leading real change from the front line · 2018-05-02 · steve fairman managing director, nhs...
TRANSCRIPT
Leading real change from the front line –what can you do tomake a difference for your patients?
Steve Fairman
Managing Director, NHS Improving Quality
To start,a short story
about a fridge
Image from: @TheWorldStories
• Creating a space for getting ready for change
• Invitation to thinking differently about change
• Share the collective wisdom of people in the room – 5 minutes of wisdom
Overview
Image copyright: http://13c4.wordpress.com/2007/02/24/50-reasons-not-to-change/
…your organisation may not be ‘change friendly’…
Research from the sales industry:
• 2% of sales are made on the first contact
• 3% of sales are made on the second contact
• 5% of sales are made on the third contact
• 10% of sales are made on the fourth contact
• 80% of sales are made on the fifth to twelfthcontact
Source: http://www.slideshare.net/bryandaly/go-for-no
Source: @NHSChangeDay
Employee resistance is the most common
reason executives cite for the failure
of big organizational-change efforts
Scott Keller and Colin Price (2011), Beyond Performance: How Great Organizations Build
Ultimate Competitive Advantage Source of image: Businessconjunctions.com
The NHS Change Challenge
• The World’s first mass crowd-sourcing event focused on improving healthcare
• 14,000 contributions
• 10 Barriers to change identified
• 11 Building Blocks for change identified
• 17 practical solutions built by contributors
Confusing strategies
Over controlling leadership
Perverse incentivesStifling innovation
Poor workforce planning
One way communication
Inhibiting environment
Undervaluing staff
Poor project management
Playing it safe
Source: Health Service Journal, Nursing Times, NHS Improving Quality, “Change Challenge” March 2015
The 10 barriers to change identified by 14,000 contributions from front line staff
The 11 building blocks for change identified by 14,000 contributions from front line staff
Inspiring & supportive leadership
Collaborative working
Thought diversityAutonomy & trust
Smart use of resources
Flexibility & adaptability
Long term thinking
Nurturing our people
Fostering an open culture
A call to action
Source: Health Service Journal, Nursing Times, NHS Improving Quality, “Change Challenge” March 2015
Challenging the status quo
A Solution:Everybody’s ideas on board
• Simple and easy
• A place to pose questions about delivery of your service, or staff or patient experience
• A place anyone can post responses
• Locally owned improvement plans!
Everybody’s ideas on board (2)
A Solution:Use a Change Model
• No one model has all the answers
• A mental framework and a process that can help
• Use evidence of what makes change successful
• Helpful to see the change through different lenses
Use a Change Model (2)
Bigger picture / longer term thinking
Poor workforce planning
Poor project management
A Solution:An online NHS Forum
• The NHS is terrible at shouting about its successes
• More wheels are reinvented by the NHS than by Ford
• Share!
An online NHS Forum (2)
Inhibiting environment
A Solution:Empower everyone to be a change agent
• It’s easy to feel isolated if you want to change things
• Build everyone’s QI skills and confidence and willingness to take on a challenge as an antidote
• Resistance to change will fall…
Empower everyone to be a change agent (2)
Flexibility and adaptability Playing it safe
Poor workforce planning
Source: @NHSChangeDay
Source: @NHSChangeDay
What is the issue here?
“permission” ? (externally generated)
or
Self efficacy ? (internally generated)
Building self-efficacy: some tactics
1. Create change one small step at a time
2. Reframe your thinking: failed attempts are learning opportunities
3. Make change routine rather
than an exceptional activity
4. Get social support
5. Learn from the best
Self-efficacy
There is a positive, significant relationship between the self-efficacy beliefs of a change agent and her/his ability to facilitate change
and get good outcomes
Source of image:www.h3daily.com
“Thousands of patients have died
needlessly because of a damaging reluctance amongst doctors and the public to accept changes in the NHS,
according to the country’s top emergency doctor
“
5 Questions for to take away for reflection
1. What are the opportunities for me to build my perspectives and skills as an agent of change?
2. How can I build self efficacy as a change agent?
3. How do I move beyond skills and knowledge of change to live and be change?
4. Who can help and support me as a change agent?
5. What are the implications for the way I work?
Thank you