@helenbevan Rocking the boat and staying in it: respiratory leader as organisational radical Helen Bevan Delivery team NHS Improving Quality @helenbevan @NHSIQ
Rocking the boat and staying in it:respiratory leader as organisational radical - Helen Bevan Presented by Helen Bevan at 'Influencing and coordinating respiratory care in London': an invitation only event for current and future respiratory leaders in London. Kings College London – Strand Campus, Friday June 28th 2013 PCRS-UK & the respiratory leaders programme – Part 1 The two PCRS-UK workshops considered different but complementary approaches to acquiring some of the essential knowledge, skills and qualities to becoming an effective respiratory leader. In this first session Helen Bevan will inspired you to communicate your ideas and learn more effectively using innovative media and show you how being a disruptive radical can help you and your organisation achieve better value care – a concept everybody can agree with.
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1. @helenbevan Rocking the boat and staying in it: respiratory
leader as organisational radical Helen Bevan Delivery team NHS
Improving Quality @helenbevan @NHSIQ
2. @helenbevan
3. @helenbevan
4. @helenbevan How does it feel to be a
heretic/radical/rebel/maverick in our organisation?
5. @helenbevan
6. @helenbevan What happens to
heretics/radicals/rebels/mavericks in organisations?
7. @helenbevan
8. @helenbevan Are you a boat rocker? One who challenges the
status quo when they see that there could be a better way Energise
their organisation by working from their true self Capable of
working with others to create success NOT a destructive
troublemaker Walk the fine line between difference and fit, inside
and outside, rock the boat but manage to stay in it
9. @helenbevan Troublemaker Radical Complain Create Me-focused
Mission-focused Anger Passion Pessimist Optimist Energy-sapping
Energy-generating Alienate Attract Problems Possibilities Alone
Together Source : Lois Kelly www.foghound.com Sometimes people see
us radicals as troublemakers
10. @helenbevan Task Talk to others at your table about your
experiences around rebels and troublemakers Which have you been and
why? What moves people from being good to bad? How do we protect
against this?
11. @helenbevan First they ignore you, then they laugh at you,
then they fight you, then you win Gandhi
12. @helenbevan Valuing radicals New truths begin as heresies
(Huxley, defending Darwins theory of natural selection) big things
only happen in organisations because of heretics and radicals
13. @helenbevan
14. @helenbevan Source: Foghound
15. @helenbevan Four tactics for organisational radicals 1.
Start with myself 2. Build alliances 3. Work out what might help
others to change 4. Don't be a martyr
16. @helenbevan Four tactics for organisational radicals 1.
Start with myself 2. Build alliances 3. Work out what might help
others to change 4. Don't be a martyr
17. @helenbevan There is nothing more difficult to carry out,
nor more doubtful of success, nor more dangerous to handle, than to
initiate a new order of things. For the reformer has enemies in all
those who profit by the old order, and only lukewarm defenders in
all those who profit by the new Niccolo Machiavelli 15th
century
18. @helenbevan "Theres only one corner of the universe you can
be certain of improving, and thats your own self." Aldous
Huxley
19. @helenbevan
20. @helenbevan 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
21. @helenbevan 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 we
surrender a part of ourselves, and silence our commitment, in order
to survive
22. @helenbevan Source: Foghound
23. @helenbevan
24. @helenbevan 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 we
surrender a part of ourselves, and silence our commitment, in order
to survive 2. leave the organisation
25. @helenbevan 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 we
surrender a part of ourselves, and silence our commitment, in order
to survive 2. leave the organisation we cannot find a way to be
true to our values and commitments and still survive
26. @helenbevan 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 we
surrender a part of ourselves, and silence our commitment, in order
to survive 2. leave the organisation we cannot find a way to be
true to our values and commitments and still survive 3. stridently
challenge the status quo in a manner which is increasingly radical
and self-defeating
27. @helenbevan 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 we
surrender a part of ourselves, and silence our commitment, in order
to survive 2. leave the organisation we cannot find a way to be
true to our values and commitments and still survive 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
dont belong
28. @helenbevan 1. convictions and values driven 2. strong
sense of self-efficacy belief that I am personally able to create
change belief in others 3. action orientated ignite collective
action mobilising others, inspiring change 4. able to join forces
with others work as a collective body for commonly valued changes
5. able to achieve small wins which create a sense of hope, self-
efficacy and confidence 6. optimistic in the face of challenge see
opportunities take account of obstacles What do we know about
successful boat rockers?
29. @helenbevan Three assumptions for organisational radicals
1. Assume that everyone has a noble intention 2. Motivation and
behaviour in a change process are due to interpersonal interaction
(not just innate character trait) 3. My role as a change agent is
about alignment, not judgement
30. @helenbevan Four tactics for organisational radicals 1.
Start with myself 2. Build alliances 3. Work out what might help
others to change 4. Don't be a martyr
31. @helenbevan The easiest way to thrive as an outlier ...is
to avoid being one Seth Goodin
32. @helenbevan if you want to go fast, go alone. If you want
to go far, go together African proverb quoted by Al Gore
33. @helenbevan 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)
34. @helenbevan What do we need to do? 1. Tell a story
35. @helenbevan What do we need to do? 1. Tell a story 2. Make
it personal
36. @helenbevan What do we need to do? 1. Tell a story 2. Make
it personal 3. Be authentic
37. @helenbevan What do we need to do? 1. Tell a story 2. Make
it personal 3. Be authentic 4. Create a sense of us (and be clear
who the us is)
38. @helenbevan What do we need to do? 1. Tell a story 2. Make
it personal 3. Be authentic 4. Create a sense of us (and be clear
who the us is) 5. Build in a call for urgent action
39. @helenbevan
40. @helenbevan
41. @helenbevan
42. @helenbevan
43. @helenbevan Four tactics for organisational radicals 1.
Start with myself 2. Build alliances 3. Work out what might help
others to change 4. Don't be a martyr
44. @helenbevan
45. @helenbevan Stages of change Transtheoretical model of
behaviour change Prochaska, DiClemente & Norcross (1992)
46. @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
47. @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!
48. @helenbevan Stages of change Smoking Prochaska, DiClemente
& Norcross (1992) I am not aware my smoking is a problem I have
no intention to quit
49. @helenbevan Stages of change Smoking Prochaska, DiClemente
& Norcross (1992) 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
50. @helenbevan Stages of change Smoking Prochaska, DiClemente
& Norcross (1992) 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.
51. @helenbevan Stages of change Smoking Prochaska, DiClemente
& Norcross (1992) 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!
52. @helenbevan Stages of change Smoking Prochaska, DiClemente
& Norcross (1992) 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 am continuing to not smoke.
I sometimes miss it but I am still not smoking
53. @helenbevan Stages of change Smoking Prochaska, DiClemente
& Norcross (1992) 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 am continuing to not smoke.
I sometimes miss it but I am still not smoking
54. @helenbevan Stages of change Transtheoretical model of
behaviour change Prochaska, DiClemente & Norcross (1992)
55. @helenbevan 90% of the tools available for healthcare
change agents are designed for the action stage The reality of our
change situation Our tools are often not effective at the stage of
change that most people we work with are at Its hard to engage
people in change Its 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 lead or facilitate the change
56. @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
57. @helenbevan 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
58. @helenbevan So what do we TEND to do? Lower our ambitions
for improvement Focus our energies on those who are already in the
action stage Put negative labels on those who are not yet at the
action stage such as blocker or resister or laggard Blame the
leadership for not enforcing change Overestimate the motivation of
those who say theyre ready to change and underestimate the
motivation of those who indicate no interest in change
(Lundberg)
59. @helenbevan So what SHOULD we do Listen and understand
appreciate the starting point elaborate interests Build meaning and
conviction in the change Roll with resistance (Singh) Dont argue
against it Encourage elaboration of resistance What makes it so
hard? What would help? Build shared purpose
60. @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
61. @helenbevan Discussion What might you do to: enhance your
own role as a respiratory maverick, radical or heretic? Support
other mavericks, radicals or rebels in your organisation or
system?
62. @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 Seidman
63. @helenbevan We have a choice This is the true joy of life,
the being used up for a purpose recognised by yourself as a mighty
one, being a force of nature instead of a feverish, selfish little
clot of ailments and grievances, complaining that the world will
not devote itself to making you happy George Bernard Shaw