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

Helen Bevan

Source of image: showstudio.com

“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

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

Leading change in a new era

Dominant approach Emerging direction

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

Leading change in a new era

Dominant approach Emerging direction

Most healthcare transformation

efforts are driven from this side

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

What’s your theory of change?

Source of cartoon: Networkednonprofit.org

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

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”

From “have to” to “want to”

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

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

‘ ‘

’ ’

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

Five enabling themes

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

What happens to heretics/radicals/rebels/mavericks

in organisations?

Source of image: findingmyself.net

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

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

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

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

“You can’t

cross a chasm in

small steps”

David Lloyd George

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

Don’t have emotional equity invested in the past

Gary Hamel

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

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)

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

Make it a personal PERFORMANCE target.

@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

@HelenBevan

“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

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