‘Dis*ruption - an agent
of constructive change'
Jackie Lynton: Head of Transformation @jackielynton
Dominic Cushnan: Actionable Knowledge Manager @dominiccushnan
Horizons Group, NHSIQ
#NHSChangeDay #SHCRchat
Horizons Group
Small team
Operate at the edge of current
thinking and change
Share the disruptive power of
connecting, leading edge
knowledge, transformation and
innovation
Connect people to empower
them, to help health and care
to think differently about the
rules of change and make
sense of it in their own context
#NHSChangeDay #SHCRchat
Our new White Paper - Five enabling themes
www.nhsiq.nhs.uk/
@HelenBevan
whitepaper
#NHSChangeDay #SHCRchat
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
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
100%
100% of all projects evaluated as
“Successful” had a good
technical solution or approach
COMMITMENT
ENGAGEMENT
ENERGY
98%
Over 98% of all projects evaluated
as “Unsuccessful” also had a good
technical solution or approach
COMMITMENT
ENGAGEMENT
ENERGY
Most change efforts are built upon the shaky foundation of
five flawed assumptions;
1. That change can be managed
2. That human beings are objective
3. That there are ‘X’ steps to change
4. That we have a neutral starting point for change
5. That change, itself, is the goal
Peter Fuda
http://www.peterfuda.com/wp-content/themes/peterfudabootstrap/content/Why-Change-Efforts-Fail.pdf
@HelenBevan
Why is change needed and what needs
to change?
#NHSChangeDay #SHCRchat
Leading change in a new era
Dominant approach
@HelenBevan
Emerging direction
Leading change in a new era
Most healthcare
transformation
efforts are driven
from this side
@HelenBevan
Using disruptive methods in change
Source of image: www.slideshare.net/mexicanwave/champions-trolls-10-years-of-the-cipd-online-community
•
•
•
•
•
•
•
Facebook didn’t exist
Twitter was still a sound
The cloud was still in the sky
4G was a parking place
LinkedIn was a prison
Applications were what you sent to college
Skype was a typo
Thomas Friedman,
World Economic Forum,
Quoted by http://ayeletbaron.com
Disruptive innovations already
available for healthcare professionals and patients
Its about people not technology!
If the ‘change’ were a patient and
the symptoms were found to be
persisting despite intensive therapy,
the diagnosis should be questioned
and new interventions considered.
Technology is not the goal –
the goal is the goal!
Disrupting the status quo
1. History tells us that, innovation
flourishes no matter how difficult
the environment
2. Disruptive attackers thrive in
downturns by taking advantage of
‘disruptive opportunity’
3. Today's tough times in healthcare
can lead to seminal changes in the
world of disruptive innovation/technology;
because it throws us into finding a different way
What's Next for Innovation?:
Disruptive Developments to Watch through the Downturn
is the new normal!
“By questioning existing ideas, by
opening new fields for action,
change agents actually help
organisations survive and adapt
to the 21st Century.”
Céline Schillinger
Image by neilperkin.typepad.com
@HelenBevan
Innovation is not a mystical state
“It's a natural state - a
human birthright. The
people in your
organisation, in fact,
already are innovative. The
only thing is: their natural
ability to be innovative is
being obscured by their
own habits of mind and a
variety of bothersome
organisational constraints.”
Source and picture: Name: The heart of innovation:
How we spark innovation, Oct 24, 2013. Ideas
champions.com
Changing our mindset about 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
Source: Helen Bevan
A disruptive case study
Probably the largest simultaneous
improvement initiative in the history of
healthcare
@HelenBevan
@HelenBevan
#APACForum
@HelenBevan
#Quality2014 #f1
What is NHS Change Day?
NHS Change Day is a
grassroots movement with the
purpose of empowering each
other to take action to improve
health and care. It connects
people, bringing them together
to in turn do something better
together. It celebrates and
shares every improvement we
make better together. Date
March
www.changeday.nhs.uk
NHS Change Day is supported and coordinated by NHS Improving Quality.
NHS Change Day
Aim:
Our shared purpose for NHS Change Day is to ignite thousands of
actions that will improve care for people. If you are inspired, then join
us in delivering actions that make a difference.
@HelenBevan
@HelenBevan
#APACForum
Resources to improve health and care
Economic resources
diminish with use
• money
• materials
• technology
Natural resources
grow with use
• relationships
• commitment
• community
Based on principles from Albert Hirschman, Against Parsimony
#NHSChangeDay
@HelenBevan @BoelGare
#SHCRchat@JackieLynton #Quality 2014 #M5
Simple Rules
Commitment vs Compliance
How can we innovate in a complex system and how can we make
innovation everyday business?
Underlying principles:
Small inputs can make big change, collective action, holding
yourself and each other to account, intrinsic motivation, large-scale
change, social movement principles. Call to action
1.
2.
3.
4.
5.
Make a pledge, publically, website
Chose a pledge that means something to you
Pledge (action), share, do, inspire (improvement cycle)
Goal: 1st year 65,000 pledges, 2nd year 802,000 pledges 3rd
pledge to action
Date
NHS Change Day 2014
More than 800,000 pledges to take action
• 81 separate Campaigns
• 86 million twitter
impressions
• 35,400 video views
• 95,000 daily reach on
Facebook
• More than 98% of the
activity through volunteers
@HelenBevan
@HelenBevan
#APACForum
Example pledge – Jeharna’s story
Member of the public
“
”
The way my brother was looked
after by the NHS staff was just
brilliant and I wanted to say
thank you.
COMMITMENT
ENGAGEMENT
ENERGY
Example pledge – Damian’s story
Individual
“
It has prompted myself, and
others to discuss with our
pharmacies methods of
improving the taste of one of
the common medicines for
children.
COMMITMENT
ENGAGEMENT
”
ENERGY
Louise's Story
2nd year student nurse – York University
Louise carrying out her change day
pledge ‘Mock ward’ 2013
COMMITMENT
ENGAGEMENT
ENERGY
Example pledge – Ashley’s story –
Barking Havering and Redbridge Trust
Main Trust wide
pledge for NHS
Change day in
2013
Guardian Service
Informal way of
raising concerns
“
Change Day gave me permission to
use my energy in the direction that I
wanted to use it
COMMITMENT
ENGAGEMENT
ENERGY
BHRUT & THE GUARDIAN SERVICE
Staff Feedback:
The following responses in the 2013 NHS Staff Survey in
the Health, Wellbeing and Safety at Work category had
the largest overall shifts in the Trust when compared to
2012:
Would you feel safe raising
your concern?
Would you feel confident your
Trust would address your
concern?
Total
2012
Total
2013
Total
All*
Yes
752
58%
1072
80%
45,025
71%
No
192
15%
269
20%
6,999
11%
Yes
516
40%
932
70%
34200
54%
Harvard Business Review
McKinsey M-Prize
Leaders Everywhere Challenge
Nesta and Observer
50 New Radicals
Our new White Paper - Five enabling themes
www.nhsiq.nhs.uk/
@HelenBevan
whitepaper
Getting
information off the
internet is like taking a
drink from a fire
hydrant
Mitchell Kapor
What is The Edge
•
A platform for change activists in health and
care to learn, connect and grow
•
Mobilising and organising and connecting with
other change activists
•
Curation vs Content creation
•
Seek, Sense, Share what does it mean
•
Why curation?
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
Friends of the Edge
theedge.nhsiq.nhs.uk
@jackielynton
@dominiccushnan
#NHSChangeDay #SHCRchat