leading real change from the front line · 2018-05-02 · steve fairman managing director, nhs...
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Leading real change from the front line –what can you do tomake a difference for your patients?
Steve Fairman
Managing Director, NHS Improving Quality
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To start,a short story
about a fridge
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Image from: @TheWorldStories
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• Creating a space for getting ready for change
• Invitation to thinking differently about change
• Share the collective wisdom of people in the room – 5 minutes of wisdom
Overview
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Image copyright: http://13c4.wordpress.com/2007/02/24/50-reasons-not-to-change/
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…your organisation may not be ‘change friendly’…
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Research from the sales industry:
• 2% of sales are made on the first contact
• 3% of sales are made on the second contact
• 5% of sales are made on the third contact
• 10% of sales are made on the fourth contact
• 80% of sales are made on the fifth to twelfthcontact
Source: http://www.slideshare.net/bryandaly/go-for-no
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Source: @NHSChangeDay
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Employee resistance is the most common
reason executives cite for the failure
of big organizational-change efforts
Scott Keller and Colin Price (2011), Beyond Performance: How Great Organizations Build
Ultimate Competitive Advantage Source of image: Businessconjunctions.com
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The NHS Change Challenge
• The World’s first mass crowd-sourcing event focused on improving healthcare
• 14,000 contributions
• 10 Barriers to change identified
• 11 Building Blocks for change identified
• 17 practical solutions built by contributors
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Confusing strategies
Over controlling leadership
Perverse incentivesStifling innovation
Poor workforce planning
One way communication
Inhibiting environment
Undervaluing staff
Poor project management
Playing it safe
Source: Health Service Journal, Nursing Times, NHS Improving Quality, “Change Challenge” March 2015
The 10 barriers to change identified by 14,000 contributions from front line staff
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The 11 building blocks for change identified by 14,000 contributions from front line staff
Inspiring & supportive leadership
Collaborative 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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A Solution:Everybody’s ideas on board
• Simple and easy
• A place to pose questions about delivery of your service, or staff or patient experience
• A place anyone can post responses
• Locally owned improvement plans!
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Everybody’s ideas on board (2)
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A Solution:Use a Change Model
• No one model has all the answers
• A mental framework and a process that can help
• Use evidence of what makes change successful
• Helpful to see the change through different lenses
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Use a Change Model (2)
Bigger picture / longer term thinking
Poor workforce planning
Poor project management
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A Solution:An online NHS Forum
• The NHS is terrible at shouting about its successes
• More wheels are reinvented by the NHS than by Ford
• Share!
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An online NHS Forum (2)
Inhibiting environment
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A Solution:Empower everyone to be a change agent
• It’s easy to feel isolated if you want to change things
• Build everyone’s QI skills and confidence and willingness to take on a challenge as an antidote
• Resistance to change will fall…
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Empower everyone to be a change agent (2)
Flexibility and adaptability Playing it safe
Poor workforce planning
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Source: @NHSChangeDay
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Source: @NHSChangeDay
What is the issue here?
“permission” ? (externally generated)
or
Self efficacy ? (internally generated)
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Building self-efficacy: some tactics
1. Create change one small step at a time
2. Reframe your thinking: failed attempts are learning opportunities
3. Make change routine rather
than an exceptional activity
4. Get social support
5. Learn from the best
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Self-efficacy
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
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“Thousands of patients have died
needlessly because of a damaging reluctance amongst doctors and the public to accept changes in the NHS,
according to the country’s top emergency doctor
“
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5 Questions for to take away for reflection
1. What are the opportunities for me to build my perspectives and skills as an agent of change?
2. How can I build self efficacy as a change agent?
3. How do I move beyond skills and knowledge of change to live and be change?
4. Who can help and support me as a change agent?
5. What are the implications for the way I work?
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Thank you