@HelenBevan

Health and care radicals for large scale improvement

Presentation at the mini-symposium on improvement science to celebrate Jönköping

Academy’s first 5 years

Helen Bevan @HelenBevan

@HelenBevan

Theothersidestory.co.uk @GrangerKate

@HelenBevan

Emerging themes in large scale change

Organisation Community

Power through hierarchy Power through connection

Mission and vision Shared purpose

Making sense through rational argument

Making sense through emotional connection

Leadership-driven (top down) innovation

Viral (grass-roots driven) creativity

Tried and tested, based on experience

“ Open” approaches , sharing ideas & data, co-creating change

Transactions Relationships

Dominantapproach

Emerging direction

Source: @HelenBevan

@HelenBevan

The implications for leaders and change agents (of moving

from left to right) are profound!

Organisation Community

Power through hierarchy Power through connection

Mission and vision Shared purpose

Making sense through rational argument

Making sense through emotional connection

Leadership-driven (top down) innovation

Viral (grass-roots driven) creativity

Tried and tested, based on experience

“ Open” approaches , sharing ideas & data, co-creating change

Transactions Relationships

Dominant approach Emerging direction

@HelenBevan

John Kotter: “Accelerate!”

• We won’t create big change through hierarchy on its own

• We need hierarchy AND network• Many change agents, not just the usual few • Changing our mindset

• From “have to” to “want to”• Head and heart, not just head

and

@HelenBevan

The Network Secrets of Great Change AgentsJulie 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

@HelenBevan

“If people give to a cause, they expect a relationship, not a transaction”

Nilofer Merchant

@HelenBevan

“A cynic, after all, is a passionate person who does not want to be disappointed again”Zander R and Zander B (2000) The art of possibility. Harvard Business School Press. As quoted by Steve Onyett

@HelenBevan

is the new normal!

“By questioning existing ideas, by opening new fields for action, change

agents actually help organisations survive and adapt to the 21st Century.”

Céline SchillingerImage by neilperkin.typepad.com

@HelenBevan

@rebelsatwork rebelsatwork.com

Across the world, the change agent movement is exploding!

@chagwwChangeagentsworldwide.com

@corprebelsCorporaterebelsunited.com

@HelenBevan

The largest simultaneous improvement initiative in the history of the NHS

@HelenBevan

Its started with a tweet!

Young clinical leaders & improvement leaders started to talk about how they could improve care

Damian RolandStuart Sutton Helen Bevan

@HelenBevan

NHS Change Day - A call to action

@HelenBevan14

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A 189,000 pledge mountain!

15

@HelenBevan

People took action all over the country

#NHSChangeDay@PowerNHS

@HelenBevan

Probably the only winner of a global

challenge to develop leaders in the corporate

world that names Saul Alinsky and Marshall Ganz as major influencers

@HelenBevan

Change Day 2013 was an extraordinary moment in the history of the NHS. It taught us that large-scale

improvement is possible in the NHS & that the best way to do it is through collective commitment, action & by

keeping it simple.

@HelenBevan

The largest simultaneous improvement

initiative in the history of the NHS

@HelenBevan

Source: @NHSChangeDay

@helenbevan #1000LivesPlus

@helenbevan@HelenBevan

What happens to heretics/radicals/rebels/mavericks

in organisations?

@helenbevan@HelenBevan

@helenbevan@HelenBevan

“There is nothing more difficult to carry out, nor more doubtful of success, nor more dangerous to handle, than to initiate a new order of things. For the reformer has enemies in all those who profit by the old order, and only lukewarm defenders in all those who profit by the new”

Niccolo Machiavelli 15th century

@helenbevan@HelenBevan

We need to be boatrockers!

• Walk the fine line between difference and fit, inside and outside, rock the boat but manage to stay in it

• Able to challenge the status quo when we see that there could be a better way

• Conform AND rebel• Capable of working with others

to create success NOT a destructive troublemaker

Source: Debra Meyerson

@helenbevan@HelenBevanSource : Lois Kelly www.foghound.com

Sometimes organisational leaders see radicals as troublemakers

@helenbevan@HelenBevan

Task

• Talk to others around you about your experiences regarding “radicals” and “troublemakers”

• Which have you been and why?• What moves people from being “radical” to

“troublemaker”?• How do we protect against this?

@helenbevan@HelenBevan

First they ignore you, then they laugh at you, then they fight you, then you win

Gandhi

@helenbevan@HelenBevan

Valuing radicals

• “New truths begin as heresies” (Huxley, defending Darwin’s theory of natural selection)

• big things only happen in organisations because of heretics and radicals

@helenbevan@HelenBevan Source: Foghound

@helenbevan@HelenBevan @RobertVarnam #IHI25Forum #ChangeAgents

"There’s only one corner of the universe you can be certain of

improving, and that’s your own self." Aldous Huxley

@helenbevan@HelenBevan

@helenbevan@HelenBevan

1. convictions and values-driven2. strong sense of “self-efficacy”

belief that I am personally able to create change belief in others

3. action orientated ignite collective action mobilising others, inspiring change

4. able to join forces with others work as a collective body for commonly valued changes

5. able to achieve small wins which create a sense of hope, self-efficacy and confidence

6. optimistic in the face of challenge see opportunities take account of obstacles

What do we know about successful boat rockers?

Source: adapted from Debra E Meyerson

@helenbevan@HelenBevan

Being a great change agent is about knowing, doing, living and being improvement

@helenbevan@HelenBevan

Five modules:• 31st January: Starting from a position of

strength: change starts with me• 7th February: Forming communities: building

alliances for change• 14th February: Rolling with resistance• 21st February: Making change happen• 28th February: Moving beyond the edge

www.changeday.nhs.uk/healthcareradicals

@helenbevan@HelenBevan

Outwitted

He drew a circle that shut me out -Heretic, rebel, a thing to flout.But Love and I had the wit to win:We drew a circle that took him in.

Edward Markham