Creating shared purpose
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The slides that Helen Bevan and Jen Rodgers presented at #GiantSteps19 on 22 November 2019
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Creating shared purpose
- 1. Creating shared purpose Helen Bevan @HelenBevan Jen Rodgers @jenfrodgers #GiantSteps19 View or download the slides from SlideShare: tiny.cc/HelenandJen
- 2. 2 | Our agenda • An exponentially changing word and what it means for us • The importance of shared purpose • Why purpose is different to aim (and why we need both) • Case study • Creating our shared purpose • Starting from a place of love @helenbevan @jenfrodgers #GiantSteps19
- 4. 4 | 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
- 5. 5 | Many of the ways we go about improving health and care were designed in a different mindset for a different set of circumstances We are often operating with 20th century change practice in a 21st century world Source of images : http://www.slideshare.net/dachisgroup/dave- gray-the-connected-company
- 6. Shared purpose becomes even more important in an increasingly complex world Shared purpose
- 7. Why shared purpose? [Shared] purpose goes way deeper than vision and mission; it goes right into your gut and taps some part of your primal self. I believe that if you can bring people with similar primal-purposes together and get them all marching in the same direction, amazing things can be achieved. Seth Carguilo @Sch4Change #S4CA
- 8. Improvement is anchored in purpose @helenbevan @jenfrodgers #GiantSteps19
- 9. We have to reconnect our health and care actions back to the shared purpose at the founding of the NHS, back to principles of social justice Prerana Issar Chief People Officer, NHS Definition adapted by Helen Bevan from Janet Finn and Maxine Jacobson
- 10. 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 Mark Jaben on the neuroscience of resistance to change
- 11. Where do we start? • In improvement methodology, our first question is “What is our aim”? • In social movement practice and community organising, our first question is “who are our people?” Who are our people? What unites us (our shared purpose)? What is our aim? @helenbevan @jenfrodgers #GiantSteps19
- 12. The model for improvement Who are our people? What unites us (our shared purpose?)
- 13. Don’t confuse PURPOSE with AIM • An aim is setting a determined course in order to achieve a set goal within a specific timescale • Purpose seeks to make explicit the reason behind something that is being done. Purpose defines WHY we are doing what we are doing, and WHAT we hope to achieve from it @helenbevan @jenfrodgers #GiantSteps19
- 15. We have a particular challenge in creating shared purpose in a health and care setting…… Source: Philip Hadridge Idenk.com @helenbevan @jenfrodgers #GiantSteps19
- 16. Why is it that the more compelling the mission, the more tricky it can be to get the best collaborative behaviours and the necessary focused action? And how can some places that are trying to achieve the most crucial and needed changes to the world we live in be riven with petty politics and driven by individuals sometimes ruthlessly pursing their own agendas?” Source: Philip Hadridge Idenk.com A pattern that not only bewilders and frustrates long serving leaders but also comes as a shock to new recruits.
- 17. The noble purpose paradox: how it manifests itself • We question the motivations and actions of co-workers or other leaders and amplify differences in point of view • Personal interpretations of right and wrong come to the fore • We find it hard to present alternative points of view without arguments or undercurrents of resistance • We find that raising some of the issues at work about power or ambition is almost impossible Source: Philip Hadridge Idenk.com @helenbevan @jenfrodgers #GiantSteps19
- 18. The noble purpose paradox: Things to keep checking and working on • An Aligned purpose: agreement about direction and priorities. Between strategy and operations; between divisions; between organisational and personal priorities • Attitudes: that the desired behaviours are clearly spelt out, embodied by senior leaders and reinforced in who is hired (a rewarded and promoted • Accountable Autonomy: encouraging initiative, within the frameworks of Aligned purpose and suitable Attitudes. • Building Awareness of what is expected, and how that fits with personal motivations and goals, Source: Philip Hadridge Idenk.com
- 19. Leaders are “signal generators” As a leader, think of yourself as a “signal generator” whose words and actions are constantly being scrutinised and interpreted, especially by those below you [in the organisational system]. Charles O’Reilly What an organisation’s leaders pay close attention to and shower with time — not what they say — will provide the best clues about its culture. Edgar Schein Source of image: vintage-radio.com @helenbevan @jenfrodgers #GiantSteps19
- 20. Avoiding “de facto” purpose Source: Delivering Public Services That Work: The Vanguard Method in the Public Sector • Shared purpose can easily be displaced by a “de facto” purpose: reducing costs reducing length of stay complying with regulators hitting targets, standards or key performance indicators completing activities within a timescale and budget • If purpose isn’t explicit and shared, then it is very easy for something else to become a de facto purpose in the minds of the workforce • De facto purpose is toxic, leads to burn out and blocks engagement “de facto” means that something exists in reality even if it isn’t intended
- 21. “I have some key performance indicators for the next 12 months” or “I have a dream” Source: @RobertVarnam
- 22. @hugrhc
- 23. @hugrhc
- 24. “…..it would be great to be doing everything we can, not just watch” “the rules were different on different days” “It really affects your emotions…..when I can get him out and hold him is a really good day” @hugrhc
- 25. Subjects: 42 primary caregivers and their infants, < 35weeks gestation Intervention: • Caregivers attended > 8 hours per day • Daily parent education sessions • Mentoring by bedside nurses Outcomes: • Significant increase in rate of change of weight gain • Increased breast-feeding rates • Decreased Parental Stress Survey score @hugrhc
- 27. 3.Common purpose OUR PURPOSE: “Everyone will work together to ensure that parents are empowered to be primary caregivers with the confidence to care for their baby during their stay in the neonatal unit, through their transition to home and beyond.” @hugrhc
- 28. Starting small and simple @hugrhc
- 29. @hugrhc
- 30. FAMILY AWARENESS SESSIONS NICU Level 1 Seminar Room FEBRUARY 2018 Next to Waiting Area 2-3pm ALL PARENTS & FAMILY MEMBERS WELCOME – We would love to see you all! MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY SUNDAY 5 TH OUR FAMILY’S TEA AND COFFEE AFTERNOON 6 th “Bathing, Sterilising and Making up Feeds” 7 th “How Will My Baby Grow” 8 th “Transition to Breastfeeding” 9 th 10 th 11 th 12 th OUR FAMILY’S TEA AND COFFEE AFTERNOON 13 th 14 th “Tube Feeding” 15 th “Getting Ready for Home” 16 th 17 th “Level 2 Tour – Meet on Level 1 reception” 18 th 19 th OUR FAMILY’S TEA AND COFFEE AFTERNOON 20 th “Expressing Milk” 21 st “Knit and Natter” 22 nd “Comforting your baby” 23 rd 24 th 25 th 26 th OUR FAMILY’S TEA AND COFFEE AFTERNOON 27 th “Bookbug” 28 th “Helping Your Baby to Develop while in NICU” 1 st “Memory Making” 2 nd 3 rd “Level 2 Tour – Meet on Level 1 reception” 4 th @hugrhc
- 31. @hugrhc
- 32. @hugrhc
- 34. @hugrhc
- 35. How do we create shared purpose? Create a safe space Look for commonalities and understand differences Create a statement of purpose @helenbevan @jenfrodgers #GiantSteps19
- 37. Shared: what unites us? Look for commonalities – and understand differences • Start with each individual talking about their own stories (“what matters to me”) • Talk about the parts of the stories that unite the group • Discuss differences in perspective and how differences will be addressed @helenbevan @jenfrodgers #GiantSteps19
- 38. Create a statement of purpose • Consider how the sense of “us” (shared values and ambitions) can be translated into a statement of shared purpose that we can all unite around • Watch your language and perspective • Create a purpose, not an aim • Does it pass the “purpose” test? @helenbevan @jenfrodgers #GiantSteps19
- 39. Purpose is the deepest dimension within us – our central core or essence – where we have a profound sense of who we are, where we came from and where we’re going. Purpose is the quality we choose to shape our lives around. Purpose is a source of energy and direction. Leider The “purpose” test: Does your proposed purpose fit with this? @helenbevan @jenfrodgers #GiantSteps19
- 40. 40
- 41. Our shared purpose: #EndPJParalysis
- 44. If we want people to take action, we have to connect with their emotions through values action values emotion Source: Marshall Ganz @helenbevan @jenfrodgers #GiantSteps19
- 45. Change starts with me
- 46. After years of intensive analysis, Google discovered that the key to high performing teams that deliver change is being nice Project Aristotle: https://www.youtube.com/watch?v=UfGiCnhdU78&feature=youtu.be&list=PLHEw3ja- xoaZybvz9f0b1_6bJyG7zZO6L
- 47. …..Ultimately, the secret of quality is love. ……If you have love, you can then work backward to monitor and improve the system. Avedis Donabedian @helenbevan @jenfrodgers #GiantSteps19
- 48. It is catching on
- 49. Leading from a place of love At the most profound level, love is about our deep affiliation with the moral purpose of the health and care system and our goal of improving health for every individual and for whole populations. We translate this into action by leading with love; committing to, connecting with, affirming and making things meaningful for those we serve. We are able to make our greatest contributions, individually and collectively, when we work in a loving environment, enabling everyone to do their best, fulfilling our higher purpose. Love is a unifying force and it builds collective power for change. Helen Bevan and Goran Henriks
- 50. Tactics for leaders of shared purpose: Out-love everyone else Source of image: Bradley Burgess@helenbevan @jenfrodgers #GiantSteps19
- 51. Source: @NHSChangeDay 51 @helenbevan @jenfrodgers #GiantSteps19
- 52. Confronting people with their freedom may be the ultimate act of love Peter Block Source of quote: Celine Schillinger @helenbevan @jenfrodgers #GiantSteps19
Editor's Notes
- Link below http://www.bbc.co.uk/news/magazine-23790147 http://www.bbc.co.uk/learningzone/clips/martin-luther-king-i-have-a-dream-pt-1-2/1293.html With the brooding statue of Abraham Lincoln peering down at him, King began by telling protesters that their presence in the symbolic shadow of the "great emancipator" offered proof of the marvellous new militancy sweeping the country. For too long, he complained, black Americans had been exiles in their own land, "crippled by the manacles of segregation and the chains of discrimination". The whirlwinds of revolt would continue to shake the very foundations of the country: "And those who hope that the Negro needed to blow off steam and will now be content will have a rude awakening if the nation returns to business as normal," King said. It would be fatal for the nation "to overlook the urgency of the moment and to underestimate the determination of the Negro". “He's good - he's damned good” Kennedy on King Wearied by the suffocating heat, the crowd's initial response was muted. The speech was not going well. "Tell 'em about the dream, Martin," shouted Mahalia Jackson, referring to a rhetorical riff that King had used several times before, but which had not made it into his prepared speech because aides insisted he needed fresh material. But King decided to cast aside his prepared notes, and launched extemporaneously into the refrain for which he will forever be remembered. "I have a dream that one day this nation will rise up and live out the true meaning of its creed," he shouted, his out-stretched right arm reaching towards the sky. Soon he was hitting his rhythm, invigorated by the chants and cries of the crowd. "Dream on!" they shouted. "Dream on!" With his voice thundering down the Mall, King imagined a future in which his children could "live in a nation where they will not be judged by the colour of their skin but by the content of their character". Then he reached his impassioned finale. King asked the crowd to yell so it was heard the world over Watching at the White House, the president was riveted. Like so many Americans, it was the first time he had heard the 34-year-old preacher deliver a speech in its entirety - the first time he had taken its measure, listened to its cadence. "He's good," Kennedy told one of his advisors. "He's damned good." The aide was struck, however, that the president seemed impressed more by the quality of King's performance rather than the power of his message.
- We want to share our journey in FICare, which we are still, and always will be on. As with many good things, it started at a time of challenge…. In 2015 we moved into our new NNU, which you see here. Bringing together two existing Units and their teams. We had a fantastic new house, but it didn’t feel like a home, nor did we feel like one big happy family,..with over 40 families, and over 200 staff…… There were challenges in communication, in continuity and we felt disempowered One nightshift Ainsley told be how much better things were in Newcastle…. It made me sad that we didn’t have the same pride in our own unit, and the same support for families.,,,,
- This concept of involving families in the care of their baby in the Neonatal Unit is not new, some of our enlightened colleagues have appreciated this for a long time. One group in particular who embraced this concept and translated it from lower resource settings to the highly-resourced NICU are Karel O’Brien, Shoo Lee and colleagues in Mount Sinai in Toronto. They gave it a name, Family Integrated Care, and demonstrated the benefits in a pilot study, and a more recent cluster randomized controlled trial, published last year. Consistently demonstrated improvements for babies and parents. AND WE HEARD ABOUT PIONEERING UNITS IN THE UK WHO WERE TRYING THIS APPROACH, IN LEEDS, IN IMPERIAL, IN EXETER, SWANSEA.
- WE returned full of enthusiasm, hyper motivated But quickly realized that not everyone shared our enthusiasm: Some were worried that involving families was a way of reducing nursing shifts Some thought it was about letting parents give IV drugs, or cannulate or intubate their baby WE REALISED THAT THE BIGGEST CHALLENGE IS THE CHANGE IN CULTURE FOR STAFF, FROM CARER TO MENTOR
- SO HOW DID WE DO THAT IN OUR UNIT? WE STARTED BY USING “FOUR PILLARS OF FIC” FROM TORONTO, BUT ADDED A FIFTH “COMMUNICATION” AND AS IMPORTANTLY, WHAT YOU SEE HERE ARE DIFFERENT STAFF PUTTING THEIR NAME UP AGAINST GROUPS, AND STAFF, INCLUDING MANY STAFF NURSES, VOLUNTEERING TO LEAD AND CO-ORDINATE THESE GROUPS.
- So Emotions help us understand what we value in the world. Why did the story of Alice work ? So why was this story powerful? Why do we respond differently when we hear about Alice rather than when we see the policy data and financial balance sheet? So public narrative when used intentionally for a purpose to connect with others to move to action is a powerful skills set and leadership gift. When we hear stories that make us feel a certain way those stories remind us of our core values. We experience our values through emotions. Then we are prepared to take action on those values. Through our emotions we are more likely to take action Research by Martha Nussbaum a Moral philosopher, tells us that people who have a damaged (a-mig-da- la) Amygadla the part of the brain which controls emotions, when faced with decisions can come up with many options from which to choose but cannot make a decision because the decision rests upon judgements of value. If we cannot feel emotion we cannot experience values that orient us to the choices we must make Shortly we will be thinking about the lived experiences that have moved you to action…we’ll be drawing on those a few minutes as you start to craft your own stories.