Appreciative inquiry

Appreciative inquiry
Appreciative Inquiry Dr. Shweta Goswami Junior Resident Deptt. Of Community Medicine PGIMS, Rohtak
Invested in Hotel Renovation Kept original staff Lodging for Patient’s Families $ $ $ $
Appreciate + Inquiry
Appreciate: valuing; the art of recognizing the best in people or the world around us; affirming past and present strengths, successes, and potentials; to perceive those things that give life (health, vitality, excellence) to living systems. Inquiry: the act of exploration and discovery. to ask questions; to be open to seeing new potentials and possibilities. Appreciate + Inquiry “is the study and exploration of what gives life to human systems when they function at their best.
Appreciative Inquiry It is an organizational development method that seeks to engage all levels of an organization (and often its customers and suppliers) in its renewal, change and improved performance. AI implies a particular way of asking questions in the way for enhancing the capacity for collaboration and change of people. It focuses on strengths, on good practices on possibilities instead of problems or risks.
Appreciative Inquiry- organizational development method This approach to personal change and organization change is based on the assumption that questions and dialogue about strengths, successes, values, hopes, and dreams are themselves transformational.
AI- “asset- based” or “strength-based” approach Salutogenesis: salus (=health) and genesis (= origin), means the origin of health. The salutogenic approach focuses on resources for health than on risks for diseases. It is the opposite of the pathogenic concept where the focus is on the obstacles and deficits. Salutogenesis is a way of thinking, being, acting and meeting people in a health promotion manner
Comparing- ethos Problem solving focus Asset or strength focus Negative event directed Positive research directed Deficit methods Positivist methods-story sharing Problem finding Build on successes or experiences of success Focused on dysfunction (social or intra-psychic) Rebuild relationships, create a collaborative vision and tap into passion and generative core
PROBLEM SOLVING VS. ASSET FOCUS Problem solving (deficit based change) “Felt Need” Identify problem Conduct root cause analysis Analyze Possible Solutions Develop action plan (Treatment) Basic assumption: An Organization is a “problem-to-be solved” Appreciative inquiry (strength based innovation) “Valuing the best of what is” Appreciate Imagine (What might be) Dialogue and design (What should be) Create (What will be) Basic assumption: “An organization is a mystery to be embraced” Basic Assumptions What we focus on becomes our reality Reality is created in the moment, and there are multiple realities In every ongoing team/group/ organisation . . . Some-thing( s) work People have more confidence and comfort to journey to the future (the unknown) when they carry forward parts of the past (the known) The mode and language of inquiry effects the org. being observed Comparing- ethos
Underlying theories & Research Effects of both positive and negative thinking on the outcomes of surgery: patients with Appreciate more + positive Inquiry thoughts recovered at a much faster rate
Underlying theories & Research The Pygmalion Effect (Self-fulfilling prophecy) - what we expect to happen will happen when Appreciate we + Inquiry project certain expectations on another
Underlying theories & Research The Placebo Effect - people experience what they expect to experience Appreciate + Inquiry Beliefs are powerful factors in what we can achieve
Underlying theories & Research  Neuroplasticity (brain can be rewired); intentional work on feeling optimistic Appreciate strengthens + Inquiry neural connections creating “muscles of optimism”  Memory and future thought are highly interrelated; Our memories are essential in helping see ourselves in the future
Underlying theories & Research Psychoneuroimmunology How stressors, and the negative emotions they generate, are translated into physical changes Appreciate + Inquiry
Six Aspects of Change and Development of which to be Aware Knowledge of the community is critical to determining its destiny. The seeds of change are implicit in the first questions we ask. A critical resource we have for creating positive change in our communities is our imagination and the capacity to free the imagination and the mind of groups. Our imagination and mind are constrained by bad habits, limited styles of thinking, underlying assumptions and traditional rules of organizing.
Six Aspects of Change and Development of which to be Aware Our styles of thinking rarely match the increasingly complex worlds in which we work… We need to discover more creative and fruitful ways of knowing. All systems (organizations and communities), as living constructions, are largely affirmative and respond to positive thought and positive knowledge.
Understanding Appreciative Inquiry A major assumption of AI is that in every community something works. Change can be managed through the identification of what works, and focus on how to build on it.
AI- Key Concepts
AI- Five Principles Constructionist Principle Principle of Simultaneity Poetic Principle Anticipatory Principle Positive Principle
1.Constructionist Principle Appreciate + Inquiry
Constructionist Principle Social Constructionism argues that the language and metaphors we use don't just describe reality (the world), they actually create 'our' reality (the world). The way we know (think/feel), influences our attitude and response We make meaning out of our lives and our experiences in conversation with others. The language we use to describe things actually shapes how we see them. People can go through exactly the same challenging or negative experience – but use very different language and tell very different stories about that experience. Some people focus on being a victim – and this becomes their reality. Others focus on their stories of survival and how they overcame the challenge, creating a very different reality for themselves
In an organisation same thing can happen-organisations are made up of social constructs If the stories being told around the lunch table or over the coffee breaks are all about how terrible the boss is and how overworked people are, then those stories will shape their reality. And that’s going to be the kind of place they will build – an unhappy place that will probably never reach its full potential. But if the stories people tell are about how good it is to work there, and the language they use about each other and their boss is mostly positive – then they are going to see a different reality. And this will in turn affect the kind of workplace it becomes - a happier and more productive environment
IMPLICATIONS If social reality is shaped by how we talk about it, it makes sense to talk about what is working, what we are proud of, what gives life to the organisation, and what we want. What changes could you make to what you talk about, or the way you talk about it, to get the best from your team, your colleagues, or your boss? What specific changes will you try out in: the questions you ask; the stories you tell?
2. Poetic Principle Appreciate + Inquiry
Poetic Principle The organization can be seen as an open book—an incomplete story that is continually being co-authored by group members over time. It is open to interpretation, we are free to study virtually any topic related to the group, its members and their experiences. We can look for what is going wrong or what is going right and the greater gains are made when the means and ends of inquiry are aligned. If we seek to increase employee retention we should inquire into why people stay in our organization rather than focus on employee turnover. Appreciative inquiry chooses to focus on the positive and lifegiving forces
3. Simultaneity principle Appreciate + Inquiry
The principle of simultaneity Inquiry and change are not separate. Change begins with the first questions we ask and the questions we ask determine what we find. So, the act of inquiring is a intervention AI questions do not seek ‘‘right’’ answers, but rather they generate conversations that seek out the ‘‘essential goodness’’ of the system as a platform for creating an even ‘‘better’’ system.
4. Anticipatory Principle Appreciate + Inquiry
The anticipatory Principle An anticipatory view of organizational life posits that the image of the future is a guiding force in organizational life. Our greatest resource for generating constructive organizational change is our collective imagination and discourse about the future. AI opens up our creative minds to think about new ideas and ways of thinking about “old topics”. We can look into the future and see the possibilities because our mind is not focused on fixing the current problem or the problems of the past. We can anticipate a different future than we had in the past.
5. The positive principle Appreciate + Inquiry
The positive principle Building momentum for change requires hope, inspiration and sheer joy in creating with one another. Just as plants turn towards sunlight, human systems tend to turn towards positive images and those things that give them energy and nourish their sense of joy and happiness. The human spirit is lifted when we talk about possibilities, hopefulness, joy, and positive images of our future. This energy will allow our minds to create images that we haven’t imaged before. The more positive the questions that are asked, the more people are captivated by the inquiry process and the longer the benefits are sustained.
Appreciate + Inquiry The 4-D Appreciative Inquiry Cycle
The 4-D Appreciative Inquiry Cycle Appreciate + Inquiry
DISCOVERY STAGE The task in this phase is to inquire into and discover the positive capacity of the organization or community through carefully crafted appreciative questions. the questions are designed to engage participants in the telling of stories to one another about what gives energy and vitality to the system. people seek to explore their strengths, assets, peak experiences, ‘‘What’s and successes going and right to understand the unique conditions that and made how their do moments we get of more excellence of it?’’ possible. In contrast to methods which search for the root causes of problems, it is a method that searches for the root causes of success.
Creativity starts with an'appreciative' eye. DISCOVERY STAGE The point of the appreciative protocol is not to dismiss problems but to offer a broader lens through which people can cast an Appreciative eye on their system.
Formulating the Discovery Questions Frame questions in an affirmative way that implies respect for group members; Ask open-ended questions that invite stories and embellishments rather than yes/no responses; Build affinity among participants by framing questions such as “tell us a story about a time when members of this group played an important role helping you to realize a dream or overcome a challenge”; Add additional questions to determine the necessary details (the who, what, when, where and how of the event); and Seek stories of personal experiences from participants rather than accounts of others.
Project of a two-and-a-half-year partnership between Canada’s International Institute for Sustainable Development (IISD) and MYRADA, a south Indian development organization. Funding was provided by the United Kingdom’s Department for International Development.
The goal of the IISD/ MYRADA appreciative inquiry project was to advance sustainable development and facilitate sustainable livelihoods by providing governmental and non-governmental organizations in India with a better method of designing and delivering programs—one that identified and reinforced a community’s strengths, achievements and vision, rather than focusing on its problems, deficiencies and needs.
Addressed two interrelated and complementary factors GROUP CAPACITY BUILDING COMMUNITY DEVELOPMENT
GROUP CAPACITY BUILDING Consider periods when the group was working at its best Stories will relate to internal processes such as decisionmaking, leadership, financial management and reporting; and core values such as transparency, participation and equity. The visions and action plans that emerge will address how those internal processes could be strengthened.
COMMUNITY DEVELOPMENT Stories might relate to building a road, reducing illiteracy in the family or eliminating gambling in the village. The visions that follow will address the group’s role within the large community. They might relate to immunizing local children, undertaking a watershed development project, empowering women through literacy training or starting new self-help groups.
Story Analysis The facilitator helps the group draw common themes from the stories and to understand more completely the conditions that made the peak experiences possible. What are the strengths that made the achievement possible? What individual and group values are reflected in the story? What external conditions existed that contributed to the peak experience?
EVALUATION OF THE DISCOVERY STAGE Stories were factual Stories were inspiring and energizing Affinity among participants was enhanced Stories and enabling factors were adequately documented New strengths were revealed There was an adequate understanding of Discovery process
themes and patterns emerge that inspire hope and possibility. ‘‘What is the world calling us to become?’’ Dream Stage a time for passionate thinking ‘‘What might we become if our exceptional moments were the norm?’ It is a time to imagine an ideal future -Because it is a dream that is grounded in people’s The objective of the Dream Stage is to enable participants to evolve real quality experiences visions based it is on more their believable strengths and and values. more achievable.
In the Dream Stage, local people discuss how they can build on their strengths to better their group and their community. What would the group be in five years? What would be its greatest achievement? What role would the group members play in the development of their village? Three women discussing their vision of the future
Recording the output – Provocative Propositions “A provocative proposition is a statement that stretch the system from where it is to where it wants to be” It is provocative- stretches and challenges the group It is grounded. It is desired. It is highly participative. It stimulates organizational learning. It addresses multiple aspects of the group’s structure and activities-leadership, societal purpose, communication, staff, structures, practices, community relations, etc. It balances existing activities with future goals
Characteristics Of Good Visions Holistic Challenging Achievable/ Realistic Shared Documented and institutionalized Evolving Internalized Reinforces existing strengths Not heavily dependent on outside agencies:
Design Stage The Design Stage is intended to bring together participants in a dialogue about creating their desired future The objective of this phase is to create /design principles that will inform the system’s structures and policies that can move them toward the realization of their dream.
Design Stage Exercises Setting short term & long term goals Prioritizing the dreams- Group Discussion Which of the goals is most important to the group? What would you like to start working on right away? Which aspects of the group would you like to strengthen first? Developing action plans Planning can be seen as analogous to architecture in which the various systems within a building complement each other to produce a structure with certain characteristics.
Delivery/ Destiny Stage The system moves to fulfill its destiny. People begin to read the organization or community in a new way—a way that invites possibility, forges new networks of relationships, acquire new skills and ultimately effects the direction and meaning of one’s actions. time for unleashing the creative energy of the system to undertake individual and collective action.
Effective Delivery emphasizes: Innovation Continuous learning Nurturing an appreciative eye Institutionalizing the appreciative inquiry process Self-reliance Monitoring Participation Transparency
Appreciative inquiry should be seen as part of a larger development strategy establishing an inspiring group vision articulating shared values developing strategies Can be a useful feedback tool Appreciative inquiry creates a sense of ownership in new initiatives
Appreciate + Inquiry Examples of AI Application
Creating Sustainable Change in the Interprofessional Academic Primary Care Setting: An Appreciative Inquiry Approach Intervention- Appreciative Inquiry (AI) approach to advance teamwork in one family health team in Ontario Aim- the aim was to understand when, how, and why interprofessional communication and collaboration were facilitated or impeded in practice.
Findings- Improved patient-centredness Formalized interprofessional meetings Bi- monthly interfrofessional case conference Clinic huddle- first five minutes of both morning and afternoon clinics
The patient voice: Appreciative inquiry into participants’ stories about living well with diabetes Research question: to learn from the patient’s experience of diabetes self management Sample: A convenience sample of 13 participants Diabetic or being at risk. Method: Thematic analysis was used to examine the positive stories elicited. Interviews were coded, themes were identified and reflective documents were produced for each interview.
Interpersonal Results: Participants who self report living well with diabetes Support simultaneously embrace their condition and embrace life. They do so through the complex interaction of experiential knowledge, interpersonal support, and personal qualities e.g. family, friends, diabetes peers, colleagues and healthcare team Experiential Knowledge e.g. understanding and managing individualized responses to food, exercise and stress Simultaneously Embracing Diabetes and Embracing Life Personal Qualities e.g. balance, compassion, confidence, honesty, hope, humour, optimism, persistence, respect
Recommendations Consider use of an appreciative inquiry design in asset focused investigations of patient experiential knowledge of self management. Assess how consideration of patient experiential knowledge, interpersonal support and personal qualities is integrated into patient centered care
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