Rocking the boat and staying in it - Helen Bevan

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    18-Oct-2014

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Helen Bevan explains the concept of 'boat rockers' - one of the core principles at the heart of NHS Change Day

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@helenbevan Rocking the boat and staying in it: respiratory leader as organisa3onal radical Helen Bevan Delivery team NHS Improving Quality @helenbevan @NHSIQ @helenbevan @helenbevan How does it feel to be a here0c/radical/rebel/maverick in our organisa0on? @helenbevan @helenbevan What happens to here0cs/radicals/rebels/mavericks in organisa0ons? @helenbevan @helenbevan Are you a boat rocker? One who challenges the status quo when they see that there could be a be@er way Energise their organisa0on by working from their true self Capable of working with others to create success NOT a destruc0ve troublemaker Walk the ne line between dierence and t, inside and outside, rock the boat but manage to stay in it @helenbevan Troublemaker Radical Complain Create Me-focused Mission-focused Anger Passion Pessimist Op0mist Energy-sapping Energy-genera0ng Alienate A@ract Problems Possibili0es Alone Together Source : Lois Kelly www.foghound.com Some3mes people see us radicals as troublemakers @helenbevan Task Talk to others at your table about your experiences around rebels and troublemakers Which have you been and why? What moves people from being good to bad? How do we protect against this? @helenbevan First they ignore you, then they laugh at you, then they ght you, then you win Gandhi @helenbevan Valuing radicals New truths begin as heresies (Huxley, defending Darwins theory of natural selec0on) big things only happen in organisa0ons because of here0cs and radicals @helenbevan @helenbevan Source: Foghound @helenbevan Four tac3cs for organisa3onal radicals 1. Start with myself 2. Build alliances 3. Work out what might help others to change 4. Don't be a martyr @helenbevan Four tac3cs for organisa3onal radicals 1. Start with myself 2. Build alliances 3. Work out what might help others to change 4. Don't be a martyr @helenbevan There is nothing more dicult to carry out, nor more doub9ul of success, nor more dangerous to handle, than to ini;ate a new order of things. For the reformer has enemies in all those who prot by the old order, and only lukewarm defenders in all those who prot by the new Niccolo Machiavelli 15th century @helenbevan "Theres only one corner of the universe you can be certain of improving, and thats your own self." Aldous Huxley @helenbevan @helenbevan What are the risks for a boat rocker? 1. Our experiences of being dierent can be fundamentally disempowering. This can lead us to conform because we see no other choice @helenbevan What are the risks for a boat rocker? 1. Our experiences of being dierent can be fundamentally disempowering. This can lead us to conform because we see no other choice we surrender a part of ourselves, and silence our commitment, in order to survive @helenbevan Source: Foghound @helenbevan @helenbevan What are the risks for a boat rocker? 1. Our experiences of being dierent can be fundamentally disempowering. This can lead us to conform because we see no other choice we surrender a part of ourselves, and silence our commitment, in order to survive 2. leave the organisa0on @helenbevan What are the risks for a boat rocker? 1. Our experiences of being dierent can be fundamentally disempowering. This can lead us to conform because we see no other choice we surrender a part of ourselves, and silence our commitment, in order to survive 2. leave the organisa0on we cannot nd a way to be true to our values and commitments and s0ll survive @helenbevan What are the risks for a boat rocker? 1. Our experiences of being dierent can be fundamentally disempowering. This can lead us to conform because we see no other choice we surrender a part of ourselves, and silence our commitment, in order to survive 2. leave the organisa0on we cannot nd a way to be true to our values and commitments and s0ll survive 3. stridently challenge the status quo in a manner which is increasingly radical and self-defea0ng @helenbevan What are the risks for a boat rocker? 1. Our experiences of being dierent can be fundamentally disempowering. This can lead us to conform because we see no other choice we surrender a part of ourselves, and silence our commitment, in order to survive 2. leave the organisa0on we cannot nd a way to be true to our values and commitments and s0ll survive 3. stridently challenge the status quo in a manner which is increasingly radical and self-defea0ng this just conrms what we already know that we dont belong @helenbevan 1. convic0ons and values driven 2. strong sense of self-ecacy belief that I am personally able to create change belief in others 3. ac0on orientated ignite collec0ve ac0on mobilising others, inspiring change 4. able to join forces with others work as a collec0ve body for commonly valued changes 5. able to achieve small wins which create a sense of hope, self-ecacy and condence 6. op0mis0c in the face of challenge see opportuni0es take account of obstacles What do we know about successful boat rockers? @helenbevan Three assump3ons for organisa3onal radicals 1. Assume that everyone has a noble inten0on 2. Mo0va0on and behaviour in a change process are due to interpersonal interac;on (not just innate character trait) 3. My role as a change agent is about alignment, not judgement @helenbevan Four tac3cs for organisa3onal radicals 1. Start with myself 2. Build alliances 3. Work out what might help others to change 4. Don't be a martyr @helenbevan The easiest way to thrive as an outlier ...is to avoid being one Seth Goodin @helenbevan if you want to go fast, go alone. If you want to go far, go together African proverb quoted by Al Gore @helenbevan Framing Is the process by which leaders construct, ar3culate and put across their message in a powerful and compelling way in order to win people to their cause and call them to ac3on Snow D A and Benford R D (1992) @helenbevan What do we need to do? 1. Tell a story @helenbevan What do we need to do? 1. Tell a story 2. Make it personal @helenbevan What do we need to do? 1. Tell a story 2. Make it personal 3. Be authen0c @helenbevan What do we need to do? 1. Tell a story 2. Make it personal 3. Be authen0c 4. Create a sense of us (and be clear who the us is) @helenbevan What do we need to do? 1. Tell a story 2. Make it personal 3. Be authen0c 4. Create a sense of us (and be clear who the us is) 5. Build in a call for urgent ac0on @helenbevan @helenbevan @helenbevan @helenbevan @helenbevan Four tac3cs for organisa3onal radicals 1. Start with myself 2. Build alliances 3. Work out what might help others to change 4. Don't be a martyr @helenbevan @helenbevan Stages of change Transtheore0cal model of behaviour change Prochaska, DiClemente & Norcross (1992) @helenbevan The model is mostly used around health-related behaviours smoking cessa0on exercise adop0on alcohol and drug use weight control fruit and vegetable intake domes0c violence HIV preven0on use of sunscreens to prevent skin cancer medica0on compliance mammography screening @helenbevan The model is mostly used around health-related behaviours smoking cessa0on exercise adop0on alcohol and drug use weight control fruit and vegetable intake domes0c violence HIV preven0on use of sunscreens to prevent skin cancer medica0on compliance mammography screening It works for organisa3onal and service change too! @helenbevan Stages of change Smoking Prochaska, DiClemente & Norcross (1992) I am not aware my smoking is a problem I have no inten0on to quit @helenbevan Stages of change Smoking Prochaska, DiClemente & Norcross (1992) I am not aware my smoking is a problem I have no inten0on to quit I know my smoking is a problem I want to stop but no plans yet @helenbevan Stages of change Smoking Prochaska, DiClemente & Norcross (1992) I am not aware my smoking is a problem I have no inten0on to quit I know my smoking is a problem I want to stop but no plans yet I am making plans & changing things I do in prepara0on. @helenbevan Stages of change Smoking Prochaska, DiClemente & Norcross (1992) I am not aware my smoking is a problem I have no inten0on to quit I know my smoking is a problem I want to stop but no plans yet I am making plans & changing things I do in prepara0on. I have stopped smoking! @helenbevan Stages of change Smoking Prochaska, DiClemente & Norcross (1992) I am not aware my smoking is a problem I have no inten0on to quit I know my smoking is a problem I want to stop but no plans yet I am making plans & changing things I do in prepara0on. I have stopped smoking! I am con0nuing to not smoke. I some0mes miss it but I am s0ll not smoking @helenbevan Stages of change Smoking Prochaska, DiClemente & Norcross (1992) I am not aware my smoking is a problem I have no inten0on to quit I know my smoking is a problem I want to stop but no plans yet I am making plans & changing things I do in prepara0on. I have stopped smoking! I am con0nuing to not smoke. I some0mes miss it but I am s0ll not smoking @helenbevan Stages of change Transtheore0cal model of behaviour change Prochaska, DiClemente & Norcross (1992) @helenbevan 90% of the tools available for healthcare change agents are designed for the ac3on stage The reality of our change situa3on Our tools are oken not eec0ve at the stage of change that most people we work with are at Its hard to engage people in change Its hard to get people to make the changes we want them to make People get irritated, defensive, irra0onal We feel powerless in our ability to lead or facilitate the change @helenbevan Example - Surgical Checklist Designed for Stage 4 ACTION! Mandated it through targets Despite compelling case for change people resisted it no values connec0on People did the task and missed the point @helenbevan One key issue is that many doctors already feel that they are delivering pa;ent centred care unfortunately that is not what pa;ents report. Dr Nigel Mathers, Vice Chair, Royal College of General Prac0ce @helenbevan So what do we TEND to do? Lower our ambi0ons for improvement Focus our energies on those who are already in the ac0on stage Put nega0ve labels on those who are not yet at the ac0on stage such as blocker or resister or laggard Blame the leadership for not enforcing change Overes0mate the mo0va0on of those who say theyre ready to change and underes0mate the mo0va0on of those who indicate no interest in change (Lundberg) @helenbevan So what SHOULD we do Listen and understand appreciate the star0ng point elaborate interests Build meaning and convic0on in the change Roll with resistance (Singh) Dont argue against it Encourage elabora0on of resistance What makes it so hard? What would help? Build shared purpose @helenbevan OutwiPed He drew a circle that shut me out - Here0c, rebel, a thing to out. But Love and I had the wit to win: We drew a circle that took him in. Edward Markham @helenbevan Discussion What might you do to: enhance your own role as a respiratory maverick, radical or here0c? Support other mavericks, radicals or rebels in your organisa0on or system? @helenbevan ....the last era of management was about how much performance we could extract from people .....the next is all about how much humanity we can inspire Dov Seidman @helenbevan We have a choice This is the true joy of life, the being used up for a purpose recognised by yourself as a mighty one, being a force of nature instead of a feverish, selsh li@le clot of ailments and grievances, complaining that the world will not devote itself to making you happy George Bernard Shaw

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