Report: Practical Guidance for scaling up healthcare innovations

There's a FAB report from WHO and Expandnet with clear and concise guidance for the scaling up of healthcare innovations.

There's no excuse now to write more how to guides (yes, that includes me!0 - let's get using the guidance we have to make a difference.

The report covers:


Scaling up: definition and underlying principles 
Why successfully tested innovations? 
A guided process from the outset 
Who should use this guide? 
Content and structure of this guide 

2. An applied framework for scaling up 
The innovation 
The user organization 
The environment 
The resource team or organization 
Strategic choice areas 

3. The innovation 
Attributes of innovations that enhance the potential for scaling up 
How to enhance the attributes of success and the potential for sustainable scaling up

4. The user organization(s) 
Attributes of user organization(s) that facilitate successful scaling up 
How to enhance the capacity of the user organization(s) to ensure successful scaling up 

5. The environment 
How to maximize the opportunities for sustainable scaling up inherent in the environment 

6. The resource team or organization 
Attributes of a successful resource team or organization 
How to ensure that the resource team or organization can maximize the potential for sustainable scaling up


7. Strategic choices for scaling up 
Type(s) of scaling up 
Dissemination and advocacy 
Organizing the scaling-up process 
Costs of scaling up and resource mobilization 
Monitoring and evaluation of scaling up 

8. Strategic planning and management of scaling up are a balancing act 
How to create and maintain balance in scaling up 

9. Conclusion 
References 

Mostly free Pages Numbers Keynote templates for the IPad

Trying to use your IPad instead of your laptop or desktop? I find it's ok as long as I don't want to create anything of length or complexity. Many of the templates designed for Windows, tend to get reformatted strangely when on the iPad.  Here are a few of my favourite places to get templates for my iPad Pages, Keynote and Numbers:

1. There are 156 templates available from Jaxworks. I've not checked them all. They do have a US bias but that's not an issue. They cover the entire gamut of business planning and management.
2. You can find templates for Pages, and Keynote here.
3. There are templates in iTunes which cost around £0.69 for a bundle - not a bad price to save time and to cheer up what might be a dull report or presentation.

Resources and Links about Positive Deviance

image from plexisinstitute.org

Positive deviance is an asset based method of change - find what works well and do more of it. I've been harping on about this for year but now it seems it has its time.  I've curated a list of resources and links in case you want to learn more about this concept.

1. Wikipedia has a decent overview of what PD is about.
2. The PD initiative is a key resource centre which includes an comprehensive set of resources including presentations, videos, books etc. Most importantly is has many case studies of PD in action. 
3. The 7 characteristics of positive deviants I'm not entirely certain about the who of PD being the same as the what, but nonetheless, there are lessons to be learnt from both aspects.
4. Here is a YouTube list of various videos covering different aspects of PD
5. The BMJ had a paper on the topic in 2009 - useful for those who need a bit of theory and credibility to back up what may seem a little "woolly"

Redundant? Starting up on your own? Free Business Planning Templates

The redundancies notices have been issued. CV's are being spruced up and the calculators are out as many NHS staff figure out whether they can work under their own steam, on contract, as consultants  by starting up their own business...

The one most important fact of a business, for which there are no exceptions, is "Cash is King".

Even if you think your new organisation you're starting up will be subbed by the Department of Health or some other contract - the same statement holds. You can't pay staff, your telephone bill, you rail-fare etc, unless you have cash in the bank.

Cash is not a promise of work - there are plenty of those that don't deliver/
Cash is not an invoice - though if you're desperate, you can ask the bank to give you a loan against it.

Cash is when the money is in the bank account.

Business planning is essential if you're planning to go on your own. You'll find that the plans have more meaning than any plan you've done for an organisation  You need an in year plan and at least a 3 - 5 year plan that sets out your strategies and goes down to the level of cash - in the bank.

To help you, I've complied a list of free templates you can use for your business planning processes:

1. There are 5 excellent plans, check-lists, budget summaries etc available from Invoiceberry.  As with all plans you'll need to edit and customise to make them your own, but the details are covered in these.
2. Microsoft Office has a number of templates for download.. They have a SWOT, 5 yr plan, business plan, balanced scorecard and an excellent waterfall forecasting model which analyse profit and loss, and balance statement each month (remember, cash is king).
3. Bplans has templates for different types of businesses - in case you are feeling like opening up a restaurant or a bicycle repair shop.
4. Teneric has a comprehensive suite of tmeplates, including a free course on how to write a business plan

Paper: Realist randomised controlled trials: A new approach to evaluating complex public health interventions

Realist reviews of complex healthcare interventions are all the rage - and justifiably so. The realist process is far better as discovering and questioning the complex interactions within health and social care than more linear methods. Specifically, it investigates the how and why of interventions, rather than a singular focus on the what.  It's the way forward.

Realist randomised controlled trials: A new approach to evaluating complex public health interventions.
Bonnel, Fletcher, MOrton, Lorenc, Moore.

Soc Sci Med. 2012 Dec;75(12):2299-306. 

The words innovation and improvement can be misleading

If you want an idea or activity to be judged as good, then label it as an innovation or an improvement. Correct?  Well, I'm not sure it should be, but it seems that's what happens. I've been wondering why it is that the words "innovation" and "improvement" are assumed to represent "the good".

At a high level, there is an ethics issue; to whom does the "good" belong? New ideas often stem from crises, and crises are often either sourced from or produced by competition. When one side creates an innovation, the other side loses.

At a more detailed level, what worries me is that by labelling an idea or activity using words that come with the assumption of good, is that we:

• fail to evaluate whether the idea does what it intends (fidelity; more about fidelity here)
• fail to check whether there are unintended consequences in applying it
• fail to understand the drive of the person or organisation behind it
• urge the spread of a "good" practice, without assessing its value
• just accept; and the more we just accept, the more we open the floodgates to ideas and activities which may no longer be what we need

There's a lot of talk in the NHS about the need for "innovation". It will be good when this is grounded into discussion about the problems that need to be solved and then the ideas and activities being introduced to solve them. Solutions need to stand on their own right, not be labelled to give them credibility.

Cutting the cloth does not a slimmer NHS make

The NHS in England is undergoing a fundamental change  It's driven by the need to cut the cloth - to cut the expenditure. The trouble is, if the body of the organisation is still fat, then trimming the clothes will neither a pretty picture nor a happy organisation. The body needs some work.

It's a little like telling someone who is used to living a life where they can buy designer clothes  shop for the best cut in steaks and live in the best areas - that they have to buy from Primark and live in a less desirable area.  Obviously this is not an ideal situation. But it is one where the person starts to live within their means. Yes, it means life will never be the same, but if the person doesn't make the shift then they may face bankruptcy and lose everything. Surely it's better to take control and create a new life that is sustainable.

The NHS has a lot of fat in it. There is waste, despite the doomsayers who tell of the end of the NHS due to budget cuts (cloth cutting). This fat often isn't obvious (it is hidden deep within the organs of the organisational body, often in small streaks, but there nonetheless. When I can buy a ream of paper cheaper than an NHS organisation - there is waste. When I or a member of my family has difficulty in getting discharged from outpatients - there is waste.

I'm on my personal mission not to become part of the obesity epidemic. I am pleased to have got through a number of (healthcare...) events without resorting to the biscuits and pastries. Maintaining an exercise regime in the snow is difficult - but not impossible  I know that buying clothes two sizes smaller will not cure what's lying beneath them.  A radical shift in behaviour is required from me.  And so for the NHS - a radical shift in how services are designed to meet the future needs of future patients is necessary. While I commiserate with the pain staff in the NHS are going through, I do hold out hope, as a patient, that eventually the cloth cutting will move on from losing staff to rethinking the way care is delivered.

3 reasons why UK healthcare should not copy US innovations and improvement methods

I've nothing against the US, it's healthcare system and the methods used by various US organisations to improve their outcomes and processes. I don't live there so my opinion on their healthcare system doesn't matter. What is my business is the importing of US methodologists and solutions into a different context.  At a high level, learning new methods such as the Improvement Model is helpful, but at a more concrete level, copying "what worked in the USA" into the NHS will always be fraught with difficulties.

Reason 1: The USA outcomes are worse than the UK.
The IOM has released a new report US Health in International Perspective; shorter lives, poorer health. The facts are stark. US citizens die younger than their peer countries, despite paying more. Crucially, the report suggests that 20% of avoidable mortality is due to poor healthcare (rather than system related issues or behavioural choices).  Specifically, the US is worse than many countries in infant mortality & low birthrate, injuries and homicides,obesity & diabetes,  heart disease, chronic lung disease.

So why are we copying "solutions" from a system which is providing for worse outcomes than ours?

Yes, it can be argued that some care processes have better outcomes, but even then, there are difficulties. For example, it's widely touted that men with prostate cancer live longer than men with similar condition in the UK. If you look into the detail, yes, US men get diagnosed earlier - but they die at a similar average age as men with prostate cancer in the UK; the US men just had longer with the diagnosis, the treatment and the cost. More details on this and similar topics on the Cancer Research Science Update Blog.

Reason 2:  US model is based on cash for activity
The incentive for the majority of healthcare services is to provide more activity as a means of generating more income. This leads to overtreatment. Sharron Browlee's book "Overtreated; why too much medicine is making us sicker and poorer" is an excellent expose on this topic.

I had a debate with a US improvement consultant yesterday about why the NHS may not be rushing to implement rapid response systems in hospitals. We have a different value system, we have a different set of economics, and a different culture about death and dying. Solutions that work in US hospitals may not be the best ones for our NHS. Yes, we still need to resolve some of the underlying issues - but I hope we can do so in a way that fits our own culture, social and economic constraints.

Reason 3: The opportunity for delivering change & improvement in publically (and part-private..) funded health system far outweighs the private led US model.
Even though the NHS is under pressure to privatise part of the healthcare services, the fact that we do have a publicly driven system, connected to social care as well - means we have an incredible opportunity to devise solutions to problems that are truly radical. While we fuss about the speed at which patients are supposed to get electronic access to their records, and how to link them with hospitals - at least we have electronic records. We have register of people with conditions, and many good primary care organisations use these to do their best for the health of their local population.

I sometimes feel that whilst we are in the embrace of US-led improvement and change methodologies we are not devising ones that will make the most of our specific context. A good start is the NHS Change Model, which is sufficiently bland yet comprehensive, to provide useful and reasonable guidance for change.  It's not earth shatteringly clever - but it is one for the NHS, by the NHS, and I believe will be helpful for the NHS.

What if managers held end of day briefings like nurses do?

Nurses do briefings at the end of their shifts. I was reminded of this by @nurchat on Twitter as it s one of the topics for their weekly #nurchat tweetup. The reminder tweet made me think - why don't healthcare managers have a similar end-of-day briefing?

The briefings can be managers with their teams, or groups of managers - I like the idea of the Executive team holding an end-of-day briefing session.There are both advantages and disadvantages to holding one, though the only disadvantages I can see are ones about timing.

Benefits

• Reflection on the day's operational activities
• Reflection on personal contribution to the day's operational activities
• Highlight priority issues
• Ensure priority issues don't fall between the management gaps
• Improved communication skills
• Improved meeting skills

Disadvantages

• when is the end of the day for managers (though a briefing can be held at 4:45 for 15 mins)
• perception that the briefing gets in the way of other meetings
• poor briefing skills means it turns into a long meeting

It seems that much of the imperative for improvement and innovations pushes nurses to learning from managers - maybe now is the time for manager to be looking at what nurses do very well, and learn new skills of their own.

National Poetry at Work Day 15 Jan; One for the innovators

January 15th, 2013. It's National Poetry at Work Day.  How will you use and encounter poetry in your workplace today?

To celebrate, here is a poem that for me fits also in the innovation and improvement workplace. Poetry is about disconnecting the brain and triggering feelings.  Does the poem below mean anything to you?  What can we learn from it about how it feels to be an innovator?

The Viola

Your mauve face squared to the sun,

            velvet soft, centred with cream

                        atop delicate stalks.

                                    -  a wild viola.

Alone in the cracks of the flagstones

            thrusting between cement crusts

                        strikingly out of place

                                    - a solitary beacon.

I watch as pedestrians acknowledge you,

            stepping aside, bowing to your bravery;

                        you bruise gently

                                    - a defiant messenger.

You shiver as the shadows pass.

            I came back the next day;

                        you had hung on

                                    - a dusty viola

January 2013 Thought Leader of the month: Paul Levy

Throughout 2013 I will be posting my thought leader of the month. It will be a personal view, of course, and I aim to recognise those I follow and whose thoughts I appreciate.

My January 2013 Thought Leader of the Month is Paul Levy.

·       Paul hosts the blog “Not running a hospital;” and he is also active on Twitter.  He’s a former CEO of a large Boston hospital and he has things to say – and he says so eloquently and with authenticity. I follow his thought leadership, even though it is USA centric and I am UK based, because he’s not afraid of speaking up when necessary, of praising when deserved and criticising constructively when required. He shares a variety of thoughts, from science, statistics, service redesign, stories and personal stuff too. This means it's easier to understand his perspective. He’s rounded and it’s easier to trust him because you get to understand his perspective. He messed up once at work, at he made an apology public on his blog - that's the authenticity that attracts me as a follower.

There are five articles in my thought leadership series:

1. What or who is a thought leader
2. Being a thought leader
3. Organisations as thought leaders; some healthcare examples
4. Medical Thought Leadership
5. Thought Leadership 2.0

You can vote / suggest February's Thought Leader by tweeting #hcthtldr

Thought Leadership 2.0

Graphic from Indiangroup.com

I came across the 2.0 version of thought leadership from the article by Maria Tabaka in Inc.  She has posited that social media has opened the way for a new form of thought leadership where

“[…] the Internet allows ordinary people with extraordinary ideas to lead and make a difference. Do you have what it takes?”

I've been saying for some years that the Roger's Diffusion of Innovations version of an opinion leader is well out of date (the book was first published in 1984). Many peer reviewed papers continue to reference this outmoded version of opinion leadership, without considering how social media and other technology based platforms has changed the opinion and thought leadership landscape.

Maria's advice on being a 2.0 thought leader is straightforward; you have to work at it.

“Begin by becoming a true expert in your arena. Do your research, and then do more research. Learn to speak about your ideas with passion; become a story-teller. Your passionate disposition will recruit followers and other leaders who respect and appreciate your insight. These folks will spread the word!

Step onto the stage, speak to live audiences, upload videos that teach and inspire, write, write, and write some more. Guest blog, invite others to blog as your guest. Author that book that has been burning to get out. Promote yourself to podcasters and broadcasters who speak to the same or a similar audience.

I like the way Maria focuses on the need to keep doing research. This is a theme from many of the publications about being a thought leader. To be out there, you need to be out there with something, some new content. You need something to be passionate about. Thought leadership is about going to depth, about sticking with a concept or idea and bringing it to life.  It’s not about spouting forth on the latest craze you’ve read about.

Thought Leadership 2.0 is about using social media to best effect.  It’s more than hanging on Twitter. Here’s a checklist of some activities a TL 2.) may be involved in. How many can you tick off.

• Active on Twitter; engage in conversation, retweet others (without making them your own), share useful information and links
• Participate in LinkedIn groups; specifically those groups within your thought leadership domain
• Host a Facebook Page, or two
• Maintain a personal blog and update it on a regular basis
• Guest blog for other influential sites / people / organisations
• Host your own podcast / video series
• Guest on others’ podcasts or video
• Use other social media sites such as Foursquare, Google+ etc

Yes, it’s hard work, but TL 2.0 is about extending your reach and cementing your passion in the reality of virtual relationships.

Previous articles in this series include:

1. What or who is a thought leader
2. Being a thought leader
3. Organisations as thought leaders; some healthcare examples
4. Medical Thought Leadership

Medical Thought leadership

I’m unconvinced whether there is “A Medical Thought Leader” role. Rather, I think there are a number of thought leadership roles for clinical professionals.

·    Clinical area thought leader; this is a professional who is thinking ahead, sharing their views, perhaps innovating in their clinical speciality.  They will be accessing and reviewing both the peer-reviewed and the greyer literature. They balance their thinking with a decent amount of talking about their hopes, dreams, fears and ideas for their speciality.

·    Techie clinical professional thought leader; this is a growing role where professionals are inhabiting the space which used to be reserved for IT geeks. They are writing apps, participating in Hackathon days, and developing idea and strategies for revolutionising healthcare.  They are mostly very active on many social media platforms.

·     Healthcare services clinical profession thought leader; that’s a bit of a mouthful but it means what it says. These are professionals whose interest lies in reconceiving the delivery of healthcare services. Some of these sit on the committees and Boards of their local services so they can use their influence. Others stay on the outside, shouting at or encouraging others.

Previous articles in this series include:

1. What or who is a thought leader
2. Being a thought leader
3. Organisations as thought leaders; some healthcare examples

Organisations as thought leaders; some healthcare examples

Thought leadership is not just about individuals. For many organisations, their mission is to be the thought leader in their sector.  I’ve listed below the healthcare related organisations that I believe to be thought leaders.

·     The Health Foundation  in London practices a pragmatic and sensible thought leadership. They base their knowledge around programs of work, linked the more academic reviews. They share knowledge very well and a great example is their work on Self Managements where all the materials can be accessed, free of charge, including train the trainer packs.  They take on new ideas and put them to work in programs. They are prepared to take risks and their work is subject to evaluation – which is also shared.  They are a charity so have no need to sell – and this shows.

·     The Kings Fund, London,  is a traditional thought leader for healthcare. They’ve moved into blogs and videos, and other social media platforms such as Twitter, Facebook and LinkedIn, as a means to share their news and views – and to help others connect. They are best loved for the discussions they hold. These are tough questions with a wide range of people taking part. They empower thought leadership in others, which is very magnanimous of them.

·     The Nuffield Trust is another UK based organisation which is a thought leader, in a fairly tightly packed thought leadership arena. They are probably best known for their sharp and necessary evaluations and reviews of policies and programs. They are trusted because they are independent and not in anyone’s funding pocket. They do blogs, publications, videos and some excellent charts.

·    The Institute for Healthcare Improvement  in Boston.  This is a well-known organisation for its work in developing strategies for improvement and in bringing together groups of interested people to share. Like any organisation, they have something to sell. However, they are quick to share new ideas in white papers and make many of their materials available to anyone, free of charge. (excepting their conferences which are notoriously expensive).

i    The other articles in this series are:

1. What or who is a thought leader
2. Being a thought leader

Is #wenurses THE NHS social movement?

I’m late to the party - #wenurses  has been around for a while; but then. I’m not a nurse. I discovered #wenurses by accident and lurked in the background of a few of their weekly tweetups.  What a joy.  Usually my Twitter feed “nhs” search column has an ever-increasing stream of negativity and attacks on the NHS.  #wenurses is different.

#wenurses is a way for nurses of all disciplines and interests to connect using social media. They can get training in using Twitter, have blogs, resources and are active with tweetups, workshops and blogs.

#wenurses tweetups are Thursday evenings at 8pm. The first tweetup of 2013 was a delight in the endless positive comments about the successes of 2012 and filled with ideas on what to do in 2013. I loved the way someone suggested it would be good to get a CEO to join them. Someone replied mentioning the twitter names of those who may be good to ask. By the end of the tweetup a number of those CEO’s were joining in the chat. That is digital democracy at it’s best.

These are nurses who don’t talk about what’s wrong, or complain about the reforms. They are asking questions about how they can be better at what they do, how they can get help in understanding changes, such as commissioning.  

Is it a social movement? I think it is because:

• There is no organisational or policy imperative that they come together and do something
• There is a simple website around which they can organise themselves on social media; it#s #wenurses website and isn't a subset of another organisation. The branding and identity is clear.
• There are no apparent rules, other than a very good statement of appropriate behaviour for nurses using social media
• It’s self-organising around topics
• It’s driven by the passion of individuals
• The purpose is clear; to use social media to connect the community of NHS nurses, to share knowledge and to provide support.

The friends and family test comes into use in the NHS in a few weeks. This is where patients will be asked if they would like a member of their family or a close friend cared for on this ward, in this hospital, by this doctor etc.  When I’m a patient, I’m going to be looking out for the small #wenurse badge. If I see a #wenurse mug on the desk then I’ll know already that this is a good placed to be.

Book Review: Rippling; how social entrepreneurs spread innovation throughout the world. Beverley Schwartz 2012

Social entrepreneurs work on societal problems; they push against the norms of societies, governments and organisations. They develop unique solutions because they have to. Social entrepreneurs are not the stuff of organisational employees. These are very focused individuals who operate outside of regular structures to make change happen. They speak up, point out and are unafraid to plough, what at times is, a lonely furrow.

This book is about large scale change and transformation. It's neither an academic review nor a pop-science polemic. Instead it covers the stories of real social entrepreneurs as they create and implement systems changing innovations.

The book provides a number of case studies and draws out some guiding principles and lessons.

Advice on being a social entrepreneur includes:

• "Take responsibility for your life"; this is about getting out there and up there with what you believe in. It's about taking your ideas and working full out to find sponsorship and to convince others. It's not about "selling" a corporate idea within the corporation, although the way social entrepreneurs influence provides useful lessons.
• "Remain objective". This sounds really odd but the essence is to avoid falling on love with your idea so much taht you're unable to see it's faults and end up defending it when others try to improve it. It is about focusing on the benefits to others - note: to others, not to yourself or your organisation.
• "Do something"; social entrepreneurs are not thought leaders or academics. They are people who get things done and they do this by marshalling their own resources (internal and external) and expending personal energy on keeping the action going. They are in for the long term and demonstrate remarkable consistency of purpose. They are 'doe-ers'.
• "Solution"; They are entirely solution focused. They constantly work to find a solutions to keep their work moving forward. They tend not to use the language of "problems" or consider problems as barriers - instead they are the opportunities to improve and speed up implementation. Sounds a bit obvious and trite - but the case studies in this book demonstrate this.

Schwartz identifies four characteristics of social entrepreneurs:

1. Purpose
2. Passion
3. Pattern
4. Participation

To some extent these seem the same characteristics that are used to define good leadership or those who foster social movements. From reading her book, I think Schwartz is positing that its the amount of each of these characteristics that matters: amount and strength. Social entrepreneurs are not spending time on office gossip, annual planning away days, business planning processes - they are putting the maximum amount of energy into their fundamental beliefs, and taking them to action.

Great book. 

Thoughtful Readership

 Do you believe everything you read? Of course, not. Confirmation bias is well known and it’s active when we choose to read a published paper about healthcare services, public policy etc. (clinical papers are different). We often, and unknowingly, select reading material that confirms our views. It’s natural. Realising we’re doing this – is not natural or instinctive. It requires effort to stand back, consider your own perspective, along with that of the authors, and come to a sort of independent position. I say “sort of” because we can never truly be an independent reviewer.

Checklist of questions to ask yourself when reading a published paper

• What is my POV and why have I chosen to read this?
• Who funded the work and how might this present itself in any bias?
• What has been left out of the paper (by methodology)?
• What terms are important in this paper and do they fit with my definitions?
• What can I learn from this paper; how does it confirm my views or bring me new ideas?
• What similar papers are available that I’d like to follow up?
• How credible is the author/s? What might be their biases? Does this matter to me?

Reading – and believing – without thought, is a dangerous bias.

Being a thought leader

This is the second article in the series. The first article was "What or who is a thought leader".

Gandi had a saying that you need to "Be the change you want to be". So if you want to be a thought leader, you need to be one. Obvious, yes? No, it isn't. I know some people who call themselves a fisherman but fish only once a decade, or they say they are a writer of novels, but they've yet to do more than the first chapter. To be a thought leader takes effort and invest in being one.

Leadersdirect  point out the need to invest in your own knowledge if you want to have followers and be considered as a thought leader:

"To be a thought leader, you need to immerse yourself in your professional domain and search for new things to say that add value to your organization's objectives."

Fastcompany  has an excellent article on the golden rules for being a thought leader from an organisational perspective:

1.       Don’t sell anything except ideas

2.       Always give it away

3.       Have a unique perspective

4.       Focus on one thing at a time

5.       Address a specific audience

6.       Admit what you don’t know

7.       Make your audience feel smarter

8.       Hire thought leaders

The same article also covers the need to thought leaders to be thoughtful, and patient, leaders.

Thought leaders are not people who lie on the sofa dreaming up new ideas (well, not all of the time, anyway).

TheCEOOnline  has a great article on the 9 essential skills for thought leadership, and the graphic below is from them. I recommend you read the whole article and use it to assess your own position as a thought leader.

Who or what is a thought leader?

This is the first in a series of posts about thought leadership.  I started by thinking about the "what" of thought leadership. It's a concept - what does it mean?

Wikipedia suggests that

"The term was coined in 1994 by Joel Kurtzman, editor-in-chief of the Booz Allen Hamilton magazine, Strategy & Business. "Thought leader" was used to designate interview subjects for that magazine who had business ideas that merited attention."

Forbes has an excellent blogpost on the topic and helpfully distinguish between what a thought leader is, and isn't. They have parts to the definition of a thought leader:

“Definition—Part One

A thought leader is an individual or firm that prospects, clients, referral sources, intermediaries and even competitors recognize as one of the foremost authorities in selected areas of specialization, resulting in its being the go-to individual or organization for said expertise.”

To me, this suggests a thought leader is someone who is recognised as such by their followers. Obvious when you think about it.

“Definition—Part Two

A thought leader is an individual or firm that significantly profits from being recognized as such.”

Ouch, this wasn’t quite so obvious, but it makes sense. Behind every thought leader is an intention, a purpose and a bias.

Leadertoday.org suggests that 

"Thought leaders are people who have an influence on how people think about an issue or situation. Through their development of models, theories or ideas, they end up with a following that stems largely from the apparent truth and/or usefulness of their ideas."

That makes sense and I like the bit about influence, and specifically that this influence is balanced with “truth” and usefulness of ideas. Though I suspect truth and usefulness are dependent on a point of view which means some people will not agree with a thought leader’s ideas. So a thought leader can be a leader for some and a non-leader for others; it all depends on the followership’s point of view.

Leadersdirect  have a good description of what a thought leader is. They mention

“Kouzes and Posner base their view of leadership on the metaphor of a journey. Their leaders sell the tickets for the journey AND help followers reach the destination. By contrast, thought leadership merely sells the tickets for the journey, leaving it to others to get to the destination on their own or with the help of managers, coaches, facilitators and catalysts.”

I like the way this separates thought leadership from organisational leadership, though I do wonder whether “regular” leaders can also be thought leaders, and vice versa.  I also wonder how many “tickets” are sold to journeys that are never taken.

The next quote from Leadersdirect I really like as it democratises thought leadership. You don’t have to be in a specific position to be a thought leader. It is about “distributed thought leadership”.

"Whenever you advocate a new idea to your colleagues or boss, you show thought leadership. It isn't necessary to have inspirational influencing skills, which is necessary for senior executives because they need to win over the entire organization and beat off their internal competitors for top jobs. Also, to initiate organization-wide change, it helps to be inspirational. But a thought leader can focus on smaller scale changes - ideas for a new product or changes to an existing one. Thought leaders can persuade others using logic, evidence or an actual demonstration of a prototype to win support."

In summary, a thought leader is:

• anyone who chooses to influence on a specific topic
• who doesn't have the responsibility to implement the ideas
• who is recognised by others as having influence on a specific topic
• who has something to gain from hereir influence

Do you agree? Anything to add?

#thtldr