@HelenBevan #NWLBC

The personal leadership challenge of making

integrated care a reality12th March 2014

Helen Bevan@HelenBevan

@HelenBevan #NWLBC

Most large scale change doesn’t fullydeliver its objectives

Source: McKinsey Performance Transformation Survey, 3000 respondents to global, multi-industry survey

70%

25%5%

Gets anywhere near achieving the change and

delivering the benefits

@HelenBevan #NWLBC

Most large scale change doesn’t fullydeliver its objectives

Source: McKinsey Performance Transformation Survey, 3000 respondents to global, multi-industry survey

70%

25%5% Delivers and

sustains the change

@HelenBevan #NWLBCImage from: @TheWorldStories

@HelenBevan #NWLBCImage from: @TheWorldStories

@HelenBevan #NWLBC

Most change efforts are built upon the shaky foundation of five flawed assumptions; that change can be managed, that human beings are objective, that there are ‘X’ steps to change, that we have a neutral starting point for change, and that change, itself, is the goalPeter Fuda http://www.peterfuda.com/wp-content/themes/peterfuda-bootstrap/content/Why-Change-Efforts-Fail.pdf Source of image: Whatsthebigideascwartzy.blogspot.com

@HelenBevan #NWLBC

Tensions that change leaders must live with

Dominantapproach

Emerging direction

Source: @HelenBevan

@HelenBevan #NWLBC

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

@helenbevan@HelenBevan

We need to be 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

@helenbevan#NHSChangeDay #SHCRchatSource : Lois Kelly www.foghound.com

There’s a big difference between a rebel and a troublemaker

Rebel

@helenbevan@HelenBevan

Reflection

• What are your insights around “radicals” and “troublemakers”?

• What moves people from being “radical” to “troublemaker”?

• How do we protect against this?

@helenbevan@HelenBevan

Valuing radicals

• “New truths begin as heresies” (Huxley, defending Darwin’s theory of natural selection)

• Big things only happen in organisations and systems because of heretics and radicals

GALILEO DESCRIBES HIS DISCOVERIES TO THE CHURCH ESTABLISHMENT

@helenbevan@HelenBevan

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

@helenbevan@HelenBevan

Peter Fuda’s Transformational Change Agent framework: my perspective

“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

@helenbevan@HelenBevan

Peter Fuda’s Transformational Change Agent framework: my perspective

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

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

• Change begins with me• Hopeful futures, creative

opportunities and potential• Multiple lenses for change • See myself in the context of

my higher purpose

@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@HelenBevan

‘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@HelenBevan

1. Driven by conviction and values2. strong sense of “self-efficacy”

belief that I am personally able to create the change

3. 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

me

BEGINS WITH

@helenbevan@HelenBevan

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@HelenBevan

What’s the difference between

self efficacyand

self esteem,self belief,

self-confidence?

@helenbevan@HelenBevan

Source: @NHSChangeDay

@helenbevan@HelenBevan

Source: @NHSChangeDay

What is the issue here?“permission” ?

(externally generated)or

Self efficacy ? (internally generated)

@helenbevan@HelenBevan

Reflection

What are some ways we can build self-efficacy?

@helenbevan@HelenBevan

Building self-efficacy: some tactics1. Invest in your own change agent development • 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@HelenBevan

Lessons for leading change from Peter Fuda

1. In order to create/sustain radical change we need to move from a burning platform (fear based urgency) to a burning ambition (shared purpose for a better future)

2. We need to articulate personal reasons for change as well as organisational reasons

3. If the fire (the compelling reason) goes out, all other factors are redundant

@PeterFuda

@helenbevan@HelenBevan

TaskTalk to the person next to you• What is “my burning ambition” for the people we

serve, my service, team and/or family?• Try to make it personal: tell others why this ambition

connects with your personal motivations

@helenbevan #IQTGOLD#NHSChangeDay

“I have some Key Performance

Indicators

for you”

or

“I have a dream”

Source: @RobertVarnam

@helenbevan@HelenBevan

Three assumptions in leading change

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@HelenBevan

Source: @NHSChangeDay

Permissionlessinnovation!

@helenbevan@HelenBevan

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@HelenBevan

ReferencesThe School for Health and Care Radicals www.changday.nhs.uk/healthcareradicals 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

Change Agents Worldwide (2013) Moving forward with social collaboration SlideShare

Fuda P (2012) 15 qualities of a transformational change agent

Moore I (2013) Diversity is the short cut to building an innovation culture

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

Verjans S (2013) How social media changes the way we work together SlideShare