Achieving change through networks - NHS Improvement · This is the era of networks We are...

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Achieving change through networks

Achieving change through networks

23 May

Helen Bevan and Penny Pereira

@HelenBevan @PennyPereira1

What we will cover

• Networks as a force for positive change

• What we know about networks and how they help

• Diverse examples of networks

• Reflecting on your networks

• Q community: enabling better networked change

This is the era of networks

We are witnessing the collapse of expertise and rise of collaborative sensemaking

David Holzmer

Source of image: ACCA

Hierarchy AND network

We still organise the health and care system like the Tabulating Machine Co. of 1917

Source of image: @corp_rebels

The 3% phenomena for change

Just 3% of people in the organisation

typically drive conversations with 90% of the other

people Source: research by IC Kollectif

Jeremy Heimens, Henry Timms This is New Power

old power new power Currency

Held by a few

Pushed down

Commanded

Closed

Transaction

Current

Made by many

Pulled in

Shared

Open

Relationship

@HelenBevan #BPSconf

The Network Secrets of Great Change Agents

Julie Battilana &Tiziana Casciaro

As a change agent, my centrality in the informal network is more important than my

position in the formal hierarchy

A co-operative structure where

interconnected groups or individuals

coalesce around a shared purpose on the

basis of trust and reciprocity

What are networks?

What are networks good for?

Well designed networks can:

• Provide efficient ways of sharing knowledge and innovation,

particularly when the knowledge base of a sector is complex,

dispersed and expanding

• Influence behaviour – shaping the norms and values that guide

decisions and actions, the opportunities available to members, the

constraints on what they do, and the activities they undertake

History of supporting networks

Which networks are you part of that support you in your improvement work?

Designing effective networks

http://www.source4networks.org.uk/

What makes an effective network for improvement?

Networks as an embedded part of an improving system

“Organisations [need to] master the complex

challenges they face by outlearning their

competition, and by applying what they learn

directly to their business. They [need] a culture

where they see, raise and solve problems in

real time, every day.”

Steven Spear

Learning health care systems

Why improvement needs peer networks?

Context

matters

Many complex

challenges

Improvement

can be hard

Our world is

siloed

How do peer networks support

improvement?

Resilience

Shared

know how

Pooled

intelligence

Scaling and

spread

Context

matters

Many complex

challenges

Improvement

can be hard

Our world is

siloed

Resilience

Shared know how

“When QI initiatives work, they often do so

because practical wisdom is deployed both in

the design and running of the programme” Mary Dixon-Woods

“Phronesis: practical and social wisdom, which is the

result of experience and social practice. It is

singular and idiosyncratic, acquired by trial and error,

and cannot be shared easily.” Philippe Baumard

Pooled intelligence

A network’s cooperative,

collegial environment

allows ‘bottom up’ views

to contribute to solving

complex […] problems’

Effective networks for improvement,

Health Foundation 2014

Development phase

Personal

Early scaling phase

Professional

Later scaling phase

Communities

Scaling and spread

Does this reflect what

you get from your

networks?

5 minutes

Discuss with your

neighbours

How peer networks support

improvement

Resilience

Shared

know how

Pooled

intelligence

Scaling and

spread

How could you get

more from your

networks?

System anatomy and physiology

What is Q?

• A connected community working

together to improve health and care

quality across the UK

• Supports people in their existing

improvement work: making it easier

to share ideas, enhance skills and

make changes that benefit patients

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Designed by you, for you

• Designed with 231 founding members – diverse

cross section of improvers from across the UK

• Members continue to help shape the community

Who’s in Q?

Anticipating 1000s of members from all backgrounds

Applicants need to demonstrate:

• Experience and understanding of improvement

• Thoughtful commitment to Q

Growing Q

Phased opportunities to apply

799 members now

2000+ by end of 2017

What Q offers

Connections at the heart of Q

“Q members […] reported a statistically significant

improvement in their assessment of their skills and knowledge

needed for the quality improvement work that they want to do”

RAND Europe, 2016

Q has reinforced my belief [...] we’re in it together and ‘None of

us knows as much as all of us!’. Q helps with the sharing!

Ashley Gould

Consultant in Public Health, Public Health Wales

Q has offered me opportunities to renew old and create new

connections across the UK. This has been both energising

(sometimes a needed boost to resilience!) and often very practical

for my day-to-day job.

Heather Shearer,

Board & Partnerships QI Development Lead, Scotland

Q improvement lab

Bringing together Q members and others to

understand and make progress on a specific

complex challenge, supported by access to expert

facilitation, analysis and creative design skills

Pilot project starting now:

What would it take for peer support to be available

to everyone who wants it to help manage their long

term health and well-being needs?

Looking forward

By 2020:

• Established large-scale, long-term home for improvers

• Connecting locally, regionally and nationally

• Vibrant community tackling local and cross-system priorities

Achieving change through networks

• Pay attention to human, social connections: critical to change

• Make the most of your networks

• Help your networks make a difference

• Support Q and help join up improvement across the UK

Visit us online: http://q.health.org.uk

Email the team: Q@health.org.uk

Follow us on Twitter: @theQCommunity #theqinitiative