Rocking the Boat and Staying in It

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<p>IHI National Forum on Quality and Safety Minicourse M10: How to Be a Great Change Agent Monday 9th December Crystal Ballroom, Salon D Helen Bevan Robert Varnam Andrew Hasler</p> <p>How to be a great change agent</p> <p> Helen BevanChief Transformation Officer@HelenBevan#SHCR#CANsurgery</p> <p>and staying in it:</p> <p>New truths begin as heresies (Huxley, defending Darwins theory of natural selection)Source of image: installation by the artist Adam </p> <p>Via @NeilPerkinStarts on the fringe (at the edge)Starts with the activistsGary Hamel</p> <p>always@HelenBevan #SCHR #CANsurgery</p> <p>SEISMIC SHIFTS@HelenBevan #SCHR #CANsurgery</p> <p>DIGITALCONNECTIONSEISMIC SHIFTS@HelenBevan #SCHR #CANsurgery</p> <p>Work complexitySEISMIC SHIFTS@HelenBevan #SCHR #CANsurgery</p> <p>DIGITALCONNECTIONSEISMIC SHIFTS</p> <p>Hierarchical power</p> <p>Work complexity@HelenBevan #SCHR #CANsurgery</p> <p>DIGITALCONNECTIONSEISMIC SHIFTS</p> <p>Hierarchical power</p> <p>Work complexity</p> <p>Change from the edge@HelenBevan #SCHR #CANsurgeryLeading change in a new era</p> <p>Dominant approachEmerging direction</p> <p>@HelenBevan #SCHR #CANsurgeryLeading change in a new era</p> <p>Dominant approachEmerging direction</p> <p>Most health and care transformation efforts are driven from this side@HelenBevan #SCHR #CANsurgery</p> <p>John Kotter, the most influential thought leader globally, recognises new approaches are needed </p> <p>FROM@HelenBevan #SCHR #CANsurgeryJohn Kotter: Accelerate! We wont create big change through hierarchy on its ownWe need hierarchy AND networkMany change agents, not just a few, with many acts of leadershipAt least 50% buy-in requiredChanging our mindsetFrom have to to want to</p> <p>TO@HelenBevan #SCHR #CANsurgeryFrom have to to want toSource of image</p> <p>@HelenBevan #SCHR #CANsurgeryThe Network Secrets of Great Change AgentsJulie Battilana &amp;Tiziana Casciaro</p> <p>As a change agent, my centrality in the informal network is more important than my position in the formal hierarchyIf 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</p> <p> is the new normal!</p> <p>By questioning existing ideas, by opening new fields for action, change agents actually help organisations survive and adapt to the 21stCentury. Cline Schillinger</p> <p>Image by #SCHR #CANsurgeryWhat happens to heretics/radicals/rebels/mavericks in organisations?</p> <p>Source of image: #SCHR #CANsurgery</p> <p>@HelenBevan #SCHR #CANsurgeryOstracism is experienced in the brain as deeply as physical pain</p> <p>@HelenBevan #SCHR #CANsurgeryWhat is a rebel?</p> <p>The principal champion of a change initiative, cause or actionRebels dont wait for permission to lead, innovate, strategiseThey are responsible; they do what is rightThey name things that others dont see yetThey point to new horizonsWithout rebels, the storyline never changes</p> <p>Source : @PeterVan @HelenBevan #SCHR #CANsurgeryWe need boatrockers!Rock the boat but manage to stay in itWalk the fine line between difference and fit, inside and outsideAble to challenge the status quo when we see that there could be a better wayConform AND rebelCapable of working with others to create success NOT a destructive troublemakerSource: Debra Meyerson</p> <p>@HelenBevan #SCHR #CANsurgery</p> <p>Source : Lois Kelly</p> <p>Theres a big difference between a rebel and a troublemakerRebel</p> <p>ReflectionWhat are your insights around rebels and troublemakers?What moves people from being rebel to troublemaker?How do we protect against this?@HelenBevan #SCHR #CANsurgery</p> <p>Source : Lois Kelly</p> <p>Theres a big difference between a rebel and a troublemakerRebel"Theres only one corner of the universe you can be certain of improving, and thats your own self." Aldous Huxley</p> <p>Source of image: able to join forces with others to create actionable to achieve small wins which create a sense of hope, possibility and confidenceMore likely to view obstacles as challenges to overcomestrong sense of self-efficacybelief that I am personally able to create the change</p> <p>Four things we know about successful boat rockersSource: adapted from Debra E MeyersonCHANGEmeBEGINS WITH@HelenBevan #SCHR #CANsurgerySelf-efficacyIf you think you can or think you can't, you are right.Henry FordThe ability to act is tied to a belief that it is possible to do soAlbert Bandura</p> <p>There is a positive, significant relationship between the self-efficacy beliefs of a change agent and her/his ability to facilitate change and get good outcomesSource of #SCHR #CANsurgery</p> <p>Source: @NHSChangeDay@HelenBevan #SCHR #CANsurgery</p> <p>Source: @NHSChangeDayWhat is the issue here?permission ? (externally generated)orSelf efficacy ? (internally generated)@HelenBevan #SCHR #CANsurgeryWhats the difference between</p> <p>self efficacyandself esteem,self belief,self-confidence?@HelenBevan #SCHR #CANsurgeryBuilding self-efficacy: some tactics1. Create change one small step at a timeReframe your thinking:failed attempts are learning opportunitiesuncertainty becomes curiousityMake change routine rather than an exceptional activity4. Get social support5. Learn from the best</p> <p>@HelenBevan #SCHR #CANsurgery</p> <p>Image copyright: #SCHR #CANsurgery</p> <p>Source: @HelenBevan #SCHR #CANsurgery</p> <p>Source: @HelenBevan #SCHR #CANsurgery</p> <p>Source: @HelenBevan #SCHR #CANsurgery</p> <p>Source: @HelenBevan #SCHR #CANsurgery</p> <p>Source: Make it a personal PERFORMANCE target.@HelenBevan #SCHR #CANsurgery</p> <p>Source: @HelenBevan #SCHR #CANsurgeryResearch from the Sales industry:How many NOs should we be seeking to get?</p> <p>2% of sales are made on the first contact3% of sales are made on the second contact5% of sales are made on the third contact10% of sales are made on the fourth contact80% of sales are made on the fifth to twelfth contact</p> <p>Source: @HelenBevan #SCHR #CANsurgeryPapers that are more likely to contend against the status quo are more likely to find an opponent in the review systemand thus be rejected but those papers are also more likely to have an impact on people across the system, earning them more citations when finally publishedV. Calcagno et al., Flows of research manuscripts among scientific journals reveal hidden submission patterns, Science, doi:10.1126/science.1227833, 2012.</p> <p>@HelenBevan #SCHR #CANsurgery</p> <p>A disruptive case study: </p> <p> Probably the biggest day of collective action for improvement in the history of the NHS</p> <p>Creating a mass movement of people working together in and with the NHS demonstrating the difference they can make, by one simple act for sustainable improvement@HelenBevan #SCHR #CANsurgeryAnyone can make a change to improve health and care.</p> <p>NHS Change Day supports these people by celebrating and sharing their actions, so that they can then inspire others.</p> <p>Change Day supports innovative campaigns and ideas by building connections and communities of support.</p> <p>On Wednesday 11 March well celebrate these changes for the better on NHS Change Day. </p> <p>How does it work?</p> <p>@HelenBevan #SCHR #CANsurgery</p> <p> Module 1: Being a health and care radical: Change starts with me</p> <p>Supported by</p> <p>@HelenBevan #SCHR #CANsurgery</p> <p>Many people have shared their stories to inspire others#100daysofchange@HelenBevan #SCHR #CANsurgery</p> <p>Many people have shared their stories to inspire others.The childrens asthma service in Heywood, Middleton and Rochdale, which is part of Pennine Care NHS Foundation Trust, consists of two Paediatric Asthma Nurse Specialists who work within a Childrens Community Team.</p> <p>They started a Facebook page to deliver asthma advice and gentle reminders for young people and their parents.</p> <p> </p> <p>@HelenBevan #SCHR #CANsurgery</p> <p>Doctors and nurses who work with older people at University Hospital Leicester wore continence pads for a day to see how it feels for their patients. </p> <p>They wore the pad for eleven hours and along with the continence specialist nurses did use it to know exactly how their patients feel. </p> <p>Continence pads for a day @HelenBevan #SCHR #CANsurgery</p> <p>In 2014, Countess of Chester Hospital decided to make a very simple change in its paint work to become Dementia friendly, after advice from their painter and decorator Rob McWhinnie.</p> <p>It costs no more to paint in dementia friendly colours. Rob McWhinnie told us At the end of the day, it doesnt matter what colour I use to paint with, the price is still the same.</p> <p> </p> <p>Dementia-friendly paint @HelenBevan #SCHR #CANsurgeryTomorrows management systems will need to value diversity, dissent and divergence as highly as conformance, consensus and cohesion.Gary Hamel</p> <p>Source of image: #SCHR #CANsurgery</p> <p>@HelenBevan #SCHR #CANsurgeryAs you create your roadmap for the future, make sure you are part of the steamroller, not part of the roadSaavik Wilcox-HamiltonSource of quote: </p> <p>@HelenBevan #SCHR #CANsurgeryFollow on Twitter @HelenBevan @NHSIQ</p> <p>Subscribe to </p> <p>Register for The School for Health and Care Radicals:</p> <p>Stay tuned for a forthcoming announcement about Change Day in BC (its a secret) #ChangeDayBC</p> <p> Four ways to connect!@School4Radicals@TheEdgeNHS</p> <p>@HelenBevan #SCHR #CANsurgeryReferences and linksBaron A (2014) Preparing for a changing world: the power of relationships Battilano J, Casciaro T (2013) The network secrets of the great change agents Harvard Business Review, July-August Bevan H, Plsek P, Winstanley (2011) Leading Large Scale Change - Part 1, A Practical Guide Bevan H (2011) Leading Large Scale Change - Part 2, The Postscript Bevan H, Fairman S (2014) The new era of thinking and practice in change and transformation, NHS Improving Quality Change Agents Worldwide (2013) Moving forward with social collaboration SlideShareDiaz-Uda A, Medina C, Schill E (2013) Diversitys new frontierFuda P (2012) 15 qualities of a transformational change agentGrant, M (2014) Humanize: How people centric organisations succeed in a social world Hamel G (2014)Why bureaucracy must dieJarche, H (2013) Rebels on the edges</p> <p>@HelenBevan #SCHR #CANsurgeryJarche H (2014) Moving to the edgesKotter J (2014) Accelerate! Harvard Business Review PressMerchant N (2013) eleven rules for creating value in the social era Llopis G (2014) Every leader must be a change agent or face extinctionMeyerson D (2001) Tempered Radicals: how people use differences to inspire change at work Harvard Meyerson D (2008) Rocking the boat: how to effect change without making trouble Harvard BPPerkins N (2014) Bats and pizzas (agility and organisational change) Schillinger C (2014) Top-Down is a Serious Disease. But It Can Be Treated School for health and Care radicals (2014) C (2014) New Mindsets for the Workplace Web Stoddard J (2014)The future of leadershipWilliams B (2014) Working Out Loud: When You Do That I Do This Weber Shandwick (2014) Employees rising: seizing the opportunity in employee activismVerjans S (2013) How social media changes the way we work together</p> <p>References and links@HelenBevan #SCHR #CANsurgery</p>


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