module 5 - moving beyond the edge

#NHSChangeDay #SHCRchat

The School for Health and Care Radicals

www.changeday.nhs.uk/healthcareradicals

Module 5: Moving beyond the edge

Supported by

#NHSChangeDay #SHCRchat#NHSChangeDay #SHCRchat

www.changeday.nhs.uk

http://www.changeday.nhs.uk/


#1mintobein


Please use the chat box to contribute continuously during the web seminarPlease tweet using hashtags #NHSChangeDay and #SHCRchatWe will produce summaries of the discussions of today’s module using Storify.com and Pinterest and put these on the websiteThe conversation continues on the live chat forum at www.changeday.nhs.uk/healthcareradicalsforum

Joining in today and beyond

http://www.changeday.nhs.uk/healthcareradicalsforum


Modules31st January: Being a health and care radical: change starts with me7th February: Forming communities: building alliances for change14th February: Rolling with resistance21st February: Making change happen28th February: Moving beyond the edge

Almost:1,300 learners8,000 Slideshare views1,500 study guide views850 Storify views

And over…4,500 tweets #SHCRchat

A weekly potential reach of 2.6M!

#NHSChangeDay #SHCRchat Source of image: www.freshnessmag.com

for today

Review of what we have learnt so far; characteristics of a transformational change agent Panel discussion - How are radicals are going to move forward with making change based on what they have learnt?“From the edge” – views about the emerging directions for change and change agentsPanel stories - Inspirational stories of how people have gone beyond the edge Reflections and key messages about the school Panel discussion – What groups have formed and what has come out of the mentorship programme?What next for the school?


Pulling it all together: the characteristics of a radical

change agent


Skills and methods for creating change

Ability to make sense of, and reshape perceptions of ‘reality’

Personal characteristics and qualities

Peter Fuda’s Transformational Change Agent framework


“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

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

Peter Fuda’s Transformational Change Agent framework: my commentary


Personal characteristics and qualities

“Being” as a health and care radical


“Being an effective Change Agent involves demonstrating what you

teach as much as pontificating from the mountaintops. Any behaviour we askothers to adopt, we must consistently

represent in our own work, and share the positive outcomes.”

Bryce WilliamsWorking Out Loud


CHANGEme

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



CHANGEme

BEGINS WITH



• 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


#NHSChangeDay #SHCRchat#NHSChangeDay #SHCRchatSource : Lois Kelly www.foghound.com

Rebel

http://www.foghound.com/


CHANGEme

BEGINS WITH



• 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



Ability to make sense of, and reshape perceptions of

‘reality’

“Seeing” as a health and care radical


‘En este muno traidorNo hay verdad ni mentira,Que todo esta en el color

Del cristal con que se mira’

In this world of many mazesThere is nothing false or true:All depends upon the hue

Of the glass through which one gazes(Sixteenth-century Spanish quatrain)


“Seeing, looking, monitoring, listening, perceiving and especially the indefinite concept

of intuitive feeling ”Aubrey Jango

Seeing


‘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


• The big picture• Multiple perspectives• The positive intentions of others• Possibility of bad change processes rather than

resistors, blockers and laggards• Hopeful futures, creative opportunities and

potential• Multiple paradigms for change (eg, diagnostic and

dialogic)• See myself in the context of my higher purpose

“Seeing” as a health and care radical


Skills and methods for creating change

“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

“Doing” as a health and care radical


Use models, theories and frameworks effectively


Conclusions for health and care radicals?


Learning journeys…Panel discussion #1

Facilitator – Jenny Price Time – 10 minutes


Lana Nicholson

My key learning:They’re not laggards, they’re just Precontemplative!

How I am moving beyond the edge:Best Quality together


Susan Wighton

My key learning:The NHS is embracing a fundamental change of perspective, returning to its social movement roots.

How I am moving beyond the edge:I have founded Health-Hum*, focussing on health literacy using grassroots networking

(*seeking charitable status)


“From the edge”

Source of image:hoodlinghole.blogspot.com


• 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 ?

What do we mean by “the edge”?

#NHSChangeDay #SHCRchat#NHSChangeDay #SHCRchat Source of image: panchecco.deviantart.com

On the edge of glory?


• Change is happening at a faster rate and is becoming more disruptive

• Many of the ways we go about change were designed for a different era and different set of circumstances

• Complex work is getting more complex and that makes it difficult to replicate and copy; creative work is changing more quickly both require more tacit knowledge which is best

developed through conversation and social relationships rather than instruction manuals and best practice databases

Source: Change Agents Worldwide and Steven Verjans

What is happening with change?


Organisation CommunityPower through hierarchy Power through connectionMission and vision Shared purposeMaking sense through rational argument

Making sense through emotional connection

Leadership-driven (top down) innovation

Viral (grass-roots driven) creativity

Tried and tested, based on experience

“ Open” approaches , sharing ideas & data, co-creating

change

Transactions Relationships

Dominantapproach

Emerging direction

Source: @HelenBevan

From module one

Emerging themes in change & transformation?


ButThe only way tacit knowledge can be broadly shared…

…is to turn it into explicit knowledgeVERY difficult

Few organisations succeed

Gray D (2012) The Connected Company

Tacit knowledge is where the action is….

It’s the people with tacit knowledge who deliver the

results


“Tacit knowledge is best developed through conversations

and social relationships”Harold Jarche

Source of image: northcentralcollege.edu


• As bridge builders between disconnected groups

• As curators and sharers of knowledge

Two of the biggest future opportunities for health and care radicals


Potential to share on a massive scale


To stimulate new and ‘disruptive’ approaches in support of health and care transformation, operating at the edge of current thinking and practice:• skip a generation of thinking about how to create

large scale change • skip a generation in new people to connect with:

emerging leaders, clinical trainees, students• Skip a generation of methods for change: open

innovation, social media, crowdsourcing, hackathons

Role of the Horizons Group


What next for The School for Health and Care Radicals?


Some inspirational stories of how people have gone beyond the edge…

Panel discussion #2

Facilitator – Pip HardyTime – 10 minutes


Nick Graham


Carol Read, Innovation Lead

Salisbury NHS Foundation Trust


• Inspirational network - #SHCR Chat

• NHS Change Model – Spread of innovation

• NHS Change Day started with a tweet

• My pledge & Twitter experiment 22/23 Feb

Change starts with me


• NHS Innovation – Based on original sunflower cream formula used at hospital for over 20 years

• First moisturising cream with the NHS logo

• 100% profits back into NHS patient care

Making change happen -www.mytrusty.co.uk


Innovation in partnership with diverse communities• Salisbury Hospital Staff &

volunteers• Other hospitals, GP

Surgeries, Walk in Clinics, other clinics, Independent retailers, Hotels

• Wessex AHSN

Right Here – Right Now


• The BBC One Show – My Trusty® tested by Alex Jones, Matt Baker & Paddy McGuinness

• The Independent, Mail on Sunday, Style magazine, Radio 3, BBC South Today

• Glossy box, Blogs, YouTube

Media interest


• Join my pledge - “I pledge to connect with others and develop a network that can fast-track innovative ideas to improve patient care”

• Find out more from www.mytrusty.co.uk, FB & @My_Trusty or @CarolLRead

• Try out the cream on NHS Change day @WessexAHSN Stand @NHSExpo• Email contact :- [email protected]

#SHCR - Be part of the story…

http://www.mytrusty.co.uk/


Some reflections…


1. There is a massive untapped reservoir of energy and talent out there and the potential is outstanding

2. The core audience is different to what we anticipated: more expert more specialist

8 things I have learnt from this experience of The School for Health and Care Radicals


3. The most important need is for connection and community4. How to build the relationship between tacit and explicit knowledge5. The best experience seems to be synchronous in time, asynchronous in location6. We benefit greatly from our global connections7. All teach, all learn8. We need to move forward to:

a. Gloryb. the next phase of The School for Health and Care Radicals

8 things I have learnt from this experience of The School for Health and Care Radicals


Our developing communities

Panel discussion #3

Facilitator – Liz CarterTime – 10 minutes


Ibukun and Helen


• Ibukun said that she wanted motivation and inspiration from the relationship

• Helen ‘I am keen to learn from others and to be able to share my experiences of change and supporting others (teams and individuals)’

• Ibukun has made links with people, to start gathering stories to help build the ‘case for change’ and identify opportunities for improvement.

• She also agreed to speak at a conference about being a radical and several people gave feedback about how inspiring she was, providing hope.

• The materials from the School have helped provide a starting point for our conversations with each other and others. We have established a way of maintaining the relationship as we continue our journey, via e-mail and skype.

Ibukun and Helen


Radicals from Down UnderNZ - Learning Group


Alex Nicholas

Margaret Aimer

Natalie Leger

Alison Schneller

Katrina Wahanui

Alex Twigg

Lynne Maher

Priyesh Tiwari

Eman Radwan

Meet the team


• Improve personal practice of community organising skills

• Develop a group of community organising learners, leaders and practitioners within Counties Manukau Health (and partnering organisations)

• Contextualise the learning from the programme within our roles, work and community here in NZ

• Increase the awareness for community organising approaches in our respective services, departments, teams and organisations

Purpose of group


“As a group we have been able to talk about the concepts, share each of our own learning and put it into our own context here in Auckland.”

“The experience has helped to reaffirm some of our existing learning, challenge some of our current thinking and helped us to develop plans for sharing the learning more widely.”

“We have learnt that what’s required for effective & sustainable change – the investment of time in relational conversations to build shared purpose and meaning - is not always valued by organisations managing pressing political and economic pressures.”

“We are beginning to appreciate the importance of a community of radicals to sustain and encourage each other as we articulate organisational heresies!”

What we’ve learnt together


Susan and Loy

Susan and Loy


• We can both learn from each other• These connections need to survive

beyond the duration of the modules• Creating a thriving network of radicals

could exert a significant force for change.

Susan and Loy – our learning


• Loved the quote from flash dance about passion • We have uploaded the radicals school content and narrative

onto the organisations electronic shared space• Inspirational, sharing with people with similar mind set which

doesn’t happen across normal organisation life• Offers potential for what we can do next• Massive enabler• Opens up thinking around what’s possible• Our ambition for next year is to provide health and care case

studies for next years programme

Feedback from CMCSU


Shucong and Lynne


• Pace of work is making it difficult to prioritise• I am still here for anything that you need• I am keeping on top of the education through

the power points and enjoying what I am reading

• Thank you for your matchmaking skills. I am positive that I will have a beneficial (and radical) experience

Emerging themes and feedback:


Gain a certificate as a health and care change agent AND claim your continuing professional development points – Clinics coming soon…

Take some actions to demonstrate your learning from the school and become a “certified 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• Receive a framed certificate (UK residents only)

More details can be found here: http://changeday.nhs.uk/resources#sfhcr

http://changeday.nhs.uk/resources#sfhcr

http://changeday.nhs.uk/resources#sfhcr


To do at least one thing every week of the year that is "not in my job description”To listen and hear the unspokenTo reflect on every day by having a ‘best moment’To set up a Paired Learning programme for Doctors and Managers to work together and learn from each otherTo donate platelets, raise awareness of the need for more platelet donors, and encourage friends and family to join me.I pledge to speak the truth, even if my voice shakesI pledge to (attempt to!) set up a choir or series of choirs for NHS Change DayTo say thank you for pledgingI pledge to "connect the dots" supporting Clinical Leadership and Team Engagement

Some example pledges…


Post these or similar actions as a pledge on the NHS Change Day pledge wall http://changeday.nhs.uk/campaign• What effort would be required on your part to action

your pledge for Change Day and do the follow up work for certification??

• Why would it be beneficial for you to be a certified Change agent?

• Who can help you with this process?

Calls to action campaigns for this week

http://changeday.nhs.uk/

http://changeday.nhs.uk/


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?

Questions for reflection

module 5 - moving beyond the edge

Health & Medicine