thinking differently in the nhs - zoe lord - change management institute

@ZoeLord1 #cmiDisrupt

Zoe Lord National Improvement Manager

NHS England @ZoeLord1

How and why we’re thinking differently

in the NHS…

@ZoeLord1 #cmiDisrupt @HelenBevan@ZoeLord1 #cmiDisrupt

Overview…

• Why we’re using new thinking…• Concepts into practice:• Crowdsourcing • Hackathons


Why new methods?

• Patient need & expect high quality safe care, right first time at the right cost.


Why new methods?


Why new methods?

• People need high quality safe care, right first time at the right cost.

• Traditional methods…• We’re not getting the results we desire• 70% change programmes fail • Needs to be quicker • We know there are new methods• Constantly learning…


Jeremy Heimens TED talk “What new power looks like”

old power new power

Currency

Held by a few

Pushed down

Commanded

Closed

Transaction

Current

Made by many

Pulled in

Shared

Open

Relationship

https://www.youtube.com/watch?v=j-S03JfgHEA

https://www.youtube.com/watch?v=j-S03JfgHEA


Source : Ross Dawson (2015)


The power of co-creation


Crowdsourcing…

@ZoeLord1


The Change Challenge

Tapping the collective brilliance of the NHS


The process:

Step 1 :The build-upSetting the right foundation for campaign launch

Step 2:Launch campaign, explore barriers and enablersWeeks 1-4Launch the campaign for bottom up change and questions to the crowd to develop the barriers and building blocks for change.

Step 3Propose solutions Weeks 5-6Crowd invited to share, build and validate list of potential solutions

Step 4Develop toolkitWeek 7 best ideas selected by crowd and panel selectsWeeks 8-9 crowd develops best ideas into toolsWeeks 9-11 works on key outputs

Step 5:Spread and EmbedWeek 12Publication of interactive guide / ‘new era’ toolkit / manifesto for change / celebrated cases

Development of the process, questions, objectives and communication plan

Questions:-What things block or help you from delivering bottom-up change:· inside your organisation, to improve or transform services, and· across organisations to improve the health and wellbeing of a local population?

Questions:- What solutions work? What approaches have you used or observed that others could learn from and copy? Please share your stories and learning about what did and didn't work. What solutions should we test? What ideas do you have that we could test out? Share ideas (these can be completely new) that you believe could support bottom-up change in the NHS, if we gave them a chance.

47 ideas selected for the crowd to develop. Crowd asked to develop these into workable tools; tangible and practical enough to be used widely across health and care organisations to deliver bottom up change for patients, staff and the public. To do this, please tell us: - what steps need to be taken, - who needs to be involved, and - what commitments…

The HSJ and Nursing Times share outputs :• project overview,• ‘how to’ guides for

application of crowdsourcing

• ‘how to’ toolkit of prioritised ‘hacks’/ solutions

Result: a foundation for a social movement of bottom up change

Project over 12 weeks


What does the NHS workforce think? 14,000 contributors recently identified 10 barriers to change:

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


What does the NHS workforce think? 14,000 contributors recently identified 11 building blocks for change:

Inspiring & supportive leadershipCollaborative 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


Help us to capture redesign principles for care models to get better, quicker outcomes from

change

CAREDESIGN2016System redesign principles for care models

#CareDesign

Join in: nhsiq.crowdicity.com


Platform methodology for our redesign principlesPre-sprint Sprint 1 Sprint 2 Sprint 3

Expert group sense-check of redesign principles & crowdsourcing process

“Have we got the right redesign principles?”

“Tell us about the redesign principles in action”

“How do we make the redesign principles happen?”

V1.0 of redesign principles paper “Starter-for-ten” shared with expert group of “systems engineers” both from within and outside the NHS

The ten redesign principles will be presented via the crowdsourcing platform to our collaborators (widespread engagement)

Invite practical examples and case studies that demonstrate the refined ten redesign principles working and in action

Invite collaborators to signpost us to tools, methods, resources and methodologies that can help in the implementation of the redesign principles

Output from each sprint becomes a new version of the paper. The socially derived redesign principles are then open for the next sprint and round of crowdsourcing


Learning from crowdsourcing

1. Explicit about the purpose2. Right question! 3. The right question takes time!4. Test first 5. Right crowd6. Keep it simple 7. Keep timeframe flexible8. Respond to comments 9. Right platform10. Warm up act!


Hackathon…


Hackathon

Break down and rebuild

Energised

Collaborate

Energised Prototype

Event / space

Action Focused


Our NHS Change Model


NHS Change Model

Developed in 2012 with inputs from hundreds of people, to distil twenty years of learning from

change in the NHS into a useable model to accelerate and get

better outcomes from improvement


Purpose of the refresh• Strengthen the model

• To ensure it is fit for purpose to support organisations facing significant improvement challenges

• To turn from conceptual to enabling

• To enable other areas of the health and care system (ie social care, care homes) to embrace the model by considering a change of branding


Our first hackathon…

• Why? • Conversation with Perry Timms!• Move away from traditional

methods

• How?


Pre event

• Online hack packs

• Diversity

• Event planning

• Insights


Insights• Interviewed and surveyed 200 + people • Survey Monkey


Insights• Use: • It is used for many different purposes -Projects, events, meetings

• Knowledge:• The more people know, the more they find it useful• Easy accessible information on practical application is required

• Language:• Some of the language is inhibiting

• Name:• NHS brand brings prestige• NHS brand is hindering the uptake from other care providers• Is it a model or framework?


The event

• 80 people• 1 day• Series of hacks to explore design a proof of

concept to support and enable change across health and care


Remit of the changes

• Bring on board the people who don’t like it and keep hold of the people who do like it

• Enhance the positives – rather than change for change sake

• Address what ‘it’ should be called• Think about spread and implementation


Work in progress….


Learning

• Outputs… more than we’d ever imagined! • You cant second guess!• Letting go of control… • Frame and reframing is so important• Balance between divergence and convergence • Scope – In and out of scope• People – diversity in the room• Unconference • Trust the process • Go with the flow!

Everyone wants to do it!

@ZoeLord1

4pm - 4pm, 27-28th January 2016

@ZoeLord1

Four ways to connect!1. Follow us on Twitter

@ZoeLord1 @HelenBevan @SteveFairman@TheEdgeNHS @School4Radicals

2. Subscribe to theedge.nhsiq.nhs.uk

3. Get materials from theedge.nhsiq.nhs.uk/school

…and sign up for our monthly #EdgeTalkstheedge.nhsiq.nhs.uk/edgetalks

4. Save the date for theedge.nhsiq.nhs.uk/transformathon

http://theedge.nhsiq.nhs.uk/

http://www.theedge.nhsiq.nhs.uk/school

http://theedge.nhsiq.nhs.uk/edgetalks/

http://theedge.nhsiq.nhs.uk/edgetalks/

http://theedge.nhsiq.nhs.uk/transformathon/

http://theedge.nhsiq.nhs.uk/transformathon/

http://www.theedge.nhsiq.nhs.uk/school

thinking differently in the nhs - zoe lord - change management institute

Healthcare