SHCR II Module 5 Moving beyond the edge

#SHCR @school4radicals

http://www.theedge.nhsiq.nhs.uk/school/

Module 5:

Moving beyond the edge

Supported by

http://www.theedge.nhsiq.nhs.uk/school/

#SHCR @school4radicals#SHCR @School4Radicals

Joining in today and beyond• Please use the chat box to contribute continuously during the

web seminar

• Please tweet using hashtag #SHCR and the handle @School4Radicals

• Join our Facebook group School for Health and Care Radicals

• We will produce summaries of the discussions on each module using Storify and Pinterest and put on the website

• Join in the Tweetchat next Wednesday at 4-5pm (GMT) using the hashtag #SHCR


• Review of what we have learnt so far

• characteristics of a transformational change agent

• “From” the edge – views about the emerging directions for change and change agents

• Opportunities for health and care radicals

• Reflections and key messages about The School

• What next for The School?

• Questions and call to action

Source of image: www.freshnessmag.com

for today


The team today

Session lead: Helen Bevan @HelenBevan

Learning lead: Pip Hardy@PilgrimPip

Chat monitor:Dominic Cushman@domcushnan

Case study:Alison Cameron@allyc375

Twitter monitor:Kate Pound@kateslater2

Case study alumnus:Dr Jim Rawson@Jim_Rawson_MD

Case study alumna:CJ Graham@CJGrahamNHS


Icebreaker 1: What do edges mean to you?


Icebreaker 2: How do you feel as you approach the edge?

I’m ready to be radical!

I’m still sceptical.

I’m cautiously optimistic…

I’m feeling positive, let’s see how I can

make this work!


The School for Health and Care Radicals

Get certificated!


Pulling it all together: the characteristics of a radical

change agent


“Some learning reinforcement after a short space of time helps to retain

learning.”Casebourne I (2015)

Spaced Learning: An Approach to Minimize the Forgetting Curve

https://www.td.org/Publications/Blogs/Science-of-Learning-Blog/2015/01/Spaced-Learning-an-Approach-to-Minimize-the-Forgetting-Curve

https://www.td.org/Publications/Blogs/Science-of-Learning-Blog/2015/01/Spaced-Learning-an-Approach-to-Minimize-the-Forgetting-Curve


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


Peter Fuda’s Transformational Change Agent framework: my commentary

“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

• The “de facto” purpose of a health and care radical


Peter Fuda’s Transformational Change Agent framework: my commentary

“Seeing ” and “Being”• We can only do effective

“doing” if we build on strong foundations of “seeing and being”

• Give us the potential for:• better outcomes• more engagement• self-fufillment and

connection with our bigger purpose as an agent of change


“Being” as a health and care radical

Personal characteristics and qualities


“ Being an effective Change Agent involves demonstrating what you teach as much as pontificating from the mountaintops. Any behaviour we ask others to adopt, we must consistently represent in our

own work, and share the positive outcomes.”

Bryce WilliamsWorking Out Loud



CHANGE

me

BEGINS WITH

• Living my conviction and values

• Strong sense of “self-efficacy” belief that I am personally able to

create the change

• Shared purpose, not de facto purpose

• A role model and signal generator

• Stepping outside my comfort zone

• A “rebel” rather than a “troublemaker”

• Learning not judging




CHANGE

me

BEGINS WITH



create the change







‘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

#SHCR @school4radicals#NHSChangeDay #SHCRchat#SHCR @School4RadicalsSource : Lois Kelly www.foghound.com

Rebel

http://www.foghound.com/



CHANGE

me

BEGINS WITH



create the change






Jim Rawson, MD, FACR

P.L., J. Luther and Ada Warren Professor

Chair, Radiology and Imaging

Medical College of Georgia

@Jim_Rawson_MD

Case study alumnus

• 40 participants (Radiologists and other physicians, residents, students, consultants, business school faculty, administrators, public health…)

• Weekly email updates

• Weekly Chat Thursday 12 noon EST

• Weekly Conference call/discussion 5:30 pm EST

#SHCRUSA Learning Group


“Seeing” as a health and care radical

Ability to make sense of, and reshape perceptions of

‘reality’


Seeing

“Seeing, looking, monitoring, listening, perceiving and especially the indefinite concept

of intuitive feeling. ”

Aubrey Jango


“Seeing” as a health and care radical

• The big picture

• Multiple perspectives

• Reframing situations:

• failed attempts are learning opportunities

• uncertainty becomes curiosity

• The positive intentions of others

• Possibility of bad change processes rather than resistors, blockers and laggards

• Hopeful futures, creative opportunities and potential

• See myself in the context of my higher purpose


“Creative ideas reside in people’s mindsbut are trapped by fear of rejection.

Create a judgement-free environment and you’ll unleash a torrent of creativity.”

Alex Osborn

Source of image: elementsvillage.com

#SHCR @school4radicals#SHCR @school4radicals Source: http://www.slideshare.net/AndreaWaltz/gfn-slidesharegfnhandling-rejectionpositively

http://www.slideshare.net/AndreaWaltz/gfn-slidesharegfnhandling-rejectionpositively


“Doing” as a health and care radical

Skills and methods for creating change


“Doing” as a health and care radical

• Create the conditions where everyone can contribute and do their best

• Join forces with others to create action

• Achieve small wins which create a sense of hope, self-efficacy and confidence

• Appeal to both the head (logic/planning/data) and the heart (shared values/purpose, framing, relationships)

• Make change (and learning cycles from change) routine rather than an exceptional activity

• Use models, theories and frameworks effectively


Use models, theories and frameworks effectively


Case study alumna:CJ Graham


Conclusions for health and care radicals?


The mindset of the past has a tendency to hijack the transformational potential of the future

“ The greatest

danger in times

of turbulence is

not the

turbulence…….

it is to act with

yesterday’s

logic.”

Peter Drucker


“ History, even if properly construed, can blind us to important possibilities. After all, it is not the

rhythms of the past that define us, but our dreams for the future.”

Greg Satell http://www.digitaltonto.com/2014/are-you-using-data-to-analyze-the-past-

or-to-create-a-new-future/

http://www.digitaltonto.com/2014/are-you-using-data-to-analyze-the-past-or-to-create-a-new-future/


“From the edge”

Source of image:hoodlinghole.blogspot.com


#SHCR @school4radicals#SHCR @school4radicals

What do we mean by “the edge”?

• Working at the edge of organisations so we can see the potential and make connections that we couldn’t do if we were at the centre

• At the edge of current practice and knowledge about change

• Taking risks and demonstrating courage to think and do things in new ways

• On the edge of ?


Why do we go to the edge?

The edge is where those who want to challenge are able to unite,

share, support and grow together as change activist. Leading from the edge brings you into contact

with a far wider range of relationships, and in turn, this

increases our potential for diversity in terms of thought, experience

and background. Diversity leads to more disruptive thinking, faster change and better outcomes.”

“


Case study:Alison Cameron


The Patient Revolution!


From module one


What are the biggest opportunities for change agents in our system?

• As bridge builders between disconnected groups

• As curators and sharers of knowledge


Improvement teams will move from “bench

scientists” (programme managers) to knowledge leaders and connectors

http://connect.forwardmetrics.com/business-management/the-

strength-within.html

http://connect.forwardmetrics.com/business-management/the-strength-within.html

#SHCR @school4radicals#NHSChangeDay #SHCRchat#SHCR @School4Radicals

Less change programmes More change platforms

Change Programmes:• utilise systematic “change

management” approaches• Too often, leaders prescribe

the outcome and the method of change in a top-down way

• change is experienced by people at the front line as “have to” (imposed) rather than “want to” (embraced)

Change Platforms• enable everyone in the

organisation/system (including service users) to help tackle the most challenging issues

• value diversity of thought• leadership attention on

creating an environment receptive to transformational change

http://www.hsj.co.uk/resource-centre/scrap-the-programme-successful-change-starts-with-a-change-platform/5078014.article?blocktitle=Blogs-and-videos&contentID=16031

http://www.hsj.co.uk/resource-centre/scrap-the-programme-successful-change-starts-with-a-change-platform/5078014.article?blocktitle=Blogs-and-videos&contentID=16031

#SHCR @school4radicals#NHSChangeDay #SHCRchat#SHCR @School4Radicals

Curate rather than create knowledge for improvement

Source of image: John Curran designedforlearning.co.uk

Because there’s a problem….

Source of quote: Harold JarcheSource of image:http://gotcll.com/about-2/

“Gettinginformation off the

internet is like taking a drink from a fire hydrant.”

Mitchell Kapor

@@HelenBevan #Quality2014@@HelenBevan

How do we know what to learn and absorb?

Source of image: Frits Ahlefeldt

A big challenge for improvers

Tacit knowledge is where the action is….• It’s the people with tacit knowledge who deliver the results• Tacit knowledge is critical for large scale change

...but

The only way tacit

knowledge can be broadly shared…

…is to turn it into

explicit knowledge

VERY difficult

Few organisations succeed

Gray D (2012) The Connected Company

Source: Harold Jarche

“

Source: http://paul4innovating.com/2014/04/06/learning-favours-the-brave/

It is easy to copy but we often fail to recognize all the contextual factors that went into making it

that one specific organizations good practice, and I guarantee these are not yours!

Organizations need to move well beyond their lazy reliance on best practice comparison and they need to

find better ways to explore emerging practices. But that takes many into the realm of increasing uncertainties, and most people and organizations are not trained for

this exploration and experimentation.”

Knowledge exchange is the way forward but there aren’t really any easy paths

http://paul4innovating.com/2014/04/06/learning-favours-the-brave/


How the world of work is changing

From : http://jarche.com/2015/02/adapting-to-perpetual-beta/

http://jarche.com/2015/02/adapting-to-perpetual-beta/


“Tacit knowledge is best developed through conversations

and social relationships.”Harold Jarche

Source of image: northcentralcollege.edu

What is the best way to spread new knowledge?

Source of data: Nick Milton www.nickmilton.com/2/2tOjE

Social connection/discussion is

14 times more effective

than

written word/ best practice

databases/toolkits etc

Source of image: happiness-one-quote-time.blogspot.com

http://www.nickmilton.com/2/2tOjE

“Curating” knowledge in a social era

Finding things out and keeping up to date• “pulling” information, but also having it

“pushed” to us by trusted sources

Making 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

knowledge

Connecting and collaborating• Sharing complex knowledge with our

own work teams

• Testing new ideas with our own networks• Increasing connections through social

networksSource: Harold Jarche

The School is brought to you by the Horizons Group within NHS IQ

Aim of the group: to stimulate new and ‘disruptive’ approaches in support of health and care transformation, operating at the edge of current thinking and practice:

• skipping a generation of thinking about how to create radical, system-wide change

• skipping a generation in a wider level of connection: working with emerging leaders, clinical trainees, students

• skipping a generation of methods for change: open innovation, open source, digital connection, social media, change platforms, hacking

“You

can’t cross a chasm in small

steps”David

Lloyd George


6 things I have learnt from this experience of The School for Health and Care Radicals

1. The most important need is for connection and community

2. How to build the relationship between tacit and explicitknowledge

3. The best experience seems to be synchronous in time, asynchronous in location

4. We benefit greatly from our global connections

5. All teach, all learn

6. There is a massive untapped reservoir of energy, talent and willingness to lead change out there and the potential is outstanding


Discussion:

what are your reflections?


“ Employee social activism is not just not a threat any more.....

It is the future.”

Celine Schillinger

(NB: also applies to patient activism)

Source of image: webershandwick.co.uk



Call to action

1. Consider why it would be beneficial for you to be a certified change agent

2. Identify people who might help you with this process

3. Think about the action(s) you will take to prepare for certification

4. Plan to complete the follow-up work for certification


A call to arms: Recipes for Radicals

Stories and recipes to feed your soul

A resource to help us recharge, reconnect and keep the SHCR momentum going.


Gain a certificate as a health and care change agent AND claim your continuing professional development points

Take some actions to demonstrate your learning from the school and become a “certificated change agent”. If you complete the learning process you will: • Be recognised as a “certified change agent” by the school and

NHS Improving Quality • Be awarded a virtual badge that you can used on your email

signature, personal website, etc.• Be invited to take part in one of our virtual graduation

ceremonies• Take part in a virtual clinic – see News from Jo• Receive a certificate

More details in News from Jo and here: http://www.theedge.nhsiq.nhs.uk/school/resources/

http://www.theedge.nhsiq.nhs.uk/school/resources/

#SHCR @school4radicals 66

NHS IQ presents….

A Changeathon

We are running a 12 hour event on NHS Change Day that will feature inspirational change stories and broadcasts from change events across the

country.

The Changeathon will be live from 7am –7pm

Find out more here: http://changeday.nhs.uk/changeathon/

http://changeday.nhs.uk/changeathon/


Improvement FUNdamentalsYour route to improve health and careAre you…..

• A radical who wants to learn more?

• Aiming to improve health and care?

• Wanting to study at a time and place to suit you?

• Keen to connect with a global improvement community?

If so then you are not alone - this course is for you

Join us on our innovative, online course, free to all

Starting April 2015

http:www.nhsiq.nhs.uk/GoHiking #QIHikers

We will send you details of


Questions for reflection

1. How can I move in the direction of change in ways that will help me bring about the changes I want to see?

2. How will I build on my experiences of the School for Health and Care Radicals?

3. How will I build networks and communities in support of the changes I want to see?

SHCR II Module 5 Moving beyond the edge

Healthcare

radical change agent

great change agent

safety edge

school4radicalsthe school

care radicalswe

care radicalsreflections

care radicalsget

edge views