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Patient advisors as change agents
1. How to be an effective
change agent!
October 16, 2015
Marlies van Dijk
Alberta Health Services
@tweetvandijk
#PFAC2015
2.
3. What is a Change Agent?
• Champion for change
• They name things that others don’t see yet
• Point to new horizons
• A person who acts as a catalyst for change
• One who resist status quo when they see
there could be a better way
4.
5.
6.
7.
8.
9. “The people
who are crazy
enough to think
that they can
change the
world are the
ones who do”
10. What are your top three challenges in leading change?
1. Afraid I might hurt my reputation/career
2. The lead on the project resists most new ideas
3. Hate dealing with conflict and controversy
4. Working through approval processes makes me crazy
5. My ideas go against the culture of my organization
6. Don’t know enough about how to lead change
10
11. Which one of the following best characterizes your
change efforts?
1. Influencing people resistant to change
2. Trying to get complacent people to care
3. People agree with me but I see no or little
action as a result of this
4. Leading a group of committed change agents
11
14. Troublemaker Vs Radical (Change Agent)
“Troublemaker” “Radical”
Break Rules Change Rules
Complain Create
Assertions Questions
Me-Focused Mission-Focused
Anger Passion
Pessimist Optimist
Energy-Sapping Energy-Generating
Alienate Attract
Problems Possibilities
Worry That Wonder If
Doubt Believe
Social Loner Social
Source: Lois Kelly, Organizational Radicals, Foghound Study
15. Where do you fit?
Have you shifted between the two?
Table Discussions
16.
17. Constructive Conversations
• Constructive what/if
conversations
examine
assumptions, open up
possibilities, invite
everyone to
contribute and value
all points of view
Lois Kelly, Foghound
#WhatifAB
18. Possibilities
• Ask questions that highlight possibilities vs.
damn the problems
• Problems create energy, problem dissing saps
it
Lois Kelly, Foghound
20. Create Clarity
• Communicate in ways that creates clarity
from complexity
• Define context, relevancy, value
Lois Kelly, Foghound
21.
22. Let It Breathe
• Velocity scares people
• If we go to fast, we
can mow over people,
hurting our chances to
affect change
• People often need
time to absorb a new
way
Lois Kelly, Foghound
23. Listen
• Ask good questions
• Become a keen
listener
• Curiosity
Lois Kelly, Foghound
24. 1. able to join forces with others to create action
2. able to achieve small wins which create a sense
of hope, possibility and confidence
3. More likely to view obstacles as challenges to
overcome
4. strong sense of “self-efficacy”
belief that I am personally able to create the change
Four things we know about successful
Change agents
Source: adapted from Debra E Meyerson
CHANGE
me
BEGINS WITH
26. Framing
“People change what
they do less because
they are given
analysis that shifts
their thinking than
because they are
shown a truth that
influences their
feelings.”
(John P Kotter (2002), The Heart of Change)
27. Framing
• Connect with people’s hearts and minds
• Turning opportunity into action
• Hooks to pull people in
• Springboards for mobilizing support
• Need to be authentic and connect with
reality
32. #SCHR #Quality2015 @HelenBevan @BoelGare @jackielynton
Effective framing:
what do we need to do?
1. Tell a story
2. Make it personal
3. Be authentic
4. Create a sense of “us” (and be clear who the “us”
is)
5. Build in a call for urgent action
Source of image: woccdoc.org
36. is the new normal!
“By questioning existing ideas, by
opening new fields for action, change
agents actually help organisations
survive and adapt to the 21st Century.”
Céline Schillinger
Image by neilperkin.typepad.com
37. Source: Lois Kelly http://www.slideshare.net/Foghound/rocking-the-boat-without-falling-out
38. What are you trying to change and
how is it going?
Are people changing things or
behaviors?
Do you see movement? how did it
go over?
39.
40. Assumption
s
Fears
Love way it wasCertaintyDiscomfort
Why is change so hard?
Time
That which we’re afraid or unable to admit
40
41. • If you’re not part of the solution, you’re part of the problem.
• If you’re not part of the problem, you can’t be part of the solution.
41
42. #SCHR #Quality2015 @HelenBevan @BoelGare @jackielynton#SCHR #Quality2015 @HelenBevan @BoelGare @jackielynton
Building self-efficacy: some tactics
1. Create change one small step at a time
2. Reframe your thinking:
• failed attempts are learning opportunities
• uncertainty becomes curiousity
3. Make change routine rather than an exceptional
activity
4. Get social support
5. Learn from the best
43. #SCHR #Quality2015 @HelenBevan @BoelGare @jackielynton
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
51. Research from the sales industry:
How many NOs should we be seeking to get?
• 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 twelfth
contact
Source: http://www.slideshare.net/bryandaly/go-for-no
52. How have you handled “no”
before?
Any other strategies to cope with it
positively?
Table Discussion
53.
54.
55. Patients are our best business
consultants as they provide an
outside view to providers
56. Imagining and leading change may be the most
important professional competency you can practice.56
Why is change so hard? Organizations that destroy the statut quo win. Individuals who push their organizations, who inspire other individuals to change the rules, thrive.
On average, it takes 17 years for research to translate into practice
Big change only happens in healthcare organizations because of radicals
The passionate people who are willing to take responsibility for change!!
opinion profoundly at odds with what is generally accepted.
Colleen
Yet, what happens to radicals??????????
Let’s think about Heretics….Heresy is any provocative belief or theory that is strongly at variance with established beliefs or customs. A heretic is a proponent of such claims or beliefs.[1]
The end results for people who challenge established ideas/conventions isn’t always pretty!
Ignaz Philipp Semmelweis[Note 1] (July 1, 1818 – August 13, 1865)
a Hungarian physician known as an early pioneer of antiseptic procedures.
Described as the "savior of mothers", Semmelweis discovered that the incidence of puerperal fever could be drastically cut by the use of hand disinfection in obstetrical clinics. Puerperal fever was common in mid-19th-century hospitals and often fatal, with mortality at 10%–35%. Semmelweis proposed the practice of washing with chlorinated lime solutions in 1847 while working in Vienna General Hospital's First Obstetrical Clinic, where doctors' wards had three times the mortality of midwives' wards.[3] He published a book of his findings in Etiology, Concept and Prophylaxis of Childbed Fever.
Despite various publications of results where hand-washing reduced mortality to below 1%, Semmelweis's observations conflicted with the established scientific and medical opinions of the time and his ideas were rejected by the medical community.
Some doctors were offended at the suggestion that they should wash their hands and Semmelweis could offer no acceptable scientific explanation for his findings. Semmelweis's practice earned widespread acceptance only years after his death, when Louis Pasteur confirmed the germ theory and Joseph Lister, acting on the French microbiologist's research, practiced and operated, using hygienic methods, with great success.
In 1865, Semmelweis was committed to an asylum, where he died at age 47 after being beaten by the guards, only 14 days after he was committed.
On December 1, 1955, in Montgomery, Alabama, Parks refused to obey bus driver James F. Blake's order that she give up her seat in the colored section to a white passenger, after the white section was filled. Parks was not the first person to resist bus segregation. Others had taken similar steps, including Irene Morgan in 1946, Sarah Louise Keys in 1955, and the members of the Browder v. Gayle lawsuit (Claudette Colvin, Aurelia Browder, Susie McDonald, and Mary Louise Smith) were arrested months before Parks. NAACP organizers believed that Parks was the best candidate for seeing through a court challenge after her arrest for civil disobedience in violating Alabama segregation laws though eventually her case became bogged down in the state courts.[2][3]
Parks' act of defiance and the Montgomery Bus Boycott became important symbols of the modern Civil Rights Movement. She became an international icon of resistance to racial segregation. She organized and collaborated with civil rights leaders, including Edgar Nixon, president of the local chapter of the NAACP; and Martin Luther King, Jr., a new minister in town who gained national prominence in the civil rights movement.
Colleen
Steve Jobs challenged things to be different
Had a vision for a different world
Can we imagine a world right now with out our iPads, iMacs, iPhones, Apple TV?
“The ones who are crazy enough to think that they can change the world are the ones who do” - Jack Kerouac
Marlies
Marlies
Marlies
Live in a state of “manage discomfort’ – there might be an unease as they are entrepeneurs – or even to find space to be entrepreneurial
Act entrepreurial outside of their job description. “capable of squeezing through the smallest of opportunity to build evidence that my idea is good”
Official job title “change agent” – operate off the org chart – seek out places in nook and crannies in the organzation -then develop truth of the value of their idea
Octopus – she says I can squeeze through the smallest opportunity to get my idea out there – or it would get killed
Another guy: project manager – he showed value through other side projects and through a community of practice. Although his company thought he should do that through his day job
Day it is broken out – one hour meetings not condusive to entrepreneurial thinking.
Meeting culture – what can happen and not happen. Entrepreneurs get bigger blocks of time to do creative work
Hour long meetings – not contusive to entrepreneurial behaviour. They look for ways to structure their days differently – larger blocs of time.
An organization can have strong or weak entrepreneurial cultures
Marlies
Marlies
Ppt “what and how” – story telling – powerful to mobilize others to act. Through stories. Through a new outcome or new reality.
Notice that there is meager support to how to develop good story telling. Entrepreuners know this skill – through trial and error.
Two practices 1) recognize what the language gap is between stakeholders – ie,., trying telling stories about new idea at several levels – really needed to understand the concept the idea – she thought everyone was on the same page but she was missing the mark. 2)technique: progressive disclosure (from interaction and design field)– essence: sequencing information and action across several groups of people. Start with small disclosure and reveal more and more. Ie,. Progressively disclosed more in his story – and added on that as people were caught up. New idea later broadly socialized to get resources.
Important element piece
Marlies
Marlies
Colleen
How can we start to build alliances??? How can we link ideas for change/improvements….
“Frame It!”
Colleen
Framing
To connect with people’s hearts and minds
Emotional heart tug
Intrinsic motivation and values
Key to turning opportunity into action
Hooks to pull people in
Springboards for mobilizing support
Frames need to be authentic and connect with reality
Why is change so hard? I want to talk about organizational radicals!!!
Colleen
On average, it takes 17 years for research to translate into practice
Big change only happens in healthcare organizations because of radicals
The passionate people who are willing to take responsibility for change!!