being a change agent
TRANSCRIPT
@HelenBevan #womenlead
BEING a change agent
Helen Bevan
@HelenBevan
#womenlead
@HelenBevan #womenlead
“New truths begin as heresies” (Huxley, defending Darwin’s theory of natural selection)
Source of image: installation by the artist Adam Katzwww.thisiscolossal.com
Via @NeilPerkin
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@HelenBevan #womenleadSource: Lois Kelly http://www.slideshare.net/Foghound/rocking-the-boat-without-falling-out
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Functional thinking
(the things we do)
Change agents skills
Capability thinking
(our ability to do things)
Source of images: thenounproject.com
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Peter Fuda’s Transformational Change Agent Framework
Skills and methods for creating change
Possibilities, opportunities, things in a different light
A role model first and a preacher second
Source: Peter Fuda (2012) 15 qualities of a transformational change agent
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What is happening in the wider world that sets the context for change agents?
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Change is changing
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Kinthi Sturtevant, IBM 13th
annual Change Management Conference
June 2015
We rarely see two, three or four year change projects any more. Now it’s 30-60-90 day change
projects
@HelenBevan #womenleadSource: Bromford P (2015), ”What’s the difference between a test and a pilot?”
Pilots are being replaced by rapid tests and prototypes
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Acceleration of connectedness
Change is changing
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Digital skills are a critical capability for future leaders of improvement
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How does the NHS improvement community prefer to communicate?
Digital
Non-digital
ProactiveReactive
Source: RAND evaluation data from the Q community of improvement leaders
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How does the NHS improvement community prefer to communicate?
Digital
Non-digital
ProactiveReactive
Source: RAND evaluation data from the Q community of improvement leaders
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Hierarchical power is diminishing
Change is changing
Acceleration of connectedness
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Change is changing
Acceleration of connectedness
Hierarchical power is diminishing
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The Challenges
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Change is changing
Change is moving to the edge
Acceleration of connectedness
Hierarchical Power is diminishing
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An example from the Cabinet Office
http://www.slideshare.net/Openpolicymaking/060715-change-cardscollated?next_slideshow=1
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Why go to the edge?
“Leading from the edge brings us 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 outcomesAylet Baron
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Jeremy Heimens TED talk “What new power looks like” https://www.youtube.com/watch?v=j-S03JfgHEA
old power new power
Currency
Held by a few
Pushed down
Commanded
Closed
Transaction
Current
Made by many
Pulled in
Shared
Open
Relationship
The Network Secrets of Great Change AgentsJulie Battilana &Tiziana Casciaro
As a change agent, my centrality in the informal network is more important
than my position in the formal hierarchy
People who are highly connected have twice as much power to
influence change as people with hierarchical power
Leandro Herrerohttp://t.co/Du6zCbrDBC
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WHO will make the change happen?
Source: adapted by Helen Bevan from Leandro Herrera
List A• The STP Transformation
Programme Board [or equivalent]• The programme sponsors• The Programme Management
Office• The [insert number] STP
transformation work streams • The Clinical Leads of workstreams• The Directors of participating
organisations• The Change Facilitators
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WHO will make the change happen?
List A• The STP Transformation
Programme Board [or equivalent]• The programme sponsors• The Programme Management
Office• The [insert number] STP
transformation work streams • The Clinical Leads of workstreams• The Directors of participating
organisations• The Change Facilitators
List B• The mavericks and rebels• The deviants (positive). Who do
things differently and succeed• The contrarians, because they can• The nonconformists who see things
through glasses no one else has• The hyper-connected. Good or bad,
they spread behaviours, role model at a scale, set mountains on fire and multiply anything they get their hands on
• The hyper-trusted. Multiple reasons, doesn’t matter which ones
Source: adapted by Helen Bevan from Leandro Herrera
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WHO will make the change happen?List B
• The mavericks and rebels• The deviants (positive). Who do
things differently and succeed• The contrarians, because they can• The nonconformists who see things
through glasses no one else has• The hyper-connected. Good or bad,
they spread behaviours, role model at a scale, set mountains on fire and multiply anything they get their hands on
• The hyper-trusted. Multiple reasons, doesn’t matter which ones
Source: adapted by Helen Bevan from Leandro Herrera
List A• The STP Transformation
Programme Board [or equivalent]• The programme sponsors• The Programme Management
Office• The [insert number] STP
transformation work streams • The Clinical Leads of workstreams• The Directors of participating
organisations• The Change Facilitators
People who live and
perform in formal
organisation land and
people with the power to
make or break change are
two different lists (and
we need BOTH)
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What’s the evidence?The failure of large scale
transformational change projects is rarely due to the content or
structure of the plans that are put into action
To make transformational change happen we need to connect networks
of people who ‘want’ to contribute
http://iedp.com/articles/vertical-leadership/?utm_source=Sign-Up.to&utm_medium=email&utm_campaign=13787-257163-Campaign+-+01%2F09%2F2016
Source: David Dinwoodie (2015)
It’s much more about the role of informal networks in the organisations and systems
affected by change
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How well are we equipping NHS change leaders for this reality? Survey of 70 candidates for post of Head of Transformation, NHS Horizons team, July 2016:• Most candidates educated to at least Masters level• PRINCE 2 almost universal with Managing Successful Projects and
Lean methods well represented• Very few described strategic approaches to change or focussed on
social methods of change• Only limited descriptions of team /network based or facilitative
approaches to improvement • Most engaged in technostructure (technical advisory roles) – away from the locus of power in health organisations (Mintzberg typology)
• Old power/List A approaches predominated
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Let’s think about resources for change inold/new power terms
Economic resourcesdiminish with use• money• materials• human resources
diminish
Natural resourcesgrow with use• relationships• commitment • community
grow
Based on principles from Albert Hirschman and Marshall Ganz
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The capacity and drive of a team, organisation or system to act and make the difference necessary to
achieve its goals
http://www.institute.nhs.uk/tools/energy_for_change/energy_for_change_.html
Creating energy to enable transformation is a top priority
‘“Energy for change” defined as
What happens to large scale change efforts in reality
In order of frequency:1. the effort effectively “runs out of energy” and
simply fades away2. the change hits a plateau at some level and no
longer attracts new supporters3. the change becomes reasonably well established;
several levels across the system have changed to accommodate or support it in a sustainable way
Source: http://www.nhsiq.nhs.uk/8530.aspx
Why is energy for change important?
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Psychological
Physical
Spiritual
Social Intellectual
Change is most likely to happen when five energies are high
Source: http://www.institute.nhs.uk/tools/energy_for_change/energy_for_change_.html
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Social energy
Energy of personal engagement, relationships and
connections between people
It’s where people feel a sense of “us and us” rather than “us and them”
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Spiritual energy
Energy of commitment to a common vision for the future, driven by shared
values and a higher purposeGives people the confidence to move towards a
different future that is more compelling than the status quo
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Psychological energy
Energy of courage, resilience and feeling safe to do things differently
Involves feeling supported to make a change and trust in leadership and direction
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Physical energy
Energy of action, getting things done and making progress
The flexible, responsive drive to make things happen
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Intellectual energy
Energy of analysis, planning and thinking
Involves gaining insight as well as planning and supporting processes, evaluation, and arguing a
case on the basis of logic/ evidence
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High and low ends of each energy domain
Social isolated solidarity
Spiritual uncommitted higher purpose
Psychological risky safe
Physical fatigue vitality
Intellectual Illogical reason
LOW
HIGH
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Some questions
• Which group likely to have higher spiritual energy scores:• clinicians• non clinicians
• Nearer to CEO in the structure:
higher or lower overall energy scores?
Source: Respondents to the energy for change questionnaire NHSIQ/Horizons team
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Some questions
• Which group likely to have higher spiritual energy scores:• clinicians• non clinicians
• Nearer to CEO in the structure:
higher or lower overall energy scores?
Source: Respondents to the energy for change questionnaire NHSIQ/Horizons team
Answers:
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Energy analysis of six STP plans
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Energy analysis of six STP plans
Source: energy for change discourse analysis of six draft STP plans by the Horizons team September 2016
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Energy analysis of six STP plans
Source: energy for change discourse analysis of six draft STP plans by the Horizons team September 2016
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The challenge of disproportionately high intellectual energy
• Intellectual energy on its own isn’t transformational
• It keeps leaders in their comfort zone (intellect to intellect)
Emotion is the fuel for change; data and information provide
direction Dan Heath
(author of Switch)
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There has never been a time in the history of health and care when this advice has been more pertinent
“Leadership is not about making clever decisions and doing bigger deals.
It is about helping release the positive energy that exists naturally within
people”Henry Mintzberg
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The Change Challenge
Tapping the collective brilliance of the NHS
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14,000 contributions identified 10 barriers to change:
Confusing strategies
Over controlling leadership
Perverse incentivesStifling innovation
Poor workforce planning
One way communication
Inhibiting environment
Undervaluing staff
Poor project management
Playing it safe
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Front line teams get inundated with high priority messages from leaders each day, making it difficult for them to know what to focus on
Increasing number of messages as information cascade through
the organisation
Source: adapted from http://businessjournal.gallup.com/content/162707/change-initiatives-fail-don.aspx
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Front line teams get inundated with high priority messages from leaders each day, making it difficult for them to know what to focus on
Increasing number of messages as information cascade through
the organisation
Source: adapted from http://businessjournal.gallup.com/content/162707/change-initiatives-fail-don.aspx
Buy in from front line staff is critical for improvements in quality and safety . Don’t overload them
Buy in from front line staff is critical for improvements in quality and safety
Don’t overload themhttp
://healthaffairs.org/blog/2014/03/07/the-dangers-of-quality-improvement-overload-insights-from-the-field
/
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14,000 contributions identified 11 building blocks for change:
Inspiring & supportive leadershipCollaborative working
Thought diversityAutonomy & trust
Smart use of resources
Flexibility & adaptability
Long term thinking
Nurturing our people
Fostering an open culture
A call to action
Source: Health Service Journal, Nursing Times, NHS Improving Quality, “Change Challenge” March 2015
Challenging the status quo
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Being a great change agent is about doing, seeing and being change
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‘Avedis Donabedian
Ultimately, the secret of quality is love.…… If you have love, you can then work backward to monitor and improve the system
@HelenBevan #womenleadProject Aristotle: http://qz.com/625870/after-years-of-intensive-analysis-google-discovers-the-key-to-good-teamwork-is-being-nice/
After years of intensive analysis, Google discovers that the key to high performing,
teams that deliver change is Being nice
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Tactic for change agents:Out-love everyone else
Source of image: Bradley Burgess