#Endpjparalysis Enabling Change

@ZoeLord1 @HorizonsNHS #EndPJparalysis @ECISTNetwork
Enabling and sustaining
large scale change
Nick Holding
@Wolvesboy
Improvement Manager
ECIST Support Team
Zoe Lord
@Zoelord1
Deputy Director
NHS Horizons
Paul Devlin
@DevlinPJ
Improvement Manager
ECIST Support Team
Kate Pound
@KateSlater2
Improvement Manager
ECIST Support Team
@ECISTNetwork @HorizonsNHS

Zoe Lord
Deputy Director
NHS Horizons
@Zoelord1
@HorizonsNHS
Nick Holding
Improvement Manager
Emergency Care Intensive Support Team
@Wolvesboy @ECISTNetwork
Paul Devlin
Improvement Manager
@DevlinPJ @ECISTNetwork
Kate Pound
Improvement Manager
@KateSlater2 @ECISTNetwork

Where in the world are you?
Let us know in the chat room

@ZoeLord1 @HorizonsNHS #EndPJparalysis @ECISTNetwork@ZoeLord1 @HorizonsNHS #EndPJparalysis
Zoe’s Story

1 5
Poll in the chat box
I’m new to
#EndPJparalysis
and just starting
out.
I use the
#EndPJparalysis
principles &
spread the
practice across
organisations or
systems

Source: Innovisor

“Many times experts fail because they are
experts in the past version of the world”
Vikram Khosia
@wellcometrust
#expertdebate

What are we dealing with?

Model for Large Scale Change

Change Model for Health and Care

Jeremy Heimens, Henry Timms New Power: How it’s changing the 21st Century and why you need to know (2018)
new power
Current
Made by many
Pulled in
Shared
Open
Relationship
old power
Currency
Held by a few
Pushed down
Commanded
Closed
Transaction

Who are our people?

WHO will make the change happen?
List A
• The Delivery Board
• The Programme Sponsors
• The Programme Management Office
• The Delivery Board Workstreams
• The Clinical Leads
• The Directors of participating
organisations
• The Change Facilitators
Source: adapted by Helen Bevan
from Leandro Herrera

The Network Secrets of Great
Change Agents
Julie Battilana &Tiziana Casciaro
As a change agent, my centrality in the informal
network is more important than my position in the
formal hierarchy

WHO will make the change happen?
List A
• The Delivery Board
• The programme sponsors
• The Programme Management Office
• The Delivery Board work streams
• The Clinical Leads
• The Directors of participating
organisations
• The Change Facilitators
List B
• The mavericks and rebels
• The deviants (positive). Who do things
differently and succeed
• The nonconformists who see things
through glasses no one else has
• The hyper-connected who spread
behaviours, role model at a scale, set
mountains on fire and multiply anything
they get their hands on
• The hyper-trusted. Multiple reasons,
doesn’t matter which ones
Source: adapted by Helen Bevan
from Leandro Herrera

What’s the evidence?
The failure of large scale
transformational change projects
is rarely due to the content or
structure of the plans that are put
into action
It’s much more about the role of
informal networks in the
organisations and systems
affected by change
To make transformational change
happen we need to connect networks of
people who ‘want’ to contribute
Source: David Dinwoodie (2015)
http://iedp.com/articles/vertical-leadership/?utm_source=Sign-
Up.to&utm_medium=email&utm_campaign=13787-257163-Campaign+-+01%2F09%2F2016

The power, individually
and collectively, to
make a positive
difference

Power is linked to AGENCY
• The capacity of individuals & collectively to make their
own choices and to take action in a given environment
• It is about pushing the boundaries of what is possible,
mobilising others and making change happen more
quickly

Convening
Creating spaces where
people can come together to
learn and share
Its about publicising the
space to attract interesting
participation

Programme managing and Convening
• Designs a plan
• Accountability within a
governance system
• Ensures that delivery
milestones are met
• Deals with risk and ensures
that barriers are overcome
• Works with emergence
• Builds commitment to a
collective goal
• Builds relationships
• Seeks win/wins
• Makes sense of things for
adopters: the why?
• Enables spread across a whole
system
Dependent/
independent Interdependent
PROGRAMME
MANAGING
CONVENING

Mark Jaben on the science behind resistance
What NOT to do
But what we do do
Engage people
here

Mark Jaben on the science behind resistance
What NOT to do
(but what we usually do)
We don’t need buyers (who “buy-in” to change)
We need investors
What TO do
Engage
people here
Engage
people here

Sourceof image: Dr.Christina WinseyATMind-BodyConnection

Teams perform best when
five energies are high
Psychological
Physical
Spiritual
Social Intellectual
Source: http://www.institute.nhs.uk/tools/energy_for_change/energy_for_change_.html

High and low ends of each
energy domain
Social isolated solidarity
Spiritual uncommitted higher purpose
Psychological risky safe
Physical fatigue vitality
Intellectual Illogical reason
HIGHLOW

NHS England and NHS Improvement
‘I genuinely look forward to
coming to work we are more
like a family than a team’.
‘ I provide the quality of
care that my family and I
would want to receive’.
‘I love what I do and I do
what I love brilliantly thanks
to our great place to work’.
‘I feel valued, listened to
and supported to reach
my true potential’.
NHS Great Place to Work - Building a positive and
supportive environment where people can be at their best!!
#TheMissingIngredient

ACTIONABLE CONNECTED EXTENSIBLE
• Designed to make people DO something
• A call to action
• Facilitates a closer connection between
people who share the same values
• Creates further networks which promote
spread
• Easily customised, re-shaped and owned
by the people taking part
• Alteration is encouraged
Jeremy Heimens, Henry Timms
New Power: How it’s changing the 21st Century and why you need to know
(2018)

#endPJparalysis
@HelenBevan #IHIforum

https://fabnhsstuff.net/fab-stuff/starting-
with-the-patient-and-working-backwards-
fabulous-ambulance-handover-
improvements-at-hillingdon-hospital

36 |
@wolvesboy

Networks and connections

Just 3% of people in the
organisation typically
drive conversations
with 85% of the other
people
Source: research by IC Kollectif
Further reading: Organisational Network Analysis by Innovisor
Superconnectors…

People who are highly connected have
twice as much power to influence
change as people with hierarchical
power
Leandro Herrero
http://t.co/Du6zCbrDBC
@ZoeLord1 @RosieRedstone

What is the best way to spread
new knowledge?
Social connection/discussion is
14 times more effective
than the written word, best practice
toolkits & databases.
http://www.nickmilton.com/2014/10/why-knowledge-transfer-through.html

Connecting with the
improvement community via a
tweet chat
What does the National Improvement
Director need to know about the
improvement work that’s currently
ongoing across England?
In one hour (20th May 7-8pm):
1,991 tweets
were
posted
777 people took
part
1.24 million
people were
reached
Tweetchat hosted by @HorizonsNHS

The powerful
Improvement
“superconnectors”

NHS Amateur Radio Station GB1NHS
Operated by the Emergency Care
Intensive Support Team
The aim of the station is to promote NHS initiatives at scale that lead to patients receiving
excellent care, faster recovery and living longer healthier lives.
www.gb1nhs.net
@GB1NHS

Kate’s top tips
Joy at work stay connected
to your values
Build your relationships
Take control of the story
Create a shared purpose
Build network and find
your 3% don’t go it alone!

What is your top tip for someone
looking to get started on their
#EndPJparalysis journey?

Links
• NHS Horizons website
• School for Change Agents – free online materials
• Emergency Care Intensive Support Team website
• Emergency Care Intensive Support Team YouTube - ECIST1
• https://ecist.home.blog/
• Model for Large Scale Change
• Change Model
• Energy for Change Model
• First steps to quality improvement
• Bringing Lean to Life
• www.GB1NHS.net

#Endpjparalysis Enabling Change

More Related Content

What's hot (20)

Similar to #Endpjparalysis Enabling Change (20)

More from Zoe Lord (8)

Recently uploaded (20)

#Endpjparalysis Enabling Change

Editor's Notes