Being a leader of change: how to rock the boat and stay in it

@helenbevan

Being a leader of change:how to rock the boat and stay in it

Helen BevanChief Transformation Officer,

NHS Horizons Team@helenbevan

@helenbevan #NHSChangeDay

Emerging themes in large scale change

Organisation Community

Power through hierarchy Power through connection

Mission and vision Shared purpose

Making sense through rational argument

Making sense through emotional connection

Leadership-driven (top down) innovation

Viral (grass-roots driven) creativity

Tried and tested, based on experience

“ Open” approaches , sharing ideas & data, co-creating change

Transactions Relationships

Dominantapproach

Emerging direction


A polarity (not either/or)


John Kotter: “Accelerate!”• Dual operating systems: the hierarchy AND the network•Many change agents, not just the usual few •A “want-to” - not just a “have-to” - mind-set

The spirit of volunteerism - the desire to work with others for a shared purpose – creates the energy to power the network

•Head and heart, not just headPeople won’t want to do a day job in the hierarchy and a night job in the network if we appeal only to logic with numbers, contracts and business cases


Place in the networkBridge networks

versus cohesive networks

As a change agent, my centrality in the informal network is a far more important factor than my position in the formal hierarchy

Change agents who bridge disconnected

groups/individuals more likely to deliver big change

Change agents with cohesive networks more likely to deliver

minor incremental changes

The Network Secrets of Great Change AgentsJulie Battilana andTiziana Casciaro

@HelenBevan

@HelenBevan

We need three kinds of people to transform healthcare

• Professionals• Patients• Pirates

Source: Lucien Engelen

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What happens to heretics/radicals/rebels/mavericks

in organisations?

@HelenBevan

@HelenBevan

Valuing radicals

• “New truths begin as heresies” (Huxley, defending Darwin’s theory of natural selection)

• big things only happen in organisations because of heretics and radicals

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We need to be boatrockers!

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

• 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 destructive troublemaker

Source: Debra Meyerson

@HelenBevan Source : Lois Kelly www.foghound.com

Sometimes leaders see radicals as troublemakers

http://www.foghound.com/

@HelenBevan Source: Foghound

@HelenBevan

Four tactics for change agents

1. Start with myself2. Build alliances3. Work out what might help others to

change4. Don't be a martyr

"There’s only one corner of the universe you can be certain of

improving, and that’s your own self." Aldous Huxley

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What are the risks for a boat rocker?

1. Our experiences of “being different” can be fundamentally disempowering. This can lead us to conform because we see no other choice

Source: adapted from Debra E Meyerson

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1. Our experiences of “being different” can be fundamentally disempowering. This can lead us to conform because we see no other choice we surrender a part of ourselves, and silence

our commitment, in order to survive


@HelenBevan Source: Foghound

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our commitment, in order to survive2. leave the organisation


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we cannot find a way to be true to our values and commitments and still survive


@HelenBevan





3. stridently challenge the status quo in a manner which is increasingly radical and self-defeating


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3. stridently challenge the status quo in a manner which is increasingly radical and self-defeating this just confirms what we already know – that

we don’t belongSource: adapted from Debra E Meyerson

@HelenBevan

They:1.are driven by values2.have a strong belief that they are personally able to make change happen3.are able to build alliances

ignite collective action with others mobilising others, inspiring change

4.are able to achieve small wins which create a sense of hope, possibility and confidence5.are good corporate citizens

Often, the most effective change agents in organisations are the ones with the least positional authority

What do we know about successful boat rockers?


@helenbevan #IQTGOLD

Three assumptions for change agents

1. Assume that everyone has a good intention2. When people “resist” change is it more likely

to be a result of their interpersonal interaction with the change process than their character traits (“a bad change process not a difficult person”)

3. My role as a change agent is about alignment, not judgement

@HelenBevan




@helenbevan #IQTGOLD

The easiest way to thrive as an outlier...is to avoid being one

Seth Goodin

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“if you want to go fast, go alone. If you want to go far, go together”African proverb quoted by Al Gore

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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)

If we want people to take action, we have to connect with their emotions through values

actionaction

valuesvalues

emotionemotion

Source: Marshall Ganz

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What do we need to do?1. Tell a story

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What do we need to do?1. Tell a story2. Make it personal

@HelenBevan

What do we need to do?1. Tell a story2. Make it personal3. Be authentic

@HelenBevan

What do we need to do?1. Tell a story2. Make it personal3. Be authentic4. Create a sense of “us” (and be clear who the “us”

is)

@HelenBevan

What do we need to do?1. Tell a story2. Make it personal3. Be authentic4. Create a sense of “us” (and be clear who the “us”

is)5. Link your story to the change you want to see

@HelenBevan #NHSChangeDay



@HelenBevan

Task

• Talk to the person next to you• In one minute, tell them a story from your life

which illustrates why you are committed to improving healthcare

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@HelenBevan

@HelenBevan

“Stages of change” Transtheoretical model of behaviour change

Prochaska, DiClemente & Norcross (1992)

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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

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

It works for organisational and

service change too!

@helenbevan #stuconf

“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.










I have stopped

smoking!










I have stopped

smoking!

I am continuing to not smoke.

I sometimes miss it – but I am still not

smoking










I have stopped

smoking!

I am continuing to not smoke.

I sometimes miss it – but I am still not

smoking


“Stages of change” Transtheoretical model of behaviour change


@HelenBevan

90% of our change efforts are aimed at the “action” stage

• 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 make the

change happen

@HelenBevan

Example - Surgical 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

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“One key issue is that many doctors already feel that they are delivering patient centred care – unfortunately that is not what patients report.”Dr Nigel Mathers, Vice Chair, Royal College of General Practice

@HelenBevan

So what do we TEND to do?• Lower our ambitions for improvement• 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

So what SHOULD we do

• Listen and understand• appreciate others’ starting point for change

• Recognise that the people who are resisting might have a point• Don’t argue against it• Understand why people are resisting the change

• What makes it so hard?• What would help?

• Build shared purpose based on what we want for our patients

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A 189,000 pledge mountain!

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NHS Change Day 2014

• Increase the reach to 500,000 pledges• Pledge, share, do and inspire framework• Inaugurate School for Healthcare Radicals• Kickstarter challenge• Mobile first approach underpinned by social media

and industrial-strength infrastructure• Discussions with colleagues in 16 territories globally• Launch on 6th November 2013

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@HelenBevan

Probably the only winner of a global challenge

to develop leaders in the

corporate world that names Saul

Alinsky and Marshall Ganz

as major influencers

@HelenBevan

Being a great change agent is about knowing, doing, living and being improvement

@HelenBevan

....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 Speidman

@helenbevan

The conversation continues on Twitter:#SheffieldMCA

Dr Pete Jones

05 November 201312:00 – 13:00

Postgraduate Common Room,Medical Educa

tion Centre, NGH

www.SheffieldMCA.org.uk

Documents

Being a leader of change: how to rock the boat and stay in it