1. Helen Bevan Chief Transformation Officer February 20 2015
@HelenBevan #qf15

2. For those of you who attended the
Some learning reinforcement after a short space of time helps to retain learning
Casebourne I (2015)
Spaced Learning: An Approach to Minimize the Forgetting Curve

3. can’t cross a chasm in small steps” David
The ideas in this presentation come from a new kind of improvement team: the Horizons Group within NHS IQ
Aim of the group: to stimulate new and ‘disruptive’ approaches in support of health and care transformation, operating at the edge of current thinking and practice:
skipping a generation of thinking about how to create radical, system-wide change
skipping a generation in a wider level of connection: working with emerging leaders, clinical trainees, students
skipping a generation of methods for change: open innovation, open source, digital connection, social media, change platforms, hacking
“You
can’t cross a chasm in small steps” David
Lloyd George

4. “ The greatest danger in times of turbulence is not the turbulence…….
The mindset of the past has a tendency to hijack the transformational potential of the future “
The greatest danger in times of turbulence is not the turbulence…….
it is to act with yesterday’s logic
Peter Drucker

5. “
History, even if properly construed, can blind us to important possibilities.  After all, it is not the rhythms of the past that define us, but our dreams for the future
Greg Satell

6. SEISMIC SHIFTS

7. SEISMIC SHIFTS
DIGITAL
CONNECTION

8. SEISMIC SHIFTS
DIGITAL
CONNECTION
Work
complexity

9. SEISMIC SHIFTS
DIGITAL
CONNECTION
Work
complexity
Hierarchical
power

10. SEISMIC SHIFTS Work complexity DIGITAL CONNECTION Hierarchical power
Change from the edge
Hierarchical
power

11. Leading change in a new era
Dominant approach
Emerging direction

12. Leading change in a new era
Dominant approach
Emerging direction
Most healthcare transformation efforts are driven from this side

13. ‘
Some warnings
The organizations that survive the future will be those that are capable of changing as fast as change itself Gary Hamel ’

15. Curate rather than create knowledge for improvement
Source of image: John Curran designedforlearning.co.uk

16. Because there’s a problem….
Getting
information off the internet is like taking a drink from a fire hydrant
Mitchell Kapor
Source of quote: Harold Jarche
Source of image:
#Quality2014 #f1
#Quality2014

17. How do we know what to learn and absorb?
Source of image: Frits Ahlefeldt

18. A big challenge for improvement leaders
Tacit knowledge is where the action is….
It’s the people with tacit knowledge who deliver the results
Tacit knowledge is critical for large scale change
...but
The only way tacit knowledge can be broadly shared…
…is to turn it into explicit knowledge
VERY difficult
Few organisations succeed
Gray D (2012) The Connected Company
Source: Harold Jarche

19. What is the best way to spread new knowledge?
Social connection/discussion is 14 times more effective than written word/ best practice databases/toolkits etc
Source of data: Nick Milton
Source of image: happiness-one-quote-time.blogspot.com

20. Curating knowledge Finding things out and keeping up to date
“pulling” information, but also having it “pushed” to us by trusted sources
Making sense and meaning of information
Reflecting and putting into practice what we have learned
Plugging information into our own mental models and turning it into knowledge
Connecting and collaborating
Sharing complex knowledge with our own work teams
Testing new ideas with our own networks
Increasing connections through social networks
Source: Harold Jarche

22. Moving to the edge
In the near future, the edges will be where almost all high-value work will be done in organizations…… Organizational development and change management need to move to the edges, and quickly.
Harold Jarche

23. What are the biggest opportunities for change agents in our system?
As bridge builders between disconnected groups
As curators and sharers of knowledge

24. Improvement teams will move from “bench scientists” (programme managers) to knowledge leaders and connectors

25. Less change programmes More change platforms
utilise systematic “change management” approaches
Too often, leaders prescribe the outcome and the method of change in a top-down way
change is experienced by people at the front line as “have to” (imposed) rather than “want to” (embraced)
Change Platforms
enable everyone in the organisation/system (including service users) to help tackle the most challenging issues
value diversity of thought
leadership attention on creating an environment receptive to transformational change

27. What are the implications regarding performance goals?

28. WHY were performance targets introduced?
Public institutions were unwieldy, inefficient, with limited accountability
Measures that did exist were mostly ad hoc and unsystematic
Reformers had virtuous intentions
Measurement based on specific quantified targets is easier than the alternatives

30. Compliance Commitment
How are we leading?
Compliance
States a minimum standard of performance or target that everyone must achieve
Uses hierarchy, performance management systems and standardised procedures for co-ordination and control
Threat of penalties/ sanctions/ shame creates momentum for delivery
Focus on transaction
Commitment
States a collective, meaningful goal that everyone can aspire to
Based on shared purpose and shared goals (“us and us” rather than “us and them”) for co-ordination and control
Commitment to a common purpose creates energy for delivery
Focus on relationship
Source: Helen Bevan

31. focus on meaning also get compliance,
Leaders who
focus on meaning also get compliance,
without focusing on it
@JeremyScrivens

32. 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
Source of image:
vintage-radio.com

33. 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

34. @SimonJGuilfoyle Police Inspector and systems thinker

35. Purpose Obfuscation O-meter
@SimonJGuilfoyle Police Inspector and systems thinker

36. Police
@SimonJGuilfoyle Police Inspector and systems thinker

37. Education

38. Healthcare
@SimonJGuilfoyle Police Inspector and systems thinker

39. The future The numerical goals are meaningful (intrinsic motivation)
Linked with shared purpose, not de facto purpose
An investment in measurement capability
The right performance indicators are selected in the first place
Understanding of naturally occurring variation within the performance data produced
Measurement for improvement, not just
judgement
7. A wider systematic approach to measurement
and change where metrics are aligned
Source of image: salesshq.monster.com

40. ....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

41. “Ultimately, the secret of quality is love
“Ultimately, the secret of quality is love. …… If you have love, you can then work backward to monitor and improve the system”.
Avedis Donabedian

42. Tactic for success:
Source of image: Bradley Burgess

43. Some challenges: Create organisations that are activist at their core
Find ways to:
marry innovation with complexity and scale
balance control and freedom
out-love everyone else
Source of image: rachelstivers.com

44. Identify your own opportunities to move to the edge
Think about how to ignite the disruptive innovators in your midst
Connect this to your pledge for Change Day BC
Consider how you can enable change at a faster rate than the outside world