if "action on accident & emergency" was a social movemt
Post on 21-Apr-2017
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@HelenBevan @ActiononAandE #ActiononA&E
If Action on A&E was a social movement…..
Helen Bevan@HelenBevan
@ActiononAandE#ActiononA&E
@HelenBevan @ActiononAandE #ActiononA&E
“When we talk of social change, we talk of movements, a word that suggest vast
groups of people walking together, leaving behind one way and travelling towards
another”Rebecca Solnit
@HelenBevan @ActiononAandE #ActiononA&E
What do successful social movements do?
• Define the change they want to see• Identify the pillars of power• Create a spectrum of allies• Seek to attract not overpower• Build a plan to survive victory
Source: Satell G (2017) How to create transformational change, according to the world’s most successful social movements
@HelenBevan @ActiononAandE #ActiononA&E
If we want people to take action, we have to connect with their emotions through values
action
values
emotion
Source: Marshall Ganz
@HelenBevan @ActiononAandE #ActiononA&E
“I have some A&E Performance
Indicatorsfor you”
or
“I have a dream”
Source: @RobertVarnam
@HelenBevan @ActiononAandE #ActiononA&E
“We must act with all due alacrity [speed/swiftness], yet also with the thoughtfulness
and seriousness of purpose appropriate to meaningful action”
Dr Martin Luther King Jr.
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”
@HelenBevan @ActiononAandE #ActiononA&E
Front line teams get inundated with high priority messages from leaders each day, making it difficult for them to know what to focus on
Increasing number of messages as information cascade through
the organisation
Source: adapted from http://businessjournal.gallup.com/content/162707/change-initiatives-fail-don.aspx
@HelenBevan @ActiononAandE #ActiononA&E
Front line teams get inundated with high priority messages from leaders each day, making it difficult for them to know what to focus on
Increasing number of messages as information cascade through
the organisation
Don’t overload front line staff with strategies if you want improvements
in quality and safety http://healthaffairs.org/blog/2014/03/07/the-dangers-of-quality-improvement-overload-insights-from-the-field
/
@HelenBevan @ActiononAandE #ActiononA&E
Identify the pillars of power
@HelenBevan @ActiononAandE #ActiononA&E Jeremy Heimens, Henry Timms
This is New Power
old power new power
Currency
Held by a few
Pushed down
Commanded
Closed
Transaction
Current
Made by many
Pulled in
Shared
Open
Relationship
@HelenBevan @ActiononAandE #ActiononA&E
The Network Secrets of Great Change AgentsJulie Battilana &Tiziana Casciaro
As a change agent, my centrality in the informal network is more important
than my position in the formal hierarchy
@HelenBevan @ActiononAandE #ActiononA&E
People who are highly connected have twice as much power to
influence change as people with hierarchical power
Leandro Herrerohttp://t.co/Du6zCbrDBC
@HelenBevan @ActiononAandE #ActiononA&E
Create a spectrum of allies
Source of image: Greg Satell
@HelenBevan @ActiononAandE #ActiononA&E
WHO will make the change happen?
List A• The A&E Delivery Board• The programme sponsors• The Programme
Management Office• The Delivery Board work
streams • The Clinical Leads • The Directors of
participating organisations• The Change Facilitators
Source: adapted by Helen Bevan from Leandro Herrera
@HelenBevan @ActiononAandE #ActiononA&E
WHO will make the change happen?
List A• The A&E Delivery Board• The programme sponsors• The Programme
Management Office• The Delivery Board work
streams • The Clinical Leads • The Directors of
participating organisations• The Change Facilitators
List B• The mavericks and rebels• The deviants (positive). Who do
things differently and succeed• The nonconformists who see
things through glasses no one else has
• The hyper-connected who spread behaviours, role model at a scale, set mountains on fire and multiply anything they get their hands on
• The hyper-trusted. Multiple reasons, doesn’t matter which ones
Source: adapted by Helen Bevan from Leandro Herrera
@HelenBevan @ActiononAandE #ActiononA&E
WHO will make the change happen?
List A• The A&E Delivery Board• The programme sponsors• The Programme
Management Office• The Delivery Board work
streams • The Clinical Leads • The Directors of
participating organisations• The Change Facilitators
List B• The mavericks and rebels• The deviants (positive). Who do
things differently and succeed• The nonconformists who see
things through glasses no one else has
• The hyper-connected who spread behaviours, role model at a scale, set mountains on fire and multiply anything they get their hands on
• The hyper-trusted. Multiple reasons, doesn’t matter which ones
Source: adapted by Helen Bevan from Leandro Herrera
People who live and
perform in formal
organisation land and
people with the power
to make or break
change are two
different lists
(and we need BOTH)
@HelenBevan @ActiononAandE #ActiononA&E
What’s the evidence?The failure of large scale
transformational change projects is rarely due to the content or
structure of the plans that are put into action
http://iedp.com/articles/vertical-leadership/?utm_source=Sign-Up.to&utm_medium=email&utm_campaign=13787-257163-Campaign+-+01%2F09%2F2016
Source: David Dinwoodie (2015)
It’s much more about the role of informal networks in
the organisations and systems affected by change
To make large scale change happen we should connect
networks of people who ‘want’ to contribute
@HelenBevan @ActiononAandE #ActiononA&E
Mark Jaben on the science behind resistance
What NOT to do
But what we do do Instead of buyers (who “buy-in”), we need investors
What TO do
Engage people here
Engage people here
@HelenBevan @ActiononAandE #ActiononA&E
Seek to attract not overpower
@HelenBevan @ActiononAandE #ActiononA&E
Two kinds of people at work
• Feel connected to a higher purpose
• Controlled & coordinated through shared goals & values
• Collaborate• Embrace change• Work to who they are
The contributors The compliant
• Feel disconnected from purpose• Controlled & coordinated
through performance management & standardised procedures
• Hold back• Resist change• Work to a role specification
Adapted from The Emotional Economy http://emotionaleconomy.com.au/papers-articles/why-the-winners-in-business-are-taking-the-time-to-build-a-positive-kind-social-culture/
@HelenBevan @ActiononAandE #ActiononA&E
Two kinds of people at work
• Feel connected to a higher purpose
• Controlled & coordinated through shared goals & values
• Collaborate• Embrace change• Work to who they are
The contributors The compliant
• Feel disconnected from purpose• Controlled & coordinated
through performance management & standardised procedures
• Hold back• Resist change• Work to a role specification
Gallup global research:• Only 13% of the workforce are
engaged (contributors)• Contributors create six times the
value to an organisation compared to the compliant
http://www.gallup.com/poll/165269/worldwide-employees-engaged-work.aspx
@HelenBevan @ActiononAandE #ActiononA&E
As leaders, we are “signal generators”“As a leader, think of yourself as a “signal generator”
whose words and actions are constantly being scrutinised and interpreted, especially by those below you” [in the hierarchy]…..
Charles O’Reilly, Leaders in Difficult Times
Source of image: vintage-radio.com
What leaders pay attention to matters to staff, and consequently staff pay attention to that too
@HelenBevan @ActiononAandE #ActiononA&E
Shared purpose
Owned by everyone who has a stake in the
change and improvement we are
seeking to create
OURSHAREDPURPOSE
At the end of the day, it is about looking after
people in the way they want to be
looked afterDirector of Urgent
Care
@HelenBevan @ActiononAandE #ActiononA&E
Shared purpose or “de facto” purpose?
• hitting the four hour target
• freeing up bed capacity• managing demand• reducing costs• completing activities
within a timescale• complying with regulators
PURPOSE
Owned by everyone who has a stake in the
change and improvement we are
seeking to create
OURSHAREDPURPOSE
@HelenBevan @ActiononAandE #ActiononA&E
Shared purpose or “de facto” purpose?
• hitting the four hour target• freeing up bed capacity• managing demand• reducing costs• completing activities within a
timescale• complying with regulators
Source: Delivering Public Services That Work: The Vanguard Method in the Public Sector
If purpose isn’t explicit and shared, then it is very easy for something else to become a de facto purpose in the minds of the workforce
PURPOSE
Owned by everyone who has a stake in the
change and improvement we are
seeking to create
OURSHAREDPURPOSE
@HelenBevan @ActiononAandE #ActiononA&E
Change is not the goal; the goal is the goal
Peter Fuda
Source of image: timemanagementninja.com
@HelenBevan @ActiononAandE #ActiononA&E
New Public Passion:
a growing global
movement
@HelenBevan @ActiononAandE #ActiononA&E
• Did we accomplish the goal we were trying to accomplish?
• Did our community grow stronger? (create capacity; new power – power we didn’t have before)
• Did individuals involved in the whole effort learn, grow and develop their capacity to organise with others?
How would we know if Action on A&E was successful from a social movement perspective?
@HelenBevan @ActiononAandE #ActiononA&E
After years of intensive analysis, Google discovered that the key to high
performing teams that deliver change is being nice
Project Aristotle: https://www.youtube.com/watch?v=UfGiCnhdU78&feature=youtu.be&list=PLHEw3ja-xoaZybvz9f0b1_6bJyG7zZO6L
@HelenBevan @ActiononAandE #ActiononA&E
• Steve Christian, Action on A&E• Sasha Karakusevic, Horizons team• Kathryn Perera, Horizons team• Simon Sethi, Yeovil District Hospital NHS
Foundation • Debbie Sorkin, The Leadership Centre
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