Leading Better Care for all in the North West 12 March 2014 #NWLBC Some inspiring quotes from today We need to be a bit more radical We just got on with it Amanda Lonsdale Karen Saville-Croft We need to move beyond permission Margaret Carney This is a movement of change Steve Pleasant @HelenBevan #NWLBC Putting the personal into integration Martin Routledge The personal leadership challenge of making integrated care a reality 12th March 2014 Helen Bevan @HelenBevan @HelenBevan #NWLBC Most large scale change doesn’t fully deliver its objectives 5% Gets anywhere near achieving the change and delivering the benefits 25% 70% Source: McKinsey Performance Transformation Survey, 3000 respondents to global, multi-industry survey @HelenBevan #NWLBC Most large scale change doesn’t fully deliver its objectives 5% Delivers and sustains the change 25% 70% Source: McKinsey Performance Transformation Survey, 3000 respondents to global, multi-industry survey @HelenBevan #NWLBC @HelenBevan #NWLBC Image from: @TheWorldStories @HelenBevan #NWLBC Image from: @TheWorldStories 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 goal Peter Fuda http://www.peterfuda.com/wp-content/themes/peterfudabootstrap/content/Why-Change-Efforts-Fail.pdf @HelenBevan #NWLBC Source of image: Whatsthebigideascwartzy.blogspot.com Tensions that change leaders must live with Dominant approach @HelenBevan #NWLBC Emerging direction Source: @HelenBevan 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 #NWLBC 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 Source: Debra Meyerson destructive troublemaker @helenbevan @HelenBevan There’s a big difference between a rebel and a troublemaker Rebel @helenbevan #SHCRchat #NHSChangeDay Source : Lois Kelly www.foghound.com 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 "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@RobertVarnam #IHI25Forum #ChangeAgents @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 @helenbevan @HelenBevan Source of image: fistfuloftalent.com Five things we know about successful boat rockers CHANGE BEGINS WITH 1. Driven by conviction and values me 2. strong sense of “self-efficacy”  belief that I am personally able to create the change 3. able to join forces with others to create action 4. able to achieve small wins which create a sense of hope, self-efficacy and confidence 5. More likely to view obstacles as challenges to overcome @helenbevan @HelenBevan Source: adapted from Debra E Meyerson 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 @helenbevan @HelenBevan Source of image:www.h3daily.com What’s the difference between self efficacy and 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 ? @helenbevan @HelenBevan (internally generated) Reflection What are some ways we can build selfefficacy? @helenbevan @HelenBevan Building self-efficacy: some tactics 1. 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 time 3. Reframe your thinking: • failed attempts are learning opportunities • uncertainty becomes curiousity 4. Make change (and learning cycles from change) routine rather than an exceptional activity 5. Get social support 6. Learn from the best 7. 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 @helenbevan @HelenBevan @PeterFuda Task Talk 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 @HelenBevan or “I have some Key Performance Indicators for you” @helenbevan #IQTGOLD #NHSChangeDay “I have a dream” Source: @RobertVarnam 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. @helenbevan @HelenBevan Source of image:help.adobe.com Source: @NHSChangeDay @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 References The 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 @helenbevan @HelenBevan