
The Way
Inspired by Change Rebels
Moving together
towards a shared
direction
Changing yourself
as a resource for
change
Creating the
conditions for
emergent change
Co-producing
change: “with” &
“by”, not “to” or
“for”
Shaping networks
to shape opinions
Developing
leaders
everywhere:
sustainable
systems of
distributed
leadership
Setting up
systems for
experimental
learning &
unlearning: “doing
the right next
thing”
Building
power: a
spectrum of allies
AND working
through pillars of
formal
Power
• How do we build
shared purpose,
values and
direction
together?
• How do we build
capability for
collective
leadership?
• How do we think
systemically by
default ?
• How do we create
radical structural
change that
embodies a
community
development
approach?
• How do we create
the space for
shared purpose to
emerge?
• How do we
change ourselves
to be resources for
change?
• How do we build
skills for
collaboration and
facilitation?
• How do we
unlearn?
• How might we
shift from a
scarcity to an
abundance
mindset?
• How do I know
myself?
• How do we create
space to learn
about each other?
• How do we move
from knowing
what to do to
actually doing it?
• What are the
optimal
conditions, for
instance, is there
an optimal size
• What are the ways
to create
‘community’
across a whole
system/communit
y
• We talk about
‘spaces for
change’…What are
the spaces for
change?
• How do we create
protected time to
do this together?
• How do we shift
from incremental
to radical change?
• How do we
prioritize the time
and headspace for
change?
• How do we design
and drive change
with community?
• How do we co
design in a way
that builds
reciprocal trust ?
• How do we focus
on community as
a whole while we
also co produce
change with
segments of the
community?
• How can we do
both lived
experience co
design or where
you live co design
• How do we
advance authentic
co-production?
• How might we
support citizens
and carers to be
leaders of change
• How do we work
collectively across
boundaries?
• When we talk
about
involvement, who
do we need to
involve and how?
• How do we
leverage our
informal networks
for change?
• How so we build a
spectrum of allies
for change?
• How do we create
teams that are
strong together
for change?
• How do we build
the skills and
profile of future
leaders for
change?
• How do we sustain
change when
there are
leadership
changes?
• How do we sustain
capacity and
practice for
change?
• How do we bring
multigeneration of
leaders together
and understand
different needs
and perspectives
to influence large
scale of
• How do we learn
from excellence?
• How can we
organize a safe
place where we
can dream and
explore?
• How to bring
hope, optimism,
energy and fun
into the
workforce?
• How do we lead in
the current
context while
leading for the
future
• How do we rid of
status quo
maintaining
practices and be
rebels to advice
collective change
• How do we rebuild
trust
• How do we build
trust for change?
• How do we create
the business case
for change?
• How do we
navigate the
tension between
‘risk’ and ‘learning
from failures’?
Examples of simple rules for large
scale change
Simple rules are
how WE
go about changing
what WE care about
Inspired by change rebels
Simple rules
Effective simple
rules are:
• Few (5-7)
• Generalisable
• Positive
• Active
“A set of simple rules lead to intelligent behaviour in complex
situations”
Michael Dubakov
Simple Rules
How WE go about changing what we care
about
• Invest in creating collective shared purpose
• Work at the level of community and system
• Build collective power and movement through relationships
• Share progress, success and learning (failure)
• Be and stay well and support everyone to be well
• Respect the past, let go of what doesn’t work and be bold and
brave about the future together
• Energise, have fun and hold HOPE
Lessons to embrace moving forward
1. Change leadership is a collective effort
2. Change leaders work with social and technical approaches
3. Formal leaders and boards use approaches fit for complex health
and care systems.
4. Change leaders create space for moving forward
Michael Hammer, 1993

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The future of change - strategic translation

  • 1. Leading big change: what does it take to deliver at large scale? Strategic Translation Strategic Translation Emergence over three days Created By: Helen Bevan, Goran Henrick, Jodeme Goldhar, Sasha Karakusevic “Tomorrow belongs to those who can hear it coming” David Bowie X/Twitter: #Qualityforum
  • 3. Today’s session is the culmination of the “Change” theme at the International Forum The “Change Rebels Salon” each day 16:45-17:45 M14 today 12.30- 1300 L5 Thursday Capital Suite 14-16 12.30- 1300 L12 Friday Capital Suite 6 & 13 Thursday 1100-1215: Nuka – 25 years of community-driven transformation: remarkable clinical, cost, and happiness achievements A1 1100-1215: Enabling change across a whole system A2 1315-1430: Breaking the rules and co-developing better care systems from the inside out B2 1500-1600: Creating a culture that fosters creativity and new approaches to quality improvement C2 Friday 1100-1215: Change happens one person at a time D2 1315-1430: Creating change together E2 1500-1600: The future of change F2
  • 4. Our process over 8 sessions in three days 1. Thought about our own journeys of change using image cards 2. Explored four core concepts: • Three Horizons • Change-in-degree vs. change-in-kind • Approach. Model, framework, method • Eight themes in large scale change 3. Discussed the work of others & identified themes through world cafe 5. Energised with Eurovision 5. Looked at key topics in depth with open space 6. Created the strategic translation 4. Used NOISE analysis to identify what do we need to do to enable large scale change
  • 5. WORLDEXPANDING Much of our current change practice is designed for “change-in-degree” when we also need “change-in-kind” Source: Emergent Futures Lab (2024) The new cannot be seen or thought X/Twitter: #Qualityforum
  • 6. From: Three horizons: a pathways practice for transformation Bill Sharpe and colleagues Thinking about our future direction using Bill Sharpe’s “Three Horizons” model • Horizons 2: How can we build a path between where we are now and where we would like to be in future? What actions should we take? • Horizon 1: What are our current ways of working (context, focus, methods, patterns, structures etc)? What is viable/not viable for the future? • Horizon 3: What could we do differently in the future in radically different ways to achieve our ambitious goals? Where are the emerging opportunities? Time Prevalence
  • 7. Recurring (& interconnected) themes in approaches to making large scale change happen Moving together towards a shared direction Co-producing change: “with” & “by”, not “to” or “for” Setting up systems for experimental learning & unlearning: “doing the right next thing” Creating the conditions for emergent change Developing leaders everywhere: sustainable systems of distributed leadership Building power: a spectrum of allies AND working through pillars of formal power Changing yourself as a resource for change Changing yourself as a resource for change Shaping networks to shape opinions Source: Concept review by Helen Bevan and Goran Henriks Leading transitions through uncertainty
  • 8. Recurring (& interconnected) themes in approaches to making large scale change happen Design Components and Questions Showing The Way Inspired by Change Rebels
  • 9. Moving together towards a shared direction Changing yourself as a resource for change Creating the conditions for emergent change Co-producing change: “with” & “by”, not “to” or “for” Shaping networks to shape opinions Developing leaders everywhere: sustainable systems of distributed leadership Setting up systems for experimental learning & unlearning: “doing the right next thing” Building power: a spectrum of allies AND working through pillars of formal Power • How do we build shared purpose, values and direction together? • How do we build capability for collective leadership? • How do we think systemically by default ? • How do we create radical structural change that embodies a community development approach? • How do we create the space for shared purpose to emerge? • How do we change ourselves to be resources for change? • How do we build skills for collaboration and facilitation? • How do we unlearn? • How might we shift from a scarcity to an abundance mindset? • How do I know myself? • How do we create space to learn about each other? • How do we move from knowing what to do to actually doing it? • What are the optimal conditions, for instance, is there an optimal size • What are the ways to create ‘community’ across a whole system/communit y • We talk about ‘spaces for change’…What are the spaces for change? • How do we create protected time to do this together? • How do we shift from incremental to radical change? • How do we prioritize the time and headspace for change? • How do we design and drive change with community? • How do we co design in a way that builds reciprocal trust ? • How do we focus on community as a whole while we also co produce change with segments of the community? • How can we do both lived experience co design or where you live co design • How do we advance authentic co-production? • How might we support citizens and carers to be leaders of change • How do we work collectively across boundaries? • When we talk about involvement, who do we need to involve and how? • How do we leverage our informal networks for change? • How so we build a spectrum of allies for change? • How do we create teams that are strong together for change? • How do we build the skills and profile of future leaders for change? • How do we sustain change when there are leadership changes? • How do we sustain capacity and practice for change? • How do we bring multigeneration of leaders together and understand different needs and perspectives to influence large scale of • How do we learn from excellence? • How can we organize a safe place where we can dream and explore? • How to bring hope, optimism, energy and fun into the workforce? • How do we lead in the current context while leading for the future • How do we rid of status quo maintaining practices and be rebels to advice collective change • How do we rebuild trust • How do we build trust for change? • How do we create the business case for change? • How do we navigate the tension between ‘risk’ and ‘learning from failures’?
  • 10. Examples of simple rules for large scale change Simple rules are how WE go about changing what WE care about Inspired by change rebels
  • 11. Simple rules Effective simple rules are: • Few (5-7) • Generalisable • Positive • Active “A set of simple rules lead to intelligent behaviour in complex situations” Michael Dubakov
  • 12. Simple Rules How WE go about changing what we care about • Invest in creating collective shared purpose • Work at the level of community and system • Build collective power and movement through relationships • Share progress, success and learning (failure) • Be and stay well and support everyone to be well • Respect the past, let go of what doesn’t work and be bold and brave about the future together • Energise, have fun and hold HOPE
  • 13. Lessons to embrace moving forward 1. Change leadership is a collective effort 2. Change leaders work with social and technical approaches 3. Formal leaders and boards use approaches fit for complex health and care systems. 4. Change leaders create space for moving forward