Positive change from withinMaking the most of your hidden assets

Jane Lewis

A practical way of implementing the latest thinking

How do you feel?

HM Revenue and Customs has been condemned for costing callers £136 million a year through delays in answering calls.

A quarter of 79 million calls were not answered at all despite an outlay of £900 million on customer service.

A customer perspective - Nigel

“The man I spoke with was very helpful and obviously totally clued up on what to do, unlike in some organisations; and it was sorted out within 15 minutes with a new tax code notification arriving in the mail a couple of days later.

I actually made a note of his name as well as that of his manager and wrote to thank them.”

“In every community there are people whose unusual practices or behaviours enable them to find better solutions to problems than their neighbours who have access to the same resources.”

Saving children with no money

http://www.vietvaluetravel.com/vietvalue2010-images/news/img1/conongdan_737.jpg

http://www.studentsoftheworld.info/sites/country/img/5976_04sh-vietnam-0167.jpg

• 63% malnutrition in under 3s down to 33% within a year

• 93% of children on the programme “graduated”• New feeding practices maintained 5 years later• Method used successfully in 44 countries – the

Power of Positive Deviance, (2010), Pascale, Sternin and Sternin

How?

What?

Why?

2. Find the Focus What is the real problem? What is its impact? What is our desired outcome?

3. Treasure Hunt What is the norm? Are there positive exceptions? What do they do? How do they do it?

4. Practical learningWhat can we all do?How do we do it?Repetition and reinforcement

5. Tracking progressAre we still getting better?

6. Scaling upHow can we expand the approach so that other problems can be solved in more areas? How can we build on the results?

1 Prepare the GroundWho’s really who? Who needs to be involved? Where might we start?

The “positive deviance” approach

Reducing hospital acquired infections

• 275 people a day dying in the US from HAIs; 4.5 in every 100 in-patients in 2011

• Lean/TPS – reductions of 60% in 2 units in 4 years

• PD – reductions in 14 units in 1 year• PD - HAIs reduced by 83% in 2 years across

whole institution• Policies and protocols existed but not adhered to

Finding more time for Hertfordshire Adult Care Services

3

2.21.33

24.25

33

1.5

77.59

Time Taken on Specific Categories During A Day

Logging in at start of day

Problems with Iris/Hyperwave/Printers/Software throughout day

Telephone Calls made that were unanswered or led to further work

Updating Iris or Hyperwave

Interruptions by telephone calls for other workers or by workers face to face

Travelling to and from vistis

Incorrect Info present on Iris or Hyperwave

Time spent completing tasks specif-ically for job

• Time savings between 1 and 2.5 hours per person per week in completing case records.

• Referrals Management team save about 5 – 30 minutes for each equipment list.

• Social workers save between 5% and 30% of a day in dealing with incoming phone calls

• Increased flexibility enabling a higher level of referrals to be dealt with in spite of a flu epidemic amongst the teams.

• A step in the procedure for adaptations removed for Council tenants, cutting out the need for them to be put on one of three waiting lists

Some key underlying principles

HI way of being and thinking

“Ownership not buy-in”

“Act your way into a new

way of thinking”

“Don’t decide about me,

without me”

“The group is the guru” “People don’t turn

their backs on what they have created”“There is a

solution we can find today”

“Evidencing community

wisdom”

“The whole system in the room”

What’s in a name?

• Political concern over “deviance”

• Not necessarily about being “an outlier” or “a maverick”

• “Positive deviance” means different things to different people

• Need to adapt “pure” PD to western, organisational context

The cost of troubled families

• An “averagely complex” family costs an average of £47,500 in reactive interventions in a year

• One member of a troubled family can cost the taxpayer £290,000 in one year

• A high-cost family can cost between £350,000 and £450,000 in a year

– Source – the Cost of Troubled Families, DCLG, January 2013

1200 target families

New TFI teamManager

4 team membersAdmin

FIPJob

Centre Plus

Boxing Academy

YOS

ASBAT

MARACSecondary Schools x 12

Rise

MASH

CYPS Family Support

Family Action

NHS Trusts

Octagon PRU

CAHMS

PiPs

CONA

Educational Psychology

Service

IDVA

Alcohol Dependency

Charity

DASHPolice

Insight-YPSA services

Adult IAPT

Rehab Centre

Premier League Trust

Reed DWP ESF programme

Mind

FE College

Children’s Social Care

Children’s Centres

Hearthstone

Housing Associations

Educational Welfare Service

Primary Schools x 38

Probation Service

Capturing information and evidencing progress – an option

(illustrations from Mapping the Positive Deviance MRSA Prevention Networks at the VA Pittsburgh Healthcare System Acute Care and Long-term Care Facilities, Plexus Institute, 2007)

Before

After

An all-in-one way to facilitative leadership

“After nourishment, shelter and companionship, stories are the thing we need most in the world.” ― Philip Pullman

Understanding others’ perceptions and positions - making the problem visible and real

The right data, collected by the right people, to aid understanding and measure progress

“Community”-led; opportunistic;Constructive and creative conversations, shared practical learning

Delivers

• Engagement through action• Genuine commitment, not just “compliance

commitment”.• Improved performance• Personal responsibility• “Communities of Capability”• “It helps people to decide for themselves to behave in

the way that we as leaders would like them to….” – Graeme Gordon, Director of Strategy, Southwark Council

People like it!

What next?

• Where there is the will to tackle a tough problem at the front line and try something different

• In professional environments – giving the work back to the front line

• Where small changes in behaviour and practice make a big difference e.g. call centres

So what? More experiences like Nigel’s

More reading and contacts

www.woodward-lewis.co.uk