Talking and Really Listening – Taking an Innovative Approach to

Large Scale Change

Tricia Boyle & Nicola HarkinsOrganisational Development Department

NHS Fife

• Explore when to use dialogue techniques for achieving service change

• Outline three fundamental dialogue concepts

• NHS Fife examples explained

• Questions and Answers

Aims for the Session

Why use Dialogue Methodologies?

• Complex issue which is also important

• Project management or hierarchy processes have not delivered positive results

• No obvious single solution

• Service delivered through interconnected roles/functions all need to be bought in

• No clear lines of authority

• Need to increase understanding of all perspectives including the customer/patient, before they will commit

• So that all voices involved can be heard and acted on

Monologue to Generative Conversation

Conception

Skilful conversation

Table tennis

Ploughing a field

Beating down

Solo voice

MonologueDebate

Discussion

Dialogue

Generative dialogue

Pool of water

Adapted from W. Isaacs

Dialogue Actions & Intentions

Adapted from D Kantor “Four Player Model”

Move (Change)

Follow (Support)

Oppose (Contrast)

Bystand (Notice)

Advocacy

Inquiry

Fields of Conversation

Politeness (rule following)I

Breakdown (rule revealing) II

Inquiry (rule inquiry)III

Flow (rule generation)IV

Generate new possibilitiesCollective intelligence

The whole is greater than the sum of the parts

Self inquiry into assumptionsAwareness of how we impact

on each other

Acceptance of social normsClarifying power/positions in

the room

Power contestPower positions emerge

Adapted from C Otto Scharmer 1988

ISAAC, W. N. (1999) Dialogic Leadership. The Systems Thinker; Vol. 10 No. 1 Pages 1-5

PHILIPS, M.E. & HUZZARD T (2007) Developmental magic? Two takes on a dialogue conference. Journal of Organizational Change Management Vol. 20 No. 1 Pages 8-25

DAVID, B. (1996) On Dialogue. Routledge, ISBN 0-415-14912-6

HILL, S.; HARE, U. & BALL, J. (2004) We’ve all come together as one – prisoners, staff and managers: Prison Dialogue as a means of facilitating patient/public involvement and implementing new standards in prison healthcare. Prison Service Journal No. 151 Pages 30-35

ISSACS, W. (1999) Dialogue and the Art of Thinking Together. Doubleday

SENGE, P., et al (2004) Presence. SoL, ISBN 0-9742390-1-1

WHEATLEY, M. (2002) Turning to One Another. Berrett-Koehler Publishers Inc, ISBN 1-57675-145-7

RIDINGS, A. (2011) Pause for Breath: Bringing the practices of mindfulness and dialogue to leadership conversations. Live It Publishing, ISBN-13: 978-1906954239

KANTOR, D. (2012) Reading the Room: Group Dynamics for Coaches and Leaders. Jossey-Bass, ISBN-13: 978-0470903438

FRIEDMAN, M.S. (2002) Martin Buber: The Life of Dialogue. Routledge, ISBN-13: 978-0415284752