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

#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

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

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

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 Williams
Working Out Loud

“Being” as a health and care radical
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

‘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 @School4Radicals
Source : Lois Kelly www.foghound.com
Rebel

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 minds
but 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 @school4radicalsSource: 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/

“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.c
om/business-management/the-
strength-within.html

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

Curate rather than create knowledge for
improvement
Source of image: John Curran designedforlearning.co.uk

Because there’s a problem….
Source of quote: Harold Jarche
Source of image:http://gotcll.com/about-2/
“Getting
information 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

How the world of work is changing
From : 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

“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
networks Source: 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 explicit
knowledge
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/

#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/

Improvement FUNdamentals
Your route to improve health and care
Are 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

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