How do you engage clinicians in

transformational change and

service improvement?

Professor Moira Livingston, NHS Improving Quality

Everyone Everywhere Every Time

• Financial challenges

• Quality: safety, outcomes and experience is the focus

• Rising expectations

• Increasing complex health needs

• Unacceptable variation

BACKGROUND: THE CURRENT LANDSCAPE

We need to do more, for less… and better…. and faster

Does not experience the safest and highest quality healthcare

It’s complicated

The landscape we work in

“No more nanny state on health”

2008 -2013

staff

MENTAL MODELS AND SPREAD

OF KNOWLEDGE

Edgar Schein, Professor Emeritus

MIT Sloan School

You can’t impose anything

on anyone and expect them

to be committed to it.‘‘

’’

Mental models of change - striking a balance

How we think about engagement

It’s all about

It is hard but we DO

SEE great success

and IMPROVED

UNDERSTANDING

of what HELPS

Features of success

Training is not enough:

• Identify the right people who can be leaders of change and improvement

• A culture that supports change (time encouragement and recognition)

• Mentorship

How do we get value from the investment in clinical leaders in improvement and largescale change

YOU ARE

NOT

ALONE

Clear vision: ambitious

Collective goal: Shared

purpose

Transparency of steps to get there

Consistency and

constancy

Commitment Courage

Resilience

Innovations

Small continuous improvements

measured to the millisecond

Share and Spread

Leadership and team

work

Sky’s mission in 2010 was to win Tour de France with a British rider within five years – they did it in two years

Consider• The vision and purpose

• Leadership:

– Behaviours and values

– Culture

– Courage

– Resilience

• Seeking commitment not compliance

• Focus on:

– Why - benefits to patients and clinicians

– Strengths more than deficiencies

– Everyone getting better

• Align the system levers to maximise efforts for improving quality

• Data and measurement