module 1: being a health and care radical - change starts with me
DESCRIPTION
These are the slides for module one of The School for Health and Care Radicals, a five week virtual programme, designed to equip people across the health and care system with the core skills to improve their skills as change agents. It supports NHS Change Day 2014, the grassroots movement in which everyone who values the NHS can make a pledge of action to improve things for patients and the health and care system. Big change only happens in health and care because of heretics and radicals: passionate people who are willing to take responsibility and work with others to make change happen. Being a radical isn't related to hierarchy or position and you don't have to work in the NHS or social care to qualify as one. Registrants to the school so far include patients and carers, students, senior leaders, improvement facilitators and clinical and care staff. Starting on 31 January, there will be a live weekly web seminar which will be available to 'listen again', supported by a raft of other opportunities, including coaching and mentoring, virtual discussions and tweet chats, and an ever- expanding portal of useful resources. Programme The programme focuses on five modules over five weeks, 9:30 to 11:00 am GMT • Friday 31 January: Being a health and care radical: change starts with me • Friday 7 February: Forming communities: building alliances for change • Friday 14 February: Rolling with resistance • Friday 21 February: Making change happen • Friday 28 February: Moving beyond the edge Tweetchat We will run a tweetchat each Wednesday from 16:00 to 17:00 GMT, based on the content of the module from the previous Friday. A tweetchat is a facilitated conversation using Twitter. The hashtag we will use for the tweetchats is #SHCRchat. The dates for the tweetchats are: • 5 February • 12 February • 19 February • 26 February • 5 March There is no charge to join the School of Health and Care Radicals and it is open to all, whatever your role or level, and whether or not you work in the NHS. There will be additional learning materials and opportunities in addition to the web seminars but there is no set syllabus for learners to work through - you can join for as much or as little as you want. More information: http://changeday.nhs.uk/healthcareradicalsTRANSCRIPT
#NHSChangeDay #SHCRchat
The School for Health and Care Radicals
www.changeday.nhs.uk/healthcareradicals Module 1:
Being a health and care radical: Change starts with me
Supported by
#NHSChangeDay #SHCRchat
Welcome to the School for Health and Care Radicals – a global community of change agents
• Nearly 1000 registrants for The School for Health and Care Radicals
• Nearly 90 volunteer coach and mentor volunteers• From 22 countries, including:
Australia, Belgium, Canada, Czech Republic, Denmark, England, France, Germany, Ireland, Netherlands, New Zealand, Norway,
Northern Ireland, Philippines, Saudi Arabia, Scotland, Spain, Sweden, Ukraine, United Arab Emirates, USA, Wales
#NHSChangeDay #SHCRchat
Why the School for Health & Care Radicals?It’s tough being a change agent in health and care, particularly
when other people don’t always get it or want to change.
Yet big change happens in health and care only because of heretics and radicals: passionate people who are willing to take responsibility for change. We are people who support the goals
of our health and care systems, but also want to change existing thinking and practice and improve care for patients
and people who use services.
The School for Health and Care Radicals provides tools, ideas and connections with a community of radicals to help us thrive
and survive as agents of positive change
#NHSChangeDay #SHCRchat
Joining in today and beyond
• Please use the chat box to contribute continuously during the web seminar
• Please tweet using hashtags #NHSChangeDay and #SHCRchat• We will produce summaries of the discussions on each module
using Storify.com and put on the website• The conversation continues on the live chat forum at
www.changeday.nhs.uk/healthcareradicalsforum
#NHSChangeDay #SHCRchat
• 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 thrive and survive as a radical• Questions and call to action
Source of image: www.freshnessmag.com
for today
#NHSChangeDay #SHCRchat
Why are we here? Why are you here?
#NHSChangeDay #SHCRchat
Why did you join the school?
‘I want to:• be part of changing the NHS and to learn how to be more
effective as a change maker’• learn how to implement change effectively and encourage
others to join the vision’• help others realise they're able to make changes without
seeking permission first’• network with other healthcare radicals
#NHSChangeDay #SHCRchat
Why did you join the school?
‘I want to:• learn, gain more inspiration and courage to continue what I
started’• share the joy of participating in NHS Change Day• share, be inspired and inspire others to support and coach
others to be the best they can with the aim of improving the NHS we love and cherish
• drive quality improvement, promote harm free care, make the improvement sustainable, remember patients are at the centre of everything we do
• spread change in a stealthy way!’
#NHSChangeDay #SHCRchat
31st January: Being a health and care radical: change starts with me7th February: Forming communities: building alliances for change14th February: Rolling with resistance21st February: Making change happen28th February: Moving beyond the edge
Modules
#NHSChangeDay #SHCRchat
The genesis of the School
2002
2014
2013
20102012
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
#NHSChangeDay #SHCRchat
Source: @NHSChangeDay
#NHSChangeDay #SHCRchat
The school is based on two kinds of learningTransactional 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
#NHSChangeDay #SHCRchat
What the school can offer
Five learning modules, live on Friday mornings and available 24/7
Materials, inc a weekly study guide to back up the modules changeday.nhs.uk/healthcareradicals
A weekly telephone discussion 7-8pm on Sunday evenings (if demand)
A weekly tweetchat, 4-5pm on Wednesdays #SCHRchat
A chat forum www.changeday.nhs.uk/healthcareradicalsforum
Potential to link you and/or your group with a mentor
What you might do Take part in the programme at
whatever level of engagement you want
Encourage others in your organisation or locality to join the school
Create your own local learning set or group
Join the Change Day movement and mobilise others
Keep a learning log, complete all modules and action your Change Day pledges to gain certification
#NHSChangeDay #SHCRchat
Emerging themes in change and transformation
Organisation CommunityPower through hierarchy Power through connectionMission and vision Shared purposeMaking sense through rational argument
Making sense through emotional connection
Leadership-driven (top down) innovation
Viral (grass-roots driven) creativity
Tried and tested, based on experience
“ Open” approaches , sharing ideas & data, co-creating
change
Transactions Relationships
Dominantapproach
Emerging direction
Source: @HelenBevan
#NHSChangeDay #SHCRchat
John Kotter: “Accelerate!”
• We won’t create big change through hierarchy on its own
• We need hierarchy AND network• Many change agents, not just the usual few • Changing our mindset
• From “have to” to “want to”• Head and heart, not just head
Source of image:www.slideshare.net/mexicanwave/champions-trolls-10-years-of-the-cipd-online-community
#NHSChangeDay #SHCRchat
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
#NHSChangeDay #SHCRchat
DiscussionWhat are the implications of the “emerging direction” for the way
change agents work?Organisation Community
Power through hierarchy Power through connection
Mission and vision Shared purpose
Making sense through rational argument
Making sense through emotional connection
Leadership-driven (top down) innovation
Viral (grass-roots driven) creativity
Tried and tested, based on experience
“ Open” approaches , sharing ideas & data, co-creating change
Transactions Relationships
Dominant approach Emerging direction
#NHSChangeDay #SHCRchat
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
#NHSChangeDay #SHCRchat
@rebelsatwork rebelsatwork.com
Across the world, the change agent movement is exploding!
@chagwwChangeagentsworldwide.com
@corprebelsCorporaterebelsunited.com
@helenbevan #1000LivesPlusImage copyright: http://13c4.wordpress.com/2007/02/24/50-reasons-not-to-change/
@helenbevan#NHSChangeDay #SHCRchat
What happens to heretics/radicals/rebels/mavericks
in organisations?
@helenbevan#NHSChangeDay #SHCRchat
@helenbevan#NHSChangeDay #SHCRchat
“There is nothing more difficult to carry out, nor more doubtful of success, nor more dangerous to handle, than to initiate a new order of things. For the reformer has enemies in all those who profit by the old order, and only lukewarm defenders in all those who profit by the new.”
Niccolo Machiavelli 15th century
@helenbevan#NHSChangeDay #SHCRchat
We need to be boatrockers!• 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#NHSChangeDay #SHCRchat
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#NHSChangeDay #SHCRchat
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 we surrender a part of ourselves, and silence
our commitment, in order to survive
Source: adapted from Debra E Meyerson
@helenbevan#NHSChangeDay #SHCRchat Source: Foghound
@helenbevan#NHSChangeDay #SHCRchat Source of image: quote.lifehack.org
@helenbevan#NHSChangeDay #SHCRchat
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 we surrender a part of ourselves, and silence
our commitment, in order to survive2. leave the organisation
Source: adapted from Debra E Meyerson
@helenbevan#NHSChangeDay #SHCRchat
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 we surrender a part of ourselves, and silence
our commitment, in order to survive2. leave the organisation
we cannot find a way to be true to our values and commitments and still survive
Source: adapted from Debra E Meyerson
@helenbevan#NHSChangeDay #SHCRchat
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 we surrender a part of ourselves, and silence
our commitment, in order to survive2. leave the organisation
we cannot find a way to be true to our values and commitments and still survive
3. stridently challenge the status quo in a manner which is increasingly radical and self-defeating
Source: adapted from Debra E Meyerson
@helenbevan#NHSChangeDay #SHCRchat
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 we surrender a part of ourselves, and silence
our commitment, in order to survive2. leave the organisation
we cannot find a way to be true to our values and commitments and still survive
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
Sometimes people see us radicals as troublemakers
Rebel
@helenbevan#NHSChangeDay #SHCRchat
Discussion
• What are your insights around “radicals” and “troublemakers”?
• What moves people from being “radical” to “troublemaker”?
• How do we protect against this?
@helenbevan#NHSChangeDay #SHCRchat
Valuing radicals
• “New truths begin as heresies” (Huxley, defending Darwin’s theory of natural selection)
• Big things only happen in organisations because of heretics and radicals.
GALILEO DESCRIBES HIS DISCOVERIES TO THE CHURCH ESTABLISHMENT
@helenbevan@HelenBevan @RobertVarnam #IHI25Forum #ChangeAgents
"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#NHSChangeDay #SHCRchat
‘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#NHSChangeDay #SHCRchat
History tells us that personal transformation comes before
organisational or system transformationIf 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
@helenbevan#NHSChangeDay #SHCRchat
1. Driven by conviction and values2. strong sense of “self-efficacy”
belief that I am personally able to create the change3. able to join forces with others to create action4. able to achieve small wins which create a sense
of hope, self-efficacy and confidence5. More likely to view obstacles as challenges to
overcome
Five things we know about successful boat rockers
Source: adapted from Debra E Meyerson
CHANGE
meBEGINS WITH
@helenbevan#NHSChangeDay #SHCRchat
Self-efficacy
“If you think you can or think you
can't, you are right.”
Henry Ford
“The ability to act is tied to a belief that it is possible to do so”
Albert Bandura
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#NHSChangeDay #SHCRchat
What’s the difference between
self efficacyand
self esteem,self belief,
self-confidence?
@helenbevan#NHSChangeDay #SHCRchat
Source: @NHSChangeDay
@helenbevan#NHSChangeDay #SHCRchat
Source: @NHSChangeDay
What is the issue here?“permission” ?
(externally generated)or
Self efficacy ? (internally generated)
@helenbevan#NHSChangeDay #SHCRchat
Brainstorm
What are some ways that health and care radicals can build self-efficacy?
@helenbevan#NHSChangeDay #SHCRchat
Building self-efficacy: some tactics1. Invest in your own change agent development (modules 2-5)
• create the conditions where success is more likely to happen
2. Create change one small step at a time3. Reframe your thinking:
• failed attempts are learning opportunities• uncertainty becomes curiousity
4. Make change (and learning cycles from change) routine rather than an exceptional activity5. Get social support6. Learn from the best7. Get people whose opinions you value to encourage you (mentor?)
@helenbevan#NHSChangeDay #SHCRchat
@helenbevan#NHSChangeDay #SHCRchat
1. Driven by conviction and values2. strong sense of “self-efficacy”
belief that I am personally able to create the change3. able to join forces with others to create action4. able to achieve small wins which create a sense
of hope, self-efficacy and confidence5. More likely to view obstacles as challenges to
overcome
Five things we know about successful boat rockers
Source: adapted from Debra E Meyerson
CHANGE
meBEGINS WITH
@helenbevan#NHSChangeDay #SHCRchat
The most effective change agents:• don’t waste their time and energy
blaming and complaining• take calculated risks to achieve the
outcomes they soughtNow is the time to plan steps to keep moving myself forward, with positive momentum, as a health and care radical
@helenbevan#NHSChangeDay #SHCRchat
Three assumptions for health and care radicals
1. Assume that everyone has a noble intention.2. When people “resist” change is it more likely
to be a result of their interpersonal interaction with the change process than their innate character traits (“a bad change process not a difficult person”).
3. My role as a change agent is about alignment, not judgement.
Source of image:help.adobe.com
@helenbevan#NHSChangeDay #SHCRchat
Being a great change agent is about knowing, doing, living and being improvement
@helenbevan#NHSChangeDay #SHCRchat
Being a great change agent is about knowing, doing, living and being improvement
Don’t boost self esteem
without boosting personal
knowledge and skills
@helenbevan#NHSChangeDay #SHCRchat
We have a choice“This is the true joy of life, the being used up for a
purpose recognised by yourself as a mighty one, being a force of nature instead of a feverish, selfish little clot of ailments and grievances, complaining that the world will not devote itself to making you
happy.”
George Bernard Shaw
@helenbevan#NHSChangeDay #SHCRchat
Outwitted
He drew a circle that shut me out -Heretic, rebel, a thing to flout.But Love and I had the wit to win:We drew a circle that took him in.
Edward Markham
@helenbevan#NHSChangeDay #SHCRchat
Calls to action campaigns for this weekPost these or similar actions as a pledge on the NHS Change Day pledge wall http://changeday.nhs.uk/wall• 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#NHSChangeDay #SHCRchat
Next opportunities for learning
• Sunday 2nd February 19:00-20:00 conference call discussion of
module one• Wednesday 5th February
16:00-17:00 Tweet chat #SHCRchat• Next Friday morning module 2:
Building alliances: forming communities for change
@helenbevan#NHSChangeDay #SHCRchat
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?