#NHSChangeDay #SHCRchat

‘Dis*ruption - an agent of constructive change'

Jackie Lynton: Head of Transformation @jackielynton Dominic Cushnan: Actionable Knowledge Manager @dominiccushnan

Horizons Group, NHSIQ

#NHSChangeDay #SHCRchat

Operate at the edge of current thinking and change

Share the disruptive power of connecting, leading edge knowledge, transformation and innovation

Connect people to empower them, to help health and care to think differently about the rules of change and make sense of it in their own context

Horizons Group

Small team

@HelenBevan

Our new White Paper - Five enabling themes

www.nhsiq.nhs.uk/whitepaper

#NHSChangeDay #SHCRchat

@HelenBevan

Source: McKinsey Performance Transformation Survey, 3000 respondents to global, multi-industry survey

Gets anywhere near achieving the change and

delivering the benefits

Most large scale change doesn’t fullydeliver its objectives

@HelenBevan

Most large scale change doesn’t fullydeliver its objectives

Source: McKinsey Performance Transformation Survey, 3000 respondents to global, multi-industry survey

Delivers and sustains the change

ENGAGEMENTCOMMITMENT ENERGY

100% of all projects evaluated as “Successful” had a good

technical solution or approach

100%

ENGAGEMENTCOMMITMENT ENERGY

Over 98% of all projects evaluated as “Unsuccessful” also had a good

technical solution or approach

98%

@HelenBevan

Most change efforts are built upon the shaky foundation of five flawed assumptions; 1.That change can be managed2.That human beings are objective3.That there are ‘X’ steps to change4.That we have a neutral starting point for change5.That change, itself, is the goalPeter Fuda http://www.peterfuda.com/wp-content/themes/peterfuda-bootstrap/content/Why-Change-Efforts-Fail.pdf

#NHSChangeDay #SHCRchat

Why is change needed and what needs to change?

@HelenBevan

Leading change in a new era

Dominant approach Emerging direction

@HelenBevan

Leading change in a new era

Most healthcare transformation

efforts are driven from this side

Most healthcare transformation

efforts are driven from this side

Using disruptive methods in change

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

• Facebook didn’t exist • Twitter was still a sound • The cloud was still in the sky • 4G was a parking place • LinkedIn was a prison • Applications were what you sent to

college• Skype was a typo

Thomas Friedman, World Economic Forum, Quoted by http://ayeletbaron.com

Disruptive innovations alreadyavailable for healthcare professionals and patients

Its about people not technology!

If the ‘change’ were a patient and the symptoms were found to be

persisting despite intensive therapy, the diagnosis should be questioned and new interventions considered.

Technology is not the goal – the goal is the goal!

Disrupting the status quo1. History tells us that, innovation flourishes no matter how difficult the environment

2. Disruptive attackers thrive in downturns by taking advantage of ‘disruptive opportunity’

3. Today's tough times in healthcare can lead to seminal changes in theworld of disruptive innovation/technology; because it throws us into finding a different way

What's Next for Innovation?: Disruptive Developments to Watch through the Downturn

@HelenBevan

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 Schillinger

Image by neilperkin.typepad.com

Innovation is not a mystical state

“It's a natural state - a human birthright. The people in your organisation, in fact, already are innovative. The only thing is: their natural ability to be innovative is being obscured by their own habits of mind and a variety of bothersome organisational constraints.”

Source and picture: Name: The heart of innovation: How we spark innovation, Oct 24, 2013. Ideas champions.com

Source: Helen Bevan

Compliance

States a minimum performance standard that everyone must achieve

Uses hierarchy, systems and standard procedures for co-ordination and control

Threat of penalties/ sanctions/ shame creates momentum for delivery

Changing our mindset about change?Commitment

States a collective goal that everyone can aspire to

Based on shared goals, values and sense of purpose for co-ordination and control

Commitment to a common purpose creates energy for delivery

@HelenBevan@HelenBevan #APACForum

Probably the largest simultaneous improvement initiative in the history of healthcare

A disruptive case study

@HelenBevan #Quality2014 #f1

www.changeday.nhs.ukNHS Change Day is supported and coordinated by NHS Improving Quality.

NHS Change Day is a grassroots movement with the purpose of empowering each other to take action to improve health and care. It connects people, bringing them together to in turn do something better together. It celebrates and shares every improvement we make better together. Date March

What is NHS Change Day?

@HelenBevan@HelenBevan #APACForum

NHS Change DayAim:Our shared purpose for NHS Change Day is to ignite thousands of actions that will improve care for people. If you are inspired, then join us in delivering actions that make a difference.

#NHSChangeDay #SHCRchat@HelenBevan @BoelGare @JackieLynton #Quality 2014 #M5

Resources to improve health and care

Economic resourcesdiminish with use•money•materials•technology

Natural resourcesgrow with use•relationships•commitment•community

Based on principles from Albert Hirschman, Against Parsimony

diminish grow

Simple Rules Commitment vs Compliance

How can we innovate in a complex system and how can we make innovation everyday business?

Underlying principles: Small inputs can make big change, collective action, holding yourself and each other to account, intrinsic motivation, large-scale change, social movement principles. Call to action

1.Make a pledge, publically, website2.Chose a pledge that means something to you3.Pledge (action), share, do, inspire (improvement cycle)4.Goal: 1st year 65,000 pledges, 2nd year 802,000 pledges 3rd pledge to action5.Date

@HelenBevan@HelenBevan #APACForum

NHS Change Day 2014More than 800,000 pledges to take action • 81 separate Campaigns• 86 million twitter

impressions• 35,400 video views • 95,000 daily reach on

Facebook• More than 98% of the

activity through volunteers

ENGAGEMENTCOMMITMENT ENERGY

Example pledge – Jeharna’s storyMember of the public

The way my brother was looked after by the NHS staff was just brilliant and I wanted to say thank you.

“”

ENGAGEMENTCOMMITMENT ENERGY

Example pledge – Damian’s storyIndividual

It has prompted myself, and others to discuss with our pharmacies methods of improving the taste of one of the common medicines for children.

“”

ENGAGEMENTCOMMITMENT ENERGY

Louise's Story2nd year student nurse – York University

Louise carrying out her change day pledge ‘Mock ward’ 2013

ENGAGEMENTCOMMITMENT ENERGY

Example pledge – Ashley’s story –Barking Havering and Redbridge Trust

Change Day gave me permission to use my energy in the direction that I wanted to use it“

”

Main Trust wide pledge for NHS Change day in 2013 Guardian ServiceInformal way of raising concerns

BHRUT & THE GUARDIAN SERVICE

Total 2012 Total 2013 Total All*

Would you feel safe raising your concern?

Yes 752 58% 1072 80% 45,025 71%

No 192 15% 269 20% 6,999 11%

Would you feel confident your Trust would address your concern?

Yes 516 40% 932 70% 34200 54%

Staff Feedback:The following responses in the 2013 NHS Staff Survey in the Health,

Wellbeing and Safety at Work category had the largest overall shifts in the Trust when compared to 2012:

Harvard Business Review

McKinsey M-PrizeLeaders Everywhere Challenge

Nesta and Observer50 New Radicals

@HelenBevan

Our new White Paper - Five enabling themes

www.nhsiq.nhs.uk/whitepaper

Getting

information off the internet is like taking a drink from a fire hydrant Mitchell Kapor

What is The Edge

• A platform for change activists in health and care to learn, connect and grow

• Mobilising and organising and connecting with other change activists

• Curation vs Content creation

• Seek, Sense, Share what does it mean

• Why curation?

Curating knowledge

Finding things out and keeping up to date•“pulling” information, but also having it “pushed” to us by trusted sourcesMaking sense and meaning of information•Reflecting and putting into practice what we have learned•Plugging information into our own mental models and turning it into knowledgeConnecting and collaborating•Sharing complex knowledge with our own work teams•Testing new ideas with our own networks•Increasing connections through social networks Source: Harold Jarche

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Friends of the Edge

theedge.nhsiq.nhs.uk@jackielynton

@dominiccushnan