Developing Effective Call to Actions and Exploring Your Challenge

Marlies van Dijk January 30 & 31, 2013

Fiasco From the Field

They get designed using the same mindset, belief and rules as have been used before ….

Social Movements

“A voluntary collective of individuals committed to promoting or resisting change through coordinated activity.”

- Produce a lasting and self-generating effect- Create a sense of shared identity

Bibby et al, 2009

Characteristics of Social Movements

• Energy• Mass• Passion• Commitment• Pace and momentum• Spread• Longevity

Change is about releasing energy and is largely self-directing (top-led, bottom up)

‘Moving’ people

Focus on what is the right thing to do, even if there are personal implications for me

Insists change needs opposition - it is the friend not enemy of change

People change themselves and each other - peer to peer

A planned programme of change with goals and milestones (led from the top)

‘Motivating’ people

Change is driven by an appeal to the ‘what’s in it for me’

Talks about ‘overcoming resistance’

Change is done ‘to’ people or ‘with’ them - leaders and followers

“Planned” or “Programme” view of change

“Movement” view of changevs..

Not “either/or” but “both/and”

Frame to connect with hearts and minds

Question for Reflection

“When have you felt most energize and passionate about the work you have been involved in?”

1. What were its features? 2. How would you describe it?

Different thinking for different results

5 principles for radical change:

Frame to connect with hearts and minds

Energise and mobilise for action

Organise to drive change forward

Make change a personal mission

Hold the gains and sustain momentum

FramingFraming is the key to turning an opportunity into actionFrames:• are like picture frames, what is in it you see, what is outside

you do not• provide shape and structure for organising ideas and

arguments• are ‘hooks’ for pulling people in• are ‘springboards’ for mobilising support• Frames need to be authentic and connect with an

individual’s reality

Target audience

Doctors

Nurses

Administration

The Public

Bad framing?

The ministry has asked us to seriously improve efficiency of cases.

The doctors would like to start on time and operate on more patients.

The ministry has mandated we increase efficiency. This is an important aspect of patient access.

We can’t control everything – surgery is complex and we can’t promise wait times or guarantee of surgery on that day.

Good framing?

Starting on time will hopefully result in completing all cases slated for the day.

How can we have a better run operating room theatre? This way we also don’t have to tell patients they have been cancelled that day.

If we have more efficient operating rooms we will be able to do more cases and control or reduce the wait lists

Help us, help you

Framing: Operation Room - Efficiency

• Picture frames – what is in it, you see; what is outside you do not • Provide shape and structure for organizing ideas and arguments• “Hooks” for pulling people in (frame in one way and I pull you in;

frame in another, and it goes over your head)• “Springboards for mobilizing support” • Relies on authenticity and a connection with an individual’s reality • Must be credible!

– Resonate with mainstream beliefs and experiences– In terms of claims they make– Delivered by credible people

Frame to Connect with Hearts & Minds

Approaches for Effective FramingHooking People In

– Need to build mass; therefore appeal to a range of stakeholders– Think about the different people you need in order to achieve goals

Consider based upon readiness to act … “believers, sympathizers, ambivalents, antagonists, etc…”

– Frame differently for each target group

Connect with Hearts and Minds– Emotional heart tug – Intrinsic motivation and values – Imagine if …

mental health is understood by allNo one loses their dignityhospital admissions are rare

Bridging and Linking Diverse Groups– Outward looking and inclusive– Movements that are exclusive and inward looking

become sects and elites

Use a Range of Strategies– Words, stories, anecdotes– Visual images– Humor and irony– Performance and spectacle

Our aspiration is to have a healthcare system with:

• no needless death or disease• no needless pain• no unwanted delay• no feelings of helplessness (for patients or staff)• no waste• and no inequality in service delivery

(adapted from: Don Berwick by Pursuing Perfection)

Key approaches to framing• Clearly articulate your cause:

– not too broad, not too narrow– worthy and worthwhile– ambitious and lofty, yet achievable– make more friends than enemies

• Frame to connect with people’s emotions• Frame to connect with people’s minds logic/rational thinking• Bridge and link diverse groups• Employ a range of strategies appropriately

Framing the leadership role

“Leadership is the art of mobilising others to want to struggle for shared

aspirations.”

(Kouzes and Posner)

Exercise

• Framing for critical stakeholders

A good frame …• Increases the readiness to act

• Is credible, specifically:– involve empirically credible claims– is delivered by a credible individual

• Is salient, specifically:– compatible with life experience of the audience– resonates with values and sentiments

• Is compelling and optimistic

• Aligns with the desired direction

• Has the right scope

• Remains fresh

Call to Action

• To enable others to achieve a common purpose through shared values and commitment and by doing this, create 'contagious commitment' to deliver results in challenging times.

http://www.institute.nhs.uk/qipp/calls_to_action/Dementia_and_antipsychotic_drugs.html

What is it?

Hope…

We have a choice

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Six-stage staff engagement cycle

Asking

1

Listening

2

Understanding

3

Acting

4

Measuring

5

Spreading

6

Framing questions for staff around what we do and how we do it

‘Breakthrough conversations’ with critical mass of the right people who will jointly own the problem and the solution

Hearing what’s been said, re-framing local priorities so they connect and working out what to focus on together

Mobilising and energising the right mix of people to take ownership of

the improvement opportunities

Coordinating delivery and tracking improvements around patients,

staff and performance

Using the powerful stories of the outcomes delivered to inspire others

and ‘fuel’ further spread

Fuelling a ‘groundswell’ around engagement of staff and patients in owning and delivering priority outcomes better and faster for the benefit of our patients

Building connections with our staff by

listening to them, understanding what we hear and using this to drive joint

action

Linking staff insight with what matters to

our patients and public to build a

powerful picture to inform what we do and how we do it

‘Powering up’ leaders at all levels by giving them the know-how and confidence to engage the right

people in owning and addressing priority

issues in a joined up way

In parallel and continuously:

Interested in further reading?