Impromptu Networking
Power of loose connections,
small things can make a big difference
What is a challenge
you are bringing to this
Summit?
What do you
hope to get from
and contribute to
this community of leaders?
Find a partner…4 minutes sharing…
then find another partner… then find another.
A Conversation
with Risa LavizzoMourey:
Transforming
Health Care
Through Nursing
How do you lead
a transformation?
Risa Lavizzo-Mourey, MD,
President & CEO, RWJF
Linda Wright Moore
Senior Communications
Officer, RWJF
Liberating Structures
can be used “back home” in your AC to:
• Develop ways to
work together that
spark more
innovation and
solutions
• Individually make
progress on
challenges you
face
• Help you work
more effectively
across functions
and boundaries
• Learn methods to
generate
ownership of
change efforts
Your Design Team
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Pat Farmer
Bill Lecher
Gail Finley
Patricia Hurst
Elizabeth Sether
Deb Zimmerman
Juliana Preston
Debra Toney
Pat Crombie
Marj Dugan
Natalia Baronin
Cordelia Hill
Synthesizer
Graphic Recorder
Harvester
Harvester
Harvester
Harvester
Synthesizer
Thank You to Our Sponsors
Two Attributes of a
Powerful Purpose
• A personal
touchstone for
you as an
individual
• Fundamental
justification for the
existence of your
work to the larger
community
A powerful purpose attracts participation
including and unleashing everyone
9 Whys
Becoming Clear on Purpose
Ask, “What do you do when
you are transforming
healthcare?”
– Why is it important to you?
– First answer, “_______….”
Hmmm, why is that important to
you?
– Second answer, “_______….”
OK, if your dream came true last
night, what would be different
today?
Keep asking, “Why… why… why…
until you make a discovery about
your partner’s bedrock purpose.
Then switch roles.
1-2-4-All schedule:
• 1 minute quiet
reflection, generating
an activities list
• 6 minutes in a pair
(asking why-why-why
questions), 3 minutes
each
• 4 minutes in a a small
group (4), then,
• 4 minutes debriefing,
“What happened?” Did
a community purpose
emerge in your
conversation?
• Raise your hand if you
would like to share a
pithy insight
Strategy Safari
1. What is
happening
around us
that demands
adaptation?
•
Next
Week
•
Next
Quarter
Next
Month
• Task
•
•
•
•
•
•
• Description
• Measure of
success
•
•
•
GOAL 2
•
•
•
• Description
• Measure of
success
•
•
•
GOAL 1
•
•
•
•
Next
Year
• Action
• Task
•
•
3. Given our purpose,
what seems possible
now?
5. How are we breaking
away from the current
state toward the future?
• Action
•
GAMEPLAN
•
GOAL 3
4. What is
at stake if we
do not change?
•
• Description
• Measure of
success
•
•
•
2. Where are we starting, really?
• Current status:
•
• Current status:
•
• Current status:
•
What Will Be Different!
Develop shared
understanding
of next steps
and strategy
Restore hope
for change by
igniting bold
Attract more
diverse people
to the work
action
Liberating Structures
Acting Our Way Into New Thinking by Including and Unleashing Everyone
TRIZ
Designing a Perfectly Adverse System
to Make Space for Innovation
Begin by defining a
VERY unwanted
result of your
work together
TRIZ – First Step
• First alone, then in your
small group, compile a list
of todo’s in answer to:
• In our coalitions, how can
we keep doing the same
things with the same
people and expect
different results?
• 5 minutes
• Go wild!
TRIZ - Second Step
• First alone, then in your
group, go down your list
and ask:
Is there anything we are
doing that resembles in
any shape or form to
do’s on our list?
• Make a second list of
those activities & talk
about their impact
• Be unforgiving
• 5 minutes
TRIZ – Third Step
• First alone, then in your group,
compile the list of what needs to
be stopped or changed
• Take one item at a time & ask:
How am I and how are
we going to stop it?
What is your first move?
• Be as concrete as you can
• Identify who else is needed to
stop the activity
• 5 minutes
Strategy Safari
1. What is
happening
around us
that demands
adaptation?
•
Next
Week
•
Next
Quarter
Next
Month
• Task
•
•
•
•
•
•
• Description
• Measure of
success
•
•
•
GOAL 2
•
•
•
• Description
• Measure of
success
•
•
•
GOAL 1
•
•
•
•
Next
Year
• Action
• Task
•
•
3. Given our purpose,
what seems possible
now?
5. How are we breaking
away from the current
state toward the future?
• Action
•
GAMEPLAN
•
GOAL 3
4. What is
at stake if we
do not change?
•
• Description
• Measure of
success
•
•
•
2. Where are we starting, really?
• Current status:
•
• Current status:
•
• Current status:
•
15% Solutions
Noticing and Using the Influence,
Discretion and Power Individuals
Have Right Now
What can YOU do now to
make progress on your challenge?
Appreciative Interviews
Creating Momentum by Building On and
Designing With “What Works Right Now”
Find a partner you don’t know
Tell a personal story about making a difference
in bringing the transformation of health care
through nursing to life
Henri Lipmanowicz
McCandless
Give the story
a name& Keith
if you
are inspired
Tips on Interviewing
Stories lets us “see” through
others’ eyes
• 7 minutes to ask about the
context
–
–
–
–
When
Where
Who
How
• DO NOT share your own
experience
• Collect details of the journey:
– Status quo, barriers, action,
surprises, discoveries
• Spend time exploring the
conditions and assets that
made the story possible.
Take Notes
Story Name & Details
…………………………………
Assets and Conditions
Purposes: Appreciative Interviews
•
•
•
•
•
•
Build positive energy & momentum
Solve problems by discovering what works
Spark peer to peer learning
Develop Min Specs for success
Get to know each other through positive stories
Create a new exciting narrative about the
transformation
• Discover collective power & adaptability
• You may discover positively deviant local innovations
Henri Lipmanowicz & Keith McCandless
Strategy Safari
1. What is
happening
around us
that demands
adaptation?
•
Next
Week
•
Next
Quarter
Next
Month
• Task
•
•
•
•
•
•
• Description
• Measure of
success
•
•
•
GOAL 2
•
•
•
• Description
• Measure of
success
•
•
•
GOAL 1
•
•
•
•
Next
Year
• Action
• Task
•
•
3. Given our purpose,
what seems possible
now?
5. How are we breaking
away from the current
state toward the future?
• Action
•
GAMEPLAN
•
GOAL 3
4. What is
at stake if we
do not change?
•
• Description
• Measure of
success
•
•
•
2. Where are we starting, really?
• Current status:
•
• Current status:
•
• Current status:
•
What³ Debrief
1. WHAT?
• What facts, data, & observations
stand out?
2. SO WHAT?
• How do you explain what you see?
Based on your observations, do you
see a pattern? Is it important?
3. NOW WHAT?
• What action may help you move
forward? Who else should be here?
Climbing Up & Down
The Ladder of Inference
I take based on beliefs
Actions
3. Now What?
I adopt about the world
Beliefs
Conclusions
2. So What?
I draw
Assumptions
Reflexive
Loop
I make based on meanings
Meanings
I add (cultural & personal)
1. What?
Data
I select from observations
Observable data and experiences
Adapted from
Chris Argyris, Harvard
Lunch
60 Minutes
Open Space
Technology
LiberatingHenri
Inherent
Creativity
& Leadership
Lipmanowicz
& Keith McCandless
In Large Groups with an Action-Orientation
Open Space Boosts Freedom AND Responsibility
Freedom
Responsibility
Henri Lipmanowicz & Keith McCandless
Sue & Susan’s
Campaign Imperatives
Five Campaign Imperatives
In the activation phase, to survive and succeed over the next two years, Action Coalitions:
1. Must move beyond nursing.
2. Must deliver short term results in the next 18
months even as you develop long term plans.
3. Must have courage to place the right leaders
at the helm or remove weak, ineffective
leaders.
4. Must have funding to sustain this work.
5. Must not ignore diverse stakeholders critical
to our success.
Open Space Theme
What can we stop doing or
start doing to move
forward toward our
purpose?
Henri Lipmanowicz & Keith McCandless
Four Principles and One Law
Be prepared to be surprised; and,
let your passion guide you
Law of Two Feet
• go to where you are learning or contributing
Principles of Open Space
• Whoever comes is the right people
• Whatever happens is the only thing that could have
• Whenever it starts is the right time
• When it is over it is over
Henri Lipmanowicz & Keith McCandless
Mad Tea Strategy Safari Rules
Form two circles.
You will find yourself directly across from
one other person. One person facing “out”
and the other “in.” Finish the sentence that
appears on the screen.
1) Stay curious & dig deep
2) Switch roles ~ one ding
3) Move two spaces to the right ~ two dings
Strategy Safari
1. What is
happening
around us
that demands
adaptation?
•
Next
Week
•
Next
Quarter
Next
Month
• Task
•
•
•
•
•
•
• Description
• Measure of
success
•
•
•
GOAL 2
•
•
•
• Description
• Measure of
success
•
•
•
GOAL 1
•
•
•
•
Next
Year
• Action
• Task
•
•
3. Given our purpose,
what seems possible
now?
5. How are we breaking
away from the current
state toward the future?
• Action
•
GAMEPLAN
•
GOAL 3
4. What is
at stake if we
do not change?
•
• Description
• Measure of
success
•
•
•
2. Where are we starting, really?
• Current status:
•
• Current status:
•
• Current status:
•
What³ Debrief
1. WHAT?
• What facts, data, & observations
stand out?
2. SO WHAT?
• How do you explain what you see?
Based on your observations, do you
see a pattern? Is it important?
3. NOW WHAT?
• What action may help you move
forward? Who else should be here?
Open Space
Technology
Day 2
Liberating Inherent Creativity & Leadership
In Large Groups with an Action-Orientation
Henri Lipmanowicz & Keith McCandless
25 Will Get You 10
Crowd Sourcing
On index cards, each
participant writes:
– If you were 10
times bolder,
what would
you do to move
forward?
– A first step to
act on your
idea.
No names
Write legibly
Henri Lipmanowicz & Keith McCandless
25/10 Steps
•
•
•
•
•
•
•
Pass cards around while milling
5 rounds
Rate from 1 = ho-mum to 5 = fabulous
Put rating on the back of the card
Decide before looking at other scores
Add all the scores after the last round
Read your card as the countdown rolls on
25…24…23… 22…
Henri Lipmanowicz & Keith McCandless
Lunch
60 Minutes
Gallery
Walk
+
Action
Planning
What³ Debrief
1. WHAT?
• What facts, data, & observations
stand out?
2. SO WHAT?
• How do you explain what you see?
Based on your observations, do you
see a pattern? Is it important?
3. NOW WHAT?
• What action may help you move
forward? Who else should be here?
Ecocycle
Henri Lipmanowicz & Keith McCandless
Activity List
Where are you spending time? (key activities)
What are your top strategic relationships?
• Current Activities &
Strategies
–
–
–
–
–
…
…
…
…
…
• Top Relationships
–
–
–
–
–
…
…
…
…
…
Henri Lipmanowicz & Keith McCandless
Exploring the Ecocycle
RENEWAL
BIRTH
Henri Lipmanowicz & Keith McCandless
MATURITY
CREATIVE
DESTRUCTION
Conventional Lifecycle
MATURITY
Conservation & Routinization
Bureaucrat-As-Leader
GROWTH
Strategic,
“Rational”
Management
BIRTH
Adhocracies, Exploitation
Entrepreneur-As-Leader
Henri Lipmanowicz & Keith McCandless
The “Neglected” Back Loop
RENEWAL
Exploration/Invention/Reorganization
Network Weaver-As-Leader
LEADERSHIP
Envisioning new options
CREATIVE
DESTRUCTION
Release/Crisis/Confusion
Heretic-As-Leader
Henri Lipmanowicz & Keith McCandless
Ecocycle
RENEWAL
Exploration/Invention /Reorganization
Network Weaver-As-Leader
Poverty Trap
MATURITY
Conservation & Routinization
Bureaucrat-As-Leader
Rigidity Trap
Not funding innovation
Not letting go
~ Gathering
~ Sifting
BIRTH
Entrepreneurial Action
Entrepreneur-As-Leader
Adapted from Brenda Zimmerman,
EdgeWare & Getting To Maybe
CREATIVE
DESTRUCTION
Release/Crisis/Confusion
Heretic-As-Leader
Ecocycle Worksheet Sample
AC: ______
4. Renewal
Mobilization
2. Maturity
Conservation
“Sowing”
“Harvesting”
Relationship : Activity
Activity : Relationship
.
Activity : Relationship
1. Birth
Exploitation
Activity :
Relationship
“Growing”
3. Creative
Destruction
“Plowing”
Henri Lipmanowicz & Keith McCandless
STEPS
part 1
• Use the list of activities and relationships,
reflect on your own, generating a first
draft of placements
• With one partner, coach each other to
construct an Ecocycle map – 5 minutes
each (10 minutes total)
• In your Action Coalition, decide where to
place the activities on the large wall
Ecocycle “placemat”
Henri Lipmanowicz & Keith McCandless
1
7
STEPS
OH
part 2
2
3
OH
OH
1.
For a Top Ten
2.
national map,
3.
make sticky
4.
notes for each
5.
relationship.
6.
Elect a delegate 7.
to put your post- 8.
its on the large
9.
wall tapestry
10.
Insurers / Business
Hospitals & HC Systems
Healthcare Professionals
Physicians
RNs/Nursing Students
Consumers (the public)
Government
Colleges
Unions
Philanthropy
Henri Lipmanowicz & Keith McCandless
1
OH
2
OH
3
OH
Ecocycle Insights
•
•
•
•
•
Change is continuous along the cycle
Renewal requires destruction
Need for crisis -- root word “to sift”
Need for firebreaks, don’t burn the whole forest
Patch dynamics or balance in your activities are
key to long term survival and adaptability
• Create conditions for renewal and more births
Henri Lipmanowicz & Keith McCandless
Transmitting Gameplans
1. Email to futureofnursing@aarp.org.
2. Use your thumbdrive to save onto computer in
foyer (save to “Gameplan” folder on desktop).
3. Hand a paper copy to a CCNA team member.
PLEASE CLEARLY MARK WITH YOUR STATE NAME!!
WIRELESS LOGIN: CCNA
PASSCODE: CCNA
Strategy Safari
1. What is
happening
around us
that demands
adaptation?
•
Next
Week
•
Next
Quarter
Next
Month
• Task
•
•
•
•
•
•
• Description
• Measure of
success
•
•
•
GOAL 2
•
•
•
• Description
• Measure of
success
•
•
•
GOAL 1
•
•
•
•
Next
Year
• Action
• Task
•
•
3. Given our purpose,
what seems possible
now?
5. How are we breaking
away from the current
state toward the future?
• Action
•
GAMEPLAN
•
GOAL 3
4. What is
at stake if we
do not change?
•
• Description
• Measure of
success
•
•
•
2. Where are we starting, really?
• Current status:
•
• Current status:
•
• Current status:
•
Mad Tea Strategy Safari Rules
Form two circles.
You will find yourself directly across from
one other person. One person facing “out”
and the other “in.” Finish the sentence that
appears on the screen.
1) Stay curious & dig deep
2) Switch roles ~ one ding
3) Move two spaces to the right ~ two dings
What first inspired me in
this work is…
An uncertainty we must
creatively adapt to is…
What I find challenging in
our current situation is…
What I hope can happen
for us in this work is…
In our operating environment,
something we are learning to
live with is…
A courageous conversation
we are not having is…
A big innovation
opportunity I see for
us is…
In our operating
environment, an uncertainty
we are learning to live with
is…
A concept or practice
helping us adapt
creatively is…
Something I will never
go back to is...
If we do nothing, the
worst thing that can
happen for us is…
An innovative project that
gives me confidence we are
transforming is…
Something we should
stop doing (or divest) is…
A question that
is emerging for
me is…
I like a Mad
Tea Party
because…
Operating
Environment
Strategic
Action
1-2-4-All
Current
State
What shared answers
are starting to
emerge?
Stake
Adapted from ThePrimes, Chris McGoff
Purpose &
Vision
1. Operating Environment
• What is happening around us that
demands adaptation?
• In our operating environment, something we are
learning to live with is…
• An uncertainty we must creatively adapt to is…
Jot down the best answers
you heard, pass it to your
right, again, again, again…
2. Current State
• Where are we starting, really?
• What I find challenging in our current situation is…
• A courageous conversation we are not having
about where we are now is…
Jot down the best answer
you heard, pass it to your
right, again, again, again…
3. Vision
• Given our purpose, what seems
possible now?
• What first inspired me in this work is…
• What I hope can happen for us in this work is…
• A big innovation opportunity I see for us is…
Jot down the best answers
you heard, pass it to your
right, again, again, again…
4. Stake
• What is at stake if we do not
change?
– If we do nothing, the worst thing that can
happen for us is…
– Something I will never go back to is…
Jot down the best answers
you heard, pass it to your
right, again, again, again…
5. Strategic Action
• How are we breaking away from the
current state toward the future?
– Something we must stop doing (divest) is…
– Something we should start doing (invest in) is…
– One innovative project that gives me confidence
we are transforming now is…
Jot down the best answers
you heard, pass it to your
right, again, again, again…
Balance
• Balance among the elements makes a big
difference.
• Pitfalls to avoid:
• Blue Sky Dreaminess: ignoring the current state
and operating environment
• Bad-Road Inertia: despairing over the current state;
fearing what is at stake
• Jumping Over the Moon: moving to action without
including others in conversations or agreements
Operating
Environment
1-2-4-All
Strategic
Action
What shared
answers are
starting to
emerge?
Stake
Adapted from ThePrimes, Chris McGoff
Current
State
Purpose &
Vision
Liberating Structures
– Plexus Institute www.plexusinstitute.org
– LS website www.liberatingstructures.com
– Book: Liberating Structures: Including and
Unleashing Everyone (in progress)
– keith@liberatingstructures.com
henri@liberatingstructures.com