1. No category

Helen Bevan
Chief Transformation Officer
@HelenBevan NFKH
@HelenBevan
@HelenBevan NFKH
@HelenBevan NFKH
Everyone has gifts and strengths
What superpower do you have?
@HelenBevan NFKH
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
You can’t be a rebel on your own
Rebel
@helenbevan #SHCRchat
#NHSChangeDay
Source : Lois Kelly www.rebelsatwork.com
The easiest way to thrive as an
outlier
...is to avoid being one
Seth Goodin
@helenbevanSource of image: outskirtsbattledome.wikispaces.com
@HelenBevan
Leading change in a new era
Dominant approach
@helenbevan
@HelenBevan
Emerging direction
Power in community
“Power used to come largely through and from big
institutions.
Today power can and does come from connected individuals
in community.
When community invests in an idea, it co-owns its success.
Instead of trying to
achieve scale all by
ourselves, we have a new
way to have scale. Scale
can be in, with and
through community.”
Nilofer Merchant
@helenbevan
@HelenBevan
Source
of image: orton.org
“When we talk of social change, we talk of
movements, a word that suggest vast
groups of people walking together, leaving
behind one way and travelling towards
another”
Rebecca Solnit
@helenbevan
Learning from social movement
leaders
http://www.slideshare.net/NHSIQ/the-power-of-one-the-power-ofmany?qid=97bb3464-07c2-4883-9531-c3d436a66aa1&v=qf1&b=&from_search=2
@helenbevan
@HelenBevan
@helenbevan
@HelenBevan
Six characteristics of people or groups within
effective social movements
1. They share a sense of PURPOSE: There is purposefulness about
collaborations, discussions, actions, decisions and a sense of forward momentum
2. They are UNITED: They have learned to manage their differences well enough
that they can unite to accomplish their purpose. Differences are openly debated,
discussed, and resolved.
3. They share UNDERSTANDING: There is a widely shared understanding of
what's going on, what the challenges are and why what is being done has to be
done
4. People PARTICIPATE: Lots of people and organisations in the system are
active - not just in discussions and meetings, but getting the work done.
5. They take INITIATIVE: Rather than reacting to whatever happens in their
environment, they are proactive, and act upon their environment.
6. They ACT: People do the work they must do to
make the things happen that need to happen
@helenbevan
@HelenBevan
Source: adapted from Wellstone Action
Calls to Action
@helenbevan
@HelenBevan
Leadership is….
…the art of mobilising others
to want to struggle for shared
aspirations
Jim Kouzes
@helenbevan
@HelenBevan
Source of image: environmentvictoria.org.au
Framing
… is the process by which leaders construct,
articulate and put across their message in a powerful
and compelling way in order to win people to their
cause and call them to action.
Snow D A and Benford R D (1992)
@helenbevan
@HelenBevan
What’s the
financial incentive?
What’s the
project plan?
Who is
performance
managing?
@helenbevan
@HelenBevan
Source: @RobertVarnam
The reality
“What the leader cares about (and typically bases at
least 80% of his or her message to others on) does
not tap into roughly 80% of the workforce’s primary
motivators for putting extra energy into the change
programme”
Scott Keller and Carolyn Aiken (2009)
The Inconvenient Truth about Change Management
@helenbevan
Source
of image: swedenbourg-openlearning.org.uk
@HelenBevan
Leaders ask their staff to be ready for change,
but do not engage enough in
sensemaking........
Sensemaking is not done via marketing...or
slogans but by emotional connection with
employees
Ron Weil
@helenbevan
@HelenBevan
Four gaps between
how we
communicate
change
1.
2.
3.
4.
how people
engage with that
communication
People speak intellectually but engage
emotionally
Facts are hard to remember and easy to
challenge
If we only talk about our success people won’t
believe us
People don’t want more communication; they
want meaningful communication
@helenbevan
@HelenBevan
Source: Peter Fuda
http://www.peterfuda.com/2014/10/30/traditional-comms-fail-engage/
or
“I have some Key
Performance
Indicators
for you”
@helenbevan #IQTGOLD
@HelenBevan
“I have a
dream”
Source: @RobertVarnam
If we want people to take action, we have to
connect with their emotions through values
values
emotion
action
@helenbevan
Source: Marshall Ganz
@helenbevan
@HelenBevan
But not all emotions are equal.........
urgency
anger
hope
solidarity
you can make a
difference
@helenbevan #IQTGOLD
@HelenBevan
Action inhibitors
Overcomes
Action motivators
inertia
apathy
fear
isolation
Self-doubt
Source: Marshall Ganz
‘‘Leaders must wake people out of
inertia. They must get people excited
about something they’ve never seen
before, something that does not yet
exist”
Rosa Beth Moss Kanter
@helenbevan
#SHCR
@School4Radicals
Source of image: www.linkedin.com/company/activate-brand-agency
Effective framing:
what do we need to do?
1. Tell a story
@helenbevan
@HelenBevan
Source of image: woccdoc.org
http://www.slideshare.net/amitkaps/fifth-elephant-2014-talkcrafting-visual-stories-with-data?sf3881865=1
@helenbevan
@HelenBevan
Effective framing:
what do we need to do?
1. Tell a story
2. Make it personal
@helenbevan
@HelenBevan
Source of image: woccdoc.org
Effective framing:
what do we need to do?
1. Tell a story
2. Make it personal
3. Be authentic
@helenbevan
@HelenBevan
Source of image: woccdoc.org
Effective framing:
what do we need to do?
1.
2.
3.
4.
Tell a story
Make it personal
Be authentic
Create a sense of “us” (and be clear who the “us”
is)
@helenbevan
@HelenBevan
Source of image: woccdoc.org
Effective framing:
what do we need to do?
1.
2.
3.
4.
Tell a story
Make it personal
Be authentic
Create a sense of “us” (and be clear who the “us”
is)
5. Build in a call for urgent action
@helenbevan
@HelenBevan
Source of image: woccdoc.org
Vivid details
@helenbevan #IQTGOLD
@HelenBevan
Source: Marshall Ganz
@helenbevan #IQTGOLD
@HelenBevan
@helenbevan #IQTGOLD
@HelenBevan
Talk to the person next to you
• Tell your story about why the change you are
involved in now is so important to you
• Relate it to a personal experience
You have:
• 2 minutes to prepare your story
• 3 minutes each to tell your story
@helenbevan
@HelenBevan
What is a
RCT?
@helenbevan
@HelenBevan
Randomized Coffee
Trial!
@helenbevan
@HelenBevan
Outcomes of randomised coffee trials
@helenbevan
@HelenBevan
How do we create a sense of
“us” to build momentum for
change?
@helenbevan
#SHCR
@School4Radicals
Source of image: www.tannerfriedman.com
Moving beyond us and them
to us and us
@helenbevan
@HelenBevan
Source of image: www.delta7.com
The Network Secrets of Great Change Agents
Julie 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
strong ties (cohesive)
v.
weak ties (disconnected)
@helenbevan
@HelenBevan
Source of image: http://www.forbes.com/fdc/welcome_mjx.shtml
When we spread change through strong ties:
• we interact with “people like us”, with
the same life experiences, beliefs and
values
• Change is “peer to peer”; GP to GP,
social worker to social worker, nurse to
nurse, community leader to
community leader
• Influence is spread through people
who are strongly connected to each
other, like and trust each other
@helenbevan
When we spread change through strong ties:
• we interact with “people like us”, with
the same life experiences, beliefs and
values
• Change is “peer to peer”; GP to GP,
social worker to social worker, nurse to
nurse, community
leader
to
IT WORKS
BECAUSE:
people are far
community leader
more likely to be influenced to
adopt new
behaviours
• Influence is spread
through
people or ways of
working
from those
with whom they
who are strongly
connected
to each
aretrust
most
strongly
other, like and
each
othertied
@helenbevan
The pros and cons of strong ties
Pros
@helenbevan
Cons
When we seek to spread change
through weak ties
• we build bridges between groups and
individuals who were previously different and
separate
• we create relationships based not on preexisting similarities but on common purpose
and commitments that people make to each
other to take action
• We can mobilise all the resources in our
organisation, system or community to help
achieve our goals
@helenbevan
@HelenBevan
Why we need to build weak ties AS WELL AS
strong ties
• Weak ties are more likely to lead to change at scale
because they enable us to access more people with
fewer barriers
@helenbevan
@HelenBevan
More on weak ties: https://www.youtube.com/watch?v=w7AzRVxhEXA#t=45
Why we need to build weak ties AS WELL AS
strong ties
• Weak ties are more likely to lead to change at scale
because they enable us to access more people with
fewer barriers
• In situations of uncertainty, we have a tendency to
revert to our strong tie relationships
 yet the evidence tells us that weak ties are much
more important than strong ties when it comes
to searching out resources in times of scarcity
@helenbevan
@HelenBevan
Why we need to build weak ties AS WELL AS
strong ties
• Weak ties are more likely to lead to change at scale
because they enable us to access more people with
fewer barriers
• In situations of uncertainty, we have a tendency to
revert to our strong tie relationships
 yet the evidence tells us that weak ties are much
more important than strong ties when it comes
to searching out resources in times of scarcity
• The most breakthrough innovations and most
radical change will come when we tap into our weak
ties
@helenbevan
@HelenBevan
Sources of weak ties
@helenbevan
@HelenBevan
Three components of a great narrative
• Diagnostic – what is the problem that
we are addressing? What is the extent
of the problem? What is the specific
source or sources?
• Prognostic – what could the future look
like? What is our “plan of attack” and
our strategy for carrying out the plan?
• Motivational – why is this urgent?
What is our call for action that
connects with the motivational and
emotional drivers of our audience?
Source: Benford and Snow
@helenbevan
@HelenBevan
Source of image: www.ecommercedefense.com
Four keys to collaboration
• Lean into your discomfort
• Listen as an ally
• State your intent
• Share your “street corner”
Source: Judith Katz and Fred Miller
@helenbevan
@HelenBevan
@helenbevan
@HelenBevan
Four keys to collaboration
• Lean into your discomfort
• Listen as an ally
• State your intent
• Share your “street corner”
Source: Judith Katz and Fred Miller
@helenbevan
@HelenBevan
http://weneedsocial.com/blog/2013/8/25/disr
upted-disruptors-unite
@helenbevan
@HelenBevan
57
Source of image: http://switchandshift.com/transactional-ortransformational-which-leadership-style-is-best
@helenbevan
@HelenBevan
“You don’t need an engine when you have
wind in your sails”
@helenbevan #IQTGOLD
@HelenBevan
Questions for reflection
1. What learning and inspiration can you take
from social movement leaders to help you in
your role as an agent of change in health and
care?
2. How will you attract the attention of the people
you want to call to action?
3. Who are the people who are currently
disconnected that you want to unite in order to
achieve your goal for change? How can you
build a sense of “us” with them?
@helenbevan
@HelenBevan
What happens to large scale
change efforts in reality?
In order of frequency:
1. the effort effectively “runs out of energy” and
simply fades away
2. the change hits a plateau at some level and no
longer attracts new supporters
3. the change becomes reasonably well established;
several levels across the system have changed to
accommodate or support it in a sustainable way
Source: Leading Large Scale Change:
a practical guide (2011), NHS Institute
@helenbevan
@HelenBevan
Research shows that more than almost
any other factor affecting an
organisation, organisational energy can
lead to either a wellspring of corporate
vitality or the destruction
of its very core
Source: Bruch and Vogel
@helenbevan
#SHCR
@School4Radicals
Bruch and Vogel research
Organisations with HIGH productive
energy scored higher on:
• overall performance - 14% higher
• productivity – 17%
• efficiency – 14%
• customer satisfaction – 6%
• customer loyalty – 12%
@helenbevan
@HelenBevan
@helenbevan
#SHCR
@School4Radicals
Energy for change is:
Spiritual
the capacity and
drive of a team,
organisation or
system to act
and make the
difference
necessary to
achieve its goals
Social
Psychological
Physical
@helenbevan
@HelenBevan
Intellectual
Five energies for change
Energy
Definition
Social
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”
Spiritual
energy of commitment to a common vision for the future, driven
by shared values and a higher purpose. It gives people the
confidence to move towards a different future that is more
compelling than the status quo
Psychological
energy of courage, resilience and feeling safe to do things
differently. It involves feeling supported to make a change and
trust in leadership and direction
Physical
energy of action, getting things done and making progress. It is
the flexible, responsive drive to make things happen
Intellectual
energy of analysis, planning and thinking. It involves gaining
insight as well as planning and supporting processes, evaluation,
and arguing a case on the basis of logic/ evidence
@helenbevan
@HelenBevan
High and low ends of each energy domain
Low
High
Social
isolated
solidarity
Spiritual
uncommitted
higher purpose
Psychological
risky
safe
Physical
fatigue
vitality
Intellectual
Illogical
reason
@helenbevan
@HelenBevan
Some questions
• Which group likely to have
higher spiritual energy
scores (clinicians/non
clinicians?)
• Nearer to CEO, higher or
lower energy scores?
@helenbevan
@HelenBevan
Energy for change profile
Social
5
4
3
Intellectual
2
1
Physical
@helenbevan
• Are particular
energy domains
more dominant
than others for
Spiritual
our team at the
moment?
• Is this the
optimal energy
profile to help
us achieve our
Psychological
improvement
goals?
Team 1: what’s your assessment of
their energy for change?
Social
5
4
3
Intellectual
2
Spiritual
1
Physical
@helenbevan #IQTGOLD
@HelenBevan
Psychological
Team 2: what’s your assessment of
their energy for change?
Social
5
4
3
Intellectual
2
Spiritual
1
Physical
@helenbevan #IQTGOLD
@HelenBevan
Psychological
Ten key principles of large scale change
1.
Movement towards a new vision that is better and fundamentally
different from the status quo
2.
Identification and communication of key themes that people can
relate to and that will make a big difference
3.
Multiples of things (‘lots of lots’)
4.
Framing the issues in ways that engage and mobilise the
imagination, energy and will of a large number of diverse
stakeholders in order to create a shift in the balance of power
and distribute the leadership
5.
Mutually reinforcing change across multiple
processes/subsystems
http://www.slideshare.net/NHSIQ/leading-large-scale-change-part-1
@helenbevan
@HelenBevan
Ten key principles of large scale change
6.
Continually refreshing the story and attracting new, active
supporters
7.
Emergent planning and design, based on monitoring progress
and adapting as you go
8.
Many people contribute to the leadership of change, beyond
organisational boundaries
9.
Transforming mindsets, leading to inherently sustainable
change
10.
Maintaining and refreshing the leaders’
energy over the long haul
http://www.slideshare.net/NHSIQ/leading-large-scale-changepart-1
@helenbevan
@HelenBevan
“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
There has never been a time in the history
of healthcare when this advice has been
more pertinent
@helenbevan
#SHCR
@School4Radicals
Employee resistance is the
most common reason
executives cite for the
failure of big
organizational-change
efforts
Source of image:
Businessconjunctions.com
@helenbevan
@HelenBevan
Scott Keller and Colin Price
(2011), Beyond Performance: How
Great Organizations Build Ultimate
Competitive Advantage
“
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
“
@helenbevan
@HelenBevan
Leaders ask their staff to be ready for change,
but do not engage enough in
sensemaking........
Sensemaking is not done via marketing...or
slogans but by emotional connection with
employees
Ron Weil
@helenbevan
@HelenBevan
‘‘
Resistant behaviour is a good
indicator of missing relevance
Harald Schirmer
http://de.slideshare.net/haraldschirmer/strategies-for-corporate-change-the-newrole-of-hr-driving-social-adoption-and-change-in-the-enterprise
@helenbevan
Source of image: driverlayer.com
‘‘
Cultural change
is a million
subversive acts
of resistance
Brene Brown
Source of image: zazzle.com
@helenbevan
@helenbevan
@HelenBevan
“Stages of change”
Transtheoretical model of behaviour change
@helenbevan
@HelenBevan
Prochaska, DiClemente & Norcross (1992)
The model is mostly used around
health-related behaviours
•
•
•
•
•
•
•
•
•
•
smoking cessation
exercise adoption
alcohol and drug use
weight control
fruit and vegetable intake
domestic violence
HIV prevention
use of sunscreens to prevent skin cancer
medication compliance
mammography screening
@helenbevan
@HelenBevan
The model is mostly used around
health-related behaviours
•
•
•
•
•
•
•
•
•
•
smoking cessation
exercise adoption
alcohol and drug use
weight control
fruit and vegetable intake It works for
organisational and
domestic violence
HIV prevention
service change too!
use of sunscreens to prevent skin cancer
medication compliance
mammography screening
@helenbevan
@HelenBevan
“Stages of change”
Smoking
@helenbevan
@HelenBevan
I am not aware my
smoking is a
problem – I have no
intention to quit
Prochaska, DiClemente & Norcross (1992)
“Stages of change”
Smoking
I am not aware my
smoking is a
problem – I have no
intention to quit
I know my smoking
is a problem – I
want to stop but no
plans yet
@helenbevan
@HelenBevan
Prochaska, DiClemente & Norcross (1992)
“Stages of change”
Smoking
I am not aware my
smoking is a
problem – I have no
intention to quit
I know my smoking
is a problem – I
want to stop but no
plans yet
I am making plans
& changing things
I do in
preparation.
@helenbevan
@HelenBevan
Prochaska, DiClemente & Norcross (1992)
“Stages of change”
Smoking
I am not aware my
smoking is a
problem – I have no
intention to quit
I know my smoking
is a problem – I
want to stop but no
plans yet
I have
stopped
smoking!
@helenbevan
@HelenBevan
I am making plans
& changing things
I do in
preparation.
Prochaska, DiClemente & Norcross (1992)
“Stages of change”
Smoking
I am continuing to
not smoke.
I sometimes miss it
– but I am still not
smoking
I have
stopped
smoking!
@helenbevan
@HelenBevan
I am not aware my
smoking is a
problem – I have no
intention to quit
I know my smoking
is a problem – I
want to stop but no
plans yet
I am making plans
& changing things
I do in
preparation.
Prochaska, DiClemente & Norcross (1992)
“Stages of change”
Smoking
I am continuing to
not smoke.
I sometimes miss it
– but I am still not
smoking
I have
stopped
smoking!
@helenbevan
@HelenBevan
I am not aware my
smoking is a
problem – I have no
intention to quit
I know my smoking
is a problem – I
want to stop but no
plans yet
I am making plans
& changing things
I do in
preparation.
Prochaska, DiClemente & Norcross (1992)
“Stages of change”
Transtheoretical model of behaviour change
Prochaska, DiClemente & Norcross (1992)
@helenbevan
@HelenBevan
Some questions
• Which stage do most change activities in
health and care focus on?
• Which stage are most people actually at?
@helenbevan
@HelenBevan
90% of the tools available for health and care change
agents are designed for the “action” stage
The reality of our change situation
• Our tools are often not effective at the stage of change
that most people we work with are at
• It’s hard to engage people in change
• It’s hard to get people to make the changes we want
them to make
• People get irritated, defensive, irrational
• We feel powerless in our ability to lead or facilitate the
change
@helenbevan
@HelenBevan
Example – WHO Surgical Safety Checklist
• Designed for Stage 4 –
ACTION!
• Mandated it through
targets
• Despite compelling
case for change –
people resisted it – no
values connection
• People did the task
and missed the point
@helenbevan
IN A NUTSHELL
• Evidence from observational studies that the use of surgical safety
checklists results in striking improvements in outcomes
• Led to rapid adoption of such checklists worldwide
• Researchers studied effect of mandatory adoption of checklists in
Ontario, Canada
• Use of checklists not associated with significant reductions in
operative mortality or complications
@helenbevan
@HelenBevan
So what do we TEND to do when people
resist?
• Lower our ambitions for improvement
• Focus our energies on those who are
already in the “action” stage
• Put negative labels on those who are
not yet at the action stage such as
“blocker” or “resister” or “laggard”
• Blame “the management” for not
enforcing change
@helenbevan
@HelenBevan
‘‘
The single biggest problem
in communication is the
illusion that it has taken
place
George Bernard Shaw
@helenbevan
@HelenBevan
So what SHOULD we do?
• Listen and understand
• appreciate the starting point
• elaborate interests
• Roll with resistance (Singh)
• Don’t argue against it
• Encourage elaboration of resistance
• What makes it so hard?
• What would help?
• Build meaning and conviction in the change
@helenbevan
@HelenBevan
• I am not thinking about
changing my behaviours,
actions or work processes
• The problem or issue is
outside my frame of
awareness or my perceived
need
@helenbevan
@HelenBevan
• The focus should be on
creating awareness for me of
the need to change
• Remember the goal is not to
make me (as a
precontemplator) change
immediately, but to help me
move to contemplation
Thinking about your own situation
Focussing on Prochaska, DiClemente and
Norcross’s Stages of Change model:
• What stage of change are some of the key
people that you need to influence for your
change initiative at?
• What actions can you take to help them move
to the next stage?
@helenbevan
@HelenBevan
‘‘
@helenbevan
@HelenBevan
If your horse dies,
get off it
Cherokee proverb
Source of image: fenwickgallery.co.uk
@helenbevan #IQTGOLD
@HelenBevan
What is our approach to change?
Compliance
Commitment
States a minimum performance
standard that everyone must
achieve
States a collective goal that
everyone can aspire to
Uses hierarchy, systems and
standard procedures for coordination and control
Based on shared goals, values
and sense of purpose for coordination and control
Threat of penalties/ sanctions/
shame creates momentum for
delivery
Commitment to a common
purpose creates energy for
delivery
@helenbevan
@HelenBevan
Source: Helen Bevan
Leaders who
focus on meaning also
get compliance,
without focusing on it
@JeremyScrivens
@helenbevan
@HelenBevan
We know that ...
• Shared purpose is a common thread in successful
change programmes*
• Organisations and change initiatives with strong
shared purpose consistently outperform those
without it.**
*What makes change successful in the NHS? Gifford et al 2012 (Roffey Park Institute)
**Management Agenda 2013 Boury et al (Roffey Park Institute)
@helenbevan
@HelenBevan
A 3-word concept
@helenbevan #SHCRchat
#NHSChangeDay
[Shared] purpose goes way deeper than
vision and mission; it goes right into your gut
and taps some part of your primal self. I
believe that if you can bring people with
similar primal-purposes together and get
them all marching in the same direction,
amazing things can be achieved.
Seth Carguilo
@helenbevan #IQTGOLD
@HelenBevan
The power of shared purpose:
Perhaps the single most important influence on program
response by individual units—either in promoting or
resisting change—was the extent of consensus and
coalition among the senior medical and nursing staff on
individual Intensive Care Units….
[Consultant says] ‘I think it’s been successful because it’s
a unifying program, it’s one of the few things that we’ve
done that hasn’t been just a doctor thing, or just a nurse
thing, it’s involved the doctors and the nurses together.’
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3704826/
@helenbevan
@HelenBevan
As leaders, we are “signal generators”
“As a leader, think of yourself as a “signal generator”
whose words and actions are constantly being
scrutinised and interpreted, especially by those
below you” [in the hierarchy]
“Signal generators reduce uncertainty and ambiguity
about what is important and how to act”
Charles O’Reilly,
Leaders in Difficult Times
@helenbevan
@HelenBevan
Source of image:
vintage-radio.com
Avoiding “de facto” purpose
• What leaders pay attention to matters to staff, and consequently
staff pay attention to that too
• Shared purpose can easily be displaced by a “de facto” purpose:
 hitting a target
 reducing costs
 reducing length of stay
 eliminating waste
 completing activities within a timescale
 complying with an inspection regime
• If purpose isn’t explicit and shared, then it is very easy for
something else to become a de facto purpose in the minds of the
workforce
Source: Delivering Public Services That Work: The Vanguard Method in the Public Sector
@helenbevan
@HelenBevan
@helenbevan
@HelenBevan
@SimonJGuilfoyle Police Inspector and systems thinker
@helenbevan
@HelenBevan
@SimonJGuilfoyle Police Inspector and systems thinker
Police
@helenbevan
@HelenBevan
@SimonJGuilfoyle Police Inspector and systems thinker
Education
@helenbevan
@HelenBevan
@SimonJGuilfoyle Police Inspector and systems thinker
Healthcare
@helenbevan
@HelenBevan
@SimonJGuilfoyle Police Inspector and systems thinker
....the last era of management was about how
much performance we could extract from
people
.....the next is all about how much humanity we
can inspire
Dov Seidman
@helenbevan
@HelenBevan
@helenbevan
#SHCR
@School4Radicals