Rocking the boat and staying in it: a presentation for Healthcare Improvement Scotland
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Transcript of Rocking the boat and staying in it: a presentation for Healthcare Improvement Scotland
@HelenBevan #HISQIconnect
and staying in it: How to be a great change agent
@HelenBevan #HISQIconnect
Helen Bevan
Source of image: showstudio.com
@HelenBevan #HISQIconnect
“New truths begin as heresies” (Huxley, defending Darwin’s theory of natural selection)
Source of image: installation by the artist Adam Katz www.thisiscolossal.com
Via @NeilPerkin
@HelenBevan #HISQIconnect @HelenBevan #HISQIconnect
Starts on the fringe
(at the edge)
Starts with the activists Gary Hamel
always
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Our new White Paper • Examines leading trends in
change and transformation
globally
• How to make change
happen at a faster rate and
be more disruptive
• Join the new breed of
leaders of health and care
globally, rewriting the rules
of change and leading
change from the future for
different results
www.nhsiq.nhs.uk/whitepaper
@HelenBevan #HISQIconnect @HelenBevan #HISQIconnect
Leading change in a new era
Dominant approach Emerging direction
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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
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Leading change in a new era
Dominant approach Emerging direction
Most healthcare transformation
efforts are driven from this side
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@HelenBevan #HISQIconnect @HelenBevan #HISQIconnect
We are on a collision course between the new, organic, human-focussed forces of
social media and the machine world of our organisations
“ “
Source of image: sullybaseball.blogspot.com
Source: Maddie Grant
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What’s your theory of change?
Source of cartoon: Networkednonprofit.org
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John Kotter, the most influential thought leader globally, recognises new approaches are needed
FROM
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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
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From “have to” to “want to”
Source of image s:www.slideshare.net/mexicanwave/champions-trolls-10-years-of-the-cipd-online-community
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Unleashing the spirit of the volunteer
You may be able to ‘buy’ a person’s back
with a paycheck, position, power or fear but a
human being’s genius, loyalty and tenacious
creativity are volunteered only.
The world’s greatest problems will be solved
by passionate, unleashed ‘volunteers’
Stephen Covey, Turn the ship around, via @MarkGraban
Source of image: www.volunteerweekly.org
‘ ‘
’ ’
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The Network Secrets of Great Change Agents Julie 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
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Five enabling themes
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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
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What happens to heretics/radicals/rebels/mavericks
in organisations?
Source of image: findingmyself.net
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What is a rebel?
• 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
• Rebels aim for greatness, healthy fire, worthiness
• 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
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The 90/30 conundrum
of senior leaders say
that to create more
innovation, they need to
activate the radicals/
disruptive innovators in
their organisations or
systems
of senior leaders are
very satisfied that
radicals/innovators
can provide this value
in their organisations
or systems
Source: rebelsatwork.com
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We need boatrockers!
• Rock the boat but manage to stay in it
• Walk the fine line between difference and fit, inside and outside
• 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 #HISQIconnect Source : Lois Kelly www.rebelsatwork.com
There’s a big difference between a rebel and a troublemaker
Rebel
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Reflection
• What are your insights around “rebels” and “troublemakers”?
• What moves people from being “rebel” to “troublemaker”?
• How do we protect against this?
@HelenBevan #HISQIconnect Source : Lois Kelly www.rebelsatwork.com
There’s a big difference between a rebel and a troublemaker
Rebel
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“You can’t
cross a chasm in
small steps”
David Lloyd George
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A new kind of improvement team: the Horizons Group
To stimulate new and ‘disruptive’ approaches in support of health and care transformation, operating at the edge of current thinking and practice:
• skip a generation of thinking about how to create radical, system-wide change
• skip a generation in a wider level of connection: emerging leaders, clinical trainees, students
• skip a generation of methods for change: open innovation, open source, social media, crowdsourcing, hacking
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Don’t have emotional equity invested in the past
Gary Hamel
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Some challenges:
• Create organisations that are activist at their core
• Find ways to:
• marry innovation with complexity and scale
• balance control and freedom
• out-love everyone else
Source of image: rachelstivers.com
@HelenBevan
Peter Fuda’s Transformational Change Agent framework
Skills and methods for creating change
Ability to make sense of, and reshape perceptions of ‘reality’
Personal characteristics and qualities
@HelenBevan
Peter Fuda’s Transformational Change Agent framework: my perspective
“Doing” • Where most change agents
in health and care put most of their effort and emphasis
• What others typically judge us on
• What we often perceive we need to do to add value
• What most change and improvement courses focus on
@HelenBevan
Peter Fuda’s Transformational Change Agent framework: my perspective
“Seeing ” and “Being” • We can only do effective
“doing” if we build on strong foundations of “seeing and being”
• Change begins with me • Hopeful futures, creative
opportunities and potential • Multiple lenses for change • See myself in the context of
my higher purpose
@HelenBevan
"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
1. able to join forces with others to create action
2. able to achieve small wins which create a sense of hope, self-efficacy 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
Source: adapted from Debra E Meyerson
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
Source: @NHSChangeDay
@HelenBevan
Source: @NHSChangeDay
What is the issue here?
“permission” ? (externally generated)
or
Self efficacy ? (internally generated)
@HelenBevan
What’s the difference between
self efficacy and
self esteem, self belief,
self-confidence?
@HelenBevan
Building self-efficacy: some tactics
1. 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 Image copyright: http://13c4.wordpress.com/2007/02/24/50-reasons-not-to-change/
@HelenBevan
Source: http://www.slideshare.net/AndreaWaltz/gfn-slidesharegfnhandling-rejectionpositively
@HelenBevan
Source: http://www.slideshare.net/AndreaWaltz/gfn-slidesharegfnhandling-rejectionpositively
@HelenBevan
Source: http://www.slideshare.net/AndreaWaltz/gfn-slidesharegfnhandling-rejectionpositively
@HelenBevan
Source: http://www.slideshare.net/AndreaWaltz/gfn-slidesharegfnhandling-rejectionpositively
@HelenBevan
Source: http://www.slideshare.net/AndreaWaltz/gfn-slidesharegfnhandling-rejectionpositively
Make it a personal PERFORMANCE target.
@HelenBevan
Source: http://www.slideshare.net/AndreaWaltz/gfn-slidesharegfnhandling-rejectionpositively
@HelenBevan
Research from the Sales industry: How many NOs should we be seeking to get?
• 2% of sales are made on the first contact
• 3% of sales are made on the second contact
• 5% of sales are made on the third contact
• 10% of sales are made on the fourth contact
• 80% of sales are made on the fifth to twelfth contact
Source: http://www.slideshare.net/bryandaly/go-for-no
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“Papers that are more likely to contend against the status quo are more likely to find an opponent in the review system—and thus be rejected —but
those papers are also more likely to have an impact on people across the system, earning them
more citations when finally published”
V. Calcagno et al., “Flows of research manuscripts among scientific journals reveal hidden submission patterns,”
Science, doi:10.1126/science.1227833, 2012.
—
@HelenBevan
Underpinning theme:
“Tomorrow’s management systems
will need to value diversity, dissent and
divergence as highly as conformance, consensus
and cohesion.”
Gary Hamel
#IQTGOLD
Leading change
from the edges
Go out to your edges. Explore the possibilities. Because you will find more opportunity in the edges, where you will be able to imagine, invent and thrive
Ayelet Baron
@HelenBevan
• Identify your own opportunities to move to the edge
• Think about how to ignite the disruptive innovators in your midst
• Consider how you can enable change at a faster rate than the outside world
@HelenBevan
As you create your roadmap for the future, make sure you are part of the
steamroller, not part of the road Saavik Wilcox-Hamilton
Source of quote: http://slidesha.re/1B6jrZw
“
“
@HelenBevan
References and links Baron A (2014) Preparing for a changing world: the power of relationships
Battilano J, Casciaro T (2013) The network secrets of the great change agents Harvard Business Review, July-August
Bevan H, Plsek P, Winstanley (2011) Leading Large Scale Change - Part 1, A Practical Guide
Bevan H (2011) Leading Large Scale Change - Part 2, The Postscript
Bevan H, Fairman S (2014) The new era of thinking and practice in change and transformation, NHS Improving Quality
Change Agents Worldwide (2013) Moving forward with social collaboration SlideShare
Diaz-Uda A, Medina C, Schill E (2013) Diversity’s new frontier
Fuda P (2012) 15 qualities of a transformational change agent
Grant, M (2014) Humanize: How people centric organisations succeed in a social world http://prezi.com/usju20i0nzhd/humanize-how-people-centric-organizations-succeed-in-a-social-world/ Hamel G (2014)Why bureaucracy must die
Jarche, H (2013) Rebels on the edges
@HelenBevan
Jarche H (2014) Moving to the edges
Kotter J (2014) Accelerate! Harvard Business Review Press
Merchant N (2013) eleven rules for creating value in the social era
Llopis G (2014) Every leader must be a change agent or face extinction
Meyerson D (2001) Tempered Radicals: how people use differences to inspire change at work Harvard
Meyerson D (2008) Rocking the boat: how to effect change without making trouble Harvard BP
Perkins N (2014) Bats and pizzas (agility and organisational change)
Schillinger C (2014) Top-Down is a Serious Disease. But It Can Be Treated
School for health and Care radicals (2014) www.changeday.nhs.uk/healthcareradicals
Shinners C (2014) New Mindsets for the Workplace Web
Stoddard J (2014)The future of leadership
Williams B (2014) Working Out Loud: When You Do That… I Do This
Weber Shandwick (2014) Employees rising: seizing the opportunity in employee activism
Verjans S (2013) How social media changes the way we work together
References and links