Module 4 chat box school for change agents

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Module 4 Chat Box – School for Change Agents

from Adrian Woodfield to All Participants:

Hello from a sunny Orkney!


yes - I'm early!

from Emily Lau to All Participants:

Yup!

from Emma Hill to All Participants:

yes


not yet.....guessing that you are asking if we can hear something?


is anyone speaking now?


No - just some background music


aah! - music and Apollo 11!


fantastic!


:)

from Helen Bevan to All Participants:

Hi everyone. Great to see so many of you signed on nice and early. Who is joining us today and

where are you?

from Douglas Natusch to All Participants:

Hi, my name is Douglas Natusch and I am joining you from South Devon


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though these normally start at three? but funky apollo music stuff is fine.

from Oliver Benson to All Participants:

We start at 3pm but play some music while people join us.


what album is it from? Anyone know?

from Tom de Salis to All Participants:

I prefer this to last week's music, maybe I should come early every week!


Track is Public Service Broadcasting - Go


PSB!


great! got to get that

from Leigh Kendall to All Participants:

Quite apt really!


it's because we are in mission control today


Orkney - go!


Birmingham - go!


old enough to remember this - wahted it on a COLOUR TV at junior school

from Kate Pound to All Participants:

Hi all great to see so many people today


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they had to rent it - too expensive to buy!

from Paul Woodley to All Participants:

Coventry - go!

from Paula Ward to All Participants:

Nottingham


hi Helen


Hi from sunny Bournemouth


Thunderbirds are go!


er - thanks My Tracey


*Mr

from Tony Longbone to All Participants:

afternoon all, hope we're well

from Fiona Mac to All Participants:

Hello from the Wild Borders of Wales


Can we have a playlist please? My kind of music!


I really liked to Apollo music

from Val Edwards to All Participants:

Hello all from a very sunny Salford, Manchester

from Kathryn Perera to All Participants:

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Hello everyone and welcome!

from Lucy Butler to All Participants:

Morning from Dunedin New Zealand

from Pip Hardy to All Participants:

Hello from sunny Cambridge!


Stunning weather in London, overlooking St James' Park today.

from Stacey Kavanagh to All Participants:

Hello, Stacey Kavanagh, from Advancing Quality Alliance in Manchester

from Heather Callum to All Participants:

Hello from Guelph, Ontario, Canada!

from Kirstie Lawrence to All Participants:

Hi all! Kirstie from Warwickshire here. Im a final year OT student.

from Jennie Huntley to All Participants:

Hello from sunny, springy Ashford in Kent - Jennie from Kent Community Health NHS Trust....yes

loved the Apollo song....please let us know whose tune that is

from Asha Gaines to All Participants:

Hey y'all! I'm from Atlanta, GA, USA Population Health Coordinator

from Sharon Brown to All Participants:

Hello from South Tees Hospitals in sunny, grass cut smelling Middlesbrough!

from Katy McNeil to All Participants:

Hi it's Katy from Scottish Government - sunny spring day in Edinburgh too


Hello my name is Tony, perched with my hand in there practicing one handed typing

from Sajjad Mushtaq to All Participants:

Hi from Birmingham, UK

from patricia wimmer to All Participants:

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Goos afternoon everybody, Patricia Wimmer from a sunny Tilburg, the Netherlands

from Georgina Ritchie to All Participants:

Hi Everyone, Im Georgina Ritchie District Nurse from University of Central Lancashire, not sure baout

the weather I havent seen daylight since early this morning

from Patricia Burns to All Participants:

Hi Patricia Burns from Edinburgh which is crisp and bright today!

from pramod kumar to All Participants:

Hi Dr Pramod Kumar from Wexham Park hospital , Slough

from Michele Young to All Participants:

Hi I'm in OUH anyone else attending?

from Malcolm Cooper to All Participants:

Hello to you all. Malcolm Cooper here enjoying a sunny day in South London.


Typing from Wolverhampton UK with glorious blue skies

from Yvonne Newbold to All Participants:

Hello all, I'm Yvonne Newbold, and I'm doing this from Wallington, which is both Surrey and London.

I'm at home and it must be a nice day because this is the first day in months that the central heating

hasn't had to be turned on!

from Brian Markey to All Participants:

Hi Everyone, I'm Brian Markey, Project Manager for the National ePrescribing Project in Ireland...

lovely day here too!

from Shelley Cornick to All Participants:

Hi from Shelley in Newfoundland Canada. We still have snow on the ground here and a heavy

snowfall forecast for the weekend.

from Lisa Sharrock to All Participants:

Hi everyone, Lisa Sharrock Team Manager RMN / CBT therapist North Staffs Combined Healthcare

Trust North Staffordshire enjoying the beautiful sunshine :)

from Wendy Johnson to All Participants:

Sunny, and blustery near Edinburgh

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from Rose McCaul to All Participants:

Spring has arrived in Dublin. My name is Rose Senior Environmental Health Manager Health &

Wellbeing Division HSE

from Rebecca Tringham to All Participants:

Here in Birmingham we have a beautiful blue sky :-)

from Rebecca Fyffe to All Participants:

Hi everyone, from Rebecca - NHS Fife, Scotland.

from Victoria Hill to All Participants:

Hi, Victoria, Pharmacist from Halifax, West Yorkshire - lovely blue sky here too!

from naomi ledwith to All Participants:

Hi naomi from manchester


I am a pharmacist too


Fab!


I miss having my own window, everyone seems to have their blinds closed!

from James Rawson to All Participants:

Jim Rawson from Augsuta, GA USA joining the call.

from Karen Perkins to All Participants:

Sunny lunchtime run, feeling refreshed!

from Shelley Huffman to All Participants:

Good morning - signing on from Ontario Canada.

from Claire Maggs to All Participants:

Good afternoon, lovely sunshine here in Birmingham, UK

from julie smith to All Participants:

Afternoon

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from Chrysta Mayhew to All Participants:

Sunny day in Toronto, Canada! Hello everyone

from Andrew Blane to All Participants:

Hello everyone from sunny Leeds

from Helen Bevan to All Participants:

Great to see such an outstanding diversity of people on the webex. We will start in 2 minutes

from Ans Luyben to All Participants:

hello everyone from switzerland

from Christine Clarke to All Participants:

Hello from Sunny Worcestershire

from Catherine Fleetwood to All Participants:

Hello from sunny West Yorkshire. Leeds to be precise :)

from Tom O'Sullivan to All Participants:

too nice to be inside! ;-(


lol @tom

from Jonathan Williams to All Participants:

Hello from sunny Lancashire


Hi everyone from Nottingham

from Emma Kelly to All Participants:

Hi from sunny East Kent (Ashford - not quite the seaside but not far!)

from Leigh Morgan-Jones to All Participants:

Thanks to Anthony for the Twitter chat this week

from MADELYN GRIFFITHS to All Participants:

hello from Bristol

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Hi all :-)

from Rachel Volland to All Participants:

@Jonathon Williams where are you in Lancashire? It is high from sunny Salford, Manchester here

from Malanie Greenaway to All Participants:

A group us here from chilly Edmonton Canada


it's sunny in Leeds, Malanie, but definitely still chilly!

from Lori Williamson to All Participants:

Hi from a lovely sunny Buckinghamshire

from Felicity Mitchell to All Participants:

hello all

from Caroline Carswell to All Participants:

Caroline @soundadvice_pro, from spring-time Dublin, Ireland!

from Bonny Johnson to All Participants:

Sunny and cold in the Ottawa Valley Ontario Canada

from Kate Emery to All Participants:

Hello from Gorleston, Great Yarmouth

from eileen sharp to All Participants:

Hi all from sunny Stirling, Beautifu view of the castle

from Tanya Burchell to All Participants:

Hi from a sunny Gloucester

from joanne reay to All Participants:

Lovely and sunny in Fulbourn but slight breeze.... windows open!

from Tracy Clifford to All Participants:

small keen group here in caledon ontario

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from Mel Harrington to All Participants:

Hi all - sunny in Carlisle as well, makes a change!

from Mandy Rudczenko to All Participants:

difficult to apply this to carer experience

from Rob Cockburn to All Participants:

Scored mine high, but that was 3 years ago and I know it has 'fallen back' since then - lack of

sustainability

from Andrew Marsh to All Participants:

yes 6.5!

from Becky Haines to All Participants:

This of course assumes that specific objectives were defined and measured:-)


i scored mine a 10 but, the objectives were not the ones to deliver sustanable change


my thoughts too


@mandy - as a carer, service standards, personalisation of care, TLAP?


the individuals that had to implement the change were not invested in it

from Charlotte Welsh to All Participants:

Becky that is what I was thinking!


I may not have known the objectives ...

from colin Waldron to All Participants:

No change made as business case did not stack up and project stopped:-(


Rate of failure

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from Maya Pajevic to All Participants:

70% fail


numbers that fail


safe zone


So Lean consultants can sell their business to you!

from vicki nash to All Participants:

fail rate

from Nigel Millar to All Participants:

someone made it up


Natural distibution of engagement and drop out?


LSC failure rate

from Hugo Lemay to All Participants:

critical mass


Research from Kotter, Fuda, et al

from Michele Wood to All Participants:

not sure

from Trevor Fossey to All Participants:

%of of failure


natural distribution

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i'd have put it at unsuccessful

from Jane Ansell to All Participants:

Fail rate


historic

from Jane Douthwaite to All Participants:

Total fail or fail to be as effective as they could be

from Avril Washington to All Participants:

But isn't this being challenged?


that is comforting somewhat when i consider my own failures


Often driven from unrealistic goals


Does this depend on how we measure? Surely some objectives would have been met, even if not full

change intended?


so are we asking too much or is the system too rigid?


both?

from jo Palmer to All Participants:

over what time periods?


1 -3 years is a short timescale for major cultural change


so proud to see i could class myself in the 5%

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Is it that people's hearts aren't in it?


Good chart here:

https://www.google.com/amp/s/www.forbes.com/sites/markmurphy/2016/06/05/this-chart-

shows-why-so-many-change-management-efforts-fail/amp/


too many competing priorities


Its that we dont get where peoples hearts are


too many cooks!

from chris malvern to All Participants:

scopecreep a big factor - sometimes objectives change....


Constaqnt organisational changes prevent individuals from following through with projects they

start


Lack of honesty about what the challenges really are


not enough CO-PRODUCTION!!!


5% that maintain change would also have to achieve change in the first place


Inability to openly discuss what's wrong without blame


change is often forced on others without ensuring that this change is wanted


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Often context has changed by the time you are scaling up, so maybe we need to be better at

continual review of change methods


Intersting - was involved in Spinal Collaboration - what learnign was there from those projects in

terms of scaling out from pilots?


human factors - we don't like admitting it didn't work....


No commitment with the goals set


@Becky Haines I cant get that link to work

from Angela Catley to All Participants:

Sometimes scale can be 'scaling out' not just scaling up. The collective impact of lots of small

connected things.


change is hard - until you change yourself first


The passion shown by leaders of change isnt felt by those that are left behind to manage it-

Stakeholder engagement needs to go beyond retoric, it needs to benefit individuals


people moving on to new roles during change programme can be big issue - need to maintain core

team and commitment


www.forbes.com/sites/markmurphy/2016/06/05/this-chart-shows-why-so-many-change-

management-efforts-fail/amp/


Maybe this?


we don't invest enough effort in evaluation to demonstrate benefits....

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individuals need to have ownership of the project too many are done TO them, not WITH them

from Stuart Clough to All Participants:

Coproduction, common goals and taking people with the change is the key for me. Communication

vital.


Vested interests? People wanting things to stay the same for their benefit?


Yes power 'with' and not power 'over'


Expectation is that change will happen in a very short space of time....


Yes Caroline Carswell!


If you havent changed yourself at teh beginning then you will just get people down


Achieving organisational change

through values alignment

Christopher M. Branson

St Francis College, Crestmead, Australia


for change to stick - it needs a gradual, inclusinve process


@Becky Haines, precisely, the magic bullet springs to mind!


Yes! Give up the illusion of control and get on with it.


Silos prevent horizontal processes!

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Why do we expect that everyone will be rational - we only imagine that we are personally - self

reflect to get going


Change needs to go from grassroots level if possible - our experience anyway


Yes - the goal is the goal - agree


Networks of motivated people better than hierarchical 'must-dos'


Read anything from Vanguard Consulting for faiure reasons - John Seddon is a great mentor.


@Victoria - yes, networks of motivated people! Sometimes patients / citizens.


Don't forget the external factors that may be opportunities to deliver the change


Senior managers fear having to hand over control of a project to staff = a sign of weakness in the

manager, not the staff


CHange is about helping people grow - not controlling their path

from Naomi Brook to All Participants:

The change process thinking itself is asset based. i like this framing


@Adrian - Best change is network driven, peer to peer if possible.


Forget who said it but "coach the senior managmeent to get out of the way"


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absolutely Nigel, change grows in my experience

from Linda D'Arpino to All Participants:

And students!


Yes Victoria Hill...Kotetr's premise in Accelerate


Kotter


Loving this asset map...


Asset mapping focuses on passion of community members to be successful


Aligning the change to the organisations values (and our own) should be meaningful


Yup - come across all of these at some time or another...


In the middle of reading Accelerate!


Dont play it safe with change - let the team provide safety by being empowered


it needs to include the barrier of lack of patient/carer involvement????


Tip o' the hat to @Jim_Rawson_MD re asset mapping


Too many strategies.


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https://www.hsj.co.uk/5083572.article link to the HSJ

from Karl Fredrik Westermann to All Participants:

Thanks, Kate! :-)

from James Rawson to All Participants:

Thanks Becky


For change you must have 1. A Vision 2. A strategy 3. People engaged - then they can make a plan


It's the exec that has no strategy, We do. They block it


can they make the vision Nigel?


Conflicting priorities at directorate level - silo working


This is so true! Need for a fewer priorities


Agree Avril.


love this film from Nottingham (NUH) about their Just Do Its! https://www.hsj.co.uk/5083710.article


FOr change do not plan for people - help people make their plan for the agreed vision and stategy


Insightful Avril

from Felicity Mitchell to All Participants:

we don't want buyers, we want investors .... module 3 :-)


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co-design with 'customers' is also critical

from Freya Burns to All Participants:

investment rather than buy in?


Perfect example- Budget announcement & Primary Care Streaming Guidance GPs at the Front Door

is a Must Do. Other NHSE CHannel Shift Guidance published the same week says it snt cost effective

which was backed up by York University Lit Review which agreed. Mixed messages


get the frontline focussed and everything else will fall into place


The priority of public sector policy makers is rarely the same as the priority of local people and vice

versa. The knack is translation and connection


Love this: The knack is translation and connection


I work in Workforce Planning, so probably shouldn't admit to that one!


True for any organization seeking to make change


@Felicity, @Mandy - perfect points!


fair to say, they're all issues!


Also lots of differeent strategies that impact on each other but don't connect


'peverse incentives' - what incentives??

from Muhammad Ali Abid to All Participants:

How does one balance Project management with Complex science of change?

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Try STP for size as a confusing strategy!


Perverse incentives: Make change, but keep doing what you've been doing...with the same

resources

from Bev Matthews to All Participants:

Agree Mandy - Participation, codesign and coproduction are key for creating the conditions for

moving to 'What matters to you' culture


Common themes throughout - quiet shocking really


spot on Becky


Vision and strategy are actually the easiest thing to agree - so start there for effective change


There is some information on our web site at NUH about our Just Do It Scheme please take a look.

Thanks Kate


For inspiring leadership for change try starting with your service users - eg patients


Open culture?? not had that in 17 years of working for the NHS


IMHO we make all of this too big...start small and demonstrate success at grassroots then move it up

in the organization


Interesting to ask this question to people in different roles - a project manager may have a very

different view than perhaps a frontline team member vs senior leader. Need to talk more and keep

folks open and engaged.


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A lot of these mirror the previous set of factors which you woudl expect as the positive side of the

coin


none


none

from Si Chun Lam to All Participants:

Seen cases of perverse incentives in the form of very poorly designed "KPIs"

from Bev Matthews to All Participants:

the #EndPJParalysis is a fab example of just doing the right thing


what does 'thought diversity mean?


differences of opinion

from David Grier to All Participants:

None are present. all are problems by their absence


We're getting there...lots of innovation attempts now that never would have happened before, but

not painless


different ages/levels of seniority/background


@becky i couldn't agree more, started small and was astounded where things ended up


https://www.nuh.nhs.uk/justdoit here is the link to the JDIs at NUH


wheres the option for all or none?

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from Kim Vereijken to All Participants:

Leading by example!


Thx Tony


tick them all! :)


I'm thinking about kingsfund; no more heros. Need to encourage continual improvement, not LSC?


collaborative working vs. too many cooks - how do we balance

from Michele Wood to All Participants:

sadly I have to leave early today, but will catch up with the recording of the rest of today's session.


Yes Tom! No need for heroics...exhausting. Just do a little bit everyday so it becomes the normal way

of working


I ticked them all but would really value someone to challenge that with me..


Dissappointing leadership result


but i only ticked them all by working outside of my organisation !


Also, something about network solutions being difficult given the 'market' environment.

from Angela Rowe to All Participants:

Thought that too Jane....about a third with inspiring, supportive leadership


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If you are looking for passion for improvement which needs change then start talking about how you

feel and help people explore their feelings


@LucyButler: https://www.kingsfund.org.uk/sites/files/kf/Future-of-leadership-and-management-

NHS-May-2011-The-Kings-Fund.pdf


this sounds great


Need to recognise hard work too, even if intended progress not made

from Lucy Butler to All Participants:

Brilliant - thanks Tom


Intersting, the parallels with people learning condition self management skills is strking


thanks lucy


I would suggest reading Daniel Pink "Drive" about motivation


my best days are always the ones where i feel things have been progressed and achieved


happening less recently


I would agree - we are in limbo with a big service provision change at the moment - there is no

progress and it is so demotivating

from Avril Washington to All Panelists:

Ignite joy! Yes!


"Flow"

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ahahahahah!


Making the progress and celebrating that progress, sharing the joy


Have realistic expectations


Maslow!


Lack of progress is so demotivatig - I struggle with resiliance at times when it can feel out of my own

control


is it about change or about reinvigoration?


Another good one: https://hbr.org/2014/06/engaging-doctors-in-the-health-care-revolution


To help with motivation for change talk about what really matters - ask Why are we here - you will

be surprised how much you agree

from Andrea Selley to All Participants:

Intrinsic motivation - so important!


Fun - yes - helps with stress

from Susan Martin to All Participants:

The suggestion about Dan Pink is great - his most recent 'Pinkcast' about finding your purpose (which

is really your organization's purpose) is very fitting for this

discussion.http://www.danpink.com/pinkcast/pinkcast-1-18-a-5-minute-exercise-for-discovering-

your-purpose/


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Sadly I think we loose sight of the intrnsic personal motivators for people sometimes and use a stick


Yes Adrian! Realistic expectations and the sense that we can walk before we run and be successful


thanks @BeckyHaines!


Ask what matters to you rather than what is the matter?


Thanks Susan for gr8 link

from david broomhall to All Participants:

This is what my trust uses for quality improvment


yes rachel


Wow. so many interesting references to go away and read - pots of tabs open!


Public Sector ---reward??? ...


yes me too, need to bookmark these tabs!


Dan Pink is great - 'Drive' particularly good


Can't keep up with them - clicking and nothign doing!


this links to motivating self-care - e.g. Health Coaching


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@Rachel - communicating what matters to you, can lead to finding mobilisers

from Alison Wilson-Shaw to All Participants:

Some intrinsic motivation can be those who work with their head and not their heart because that is

how they are wired and must not be lost in this!


Intrinsic motivators may not be within your current organisation / workplace


Intrinsic motivation means - "What is in your heart?"


Thanks @Nigel


if we relate this to maslows hierarchy of needs, where would intrinsic motivation lie? do they come

before the sense of security and food/belonging

from Ken Hancott to All Participants:

They're subconscious drivers!


Health is easy when it comes to intrinsic motivation - almost everyone will agree that we are here for

the wellbeing of the community and patients

from david broomhall to All Participants:

www.wwl.nhs.uk/News/2014/.../wwl_already_leads_the_way.aspx


How do you deal with a sitution where you have to do something, but neither motivation is there

apart from otherwise you'll get disciplined?


INcentives are a devisive form of primary motivation


Caregivers in US incented to do stuff to patients, but changing to value-based care where we are

working for and with patients

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payment by results??? not happy about that.... smacks of private companies


I wonder if intrinsic motivators find it harder to deal with stagnation/lack of change. Hit hard when

you are so passionate about the cause


Disincentive demoralise because they appear to be amoral and harmful to our community and

patietns


There's a piece missing - CO-PRODUCTION


great point @Emma Kelly


Thank you Mandy


@EmmaKelly - couldnt agree more....


clustering is no different to payment by results, cquins it's all there we just don't hear about them


I think the key is its not all or none! You need a balance !


Agree @Mandy, although if you use this model in collaboration, I guess that works?


Mandy: what about leadership by all = PFCC (Patient and family centered care?)

from Ken Hancott to All Participants:

We all have intrinsic motivation. More empathy with others' motivation is necessary.


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@Mandy encompassed in Shared Purpose?


Avoid being eaten up by others attempts to motivate you - keep to the core - what matters to our

community and patietns


Yes Muhammad!


@Rob - not if we pressume we know best! Professional 'expert' power...


Thanks.....I think it's rife in current enviornment and we need to keep the passion of our teams


*presume


change agents need to have responsiblity AND authority - not just responsibility.....


Adrian - or at least a lever into authority?


How do we get through the curent change fatigue?


Love examples of tools that make this intentional rather than "good ideas" Discipline needed to

review outcomes along the way and adjust as needed

from Fiona McKenzie to All Participants:

@Mandy Good challenge. For me it's encompassed in the first 3 - shared purpose, leadership by all

and motivate and mobilise

from Ejiro Ohare stratton to All Participants:

How do we promote that shared purpose with our leaders?


autonomy more important than authority?

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@naomi - yes, agree


how do we define authority?


So true Adrian - so we must cede the authority to the people


KPIs drive perverse behaviours


could fit Co-Pro into some of the pieces but then can get 'TEA-BAG CO-PRODUCTION' - just dip it in

for a few seconds!!


Responsible is being accountable - authority is being in control (usually an illusion)


@Mandy - lol. So true.


How to balance intrinsic leadership with the top down demands that are part of many leadership

roles? Changes that may not be on our agenda but is the national or organisational agenda


interstingly


From Ejiro More importantly how do we get them to listen to the quite vioces in thier midst?


authority in this context is the "permission" to carry out action


Very true Adrian - so we have to try not to hang on to authority and share it out


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Compliant People can sometimes suffer from Functional Stupidity which basically means they do

their work but don;t think about it!


@Mandy - TEA-BAG COPRODUCTION - Brilliant!


waiting for permission to act isn't always the way to go...


love the LD example template.....dot voting a great democratic tool too....


distributed leadership does rock...


might be waiting a long time for permission


@Naomi- love it!


Dan Pink again... https://www.youtube.com/watch?v=u6XAPnuFjJc


#JFDI :)


Temptation is to see people as one or the other, but really lots of gray here

from Frances Mead to All Participants:

you need both kinds of people the trick is knowing what each needs to motivate and enthuse them


yes @NaomiBrook


I worry in this kind of model that we are demonizing/judging a group much as we have done in the

past with introverts

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thanks @emma :)


Love being a contributor. Far from compliant! Born rebel!


Yes Frances! colleagues who may be perceived as compliant may be actually more thoughtful. Also

valuable


When you run the next trinaing event for improvement - give all participants an authority card - "You

are hereby authorised to change the system" - best if signed by the CEO


Plodders & achievers in 80's speak, turns out we need both.


you can work with employees to change from compliant to contributor. LISTEN to them and give

them responsibility


How are executives measured against this ie mainly contributers or compliant?


seek forgiveness, don't ask permission...


was told many years ago by a director from our trust - if you see something needs changing, just do

it. we need to ask permission once the groundwork has been done and are ready to make the

change


Think we are a (small) organisation of contributors - not sure if that is a good thing or not! Do we

need balance?


@nigel - love that idea - stealing it for next time :)


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Exceutives are emasued by the ctlrue of the organisation and the engagement of the people


lol @tom


i live by that Tom


Yeah - a slide with CO-PRODUCTION on it!!!!


me too @tom!


Harry is correct - cede the power


Even with permission to change, need support


haha @mandy is happy!


generally i find people find it hard to let go


Co-production is key!


public value management...oh no... :-)


We need our managers/executives to be contributers, but the higher structures want them to be

complainents!


energising people is the key to creating effective change - it matters to them


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SO true @AlisonWilson-Shaw


If the focus is on patients, its easier to let go of old ways of working.


'a facilitator of joy' on a job spec - love this !! I'll be going for that job..


LOVE the term Facilitator of Joy!


This is rining bells in my mind making me think of the Mental Health "Recovery" movment...


absolutely @becky - focus on why we are doing this


once the joy is gone- I move to find new joy. "who moved my joy?"


I think I will take hypertension of my job description and add facilitation of joy


@Clare v true, also hello CPD!


Love it Nigel!


Who is this Joy and where does she work


Brill @JulieSmith!!!


Empathy not just for patients but for your staff too :)


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works really well along side the project I work on that have a 'dream based provision'


i no longer allow others to steal my joy


*projects


BUt I will keep taking the tablets to be on the safe side


We're all going to ACR HR later today and changing our job descriptions:-)


Agent4Change and Joy Faciltator - great!


THe best job description is one you write yourself


lol @adrian


i dont facilitate joy- I spread it


@Nigel so true


i seek it


i seek, facilitate, embody and spread it :)


#1 on this list is so prevalent!!!!!


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Joy is my middle name


To keep energy for change keep recharging your batteries by talking yo your service users - write a

journal and highlight the god days to read again later


Aha! Freya - you are the missing Joy


@Nigel - yes - credit where credit is due!


Ideally the change effort morphs into a new change effort that keeps change a constant


http://pixar.wikia.com/wiki/Joy


Last year, I acheived 3. I was not prepared for the personal impact. im still struggling


Very true @Nigel. Reconnecting with patients or service users recharges the batteries


joy comes from engagement and considering wellbeing...


Build the energy change and keep doing it - go thermonuclear


Finding your 'flock' is so important for joy


What if it just becomes the way you work with engaged and motivated teams and individuals who

are always looking to spread joy and improvement?


Yes @NaomiBrook!

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@NigelMillar - take laughter three times a day, with water. p.s. Joy is 82, low blood pressure and

retired! :-)


Put the 5 together and you reach a critical mass -


but what do you do when the flock moves off and leaves you behind?


create your own flock

from Kate Emery to All Participants:

@Julie Smith - find a new one :)


@Julie Smith: be happy knowing that you are disseminating your work broadly and find a new flock:-

)


https://www.depts.ttu.edu/upwardbound/books/the-7-habits-ofhighly-effective-people.pdf


The Golden Thread of Relationships!


Psychological energy - ask for forgiveness not permission! :-)


Yes @catherine Fleetwood! can be tricky though


@Julie - run with the pack of wolves


http://qualitysafety.bmj.com/content/early/2015/06/02/bmjqs-2015-004160


36

Psychological safety, oh yes...


Love these five energies


absolutely @Naomi - takes courage!


Thanks, Chris! :-)


You can change one step at a time - it helps to achieve 10,000 steps per day

from Ejiro Ohare stratton to All Panelists:

Love these energy domian too


^lol!


oh dear...im on the wrong side of the energy level


'facilitator of courage' @catherine fleetwood?


one for my CV haha


right, thats enough. Flock, where are you


Me and my team too!


Problem is big differnce between energies inn my organsiation vs my department!

from Chris Butler to All Participants:

37

loving the connection between these 5 energies and change


#findyourflock


Love these energy domian too


The difference between Monday and Friday! :)


we're all here @julie smith


....and reason leads to wisdom..


Love this slide!


You also need dark energy


fatigue


intellectual

from Isabella Davis-Fernandez to All Participants:

isolated


intellectual


Physicial

from Shawn Volk to All Participants:

38

Physical


Intellectual

from Adrian Sieff to All Participants:

intellectual


Intellectual


intellectual


intellectual


spiratual


Intellectual


psychological


Intelleculal


Interllectual


Intellectual

from Jen Quinlan to All Participants:

psychological


39

intellectual

from Ann Quinn to All Participants:

physical


Intellectual


intellectual


fatigue


Social


intellectual


intellectual


Intellectual


fatigue

from James Turner to All Participants:

intellectual

from Dawn Plimmer to All Participants:

physical


fatigue

from Ans Luyben to All Participants:

40

intellectual


Intellectual


Psychological

from Keira Azzopardi to All Participants:

intellectual


Intellectual

from Sarah Emery to All Participants:

intellectual


intellectual


Intellectual


Physical


psychological


psychological

from Seonaid Beddows to All Participants:

psychological


oh i misunderstood the q! :)


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fatigue

from Drew Carr to All Participants:

[ntrllectual

from siobhan bonham to All Participants:

intellectual


Intellectual


intellectual

from Michelle Grouchy to All Participants:

intellectual

from Michelle Lewis to All Participants:

Intellectual


intellectual


intellectual

from Rose McCaul to All Participants:

Intellectual energy


intellectual


only thing that matters is what can be measured

from Gillian Sage to All Participants:

uncommitted

from Judith Thomson to All Participants:

42

Intellectual


Me too! Yes - completely agree with Helen

from jean dipple to All Participants:

intellectual

from Anthony Alleman to All Participants:

anything other than intellectual energy, seems illogical


this reminds me of something i saw today actually


and again..........I have a dream! (not a 10 point management plan and extensive evidence base


non!


non


non

from Christine Clarke to All Participants:

Non clinicians


Excellent point @Rob!


non

from Cathy caple to All Participants:

clinicians


43

non


non


clincians


non


clinician


non


clinians

from Keira Azzopardi to All Participants:

non clinicians

from Marie Parish to All Participants:

clinicians


clinicians


non


non (sadly)


non


44

non clinicians


non clinicians


non


non


non


non


clinicans


ckinicans


@anthony Alleman - live long and prosper


clinicians


non

from Steven Amrhein to All Participants:

no


non


45

clinicians


Non clinicians


Clinicians


clinicians


clinicians


non clinicians


clinicians


non


Non


non clinicains

from Shawn Volk to All Participants:

Clinicians


no


clinicians


46

Clinicians


clinicians

from Sorrel Talbot to All Participants:

clincians


clinicians

from Anthony Alleman to All Participants:

non


non


non-clinicians


clinicians


yes


clinicians


Non

from Aoife Gallagher to All Participants:

clinicains


clinicians

from Jocelyn Bennett to All Participants:

47

clinicians


non


non

from siobhan bonham to All Participants:

clinicans

from Sharon Kelly to All Participants:

clinicians


non clinicians

from Amy Newbery to All Participants:

clinicians


non clinicians


clinicians

from Asha Gaines to All Participants:

clinicians

from Cathy caple to All Participants:

higher


wow


vocation!!


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lower


https://twitter.com/Lukejones03/status/839820715587141632/photo/1


lower


lower


lower


lower

from Sorrel Talbot to All Participants:

lower


higher


lower


higher


lower


lower

from Marie Parish to All Participants:

higher


49

lower


lower


lower


lower


lower


lower


lower


lower


Lower


lower


lower


lower


higher


50

higher

from Ashley Burton to All Participants:

higher


CEO closer: lower

from Hugo Lemay to All Participants:

hjigher


lower


higher


higher


higher


higher


higher


higher


high

from Cheryl Mudge to All Participants:

lower

from Mubashir Arain to All Participants:

51

higher


higher


lower


higher

from Rachel Volland to Joanna Hemming (privately):

higher


lower


higher


higher


lower


higher


higher


higher


higher


52

higher

from Jennie Huntley to All Participants:

higher


higher


!


higher


higher


higher


higher


My work is my vocation


no...really.


higher


higher


higher


53

The nearer you are to the sun the greater the risk of burning up

from Chris Bungoni to All Participants:

higher


feel connected to the top


higher ... and oblivious to reality !


power is sucked out of them......


might be to do wih autonomy


and a higher extrinsic income / opportunities ...


id like to measure this


so skewed


ha look at those intellectual scores


back to results again


thats no surprise


and the reason why it feels bumpy is the wheel aint round


54

so, no selfcare?


ideas that remain on paper or in the mind


And of STPs - that's a worry


well they arent going to get off the ground are they?


Thats because the plans were done by one person and not shared


They will try to impose


STPs are being done for the wrong reason - money not better care provision.....that's sapping energy

from everyone!


Co-Creation


fantastic Red Team - go CoPro


Let's face it, we can't know everything. > focus on intellectual is to reduce risk inherent in change

activities


re: intellect https://twitter.com/Lukejones03/status/839820715587141632/photo/1


codesigning


Bet the red plan was a story not a narrative

55


@avril - yes - the "old" power


i woldnt want to be in the purple one


THe balanced place is where and equal number of people complain that there is no plan or that

there plan is too far ahead

from Hazel Murgatroyd to All Participants:

theyll get off the ground bu be draging folk with them ..... creative logic. Its a better combination

from Elizabeth Bleu to All Participants:

Interesting that intellect and physical are "external" compared to spiritual and psychological that

require a deeper level personally of commitment and energy


but what if your whole workplace is so lopsided - never mind plans for change?


Need quite a team to achieve all that


thats ok


Love the Luke Jones


gotta go sorry!


Also exposing social and spiritual and psychological energy requires trust in other members of team


Yes Elizabeth Bleu!


56

One person can have high psychological energy and benefit from rising social & spiritual energy in

the right contexts.


quite agree with you Becky TRUST is key


Great session & brilliant contributions from Participants thx


leaders are teflon-coated


Agree 100% Adrian...resilience


shared purpose = transformation


leaders have to be teflon coated or they don't have enough resiliance to do their job!


i never want to be so thick skinned though that i lose my ability to feel


A shared porpoise adds to the fun - they are so smart


that's an individual task for me!


But we are sold things with shared purpse disguise but really defacto


@tom - agree - but means that they aren't accountable as well


Remember we are all leaders. Beware reinforcing them and us. We are all signal generators.

Change starts with me!

57


Co-creation should lead to shared purpose and then co-production


STP - defacto puporse in our organisation.


Thanks for reminder Hazel!


The social movement tenets!


Seth Carguilo my hero!


@hazel - you are right - my bad


love the Seth quote


@adrian... Not bad. Full of potential to make and shape great choices :-)

from Hazel Runyararo Murwisi to All Participants:

shared purpose is key


Mind the Gap Coventry :)


yes @angela!


Shared purpose- so important to sustain energy


totally resonates and we've recently agreed we need to do more

58


Perfect quote to end on


Jaben - yes investment is two-way


@Adrian - so much accountability in the system is self serving, this is where it comes full circle and

back to patients.


Good visual


great visual!


I lied! Dov Seidman is my new hero!

from Marjolein Don to All Participants:

Question: Do you think you can get a shared purpose whilst having defacto purpose(s)?


lol @avril


love the last slide


#offthehook


quite a challenging session today


agree @adrian

from Lisa Saminaden to All Participants:

An excellent session love the last quote

59


like it!


Great session thanks


Last slide makes me verklempt (sp?)


Great thank you


Great session - many thanks


A very good session - thank you everyone


love the quote!


Good for thought...Much to think about


good change is messy - coproduction is messy


thanks for today


thank you for another challenging and inspiring hour


Two roads diverged in a wood, and I - took the one less travelled by; And that has made all the

difference (Robert Frost) #boatrocker

from Angela Rowe to All Participants:

Brilliant session - thank you!

60

from Lisa Sharrock to All Participants:

Amazing session thank you so much Helen


thank yoo


Another great session..

Thank you


Brilliant module - lots to reflect on


Great session - I love the fact that we are looking to change the way we change.


Marjolein: htink we need both or no action


Really enjoyed the session with inspiring things to think about thank you


Disrupting ourselves - love it


'be the change you want to see' - ghandi! :)


thank you again for an enlightening session


Thanks all & @Sch4Change


I'm off to spread some joy....thank you!

from Ruth Nelson to All Participants:

Still reminded on being the change I want to see...

61

from Tami Rich to All Participants:

Helen YOU'RE inspiring! As a medical mom I may be solo out here but the energy you speak of -

which I get from the patient community - is what refuels me. I turn to that when I feel down. At this

moment I see a mic drop #BeTheChange


Utterly brilliant session. Thanks all!

from Marjolein Don to All Participants:

Thanks Becky - it seemed during the session that shared is better than defacto...


Loved the session and particularly like Dov seidman quote. Thank you :)


Many thanks Helen and Team. I feel like I have had an injection of hope. Sorry not to be able to

participate in the chat room.

from Lisa Stewart to All Participants:

Thank you!


Great presentation! Thank you!


thanks, great session


Thanks for a great session from your pals at the American College of Radiology


Great inspiring session, thank you


Thanks Helen, et al


Thanks everyone - I hope you can stay for the breakouts shortly...


62

Thanks!


Thanks Helen -- great as usual.


sorry can't stay for the breakout session


Tschüss


Thanks a lot


Thanks Helen


Thank you so much Helen. So much energy. It's contagious!


many thanks - have to go now


Thank you


Each session buillds on and is more inspiring than the last ! Thanks


many thanks :)


Many thanks for another great session, lots to think about. I'm unable to stay for the break out

session, hope you all have some fab convos.


Thanks, #Stay Well


63

0800 917 1950


33136606#


Great session, sorry have to go!


OK all just finished breakout session. Interest in further info on Energy for Change and the

assessment tool behind it. I did note that it is normally carried out by a trained facilitator (did

training several years ago with Rosanna). Happy to follow up.


Thanks for a great session

END OF CHAT BOX

Module 4 chat box school for change agents

Healthcare

Transcript of Module 4 chat box school for change agents