jackie lynton presentation at cerner health conference

ENGAGEMENT COMMITMENT ENERGY

LESSONS IN TRANSFORMATION FROM THE NHS, ENGLAND

Jackie Lynton – Lead Associate Horizons Team - NHS Improving Quality


Overview

1. Why start with shared purpose?

2. Case Study: NHS Change Day

3. Lessons in transformation from the largest simultaneous improvement event in the history of the NHS in England

4. Invite you to think about one thing that you will do differently from today or what you would pledge to improve what you do


About me

1. Thirty two years experience in the NHS and social care

2. NHS Improving Quality, national improvement body

3. New national team, Horizons - leading healthcare from the future

4. Previous roles: MH nurse, social care, strategic, operational, commissioning, Mid Staffordshire hospital, large scale change

5. Leading NHS Change Day

6. I am passionate about what I do

7. I found my purpose by starting with me!

8. Three girls; 27, 23, 13


The English National Health Service (NHS) – 65 years

1. Free at the point of contact

2. Spend c£110b (USD $170b) on health services – 1st Mental health, 2nd circulatory problems, 3rd cancers and tumours

3. Employs 1.7m staff

4. Fifth largest organisation in the world

5. Serves a population of 54m people

6. Everyday over 1m people use the NHS

7. Improvements in waiting times, hospital acquired infections, cancer

8. It’s a massive complex system, that needs to improve care


Our challenges in the NHS

1. Unsustainable patterns of growth in expenditure

2. Rising demand and expectation

3. 4% compound reduction, four years running

4. £20b (USD $31b) savings – needs to be made

5. Healthcare needs to be better and cheaper

6. Huge media spotlight

7. Over regulated and fragmented system

8. Delivering higher value through quality improvement

9. How to make the savings and keep quality as an organising principle


Why start with shared purpose? 1


“For those who hope to

lead today must first tell

their story”

Patients

‘I am the

expert of me’

Change my way

of thinking…

Everyone has a

unique story

Everyday you get up with a

purpose


Purpose expresses who I am and why I do what I do

Why are you called to do the work that you do (values)

+


Shared purpose vs Organizational purpose

Shared purpose goes way deeper then vision and

mission; it goes right into the gut and taps some

part of our primal self. I believe that if you can bring

people with similar-purposes together and get them

marching in the same direction, amazing things

can be achieved.

Seth Garguilo


Inspire

Why and why now? NARRATIVE Belong Emotion Feeling Values

How and where? ACTION

Contribute Create

Connect Lead

What and Who? STRATEGY Know Think Understand Logic

How did the great social movement thinkers change the world?


Through our emotions we are more likely to be inspired to

take action

Action

Values

Emotion

For those who are inspired, the motivation to act is deeply personal (Simon Sinek)

Source: Marshall Ganz


The power of Us and Us

1. Cut on the dotted line 2. Rotate 180 degrees


Five reasons to start with shared purpose (why)

1. You cant impose anything on anybody and expect them to

be committed to it. - Edgar Schein

2. Those who start with WHY never manipulate, they inspire.

People follow them not because they have to, but because

they want to. - Simon Sinek

3. We respond differently when we hear stories, rather than

when we see the policy data or financial balance sheets.

4. Purpose helps us to understand what we value in the world

and why the work we do is important to us.

5. Commitment to a common purpose creates energy for

action and great leaders inspire us to act to create

behavioural and cultural change.


Case Study - NHS Change Day 4


70% of Large Scale Change Projects fail

70%

25%

5%

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


100% of all projects evaluated as “Successful” had a good

technical solution or approach

100%


Over 98% of all projects evaluated as “Unsuccessful” also had a good

technical solution or approach

98%


Our strategy for dealing with change sometimes looks like this….

- Structural change - Focus on productivity - Programme management - System drivers - Hitting targets - Reducing costs - Eliminating waste - Inspection regimes


The largest simultaneous improvement initiative in the history of the NHS

You cant impose anything on anyone and expect them to be committed to it. Edgar Schein


It started with a tweet!

You cant impose anything on anyone and expect them to be committed to it. Edgar Schein

Young clinical leaders and improvement leaders started to talk about how they could improve care Damian Roland Stuart Sutton Helen Bevan


Our shared purpose

Creating a mass movement of people working in and with the NHS demonstrating the difference they can make, by pledging one simple act big or small to improve patient care. Our goal: 65,000 pledges, 1000 for every year since the NHS was established

From single action to… …collective

action


Did we have a strategy?

Yes but not this kind… This kind…


Do something better together


“If you want to really understand management, manage volunteers” – Peter Drucker

It changes how you look at motivation and influence if

you remove the handcuffs of employment from your

view of managing performance

It makes you work harder at aligning your goals and

their goals

Volunteers are doing something because they want

to, not because they need to.


Core leadership team


Share one thing that you have recently changed?


Anyone can pledge – and it’s personal to you

• PLEDGE

• SHARE

• DO

• INSPIRE


Example pledge – James’s story Individual – DVT check to every ward round

I was surprised at how simple it actually was to do… “ ”

Surgeon


Example pledge – Jackie’s story Individual > organizational

By spending a day with frontline staff I was able to reconnect with why I do what I do. The staff were so committed. The Trust really took the concept of Change Day to another level by getting the whole organisation behind it.

“

” Barking, Havering and Redbridge University hospital, London


Example pledge – Ashley’s story Patient/Staff champion > to Board

Change Day gave me permission to use my energy in the direction that I wanted to use it “ ”


Example pledge – Ellie’s story Feedback Wednesday – Individual > organisational

“I was able to facilitate changes from feedback quickly, to make great

difference for our patients. Being a part of the core team inspired me even

more and the idea spread to different departments.”

Patient Experience Lead

Birmingham Children’s Hospital


Example pledge – Damian’s story Individual

It has prompted myself, and others to discuss with our pharmacies methods of improving the taste of one of the common medicines for children.

“ ” Damian Roland - Junior Doctor

Dr Rani – Childrens TV Presenter

Stuart Sutton - GP


Example pledge – Russell’s story Individual > global Cerner

Our Change Day event brought together people driving change in healthcare. It positioned Cerner as a partner for change an transformation

“


NHS Change Day survey feedback

MEASUREMENT

BENEFITS

SUSTAINABILITY AND IMPACT

Our patient satisfaction has gone through the roof. It has been so successful that we have come from daily complaints to being nominated to the ‘Outstanding and Compassionate care Award’ in less than 6 months. Heart of England Foundation Hospital

“

”


Measurement, benefits and impact

MEASUREMENT

Year 1

65,000 pledges,

creating a ground swell

BENEFITS

•Scale and accelerate the time from an idea to implementation

•Partnerships becomes possible

•Young leaders empowered (check in)

SUSTAINABILITY AND IMPACT

Small sample from a recent survey monkey:

80% Said they shared what they were doing with others

The majority of people said it caused a change in their personal behaviour

The majority of pledges led to a long term impact in the organisation

Year 2 - 2014 – 500,000 Pledge, share, do, inspire (mobile app)

Year 3 – Continuous cycle of improvement, patient experience, value


Lessons learned

3


Challenges

1. Many people did not believe it was possible to build a grassroots improvement movement inside a hierarchy like the NHS

2. Seek forgiveness rather than permission, frontline staff believing they could lead change without being told what to do

3. Leaders and managers mind set need to change with new ways of improvement thinking

4. How do we ignite the fire of NHS Change Day at Scale and enable it to go viral. Social media still novel or patchy across healthcare

5. Maintaining momentum and our own energy up. Attract new supporters

6. Copious amounts of courage and belief (took a leap of faith)


Biggest motivating factor – we didn’t tell people

what to do


We worked with the hierarchy…..

You’ve got to see people like me saying… we’re here to help you do your job better... to take away the obstacles that stop you doing it. And if we see our job like that, it’s a completely different way of thinking about how the system operates

“

” Sir David Nicholson CEO – NHS England Dementia pledge

Leadership cannot rely on a presumed monopoly of ideas


She’s a rebel…..


Organisational radicals Rock the boat …..but stay in it!

….and don’t be a

martyr!


Organisational radicals What do boat rockers do……

• Able to challenge the status quo when they see that there could be a better way

• Walk the fine line between difference and fit, inside and outside, rock the boat but manage to stay in it

• Capable of working with others to create success NOT a destructive troublemaker


Global Change Day 2014 Individuals representing 16 countries

Reconnected with my values & ‘WHY’ I came into healthcare


When you inspire be prepared for anything Global Change Day – 3 March 2014


Summary

1. Change start with self – Its starts with me!

2. Everyone has a story – they are all unique

3. Start with shared purpose, but find your purpose

4. Connect through the head, heart and hands

5. We need to work/lead differently – courageous. If you don’t believe in it yourself then don’t expect others to

6. Real power – comes from giving away power to others

7. Push the boundaries and hierarchy in pursuit of the goal – the goal is the goal

8. When we use natural resources, the more we use them, the more they grow


What will you do differently after today? I invite you to pledge to make a difference….

I pledge to……… It starts with you.....


Thank you for listening

Questions?

www.nhschangemodel/nhschangeday #nhschangeday Jackie Lynton @jackielynton [email protected] Russell Mayne @russellmayne [email protected]


jackie lynton presentation at cerner health conference

Health & Medicine

leading nhs change day

common purpose

cultural change

quality improvement

large scale change projects

improvement leaders

structural change focus

action action values