Module 1 change starts with me upload

#SHCR @School4Radicals

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

Module 1:

Being a health and care radical:

Change starts with meSupported by

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


Welcome to the School for Health and Care Radicals – a global community of change agents

• 1,643 registrants for The School for Health and Care Radicals (as of 29th January)

• From 36 countries, 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?(choose one)

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

• 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 each Wednesday at 4-5pm (GMT) using the hashtag #SHCR


Study guides

Programme Study Guide: http://www.slideshare.net/NHSIQ/shcr-ii-study-guide-20150120-final-2

Module 1 Study Guide: http://www.slideshare.net/NHSIQ/shcr-module-1-study-guide

http://www.slideshare.net/NHSIQ/shcr-ii-study-guide-20150120-final-2

http://www.slideshare.net/NHSIQ/shcr-module-1-study-guide


The team today

Session lead: Helen Bevan @HelenBevan

Learning lead: Pip Hardy@PilgrimPip

Case study alumnus:Daniel Walsh@dwalsh811

Chat monitor:Dominic Cushman@domcushnan

Twitter monitor: and alumna:Jodi Brown@jodimolden

Case study alumna:Kate Pound@kateslater2


30th January: Being a health and care radical:

change starts with me

6th February: Building alliances for change

13th February: Rolling with resistance

20th February: Making change happen

27th February: Moving beyond the edge

Modules


• 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

Source of image: www.freshnessmag.com

for today


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”

“A one day school for organisational

radicals”

Applying community organising

principles to healthcare

improvement

2015


Source: @NHSChangeDay


The school is based on two kinds of learning

Transactional learning Transformational learning

A “toolkit” of ideas & approaches

Learning through motivation, practice & feedback

Seeks to transfer useful knowledge

Seeks to transform beliefs & underlying assumptions

Learning events, presentations & materials

Experiential, interactive & action-based

Generates understanding of “what to do”

Generates increased capacity in “how to do it”

Source: John Wenger https://medium.com/corporate-learning/3deb1bb2e865

https://medium.com/corporate-learning/3deb1bb2e865


“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


So why do we keep reinventing the past

and calling it the future?

Image used under Creative Commons licence: Kicki


‘Tomorrow belongs to those who can hear it coming.’

David Bowie


SEISMIC SHIFTS


SEISMIC SHIFTS

Change from the edge


Leading change in a new era

Dominant approach Emerging direction


Leading change in a new era

Dominant approach Emerging direction

Most healthcare transformation

efforts are driven from this side

#SHCR @School4RadicalsSource: Gary Hamel

#SHCR @School4RadicalsSource:@Alfacarlo


John Kotter, the most influential thought leader globally, recognises new approaches are needed

FROM


John Kotter: ‘Accelerate!’

• We won’t create big change through hierarchy on its own

• We need hierarchy AND network

• Many change agents, not just a few, with many acts of leadership

• At least 50% buy-in required

• Changing our mindset

• From ‘have to’ to ‘want to’

TO


From ‘have to’ to ‘want to’

Source of image s:www.slideshare.net/mexicanwave/champions-trolls-10-years-of-the-cipd-online-community


Managers know how to command obedience and diligence, but most are clueless when it comes to galvanizing the sort of volunteerism that animates life on the social web.

Initiative, imagination and passion can’t be commanded—they’re gifts.

Gary Hamel http://www.mixmashup.org/blog/reinventing-

management-mashup-architecture-ideology

‘ ‘

http://www.mixmashup.org/blog/reinventing-management-mashup-architecture-ideology


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 Herrero

http://t.co/Du6zCbrDBC

http://t.co/Du6zCbrDBC


Discussion

What are the implications of the “emerging direction” for the way

change agents work?


is the new normal!

‘By questioning existing ideas, by opening new fields for action, change

agents actually help organisations survive and adapt to the 21st Century.’

Céline SchillingerImage by neilperkin.typepad.com


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

@helenbevan

What happens to heretics/radicals/rebels/mavericks

in organisations?

@helenbevan

@helenbevan #IQTGOLD#NHSChangeDaySource: Lois Kelly http://www.slideshare.net/Foghound/rocking-the-boat-without-falling-out

@HelenBevan

Ostracism is experienced in the brain as deeply as physical pain

@helenbevan

We need to be boat rockers!

• 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

@helenbevan

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

@helenbevan


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


@helenbevan

@helenbevan


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


2. leave the organisation


@helenbevan





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


@helenbevan






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


@helenbevan






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

@helenbevan#NHSChangeDay #SHCRchatSource : Lois Kelly www.foghound.com

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

Rebel

http://www.foghound.com/

@helenbevan

Reflection

• What are your insights around ‘rebels’ and ‘troublemakers’?

• What moves people from being ‘rebel’ to ‘troublemaker’?

• How do we protect against this?

@helenbevan

Case study 1: troublemaker, rebel or radical?

Introducing Daniel Walsh

@helenbevan#NHSChangeDay #SHCRchatSource : Lois Kelly www.rebelsatwork.com

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

Rebel

http://www.rebelsatwork.com/

@helenbevan

Change starts with me

Source of image: jasonkeath.com

@helenbevan#SHCR @School4Radicals

‘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

@helenbevan

‘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

@helenbevan

History tells us that personal transformation comes before organisational or system

transformation

If we want to play our role, we have to focus deeply on our own perspective and the ways

http://blogs.bmj.com/quality/2013/08/19/a-call-to-action-helen-bevans-blog-2/

we interact with and influence others. The more that we can unleash that powerful reservoir of energy for change, the more our influence and impact will grow.

Image from novamagazine.com

http://blogs.bmj.com/quality/2013/08/19/a-call-to-action-helen-bevans-blog-2/

@helenbevan

1. able to join forces with others to create action

2. able to achieve small wins which create a sense of hope, possibility and confidence

3. More likely to view obstacles as challenges to overcome

4. strong sense of “self-efficacy” belief that I am personally able to create the change

Four things we know about successful

boat rockers


CHANGE

me

BEGINS WITH

@helenbevan

Self-efficacy

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

@helenbevan

What’s the difference between

self efficacyand

self esteem,self belief,

self-confidence?

@helenbevan


@helenbevan


What is the issue here?

“permission” ? (externally generated)

or

Self efficacy ? (internally generated)

@HelenBevan

Building self-efficacy: some tactics1. Create change one small step at a time

2. Reframe your thinking:

• failed attempts are learning opportunities

• uncertainty becomes curiousity

3. Make change routine rather than an exceptional

activity

4. Get social support

5. Learn from the best

@HelenBevan

Case study 2: building self-efficacy

Introducing Jodi Brown

@HelenBevan

Case study 3: building self-efficacy

Introducing Kate Pound

@helenbevan

The most effective change agents:

• don’t waste their time and energy blaming and complaining

• take calculated risks to achieve the outcomes they sought

Now is the time to plan steps to keep moving myself forward, with positive momentum, as a health and care radical

@helenbevan

Being a great change agent is about knowing, doing, living and being improvement

@helenbevan

Avedis Donabedian

‘Ultimately, the secret of quality is love.

…… If you have love, you can then work backward to monitor and improve the system.’

The secret of quality

@helenbevan

Tactic for radicals:Out-love everyone else

Source of image: Bradley Burgess

@helenbevan

Calls to action from this module

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

• Reflect on your own role / knowledge / skills as a health and care radical and create an action plan to “start with me”.

• Discuss tactics for “rocking the boat and staying in it” with other radicals.

• Identify and support others who are at risk of crossing the line from “radical” to “troublemaker”.

@helenbevan

What is a

RCT?

@helenbevan

Randomised Coffee Trial!

@helenbevan

Outcomes of randomised coffee trials

@helenbevan

Randomized Coffee Trial!• Instructions in News from Jo later today• 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]

@helenbevan

Next opportunities for learning

• Next Wednesday 4th February

16:00-17:00 GMT: Tweet chat #SHCR

• Next Friday morning 6th February

9.30-11;00 GMT: Module 2:

Building alliances for change

@helenbevan#SHCR @School4Radicals

Next issue due out on Tuesday, 3rd February!

@helenbevan

Celebration, certification and CPD!

Become a certificated change agent.

Put your learning into action.

Gain CPD points.

@helenbevan

Questions for reflection

1. What are the opportunities for me to build my perspectives and skills as an agent of change?

2. How can I build self efficacy as a change agent?

3. How do I move beyond skills and knowledge of change to live and be change?

4. Who can help and support me as a change agent?

5. What are the implications for the way I work?

@helenbevan

Goodbye and good luck!

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

Module 1 change starts with me upload

Healthcare

Transcript of Module 1 change starts with me upload