How change platforms can help transform the NHS

@HelenBevan Source of image: Buildingchangetrust.org

Helen Bevan @HelenBevan

Jodi Brown @JodiOlden

How change platforms can help transform the NHS

@HelenBevan @HelenBevan

SEISMIC SHIFTS

#Expo15NHS #EdgeTalks @HelenBevan @JodiOlden

@HelenBevan

Kinthi Sturtevant, IBM 13th annual Change Management Conference (June 2015)

We rarely see two, three or four year change projects anymore. Now it’s 30-60-90 day change

projects”


http://www.innovationexcellence.com/blog/2015/07/09/13th-annual-change-management-conference-highlights/?utm_source=hs_email&utm_medium=email&utm_content=20535245&_hsenc=p2ANqtz--W0963q5vEUgL7ecueQKfQ5nK0QPbROyo7BwHs10orC8Mhs-KVEWZbwEyxXf1c8rSQahhkhUXAPaEFtqlTzK5nEygUTw&_hsmi=20535245




DIGITALCONNECTION

SEISMIC SHIFTS



Work complexity

SEISMIC SHIFTS

DIGITALCONNECTION



DIGITALCONNECTION

SEISMIC SHIFTS

Hierarchical

power

Work complexity #Expo15NHS #EdgeTalks @HelenBevan @JodiOlden


DIGITALCONNECTION

SEISMIC SHIFTS

Hierarchical

power

Work complexityChange from the edge



Introduction to the UK Policy Lab (Summer 2015)


http://www.slideshare.net/Openpolicymaking/policy-lab-slide-share-introduction-final


Starts on the fringe (at the edge)

Starts with the activistsGary Hamel

always



Jeremy Heimens TED talk “What new power looks like”

old power new power

Currency

Held by a few

Pushed down

Commanded

Closed

Transaction

Current

Made by many

Pulled in

Shared

Open

Relationship


https://www.youtube.com/watch?v=j-S03JfgHEA



“The battle and balancing between the old and new power will be a defining feature of society

and business in the coming years”

Jeremy Heimans and Henry TimmsUnderstanding new power

Harvard Business Review, December 2014


https://hbr.org/2014/12/understanding-new-power?utm_campaign=Socialflow&utm_source=Socialflow&utm_medium=Tweet



@HelenBevan

Is your change process a cathedral or a bazaar?

http://www.unterstein.net/su/docs/CathBaz.pdf





We have a lot of cathedrals

Source: Sewell (2015), “Stop training our project managers to be process junkies”


http://acceleratingchangeprogrammes.com/2015/06/09/stop-training-our-project-managers-to-be-process-junkies/

@HelenBevan @HelenBevanFor more information visit: The Collaboration Pyramid revisited

http://www.oscarberg.net/2014/11/the-collaboration-pyramid-revisited.html



The power of co-creation



The power of the platform“Facebook, YouTube, Twitter and their lesser cousins have proved the

power of the platform.

They have shown that if your average 21st century citizen is given the tools to connect and the freedom to create, they will do so with

enthusiasm, and often with an originality that blindsides the so-called creative industries. …..

Good leadership is no longer about ‘taking charge’ or imposing a strategic vision but about creating the platforms that allow others to flourish and

create”

Ashoka, “What does leadership mean in the 21st century?”


http://www.virgin.com/unite/entrepreneurship/what-does-leadership-mean-in-the-21st-century



@HelenBevan

• systematic “change management”

• too often, leaders prescribe outcome and method of change in a top-down way

• change is experienced by people at the front line as “have to” (imposed) rather than “want to” (embraced)

Change Programmes

• everyone with an interest can help tackle the most challenging issues

• value diversity of thought• connect people, ideas and

learning• Role of formal leaders is to

create the conditions and get out of the way

Change Platforms

“Tear down the walls” #Expo15NHS #EdgeTalks @HelenBevan @JodiOlden


“A space (physical or virtual) that is created so people get the choice and opportunity to collaborate without boundaries to achieve a common purpose, tackle a challenge or improve a situationChange platforms tackle silo thinking and other barriers to the exchange of knowledge. They enable a diverse group of people to come to the table, share ideas, insight and learned experience, co-create solutions and launch experiments. Platforms thrive on trust, relationships and the collisions of minds. They build energy for change.

What is a change platform?

Definition by @JodiOlden & @HelenBevan 2015


“Change comes naturally when individuals have a platform that allows them to identify shared interests and to brainstorm solutions.”

Gary Hamel & Michele Zanini, 2014Build a change platform not a change program


http://www.mckinsey.com/insights/organization/build_a_change_platform_not_a_change_program



Evolving kinds of change platforms:

1. Connecting platforms

2. Mobilising platforms

3. Learning platforms

4. Knowledge platforms

5. Crowdsourcing platforms They overlap!



Platform principles have long been part of change practice • Building on traditions in the field of organisation

development of communities of interest and communities of practice

• Technology enables us to connect more widely and at greater speed

Source of image: Socialserviceinstitute.sg


@HelenBevan

Example platforms

Source of image: @JenniferClemo #Expo15NHS #EdgeTalks @HelenBevan @JodiOlden

@HelenBevan #Expo15NHS #EdgeTalks @HelenBevan @JodiOlden

@HelenBevan

https://www.youtube.com/watch?v=CMDKkTuLUHw

http://www.breakdengue.org/






@HelenBevan

www.newhcvoices.co.uk



The Academy of Fabulous NHS Stuff


@HelenBevan

@HelenBevan


A platform for Trust-wide transformationLeeds Teaching Hospitals NHS Trust & Clever Together

WayFinder – a Crowdsourcing methodology and platform • Step 1: 4,500 staff and stakeholders shared 45,000 contributions to

• co-create The Leeds Way – a redefinition of their vision and their values

• co-design a five year strategy – a shared agreement of what needs to happen to achieve their vision

• co-define a new behavioural framework – a new agreement of the acceptable ways in which staff will live their values embedded into recruitment, induction, training and appraisals

• Step 2: WayFinder local – every department trained to use its own crowdsourcing platform • 19 clinical service units trained • A new way of working – online workshops – to ensure staff always

have a say in what’s happening in the Trust, bringing people together to co-create solutions.

Examples of results:• Staff satisfaction is up / buy-in to vision and values at an all time high /

complaints down 17% / 18weeks RTT down by 66% / CQC acknowledgement of staff engagement and impact on quality and safety



@HelenBevan

Carousal: shows all active challenges open for staff participation

Live activity feed

Click here to submit an idea

Gamification


@HelenBevan

• Board sponsorship and buy-in (it helps)• Clearly linked to the organisation’s vision, values and strategy• A culture that promotes open engagement and values staff• A clear process for innovation and quality improvement• “No idea is bad” rule• Demonstrate quick measurable wins • Take the good with the bad (don’t succumb to risk-aversion)• Keep it live and fresh• Build in rewards: say “thank you” and recognise contributions• Informal innovation champions > organisational radicals

What makes a social innovation platform successful?

Source: Jodi Brown


@HelenBevan

http://www.insme.org/files/open-innovation-handbook





@HelenBevan

Knowledge platforms



Because there’s a problem….

Source of quote: Harold JarcheSource of image: http://gotcll.com/about-2/

Gettinginformation off the

internet is like taking a drink from a fire hydrant

Mitchell Kapor


@HelenBevan @HelenBevan #Expo15NHS #EdgeTalks @HelenBevan @JodiOlden


What is the best way to spread new knowledge?

Source of data: Nick Milton (2014), “Why knowledge transfer through discussion is 14 times more effective than writing”

Social connection/discussion is 14 times more effective than written word/best practice databases/toolkits etc.

Source of image: www.happiness-one-quote-time.blogspot.com


http://www.nickmilton.com/2014/10/why-knowledge-transfer-through.html


http://www.happiness-one-quote-time.blogspot.com/

http://www.happiness-one-quote-time.blogspot.com/


Platforms as the new documentation

Source of image: Flickr user acaben


http://www.flickr.com/photos/acaben/11518666

@HelenBevan

If you’re a programmer, you don’t even bother reading the manual, you

simply use stackoverflow to answer all your questions”


Source: Oliver Benson

@HelenBevan

Horizons Team: All our work is via change platforms


@HelenBevan

Source: Bromford P (2015), ”What’s the difference between a test and a pilot?”


http://www.bromfordlab.com/labblog/2015/7/22/tests-vs-pilots?utm_content=bufferc862c&utm_medium=social&utm_source=twitter.com&utm_campaign=buffer



Stephen Downes, 2011Connectivism & Personal Learning


http://www.slideshare.net/Downes/connectivism-and-personal-learning?next_slideshow=1



100,000

2,000

20,00065

348

25,000+

120 14,000

inc


The School is being formally evaluated by the Chartered Institute for Personnel & Development

#EdgeTalks WebEx

Fri 7th Sept, 09.30 BSThttp://theedge.nhsiq.nhs.uk/expert/how-has-the-school-for-health-and-care-radicals-made-a-difference/

Or Google: #EdgeTalks School #Expo15NHS #EdgeTalks @HelenBevan @JodiOlden

How has the School for Health and Care Radicals made a difference?

http://theedge.nhsiq.nhs.uk/expert/how-has-the-school-for-health-and-care-radicals-made-a-difference/





@HelenBevan

As a result of the school, have you…

Shared learning with others in your organisation? 7 6 %

Shared learning with others outside your organisation e.g. social media? 4 4 %

Recommended the Schoolto others? 8 3 %

Become a certifiedchange agent? 4 5 %


As a result of the school has the following improved… Not at

allTo little extent

To some extent

To a great extent

To some or great extent

Sense of purpose and motivation to improve practice 4.5 6.2 37.6 50.6 88.2Knowledge about organisational change 3.4 12.4 48.3 34.3 82.6Ability to challenge 6.2 19.1 48.9 23.6 72.5Ability to inspire and build support for change 6.2 19.1 48.9 23.6 72.5Ability to maintain relationships and keep people onside 4.5 10.7 51.7 29.8 81.5Perseverance and resilience 3.9 21.3 41.6 30.3 71.9Sense of being supported by others 5.1 17.4 38.2 37.1 75.3How often you seek other people’s views on change or the need for change 8.4 16.3 43.8 28.7 72.5Openness to other people’s points of view on change 5.6 20.8 45.5 24.7 70.2Confidence talking about the need for change 5.1 15.2 36.0 41.0 77.0



Activists from 120 countries

500,000+ Twitter impressions@theedgenhs

21,000 active users


We have supported NHS Change Day for three years

• 800,000 pledges in 2014

• 4 X the local activity/connectivity in 2015 compared to 2014

• #nhschangeday: 130m impressions

• Facebook impressions 253,999




The power of th

e platform #MatExp

The power of the platform

#NHSChangeDay + #MatExp


“Top down is a serious disease but it can be treated”

Celine Schillinger

Source of image: Leadershipfreak.wordpress.com


@HelenBevan

The Change Challenge

Tapping the collective brilliance of the NHS



• The biggest-ever digital campaign for EMAP (Health Service Journal and Nursing Times)

• 14,000 contributors to the joint campaign to “challenge top down change”

• Ground-breaking: the first-ever crowd-sourced theory of change in the NHS



• Build bridges between disconnected groups• Activate radicals and engage them in action for

change• Change the story of how we undertake large

scale and transformational change in the NHS• Lead from the edge using new era methodology

Objectives to:



The process:

Step 1 :The build-upSetting the right foundation for campaign launch

Step 2:Launch campaign, explore barriers and enablersWeeks 1-4Launch the campaign for bottom up change and questions to the crowd to develop the barriers and building blocks for change.

Step 3Propose solutions Weeks 5-6Crowd invited to share, build and validate list of potential solutions

Step 4Develop toolkitWeek 7 best ideas selected by crowd and panel selectsWeeks 8-9 crowd develops best ideas into toolsWeeks 9-11 works on key outputs

Step 5:Spread and EmbedWeek 12Publication of interactive guide / ‘new era’ toolkit / manifesto for change / celebrated cases

Development of the process, questions, objectives and communication plan

Questions:-What things block or help you from delivering bottom-up change:· inside your organisation, to improve or transform services, and· across organisations to improve the health and wellbeing of a local population?

Questions:- What solutions work? What approaches have you used or observed that others could learn from and copy? Please share your stories and learning about what did and didn't work. What solutions should we test? What ideas do you have that we could test out? Share ideas (these can be completely new) that you believe could support bottom-up change in the NHS, if we gave them a chance.

47 ideas selected for the crowd to develop. Crowd asked to develop these into workable tools; tangible and practical enough to be used widely across health and care organisations to deliver bottom up change for patients, staff and the public. To do this, please tell us: - what steps need to be taken, - who needs to be involved, and - what commitments…

The HSJ and Nursing Times share outputs :• project overview,• ‘how to’ guides for

application of crowdsourcing

• ‘how to’ toolkit of prioritised ‘hacks’/ solutions

Result: a foundation for a social movement of bottom up change

Project over 12 weeks



Reach and scale:

• 3,595 people involved - from 45 different countries

• 13,895 ideas, comments and votes shared - collectively identifying:

Final outputs were • 10 barriers• 11 building blocks• 16 solutions


@HelenBevan

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


http://www.hsj.co.uk/leadership/change-challenge/

@HelenBevan

14,000 contributions identified 11 building blocks for change:

Inspiring & supportive leadershipCollaborative 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


http://www.hsj.co.uk/leadership/change-challenge/

@HelenBevan

The power of the platform

“...demonstrates, yet again, the collective brilliance of the people who work in the NHS and wider care system”

@HelenBevan



How to create a change platform #1• Be clear about your intention or goal:• Solve a problem?• Learn from others?• Create solutions?• Mobilise for change?• Spread innovation?

• Articulate your mission• Design the stages in your process• Sprints and hacks



How to create a change platform #2• Identify the people you want in your community• Identify how to reach them• Find a platform • Existing or new • Free or paid for• Virtual or face to face

• Measure the outcomes (all the way through)• Engage your community• Set their expectations• Keep the connections flowing• Convert ideas to actions• Always, always follow up


@HelenBevan

Case study: System redesign principles for care models


@HelenBevan

A call to action!“Help us to capture system redesign

principles for care models to get better, quicker outcomes from change”


#CareDesign


Platform methodology for our redesign principlesPre-sprint Sprint 1 Sprint 2 Sprint 3

Expert group sense-check of redesign principles & crowdsourcing process

“Have we got the right redesign principles?”

“Tell us about the redesign principles in action”

“How do we make the redesign principles happen?”

V1.0 of redesign principles paper “Starter-for-ten” shared with expert group of “systems engineers” both from within and outside the NHS

The ten redesign principles will be presented via the crowdsourcing platform to our collaborators (widespread engagement)

Invite practical examples and case studies that demonstrate the refined ten redesign principles working and in action

Invite collaborators to signpost us to tools, methods, resources and methodologies that can help in the implementation of the redesign principles

Output from each sprint becomes a new version of the paper. The socially derived redesign principles are then open for the next sprint and round of crowdsourcing


@HelenBevan @Jodi Olden #EdgeTalks

How you can get involved:

• Look out for our tweets• Email: [email protected] to receive updates

& an invite to join the collaboration platform

mailto:[email protected]

@HelenBevan @HelenBevan #Expo15NHS

● Only 1% participate fully so start with a big crowd● Inject thought diversity to guard against groupthink● Mix high domain knowledge with those with high creativity

Choose the right crowd

Choose the right incentives

● Crowdsourcing cannot happen without a vibrant, committed community ● Rewards must balance intrinsic & extrinsic motivators

Crowds do not replace the team

● You’ll get volume & diversity from the crowd but be prepared to match it with equal time & effort to herd, sift & identify contributions

Crowds needlove too!

● Crowds need direction & guidance to help them feel part of their community & give of their best

Keep itsimple

● Break complex tasks down● Tasks must be small, simple & fun & fit into your crowd’s spare time

Remember Sturgeon’s Law

Communities are always right!

Fulfilling self-actualisation

● “90% of everything is crap / 10% of everything is not crap”● Allow the crowd to surface its best through voting to the top

● Crowdsourcing works because creativity, spontaneity, problem-solving & affiliation achieve self-actualisation (Maslow / Howe)

● Top-down management style does not work in crowds, nor does grass-roots anarchy● Lead with the moral authority the crowd allows

Adapted by @JodiOlden from:A Guide to Open Innovation and Crowdsourcing, Ed. Paul Sloane

The rules of crowdsourcing

http://www.simplypsychology.org/maslow.html

http://web.mit.edu/evhippel/www/books/DI/DemocInn.pdf

http://www.amazon.co.uk/Guide-Open-Innovation-Crowdsourcing-Leading/dp/0749463074




@HelenBevan

”If people give to a cause, they expect a relationship,

not a transaction”Nilofer Merchant

Once you start down this path, you have to follow up and continue


@HelenBevan

Platforms are only as good as the people leading them

Source of image: www.activationjourney.com


http://www.activationjourney.com/

@HelenBevan @Jodi Olden #EdgeTalks

Four ways to connect!1. Follow us on Twitter

@HelenBevan @JodiOlden@TheEdgeNHS @School4Radicals

2. Subscribe to theedge.nhsiq.nhs.uk

3. Get materials from theedge.nhsiq.nhs.uk/school

…and sign up for our monthly #EdgeTalkstheedge.nhsiq.nhs.uk/edgetalks

4. Save the date for theedge.nhsiq.nhs.uk/transformathon

http://theedge.nhsiq.nhs.uk/

http://www.theedge.nhsiq.nhs.uk/school

http://theedge.nhsiq.nhs.uk/edgetalks/

http://theedge.nhsiq.nhs.uk/transformathon/

http://www.theedge.nhsiq.nhs.uk/school

@HelenBevan @Jodi Olden #EdgeTalks #Expo15NHS #EdgeTalks @HelenBevan @JodiOlden

4pm - 4pm, 27-28th January 2016


Ashoka (2014) What does leadership mean in the 21st century?Berg O (2014) The Collaboration Pyramid revisitedBriggs D (2015) The elements of council as a platformBromford P (2015) What’s the difference between a test and a pilot?Dawson R (2015) The future of work and organisations Deloitte University Press (2015) Business ecosystems come of ageDeloitte University Press (2014) The power of platformsHagel J (2015) John Hagel at SXSW 2015: Narratives, platforms and movementsHagel J (2014) Platforms are not created equal: harnessing the full potential of platformsHamel G, Zanini J (2014) Build a change platform not a change programHealth Services Journal, Nursing Times, NHS Improving Quality (2015) ‘Change Challenge’ interactive toolkitHeimans J (2014) What new power looks like [YouTube]Heimens J, Timms J (2014) Understanding “New Power”Innovations- Kontor Väst (2013) Open innovation – a handbook for Researchers Ivanov E (2013) The Strength Within

References cited in the slide deck (1/2)








http://davebriggs.io/2015/06/18/the-elements-of-council-as-a-platform/



http://t.co/qPjnafNOs9

http://d2mtr37y39tpbu.cloudfront.net/wp-content/uploads/2015/04/DUP_1048-Business-ecosystems-come-of-age_MASTER_FINAL.pdf

http://dupress.com/articles/platform-strategy-new-level-business-trends/

http://www2.deloitte.com/us/en/pages/center-for-the-edge/articles/john-hagel-at-sxsw.html

http://edgeperspectives.typepad.com/edge_perspectives/2014/08/platforms-are-not-created-equal-harnessing-the-full-potential-of-platforms.html


http://m.hsj.co.uk/5083743.article




http://connect.forwardmetrics.com/business-management/the-strength-within.html


Jarche H (2014) The Seek > Sense > Share Framework Milton N (2014) Why knowledge transfer through discussion is 14 times more effective than writingO’Reilly T (2010) Government as a platformPearce D (2013) Social business discussions are the new documentationRaymond E S (2001) The Cathedral and the BazaarSatell G (2015) 4 things you should know about platformsSatell G (2012) How power is shifting from corporations to platformsSatell G (2015) Leaders must do more than inspire – we must shape networksSchillinger C (2015) Forget social networks, think social impact [YouTube]Scrivens J (2015) Enabling the experience of wholeness within enterprise social networksSewell S (2015) Stop training our project managers to be process junkiesShaw K (2015) Placing a digital platform at the heart of organisational change with OxfamSimon P (2011) The Age of the Platform

References cited in the slide deck (2/2)


http://jarche.com/2014/02/the-seek-sense-share-framework/


http://chimera.labs.oreilly.com/books/1234000000774/ch02.html#government_as_a_platform

http://www.informationweek.com/software/social/social-business-discussions-are-the-new-documentation/d/d-id/898942


http://www.digitaltonto.com/2015/4-things-you-should-know-about-platforms/?ct=t(Why_Some_Movements_Succeed_5_31_2015)

http://www.digitaltonto.com/2015/how-power-is-shifting-from-corporations-to-platforms/

http://www.digitaltonto.com/2015/how-power-is-shifting-from-corporations-to-platforms/

http://www.digitaltonto.com/2015/leaders-must-do-more-than-inspire-we-must-shape-networks/?utm_source=Digital%20Tonto%20Newsletter&utm_campaign=5accd611d0-Leaders_Must_Shape_Networks7_5_2015&utm_medium=email&utm_term=0_3e316dce02-5accd611d0-389205725&ct=t(Leaders_Must_Shape_Networks7_5_2015)


http://www.kinshipenterprise.com/_blog/Blog/post/Experience-Wholeness-Enterprise-Social-Networks-esn/#.VZP7VBtVikr

http://acceleratingchangeprogrammes.com/2015/06/09/stop-training-our-project-managers-to-be-process-junkies/

http://www.codecomputerlove.com/blog/2015/07/placing-a-digital-platform-at-the-heart-of-organisational-change-with-oxfam/

http://www.philsimon.com/books/the-age-of-the-platform/

http://www.philsimon.com/books/the-age-of-the-platform/

Healthcare

How change platforms can help transform the NHS