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Moving to action: new era thinking on spreading and scaling change

The slide deck from the session on spreading and scaling change that the @HorizonsNHS team facilitated at #Expo19NHS on 4th September

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Moving to action: new era thinking on spreading and scaling change

  1. 1. Moving to action: new era thinking on spreading and scaling change 04/09/19 #nhsspread @ExpoNHS #Expo19NHS
  2. 2. #nhsspread @ExpoNHS #Expo19NHS Claire Roche @claireroche19 Diane Ketley @dianeketley Ian Baines @ihbaines Helen Bevan @helenbevan
  3. 3. What to expect in the next 60 minutes • Polls via Slido • 7 principles to increase spread and scale • The 7 principles in practice • Co-coaching • Model of system convening • System convening in practice
  4. 4. A poll Do you know : • The person to the right of you? • The person to the left of you? • The people on both sides? • Neither of them? Slido.com
  5. 5. A poll To what extent is spreading change a challenge in your role? A very big challenge Not a challenge Slido.com
  6. 6. Question: describe your most recent attempts to spread change in a single phrase
  7. 7. The reality of spread #nhsspread @ExpoNHS #Expo19NHS “Isolated islands of improvement effect” (lack of spread)
  8. 8. Spread is a… …dynamic, reciprocal interacting, iterative and evolving activity...not linear and mechanistic …developmental, contextualised, adaptive, learning and social process #nhsspread @ExpoNHS #Expo19NHS
  9. 9. What is complexity? #nhsspread @ExpoNHS #Expo19NHS 7 interconnected principles Complexity
  10. 10. 7 interconnected principles Complexity Spread in health and care is a complex activity occurring across a system • Complexity around innovation, process, context • NHS is a complex adaptive system • Match complexity of the approach to spread with complexity of the situation #nhsspread @ExpoNHS #Expo19NHS
  11. 11. Adaptive space an interface between innovations and the business ‘as usual’ Source: Mary Uhl-Bien Networks/information flows 7 interconnected principles Complexity
  12. 12. Innovation development and spread are interdependent • How an innovation is developed influences spread • Early involvement increases commitment and ownership • Increased focus on role of adopters in adaptation and spread #nhsspread @ExpoNHS #Expo19NHS 7 interconnected principles Innovation Development
  13. 13. Focus on the value rather than the innovation • It’s about what others will value rather than what you want to spread • What problem of local priority will it solve? • What benefit will it offer? #nhsspread @ExpoNHS #Expo19NHS 7 interconnected principles Value
  14. 14. The perspective of the individual is pivotal • Changing behaviours is hard • The more work routines affected the greater the spread challenge • Generate energy for change and agency by building motivation #nhsspread @ExpoNHS #Expo19NHS 7 interconnected principles The Individual
  15. 15. From an inward to an outward mindset #nhsspread @ExpoNHS #Expo19NHS 7 interconnected principles Leadership
  16. 16. Networks build communities, energising and connecting individuals • Create a “pull” for innovation by building communities to energise individuals and maintain momentum • Support networks and encourage connections with other networks • Support use of network building mechanisms; eg platforms like WhatsApp, Slack, Facebook groups and other social media #nhsspread @ExpoNHS #Expo19NHS 7 interconnected principles Networks
  17. 17. Knowledge flows generate learning to enable spread • Collate and share local feedback and evaluation of innovation adoption and impact • Share knowledge through networks • Build a culture of learning and transparency, sharing and seeking knowledge from others #nhsspread @ExpoNHS #Expo19NHS 7 interconnected principles Learning
  18. 18. Select three principles that resonate for you? Complexity Innovation Development Value The Individual Leadership Networks Learning Tweet your story of any of these principles at #nhsspread #nhsspread @ExpoNHS #Expo19NHS
  19. 19. Applying 7 principles in practice at the Welsh Ambulance Trust Claire and Ian in conversation #nhsspread @ExpoNHS #Expo19NHS
  20. 20. #nhsspread @ExpoNHS #Expo19NHS
  21. 21. Complex systems are driven by the quality of the interactions between the parts, not the quality of the parts. Working on discrete parts or processes can properly bugger up the performance at a system level. Never fiddle with a part unless it also improves the system @ComplexWales #nhsspread @ExpoNHS #Expo19NHS
  22. 22. Please give Claire one piece of advice to inform the plans for spreading the WAST falls framework across Wales #nhsspread @ExpoNHS #Expo19NHS
  23. 23. Table discussion #nhsspread @ExpoNHS #Expo19NHS Discuss your thoughts on what you have heard about the 7 principles
  24. 24. • Matching approach to spread with complexity of the situation • Applying the seven principles in practice • Providing enabling activities delivered by a team or a number of people • All levels in the system #nhsspread @ExpoNHS #Expo19NHS System Convening involves
  25. 25. An independent initiative An interdependent initiative Improve needle safety when taking bloods Improve the emergency response to people in mental health crisis Police Voluntary sector Emergency room Mental health service Supported by specific tools & information • Social and collaborative • Built on shared purpose • Multiple methods Within a clear boundary
  26. 26. #nhsspread @ExpoNHS #Expo19NHS System convening and programme management Interdependent We need both to enable spread
  27. 27. What system convening means in practice Claire and Ian in conversation #nhsspread @ExpoNHS #Expo19NHS
  28. 28. #nhsspread @ExpoNHS #Expo19NHS Discuss with the person next to you your thoughts on what you have heard about system convening then share them on Slido Interdependent
  29. 29. • Follow #nhsspread • Horizons blogs https://nhshorizons.passle.net • Spread publication early 2020 #nhsspread @ExpoNHS #Expo19NHS Want to learn more about this approach to spread?
  30. 30. Thank You #nhsspread @HorizonsNHS Diane.ketley@nhs.net horizonsnhs.com