if "Action on Accident & Emergency" was a social movemt

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@HelenBevan @ActiononAandE #ActiononA&E If Action on A&E was a social movement….. Helen Bevan @HelenBevan @ActiononAandE #ActiononA&E

Transcript of if "Action on Accident & Emergency" was a social movemt

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@HelenBevan @ActiononAandE #ActiononA&E

If Action on A&E was a social movement…..

Helen Bevan@HelenBevan

@ActiononAandE#ActiononA&E

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@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

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@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

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“I have some A&E Performance

Indicatorsfor you”

or

“I have a dream”

Source: @RobertVarnam

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“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.

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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”

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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

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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

/

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Identify the pillars of power

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@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

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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

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People who are highly connected have twice as much power to

influence change as people with hierarchical power

Leandro Herrerohttp://t.co/Du6zCbrDBC

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Create a spectrum of allies

Source of image: Greg Satell

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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

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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

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@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)

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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

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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

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Seek to attract not overpower

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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/

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@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

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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

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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

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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

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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

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Change is not the goal; the goal is the goal

Peter Fuda

Source of image: timemanagementninja.com

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New Public Passion:

a growing global

movement

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• 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?

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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

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• 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