school for health and care radicals module 1 slides 2016

#SHCR @School4Radicals

Module 1 Being a health and care radical: Change starts with meSupported by:

http://www.theedge.nhsiq.nhs.uk/school/

Module 1 Being a health and care radical: Change starts with me


Welcome to the School for Health and Care Radicals

A global community of change agentsOver 7000 people have now taken part in The School for Health and Care Radicals, from around the world, including:

Argentina, Australia, Austria, Belgium, Brazil, Canada, Denmark, England, France, Georgia, Germany, Greece,

India, Ireland (Republic), Italy, Netherlands, New Zealand, Nigeria, Norway, Northern Ireland, Pakistan, Qatar, Russian

Federation, Saudi Arabia, Scotland, Singapore, Slovenia, South Africa, Spain, Sweden, Switzerland, Thailand, Tunisia,

Ukraine, USA, Wales


Make your mark!


Where on earth are you?


Where in the UK are you?


How are you feeling today?

I’m ready to be radical!

I’m cautiously optimistic.

I remain unconvinced or

sceptical.

I’m feeling positive, let’s see how I can make

this work!


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

• Send a request to join our Facebook group School for Health and Care Radicals

• We will produce summaries of each module discussion using Storify and Stella and put on the website

• Join in the #SHCR Tweetchat each Tuesday at 1900 (GMT)


Study guides

Programme Study Guide: http://www.slideshare.net/TheEdgeNHS/school-for-health-and-care-radicals-iii-study-guide-2016?related=2

Module 1 Study Guide: http://www.slideshare.net/TheEdgeNHS/the-school-for-health-and-care-radical-2016-module-1-study-guide?related=1

http://www.slideshare.net/TheEdgeNHS/school-for-health-and-care-radicals-iii-study-guide-2016?related=2



http://www.slideshare.net/TheEdgeNHS/the-school-for-health-and-care-radical-2016-module-1-study-guide?related=1




The team todaySession lead: Helen Bevan @HelenBevan

Learning lead: Pip Hardy@PilgrimPip Storyteller alumna:

Jon Bryant@chicustard

Session chair:Kate Pound@kateslater2

Twitter monitor: Olly Benson@ollybenson

Storyteller alumna:Wendy McIntosh@1wenmac

Chat monitor:Dominic Cushnan@domcushnan


Modules

4th February: Being a health and care radical: change starts with me11th February: Creating connections and

building communities18th February: Rolling with resistance25th February: Making change happen3rd March: Moving beyond the edge


School for Health and Radical Change Agents

Get certificated!


The first 30 Day Change Challenge guide

This is our first 30 Day Change Challenge we would like you to:-• form a team • agree a change to undertake as

a team • complete the change• review and learn • and celebrate.


Today

• Background to The School for Health and Care Radicals

• Learning processes

• Context: emerging directions in transformation and change

• Some challenges for health and care radicals

• The difference between a radical and a troublemaker

• How to rock the boat AND stay in it

• How to thrive and survive as a radical

• Questions and call to action

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The genesis of the School

2002

20142013

2010 2012

2003

NHS Change Day 2013

“A school for healthcare radicals”

Applying social movement

thinking to healthcare

improvement

“The School for Health and Care

Radicals”

Applying community organising

principles to healthcare

improvement

2016

“A one day school for organisational

radicals”


The School has been formally evaluated by the Chartered Institute for Personnel & Development

http://theedge.nhsiq.nhs.uk/school/school-evaluation/

How has the School for Health and Care Radicals made a difference?






The School has been formally evaluated by the Chartered Institute for Personnel & Development

• Change knowledge• Sense of purpose & motivation to improve practice• Ability to challenge the status quo• Rocking the boat & staying in it• Connecting with others to build support for change

Statistically significant positive effect on EVERY dimension of impact at both individual

and organisational level


The Fundamental Law of Conventional Conferences

The sum of the expertise of the

people in the audience is greater

than the sum of expertise of the people on stage.

Dave Winer

““

Source of image: www.citynet.com

http://www.citynet.com/

#SHCR @School4RadicalsSource: http://www.slideshare.net/alwynlau/learning-theories-learner-needs

http://www.slideshare.net/alwynlau/learning-theories-learner-needs

http://www.slideshare.net/alwynlau/learning-theories-learner-needs


Source: @NHSChangeDay


“New truths begin as heresies” (Huxley, defending Darwin’s theory of natural selection)

Source of image: installation by the artist Adam Katzwww.thisiscolossal.com

Via @NeilPerkin

http://www.thisiscolossal.com/


Starts on the fringe (at the edge)

Starts with the activistsGary Hamel

always


Tomorrow belongs to those who can hear it coming

David Bowie

“


If I put my ear down on the railroad track, I can hear the train

coming, and we ain’t ready.

Ray Smith, former Chairman and CEO of Bell Atlantic

Source of image: cubimention.net

“ “


The Five Year Forward View

Mentions“radical” 12 times“transformation/transformational” 13 times“change” 42 times


What is happening with change?


Kinthi Sturtevant, IBM 13th

annual Change Management Conference

June 2015

We rarely see two, three or four year change projects anymore. Now it’s 30-60-90 day change

projects

http://www.innovationexcellence.com/blog/2015/07/09/13th-annual-change-management-conference-highlights/?utm_source=hs_email&utm_medium=email&utm_content=20535245&_hsenc=p2ANqtz--W0963q5vEUgL7ecueQKfQ5nK0QPbROyo7BwHs10orC8Mhs-KVEWZbwEyxXf1c8rSQahhkhUXAPaEFtqlTzK5nEygUTw&_hsmi=20535245





Source: Bromford P (2015), ”What’s the difference between a test and a pilot?”

http://www.bromfordlab.com/labblog/2015/7/22/tests-vs-pilots?utm_content=bufferc862c&utm_medium=social&utm_source=twitter.com&utm_campaign=buffer


DIGITALCONNECTION



Empower your staff to be the voice of the organisation. They’ve got audience & credibility.

Employees have 10x more connections than corporate social accounts


Work complexity

DIGITALCONNECTION



DIGITALCONNECTION

Hierarchical

power

Work complexity



DIGITALCONNECTION

Hierarchical

power

Work complexityChange from the edge



Moving to the edge“ Traditional R&D is no longer sufficient. Big companies invest in innovation centers; some aim to act like start ups, others set out to partner with or acquire them.Either way, innovation centers spark new ideas, experiment faster, fail faster and gain momentum to affect HQ and force change from the outside in”Disruptive technology trends 2016-2018

http://www.slideshare.net/briansolis/26-disruptive-technology-trends-2016-2018-56796196/25-Traditional_RD_is_no_longer


http://www.slideshare.net/Openpolicymaking/policy-lab-slide-share-introduction-final





By joining The School for Health and Care Radicals,

you are moving to the edge!


Why go to the edge?

“ Leading from the edge brings us 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.

Aylet Baron

“


Jeremy Heimens TED talk “What new power looks like” https://www.youtube.com/watch?v=j-S03JfgHEA

old power new power

Currency

Held by a few

Pushed down

Commanded

Closed

Transaction

Current

Made by many

Pulled in

Shared

Open

Relationship

https://www.youtube.com/watch?v=j-S03JfgHEA

https://www.youtube.com/watch?v=j-S03JfgHEA


The essential flaw of quality improvement methods

The essential flaw of [quality improvement methodology] is

that, when implemented, it tends to reinforce the mechanistic and

hierarchical models that are consistent with the mental maps

of most managers.Chris Argyris, Flawed advice and

the management trap Source of image:

www.biblicalcreation.org.uk

Read more at: http://www.slideshare.net/jurgenappelo/management-30-workout

http://www.biblicalcreation.org.uk/

http://www.slideshare.net/jurgenappelo/management-30-workout

http://www.slideshare.net/jurgenappelo/management-30-workout


The Network Secrets of Great Change AgentsJulie Battilana &Tiziana Casciaro

1. As a change agent, my centrality in the informal network is more important than my position in the formal hierarchy

2. If 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


People who are highly connected have twice as much power to

influence change as people with hierarchical power.

Leandro Herrerohttp://t.co/Du6zCbrDBC

http://t.co/Du6zCbrDBC


DiscussionWhat are the implications of old vs.new power for the way change agents work?


Is your change process a cathedral or a bazaar?

http://www.unterstein.net/su/docs/CathBaz.pdf




We have a lot of cathedrals

Source: Sewell (2015) : Stop training our project managers to be process junkies


People at every level recognise that things aren’t right

“Legacy constructs that enforce bureaucracy through command-

and-control structures …with gated handovers between organizational

silos are pervasive across large organisations. These processes

were built to mitigate risk for an environment that doesn’t exist

today.”

“With this in mind, many organisations are looking for ways to improve employee

participation in the organisation’s strategy and in turn, increase retention rates

and hold on to the great people they’ve already

invested in. This results in a radical shift in the existing

work constructs……”

Thoughtworks, The unfinished business of organizational transformation

https://www.thoughtworks.com/insights/blog/unfinished-business-organizational-transformation?utm_campaign=transformation&utm_medium=social&utm_source=twitter

#SHCR @School4Radicals‘Success….depends on having an open, engaging,

and iterative process that harnesses the energies of clinicians, patients, carers, citizens, and local

community partners including the independent and voluntary sectors, and local government.

Sustainability and Transformation Plans


• systematic “change management”

• too often, leaders prescribe outcome and 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 Programmes

• everyone (including service users and families) can help tackle the most challenging issues

• value diversity of thought• connect people, ideas and

learning• Role of formal leaders is to

create the conditions and get out of the way

Change Platforms

“Tear down the walls”


“Tomorrow’s management systems will need to value diversity, dissent

and divergence as highly as conformance, consensus and

cohesion.”Gary Hamel

Image by neilperkin.typepad.com

“The single biggest mistake to avoid? Creating disruption at work. Focus on developing relationships, not disrupting and alienating people. .” Peter Vander Awera on learning from setbacks and failures

is the new normal!


We need rebels!•The principal champion of a change initiative, cause or action•Rebels don’t wait for permission to lead, innovate, strategise•They are responsible; they do what is right•They name things that others don’t see yet•They point to new horizons•Without rebels, the storyline never changes

Source : @PeterVan http://t.co/6CQtA4wUv1

http://t.co/6CQtA4wUv1


‘If you put fences around people, you get sheep. Give people the room they

need.William L McKnight


What happens to heretics/radicals/rebels/mavericks

in organisations?

#SHCR @School4RadicalsSource: Lois Kelly http://www.slideshare.net/Foghound/rocking-the-boat-without-falling-out


We need to be boatrockers!

• Walk the fine line between difference and fit, inside and outside, rock the boat but manage to stay in it

• Able to challenge the status quo when we see that there could be a better way

• Conform AND rebel• Capable of working with others

to create success NOT a destructive troublemaker Source: Debra Meyerson


What are the risks for a boat rocker?

1. Our experiences of “being different” can be fundamentally disempowering. This can lead us to conform because we see no other choice

Source: adapted from Debra E Meyerson



1. Our experiences of “being different” 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



Research shows the psychological distress that comes with inauthentic behaviour

"Staying true to yourself matters, even if it is difficult, because we notice that there is a cost involved in straying too far from your personal values.” “It seems to be true that to act in accordance with one’s own self, emotions, and values is a fundamental aspect of well-being.”

F. Gino, Maryam Kouchaki and Adam D. Galinsky (2015) The moral virtue of authenticity: how inauthenticity produces feelings of immorality and impurity

Psychological Science July 2015

http://insight.kellogg.northwestern.edu/article/the-problem-with-faking-it






our commitment, in order to survive2. leave the organisation



Research shows the psychological distress that comes with inauthentic behaviour

“it is important to note that a threat to someone’s moral self-concept is different from other negative states of mind such as feeling confused, disrespected, or overwhelmed. Clear instructions, positive feedback, and flexible hours are all undoubtedly appreciated, but for leaders who want to keep their employees engaged for as long as possible, understanding their need for a positive moral self-concept might be key.”

F. Gino, Maryam Kouchaki and Adam D. Galinsky (2015) The moral virtue of authenticity: how inauthenticity produces feelings of immorality and impurity Psychological Science July 2015




1. Our experiences of “being different” can be fundamentally disempowering. This can lead us to conform because we see no other choice we surrender a part of ourselves, and silence


we cannot find a way to be true to our values and commitments and still survive







3. stridently challenge the status quo in a manner which is increasingly disruptive and self-defeating







3. stridently challenge the status quo in a manner which is increasingly radical and self-defeating this just confirms what we already know – that

we don’t belong Source: adapted from Debra E Meyerson

#SHCR @School4RadicalsSource : Lois Kelly www.foghound.com

There’s a big difference between a rebel and a troublemaker

Rebel

http://www.foghound.com/


Reflection

• What are your insights around “rebels” and “troublemakers”?

• What moves people from being “rebel” to “troublemaker”?

• How do we protect against this?

#SHCR @School4RadicalsSource : Lois Kelly www.rebelsatwork.com

There’s a big difference between a rebel and a troublemaker

Rebel

http://www.rebelsatwork.com/


Telling her story

Wendy McIntosh@1wenmac


Storyteller: Wendy McIntosh


Change starts with me

Source of image: jasonkeath.com


"There’s only one corner of the

universe you can be certain of

improving, and that’s your own

self." Aldous Huxley

Source of image: timcoffeyart.wordpress.com


“The success of our actions as change-makers does not depend on what we do or how we do it, but on the inner place from

which we operate.”Otto Scharmer

Leading from the emerging future


1. able to join forces with others to create action2. able to achieve small wins which create a sense

of hope, possibility and confidence3. More likely to view obstacles as challenges to

overcome4. strong sense of “self-efficacy”

belief that I am personally able to create the change

Four things we know about successful boat rockers


CHANGE

meBEGINS WITH


Self-efficacy

“If you think you can or think you

can't, you are right.”

Henry Ford

“The ability to act is tied to a belief that it is possible to do so.”

Albert Bandura

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 outcomes

Source of image:www.h3daily.com


What’s the difference between

self efficacyand

self esteem,self belief,

self-confidence?



What is the issue here?“permission” ?

(externally generated)or

Self efficacy ? (internally generated)


Building self-efficacy: some tactics1. Create change one small step at a time2. Reframe your thinking:• failed attempts are learning opportunities• uncertainty becomes curiousity

3. Make change routine rather than an exceptional activity4. Get social support5. Learn from the best


Our awareness provides the underlying ground out of which our thinking and doing emerge


‘Avedis Donabedian

Ultimately, the secret of quality is love.…… If you have love, you can then work backward to monitor and improve the system.’


Tactic for radicals:Out-love everyone else

Source of image: Bradley Burgess


Telling his story

Jon Bryant@chicustard


Share the School: set up a local group!


Calls to action from this module

• Discuss tactics for ‘rocking the boat and staying in it’ with other radicals.

• Take part in a RCT (Randomised Coffee Trial).• Tweet #my3words

http://chrisbrogan.com/3-words-2016/


Take part in an RCT

What is a

RCT?


• Randomised Coffee Trial!• Randomised Coffee Trial!

Randomised Coffee Trial!


Outcomes of Randomised Coffee Trials


How to take part

• Instructions in News from Jo • Send an email to say you want to take part in the RCT

to [email protected]• We will randomly match you with another

participant in the School for Health and Care Radicals from anywhere in the world.

• At some time in the next four weeks, arrange to have a conversation over Skype (or other communication system) with a cup of coffee!

mailto:[email protected]


Questions for reflection

• How can I build self-efficacy (the belief that I can deliver change)

• How can I move beyond skills and knowledge of change to ‘live and be the change’?

• What or who do I need to support my work as a change agent?




• How can I build self-efficacy (the belief that I can deliver change)?

• How can I move beyond skills and knowledge of change to ‘live and be the change’?

• What or who do I need to support my work as a change agent?

Call to action


Celebration and certification

Put your learning into action.

Become a certificated change agent.


Next issue due out soon!


#EdgeTalks presents…

In Search of the Perfect Health Systemwith Mark Britnell @MarkBritnell

Webinar joining details: theedge.nhsiq.nhs.uk/events/2626-2

Friday 5th February, 2016 09:30-11:00 GMT

This free, live webinar will take you on a whistle-stop tour through the key messages and conclusions of Mark Britnell’s experiences of having run a hospital, a health system, a global healthcare enterprise and his own personal story as a cancer patient.

Join in the conversation on Twitter using the hashtag #EdgeTalks

http://theedge.nhsiq.nhs.uk/events/2626-2/


Next opportunities for learning

• Next Tuesday, 9th February 1900-2000 GMT: Tweet chat #SHCR• Next Thursday 6th February 1430-1600 GMT: Module 2: Creating connections and building communities


Goodbye and good luck!

‘Be the change you want to see in the world.’

Goodbye and good luck!

school for health and care radicals module 1 slides 2016

Healthcare