Time to rewrite the rules of change in health and care

It’s time to rewrite the rules
of change in health and care
Source of image: www.ohiolibertycoalition.org
Helen Bevan
APAC Forum
Wednesday 3rd September 2014
@HelenBevan
#APACForum

“New truths begin as heresies”
(Huxley, defending Darwin’s theory of natural selection)
@HelenBevan #APACForum
Source of image:
installation by the
artist Adam Katz
www.thisiscolossal.com
Via @NeilPerkin

The ideas in this talk come from
our White Paper
@HelenBevan #APACForum
• 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
w w w.nhsiq.nhs.uk/whitepaper

What is the single biggest thing that
is happening in the world now that
impacts on our ability to deliver?
Source: http://peopledevelopmentmagazine.com/dr-john-kotter/

SEISMIC SHIFTS
@H@elHeneBleevnaBne #vAaPnACForum

SEISMIC SHIFTS
DIGITAL
CONNECTION

Facebook didn’t exist,
Twitter was still a sound,
the cloud was still in the sky,
4G was a parking place,
LinkedIn was a prison,
applications were what you sent to college,
Skype was a typo Thomas Friedman,
World Economic Forum,
Quoted by http://ayeletbaron.com

SEISMIC SHIFTS
Work
complexity

SEISMIC SHIFTS
DIGITAL
CONNECTION
H ie ra rchica l
powe r
Work
complexity

SEISMIC SHIFTS
DIGITAL
CONNECTION
H ie ra rchica l
powe r
Work
complexity
Change from the edge

Many of the ways we go
about improving health
and care were designed in a
different mindset
for a different set of
circumstances
We are operating
with 20th century
change practice in a
21st century world
:
Source of images :
http://www.slideshare.net/dachisgroup/dave-gray-the-connected-company

Leading change in a new era
Dominant approach Emerging direction

Leading change in a new era
Dominant approach Emerging direction
Most healthcare
transformation
efforts are driven
from this side
Most healthcare
transformation
efforts are driven
from this side

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

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

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
@HelenBevan

What’s your theory of change?
Source of cartoon: Networkednonprofit.org

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

Across the world,
the change
agent
movement
Is exploding!
@corprebels
corporaterebelsunited.com
@HelenBevan
@chagww
changeagentsworldwide.com
@rebelsatwork
rebelsatwork.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

There’s a big difference between a rebel
and a troublemaker
@HelenBevan
Rebel
Source : Lois Kelly www.rebelsatwork.com

Reflection
• What are your insights around “rebels” and
“troublemakers”?
• What moves people from being “rebel” to
“troublemaker”?
• How do we protect against this?

A disruptive case study
Probably the largest simultaneous improvement initiative in the history of healthcare
@HelenBevan #Quality2014 #f1

NHS Change Day
Aim:
to create a mass movement of grass roots NHS staff and
people who work with and use the NHS to pledge a
simple act that can contribute to better patient care

NHS Change Day 2014
More than 700,000 pledges to take action
• 81 separate Campaigns
• 86 million twitter
impressions
• 35,400 video views
• 95,000 daily reach on
Facebook
• More than 98% of the
activity through volunteers

It started with a tweet in June 2012!
Young clinical leaders
and improvement
leaders decided to start
a social movement to
improve care
Damian Roland
Stuart Sutton
Helen Bevan

Probably the only
winner of a global
challenge to develop
leaders in the
corporate world that
names Saul Alinsky
and Marshall Ganz as
major influencers

Evaluating NHS Change Day
• We’re evaluating intention
(pledging), initiation
(doing) and outcomes
(delivering)
• We’re developing and
testing new methods to
show impact
• We want to build new
theory of large scale
change

Change Day is spreading…….
Australia
Sweden
N Ireland
Denmark
Canada
Netherlands
Saudi Arabia
USA
Finland
…….and many more

Source: @NHSChangeDay
Can I, dare I?

The School for Health and Care
Radicals
• A virtual school
• Anyone can join
• All the resources are
completely open
• Five weeks of virtual
lectures, study guides,
materials, tweetchats
• Demonstrate learning to
earn a virtual badge

The School for Health and Care Radicals
More than 1,600 enrollees from 40 countries
90 volunteer mentors
Average weekly twitter reach 2.6 million
Over 25,000 shares of the slides on SlideShare
More than 10,000 shares of the study guides
More than 10,000 tweets using #SCHRchat
Storify has been viewed 2,000 times
150 people achieved full graduation

We learnt...
1. The core audience is different to that
which we anticipated
2. The most important need is for
connection and community
3. How to build the relationship between
tacit and explicit knowledge
4. There is a massive untapped reservoir
of energy and talent out there and the
potential is outstanding
www.changeday.nhs.uk/healthcareradicals

Underpinning theme:

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

View the four minute film I will be
showing at this point in the presentation
HERE:
http://bit.ly/1zblWHj

• 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

References
Baron A (2014) Preparing for a changing world: the power of relationships
Bate P, Robert G, Bevan H.
The next phase of healthcare improvement: what can we learn from social movements?
Quality and Safety in Health Care. 2004 Feb;13(1):62-6.
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
Hamel G (2014)Why bureaucracy must die
Jarche, @H@elHeneBleevnaBne H (2013) #vAaPnACForum
Rebels on the edges

References
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
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

Time to rewrite the rules of change in health and care

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