Everything is design. Everything

Dr Steven AllderConsultant Neurologist

Introduction

My Background• Doctor• Clinical Researcher• Consultant Neurologist• Interest in ‘Hysteria”• Management, leadership

and Improvement• Harvard Executive

Development Programme

My view of title and talk• Wow!• Resonated

• Resonated but, BUT…• Design is essential but on its own not

sufficient

• Design is a social process • Embedded in a social system• To fully exploit what design can offer

societies:

• we need to cultivate our understanding of these social elements = MIND

• DESIGN of our MINDS

Phase 1Phase 2

Phase 3Phase 4

Back to start!

I will be 68!

Born

QualifiedConsultant

The Healthcare challengeStability of growth of current system

There is hope!

Redesigning health care is possible…

My results were bewildering…CVA1 N1 4hr RTT CVA2 Medicology CVA3 Strateg

y JTTaunton

Step 1: CT SA own service

SA CD 8/2006 AMD NSS AMD post FT

CVA performance

FT Via JDY

Step 2: ACT 1 - Analysis

SA LOS IP SA SA SA FT risk table Mine-theirs

SL Good

Step 3: ACT 2 Deliver change

SA Via attending

Via OBS Via Dept

Via redesign

Medicology SW vs ESD Mandate

Program

Step 4:Provoke SC

JDP AW PDR GV/PV loads CST Strategic implications

Await AJ

In all 5!

Step 5: Name and see

TR TR IC after crisis

PV aftercrisis

Ian yes Yes 1:1 Dec

Step 6:SMT PLAY and explore

Step 7: Experiment 2

Step 8:Roll-in

Won..

Lost..

Won..

Battle

Won..

Lost

Won..

Lost

Supportive

Lost.. Lost Bury me

Managed better!

DESIGN ALWAYS

APPLICABLE!

SMALL SCALE SUCCESS!

LARGE SCALE FAILURE!

A sudden insight…

These board meetings feel like my consultations with my ‘hysterical’

patients!LEON FESTINGER

Cognitive dissonance

Design of the Mind: Three Loops

Stimulus

1. InnateWisdom

2. ConditionedIntuition

3a. ReasonedJudgement

DeliveredAction

Outcome

3b. ActionLogics

Moments: Embedded in

streams activity 500-

700ms

Ever present:Move Towards

or AwayControversial

idea

Implicit learning‘Good’ (Automatic)

‘Bad’ (Should)

Explicit awareness: Own view,

Choices and decisions Action

Options:CreateDeliverAvoid

Outcome:Who’s ‘Truth’

Extended choice theoryLearning

Loop (s)

Design of the Mind: Temporal development

Stimulus

1. InnateWisdom

2. ConditionedIntuition

3a. ReasonedJudgement

DeliveredAction

Outcome

3b. ActionLogic

Learning Loops

0-5 yrs moments (Reactive)

Learning to walkLearning to talk

5-23 yrs moments (Proactive)

Learning an instrumentLearning to drive

“Hysteria”Loop 1

buried..

Design of the Mind: The developed ‘successful’ mind

Stimulus

1. InnateWisdom

2. ConditionedIntuition

3a. ReasonedJudgement

DeliveredAction

Outcome

3b. ActionLogic

Learning Loops

With expertise comes:

More Choice, Opinions and

DecisionsCAPABILITY FOR

DESIGN!CreativityInfluence

Leadership

As we mature, 23 and beyond…

The prevailing MIND paradox!

Why Important?

Why Happens?

Beyond the Stable state:

VUCADesigned to exist in the

pack!

Design of the Mind: The dangerous rational delusion

Stimulus

InnateWisdom

ConditionedIntuition

ReasonedJudgement

DeliveredAction

Outcome

ActionLogic

Learning Loop

VITAL NEED FOR:Different Options, braver choices and

hard decisions

NEW ,NON ROUTINE, DESIGN!

True CreativityReal leadership

WHEN THE HEAT IS ON…

Prof Chris Argyris:99% of executive teams with critical moments act

defensively not creatively

Totally, unconscious..

Barry Oshry – Living Systems

ResultsCVA1 N1 4hr RTT CVA2 Medicology CVA3 Strategy

JTTaunton

Step 1: CT SA own service

SA CD 8/2006 AMD NSS AMD post FT CVA performance

FT Via JDY

Step 2: ACT 1 - Analysis

SA LOS IP SA SA SA FT risk table Mine-theirs

SL Good

Step 3: ACT 2 Deliver change

SA Via attending

Via OBS Via Dept Via redesign

Medicology SW vs ESD Mandate Program

Step 4:Provoke SC

JDP AW PDR GV/PV loads CST Strategic implications

Await AJ In all 5!

Step 5: Name and see

TR TR IC after crisis

PV aftercrisis

Ian yes Yes 1:1 Dec

Step 6:SMT PLAY and explore

Step 7: Experiment 2

Step 8:Roll-in

Won..

Lost..

Won..

Battle

Won..

Lost

Won..

Lost

Supportive Lost.. Lost Bury me Managed better!

The explanation: I was advocating a non-routine design

99% of executive teams mess up critical moments

Totally, unconscious..Emotional repression….

It can be overcome…Adult Cognitive Complexity

Small % of individuals

reclaimTheir creativity

Via Destructive process!

Reality of change currently..

Undeniable need to

change…

It really isNo pain, No gain…

Doesn’t really capture it…

HERD!

Courageous individuals!

I mean, real pain:Dante’s Inferno

A better way forward: Vertical Development

Stimulus

Meta-cognition (Mindset)“Prism”

InnateWisdom

ConditionedIntuition

ReasonedJudgement

DeliveredAction

Outcome

ActionLogic

Learning Loop

7

6

5

4

3

2

1

Design of the Mind: New Skills

Stimulus

Meta-cognition (Mindset)“Prism”

InnateWisdom

ConditionedIntuition

ReasonedJudgement

DeliveredAction

Outcome

ActionLogic

Clear Intent

Learning Loop

Re-learn to be

creative

Right teams

Realistic Theory

of change

Honest feedback:

Fail often, fail safely, know

failed

Reclaim your emotional

world via your body

7

6

5

4

3

2

1

Identify context specific critical

events and moments

Real time monitoring

IMPLICITPowerlessnessPoor Self worth

ACTING REQUIRES:

VulnerabilityAnd Courage

Increasingly Intangible…

Transpersonal phenomena

Broadening the PRISM: Why so hard?

Bob’s Big idea:The real reason we are getting older: the need for WISDOM

The route forward, is a lesson from ancient times – via our Hearts….

Brene Brown Barbara Friedrickson

Everything is design. Everything

Including the tool and environment in which design can contribute…