module 5: moving beyond the edgetheedge.nhsiq.nhs.uk/wp-content/uploads/2015/11/mod… · ·...
TRANSCRIPT
#SHCR @school4radicals
http://www.theedge.nhsiq.nhs.uk/school/
Module 5:
Moving beyond the edge
Supported by
#SHCR @school4radicals #SHCR @School4Radicals
Joining in today and beyond • Please use the chat box to contribute continuously during the
web seminar
• Please tweet using hashtag #SHCR and the handle @School4Radicals
• Join our Facebook group School for Health and Care Radicals
• We will produce summaries of the discussions on each module using Storify and Pinterest and put on the website
• Join in the Tweetchat next Wednesday at 4-5pm (GMT) using the hashtag #SHCR
#SHCR @school4radicals #SHCR @School4Radicals
• Review of what we have learnt so far
• characteristics of a transformational change agent
• “From” the edge – views about the emerging directions for change and change agents
• Opportunities for health and care radicals
• Reflections and key messages about The School
• What next for The School?
• Questions and call to action
Source of image: www.freshnessmag.com
for today
#SHCR @school4radicals #SHCR @School4Radicals
The team today
Session lead: Helen Bevan @HelenBevan
Learning lead: Pip Hardy @PilgrimPip
Chat monitor: Dominic Cushman @domcushnan
Case study: Alison Cameron @allyc375
Twitter monitor: Kate Pound @kateslater2
Case study alumnus: Dr Jim Rawson @Jim_Rawson_MD
Case study alumna: CJ Graham @CJGrahamNHS
#SHCR @school4radicals #SHCR @School4Radicals
Icebreaker 2: How do you feel as you approach the edge?
I’m ready to be radical!
I’m still sceptical.
I’m cautiously optimistic…
I’m feeling positive, let’s see how I can
make this work!
#SHCR @school4radicals #SHCR @School4Radicals
“ Some learning reinforcement after a short space of time helps to retain
learning.” Casebourne I (2015)
Spaced Learning: An Approach to Minimize the Forgetting Curve
https://www.td.org/Publications/Blogs/Science-of-Learning-Blog/2015/01/Spaced-Learning-an-Approach-to-Minimize-the-Forgetting-Curve
#SHCR @school4radicals #SHCR @School4Radicals
Peter Fuda’s Transformational Change Agent framework
Skills and methods for creating change
Ability to make sense of, and reshape perceptions of ‘reality’
Personal characteristics and qualities
#SHCR @school4radicals #SHCR @School4Radicals
Peter Fuda’s Transformational Change Agent framework: my commentary
“Doing” • Where most change agents
in health and care put most of their effort and emphasis
• What others typically judge us on
• What we often perceive we need to do to add value
• What most change and improvement courses focus on
• The “de facto” purpose of a health and care radical
#SHCR @school4radicals #SHCR @School4Radicals
Peter Fuda’s Transformational Change Agent framework: my commentary
“Seeing ” and “Being” • We can only do effective
“doing” if we build on strong foundations of “seeing and being”
• Give us the potential for: • better outcomes • more engagement • self-fufillment and
connection with our bigger purpose as an agent of change
#SHCR @school4radicals #SHCR @School4Radicals
“Being” as a health and care radical
Personal characteristics and qualities
#SHCR @school4radicals
“ Being an effective Change Agent involves demonstrating what you teach as much as pontificating from the mountaintops. Any behaviour we ask others to adopt, we must consistently represent in our
own work, and share the positive outcomes.”
Bryce Williams Working Out Loud
#SHCR @school4radicals #SHCR @School4Radicals
“Being” as a health and care radical
CHANGE
me
BEGINS WITH
• Living my conviction and values
• Strong sense of “self-efficacy” belief that I am personally able to
create the change
• Shared purpose, not de facto purpose
• A role model and signal generator
• Stepping outside my comfort zone
• A “rebel” rather than a “troublemaker”
• Learning not judging
#SHCR @school4radicals #SHCR @School4Radicals
“Being” as a health and care radical
CHANGE
me
BEGINS WITH
• Living my conviction and values
• Strong sense of “self-efficacy” belief that I am personally able to
create the change
• Shared purpose, not de facto purpose
• A role model and signal generator
• Stepping outside my comfort zone
• A “rebel” rather than a “troublemaker”
• Learning not judging
#SHCR @school4radicals #SHCR @School4Radicals
‘I do not think you can really deal with change without a person asking real
questions about who they are and how they belong in the world.’
David Whyte, The Heart Aroused 1994
Source of image: fistfuloftalent.com
#SHCR @school4radicals #NHSChangeDay #SHCRchat #SHCR @School4Radicals Source : Lois Kelly www.foghound.com
Rebel
#SHCR @school4radicals #SHCR @School4Radicals
“Being” as a health and care radical
CHANGE
me
BEGINS WITH
• Living my conviction and values
• Strong sense of “self-efficacy” belief that I am personally able to
create the change
• Shared purpose, not de facto purpose
• A role model and signal generator
• Stepping outside my comfort zone
• A “rebel” rather than a “troublemaker”
• Learning not judging
Jim Rawson, MD, FACR
P.L., J. Luther and Ada Warren Professor
Chair, Radiology and Imaging
Medical College of Georgia
@Jim_Rawson_MD
Case study alumnus
• 40 participants (Radiologists and other physicians, residents, students, consultants, business school faculty, administrators, public health…)
• Weekly email updates
• Weekly Chat Thursday 12 noon EST
• Weekly Conference call/discussion 5:30 pm EST
#SHCRUSA Learning Group
#SHCR @school4radicals #SHCR @School4Radicals
“Seeing” as a health and care radical
Ability to make sense of, and reshape perceptions of
‘reality’
#SHCR @school4radicals #SHCR @School4Radicals
Seeing
“Seeing, looking, monitoring, listening, perceiving and especially the indefinite concept
of intuitive feeling. ”
Aubrey Jango
#SHCR @school4radicals #SHCR @School4Radicals
“Seeing” as a health and care radical
• The big picture
• Multiple perspectives
• Reframing situations:
• failed attempts are learning opportunities
• uncertainty becomes curiosity
• The positive intentions of others
• Possibility of bad change processes rather than resistors, blockers and laggards
• Hopeful futures, creative opportunities and potential
• See myself in the context of my higher purpose
#SHCR @school4radicals
“Creative ideas reside in people’s minds but are trapped by fear of rejection.
Create a judgement-free environment and you’ll unleash a torrent of creativity.”
Alex Osborn
Source of image: elementsvillage.com
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Source: http://www.slideshare.net/AndreaWaltz/gfn-slidesharegfnhandling-rejectionpositively
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“Doing” as a health and care radical
Skills and methods for creating change
#SHCR @school4radicals #SHCR @School4Radicals
“Doing” as a health and care radical
• Create the conditions where everyone can contribute and do their best
• Join forces with others to create action
• Achieve small wins which create a sense of hope, self-efficacy and confidence
• Appeal to both the head (logic/planning/data) and the heart (shared values/purpose, framing, relationships)
• Make change (and learning cycles from change) routine rather than an exceptional activity
• Use models, theories and frameworks effectively
#SHCR @school4radicals #SHCR @School4Radicals
The mindset of the past has a tendency to hijack the transformational potential of the future
“ The greatest
danger in times
of turbulence is
not the
turbulence…….
it is to act with
yesterday’s
logic.”
Peter Drucker
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“ History, even if properly construed, can blind us to important possibilities. After all, it is not the
rhythms of the past that define us, but our dreams for the future.”
Greg Satell http://www.digitaltonto.com/2014/are-you-using-data-to-analyze-the-past-
or-to-create-a-new-future/
#SHCR @school4radicals #SHCR @school4radicals
What do we mean by “the edge”?
• Working at the edge of organisations so we can see the potential and make connections that we couldn’t do if we were at the centre
• At the edge of current practice and knowledge about change
• Taking risks and demonstrating courage to think and do things in new ways
• On the edge of ?
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Why do we go to the edge?
The edge is where those who want to challenge are able to unite,
share, support and grow together as change activist. Leading from the edge brings you into contact
with a far wider range of relationships, and in turn, this
increases our potential for diversity in terms of thought, experience
and background. Diversity leads to more disruptive thinking, faster change and better outcomes.”
“
#SHCR @school4radicals #SHCR @School4Radicals
What are the biggest opportunities for change agents in our system?
• As bridge builders between disconnected groups
• As curators and sharers of knowledge
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Improvement teams will move from “bench
scientists” (programme managers) to knowledge leaders and connectors
http://connect.forwardmetrics.com/business-management/the-
strength-within.html
#SHCR @school4radicals #NHSChangeDay #SHCRchat #SHCR @School4Radicals
Less change programmes More change platforms
Change Programmes: • utilise systematic “change
management” approaches • Too often, leaders prescribe
the outcome and the 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 Platforms • enable everyone in the
organisation/system (including service users) to help tackle the most challenging issues
• value diversity of thought • leadership attention on
creating an environment receptive to transformational change
http://www.hsj.co.uk/resource-centre/scrap-the-programme-successful-change-starts-with-a-change-platform/5078014.article?blocktitle=Blogs-and-videos&contentID=16031
Curate rather than create knowledge for improvement
Source of image: John Curran designedforlearning.co.uk
Because there’s a problem….
Source of quote: Harold Jarche Source of image:http://gotcll.com/about-2/
“Getting information off the
internet is like taking a drink from a fire hydrant.”
Mitchell Kapor
@@HelenBevan #Quality2014 @@HelenBevan
A big challenge for improvers
Tacit knowledge is where the action is…. • It’s the people with tacit knowledge who deliver the results • Tacit knowledge is critical for large scale change
...but
The only way tacit
knowledge can be broadly shared…
…is to turn it into
explicit knowledge
VERY difficult
Few organisations succeed
Gray D (2012) The Connected Company
Source: Harold Jarche
“
Source: http://paul4innovating.com/2014/04/06/learning-favours-the-brave/
It is easy to copy but we often fail to recognize all the contextual factors that went into making it
that one specific organizations good practice, and I guarantee these are not yours!
Organizations need to move well beyond their lazy reliance on best practice comparison and they need to
find better ways to explore emerging practices. But that takes many into the realm of increasing uncertainties, and most people and organizations are not trained for
this exploration and experimentation.”
Knowledge exchange is the way forward but there aren’t really any easy paths
#SHCR @school4radicals
How the world of work is changing
From : http://jarche.com/2015/02/adapting-to-perpetual-beta/
#SHCR @school4radicals
“Tacit knowledge is best developed through conversations
and social relationships.” Harold Jarche
Source of image: northcentralcollege.edu
What is the best way to spread new knowledge?
Source of data: Nick Milton www.nickmilton.com/2/2tOjE
Social connection/discussion is
14 times more effective
than
written word/ best practice
databases/toolkits etc
Source of image: happiness-one-quote-time.blogspot.com
“Curating” knowledge in a social era
Finding things out and keeping up to date • “pulling” information, but also having it
“pushed” to us by trusted sources
Making sense and meaning of information • Reflecting and putting into practice
what we have learned • Plugging information into our own
mental models and turning it into
knowledge
Connecting and collaborating • Sharing complex knowledge with our
own work teams
• Testing new ideas with our own networks • Increasing connections through social
networks Source: Harold Jarche
The School is brought to you by the Horizons Group within NHS IQ
Aim of the group: to stimulate new and ‘disruptive’ approaches in support of health and care transformation, operating at the edge of current thinking and practice:
• skipping a generation of thinking about how to create radical, system-wide change
• skipping a generation in a wider level of connection: working with emerging leaders, clinical trainees, students
• skipping a generation of methods for change: open innovation, open source, digital connection, social media, change platforms, hacking
“You
can’t cross a chasm in small
steps” David
Lloyd George
#SHCR @school4radicals #SHCR @school4radicals
6 things I have learnt from this experience of The School for Health and Care Radicals
1. The most important need is for connection and community
2. How to build the relationship between tacit and explicit knowledge
3. The best experience seems to be synchronous in time, asynchronous in location
4. We benefit greatly from our global connections
5. All teach, all learn
6. There is a massive untapped reservoir of energy, talent and willingness to lead change out there and the potential is outstanding
#SHCR @school4radicals #SHCR @school4radicals
“ Employee social activism is not just not a
threat any more.....
It is the future.”
Celine Schillinger
(NB: also applies to patient activism)
Source of image: webershandwick.co.uk
#SHCR @school4radicals #SHCR @School4Radicals
Call to action
1. Consider why it would be beneficial for you to be a certified change agent
2. Identify people who might help you with this process
3. Think about the action(s) you will take to prepare for certification
4. Plan to complete the follow-up work for certification
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A call to arms: Recipes for Radicals
Stories and recipes to feed your soul
A resource to help us recharge, reconnect and keep the SHCR momentum going.
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Gain a certificate as a health and care change agent AND claim your continuing professional development points
Take some actions to demonstrate your learning from the school and become a “certificated change agent”. If you complete the learning process you will: • Be recognised as a “certified change agent” by the school and
NHS Improving Quality • Be awarded a virtual badge that you can used on your email
signature, personal website, etc. • Be invited to take part in one of our virtual graduation
ceremonies • Take part in a virtual clinic – see News from Jo • Receive a certificate
More details in News from Jo and here: http://www.theedge.nhsiq.nhs.uk/school/resources/
#SHCR @school4radicals 66
NHS IQ presents….
A Changeathon
We are running a 12 hour event on NHS Change Day that will feature inspirational change stories and broadcasts from change events across the
country.
The Changeathon will be live from 7am – 7pm
Find out more here: http://changeday.nhs.uk/changeathon/
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Improvement FUNdamentals Your route to improve health and care
Are you…..
• A radical who wants to learn more?
• Aiming to improve health and care?
• Wanting to study at a time and place to suit you?
• Keen to connect with a global improvement community?
If so then you are not alone - this course is for you
Join us on our innovative, online course, free to all
Starting April 2015
http:www.nhsiq.nhs.uk/GoHiking #QIHikers
We will send you details of
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Questions for reflection
1. How can I move in the direction of change in ways that will help me bring about the changes I want to see?
2. How will I build on my experiences of the School for Health and Care Radicals?
3. How will I build networks and communities in support of the changes I want to see?