Book Review: New Age of Innovation; Prahalad & Krishnan

If you're interested in large scale change and innovation then you'll find this book fascinating. On the one hand it felt like there was nothing startlingly new to me yet on the other it was neatly put together in a readable way that made sense.

A key premise is the current trend of personalisation and how value is based on the unique experience we all want. The authors refer to this as N=1. Current technology drives this, social networking, web 2.0 etc. How can we co-create value with our users and consumers? What are the challenges with managing who owns the knowledge? All good questions. They also suggest we need to make the most of collaborative networks, electronic and face-to-face, be flexible and ensure scalability. I liked the section on scalability and in my mind there is more in here than what they covered. This is a key element and is also linked to their second premise.

The 2nd key premise is the one that resources need to be global and they use another little formaula: R=G. Here they suggest the issue is that access to resources is more importnat than providing products; namely it is the solutions that matter rather than the kit or pieces. I think I agree with this. Again, scalability comes up.

They mention social movements and how they figure in the process as well as organisational transformation. There was nothing much new in the organisational process other than the context of the infomrational technology infrastructure - well, that is rather new and for some people rather perplexing.

If you've not yet engaged with Web 2.0 and new technology then this is definitely worth a read.

How to use Twitter to effect Social Change (Video)

"It takes many streams to create a river" - great quote from this video. I found this 3 minute video covers all the basics of Twitter good practice, especially for those who are hoping to influence social change through their use of the technology.  It was a bit quick and I had to rerun it to make sure I had all the info.

Book Review: Sway; the irresistable pull of irrational behaviour by Brafman & Brafman

Irrational behavour? Me? Never!

The Brafman brothers write a compelling story of how irrational our behaviour is in a variety of circumstances. While most of the book is well evidenced they bring each of the issues alive with stories that make sense - perhaps too much sense.

I'm getting a bit tired of the constant use of the airline industry as a safety example. So it was with interest I read through the case study on the crash at Tenerife which was one of the largest loss of life incidents. The authors demonstrate how the perception of loss played an important part in the creation of the incident.

Next up is a football team in the US which managed to beat all the major players but relinquishing their commitment to the predominant method of play. The story here is about how our commitment to a certain way limits our opportunities for growth and advancement. The authors show how loss and commitment add together to become a powerful irrational pull.

The chapter on value attribution is quite scary. They use a number of examples. One is of a famous violin player dressed casually playing complex tunes in an underground station during rush hour. hardly anyone paid him any notice at all. Yet some would pay large sums of money to hear him play on stage dressed in his dinner suit. The book is worth the read in this chapter about the discovery of a human fossil and how scientists of the day were not prepared to give it credence because the discoverer wasn't "one of them".

If you are currently either interviewing people for a job or going for interviews yourself, then the next chapter which looks at how initial diagnoses or decisions sway our long term responses to individuals.

Perceptions, beliefs and context come under scrutiny in the next chapter. If you want to understand why the USA has a Bipolar epidemic then read about it here. If you are involved in training and developing individuals then the examples of belief are important to understand.

So what is fairness? Read on to discover the importance of context.If you think monetary incentives are a motivation to change behaviour then the next chapter provides some examples which may rattle your thoughts. By now I was beginning to understand just how irrational we are as human beings. And just when I've grasped a bit of my own irrationality, the authors move onto the irrationality of groups, particularly looking at blockers and dissenters.

If you are wondering why no-one is following your instructions, why it is too difficult to plan something, why you always seem right and no-one else wrong... etc. then I thoroughly recommend this very readable book. It is an easy and relatively quick read (once - I had to reread to make sure I grasped what was being said).

Altering mental content - 3: Changing Minds

I come across clients who are sp captivated by the notion of spreading good ideas by stories that they forget that they also need to provide the theoretical base for the change, as well as the need to identify the key concepts - and - if required, support the development of skills to enable others to change.

I drew the above chart as my way of showign how all these topics need to come together.  Next time I am involved in helping someone draw up a spread plan, I'll spend time working through what we need to do to provide the mental content to help others adopt new practices.

6 different types of change by scale - 2: Changing Minds

Large Scale Change means different things to different people. In his book, Gardner suggests six different types of scale. I found these different levels useful in thinking through the strategies I might use to effect proposed changes.

1. Large scale changes involving diverse populations on a national or regional basis
2. Large scale change involving an homogeneous group (e.g. peer group such as theatre nurses)
3. Changes brought about by technology, science or art (e.g. a whole generation has been influenced by Harry Potter)
4. Changes within formal settings (I think of bounded organisations here).
5. Small gatherings and the more intimate shifts in perspective (e.g. group of friends who decide to change their exercise habits and support each each)
6. Changing one's own mind (which, of course, we never admit is probably the most difficult!)

Seven Key Factors in how minds change - 1: Changing Minds

Notes from the book "Changing Minds" by Howard Gardner (2004)

What I learnt was that if we want to help someone change their mind about what constitutes good practice (and thereby figure their practice is not the best so they need to decide to adopt a better practice), then it helps if we can:

1. Demonstrate what has to be changed in a way that someone can figure out for themselves what the reason is for them to change. Some people do this analytically and others deduce or infer from what they learn that a change is necessary. I think it's important to understand it's the adopter who needs to reason, not the person pushing the change.
2. Research, evidence, statistical analysis etc is crucial when working with healthcare professionals for whom this is the base of their practice. The onus of evidence is on the person pushing the change.
3. The proposed change needs to connect at the emotional and intuitive level with the potential adopter. The really good proponents of change can combine the emotive, rational and evidence content in their rhetoric.
4. The concept of redesciption intrigued me. I can see now that the person who can describe the proposed change in many different ways, whilst remaining true to the core concepts and values, is more likely to be able to convince others to change.  Not least, being able to redescribe means you know your stuff and this enhances the credibility of the proposal.
5. Rewards are obvious - pay someone and they are more likely to do it. But this doesn't always lead to the mind changing. The most basic reward is praise and confirmation of the new behaviour.
6. Real World Events - means tagging your proposals to outside influences. As a friend pointed out to me recently, a great time to raise the profile of pancreatic cancer would have been in the days after Steve Jobs died. To make the most fo these (not always sad) events, is to be prepared.
7. Resistance... it takes two to create resistance. The best way I know to deal with it is to stop pushing and to see things form the other's perspective - then, find a way to break through the debate.

Changing Minds by Howard Gardner

A book with the subtitle "The Art and Science of Changing our Own and Other Peoples' Minds" intrigued me. So much of the change process and scaling up better practice across larger systems involves helping others change their minds.  I've made a few notes from the book which I will post here in a series over the coming days.  I recommend you get hold of a copy and have a read for yourself.

The Innovator's DNA - book by Dyer, Gregerson, Christensen

The Innovator's DNA; Mastering the five skills of disruptive innovators is a book that we really need - right now - as we try to rearrange public services so we reduce costs and improve quality. I hear many people talk innovation but few actually doing it. I also think there are many innovators hidden away in organisations; just because they aren't smart at advertising themselves doesn't mean their abilities shouldn't be harnessed. So be on the look out for the following:

1. Associating; innovators connect the dots and see patterns between seemingly unrelated topics, tasks and issues
2. Observing: innovators spot emerging trends long before the formal reviews because they are intense observers of the small details.
3. Experimenting; innovators try things out - they don't necessarily talk about it or spend their time encouraging others to do it - they test things out themselves
4. Questioning; innovators can be a pain in the rear because they are curious and because they like discovering new stuff
5. Networking; it's difficult to spot patterns, notice details and test things out unless you have buddies. Innovators are terrific networkers and often link with others outside what may appear to be "normal" interests. They are also involved with groups outside their employment.

How would you rate yourself on these five categories?

Influencers: How trends become Contagious

The DigitalBuzz blog is one of my great sources. They found a high video (a film, really) Influencers: How trends become Contagious from R+I Creative that documents the importance of Influencers in setting new trends that move to mainstream. No theory, models or management gobbledegook in it!

4 resources why PowerPoint is not a good format for influencing others

PowerPoint has its place. As a method of influence it is limited, however, it has become pervasive in corporate life to the extent it is used beyond its purpose.

1. Life after death by PowerPoint 2010
This video by Comedian Don Mcquillan says it all.


2. Do my slides suck? test
This "Stop your presentation before it kills again" blogpost provides a compelling arguement to ditch your slides, or at least do some self analysis to discover the reason why you are using PowerPoint.

3. 11 ways to images poorly in slides
This blogpost covers 11 ways in how using images in PowerPoint can detract from your message. It is a compelling argument to beware the selftrained designer...

4. Dodging bullets in presentations
An excellent slideset which not only highlights the problems with using bullet points but also shows how to move to something better and more effective

Oh dear, I see I wrote this blog in bullet points. Deary me.

Overcoming resistance to change - isn't it obvious

How to overcome resistance to change is one of the most common questions I am asked. The dominant mindset I encounter is that the person who does not want to change (aka doesn't want to do what they are told to do) is resistant and therefore wrong.  There is as many answers to this issue as there are management consultants. An interesting approach is the animated video with a script by Eliyahu Goldratt of "The Goal" fame. Despite the video being largely a promotion for his new book, it does have some useful content and ideas.

5 checks to test whether your conference call is productive

Conference calling is often touted as the more productive way to have a meeting. In many cases it is, however, some calls are so badly organised, chaired and processed, that it may have been better to meet face to face - or not meet at all.

1. Don't start on time.
"We'll wait another couple of minutes for Dean and Tam."
silence
"Is Mike on the line?"
silence
"Janet can you call Mike on his mobile to check he is dialling in"
Silence

If 20 people wait 3 minutes past the start time for the people who have not joined the meeting it means 1 hour has been wasted. If 100 people wait 3 minutes it is the equivalent of 5 hours wasted by the organisation.

A good way round this problem is to predictably open the line 5 minutes before the session starts and then predictably start on time - every time. You wouldn't keep the meeting room door locked until the advertised start of the meeting.




2. Use slides
"For those of you with Internet connections, you'll see the agenda. What? Oh Mary, yes, I'm sorry, the agenda is so up to date it couldn't be circulated beforehand."
...
"Can everyone see the slides?"
"Next slide please. No, go back one. Yes, that's it."
...

Slides are used mostly as personal notes for the person speaking. As some people don't have access to the computers when they dial in, any necessary slides should be circulated before the call (rather than afterwards). Some learning styles work better when they have had time to read and then contribute.

3. Rely only on audio
Meetings of any sort work best when there is trust. Unless the session is an online seminar when your role is to push out information via some slides to a large group, then video is essential. Even in the seminar option, the speaker needs to use video.  The more participants who use video, the more everyone will pay attention and not do their email at the same time.  Multitasking is proven not to be productive.  A 90 minute conference call with everyone doing two tasks at once is unproductive. It could be replaced by a 30 minutes, focused, video-face-to-face committed time discussing what matters.

When presenters refuse to use the video option they lack the ability to influence using body language. The same goes for listeners. This makes the call ineffective and unproductive as messages have to be repeated.

4. Don't use names
'Thanks for that..um.. sorry, who was that who agreed to review the budget?"
...

Audio, especially without visual, is anonymous - which may account for why some groups enjoy using it - it feels like they are having meetings yet no much happens to move the work forward. Anonymity is not a good name as it means listeners have to work hard to keep connected.

Each time you speak, say your name: '"Sarah here, I like what you're proposing Simon, however, I am not sure about item 3."  Try and say the other person's name as often as possible to let them know you are connecting with what they are saying.

5. Have a call when an email would have done
Holding a meeting is an act of power and control, and one to be used with care.  If the intent of the call is to share information then consider first whether an email or discussion group would be a better and more productive option.  If group discussion is required - then a call is good. If information needs to be shared and not much discussion is expected or required, then another method is far more productive. Many calls can be replaced by the use of efficient and productive discussion groups and document storage systems. Huddle is a great one, though Google groups/documents is a good start.  The real issue here is about power and control; relinquishing the weekly conference call and replacing it with an online discussion group means someone has lose control of the process.

4 kinds of relationships

So much of spreading good, known and evidenced practice is based on social connections and relationships. John Maxwell has four ways in which relationships can be categorised.

1. Some people add things to life (we enjoy them) +
2. Some people subtract something from life (we tolerate them) -
3. Some people multiply something in life (we value them) *
4. Some people divide something in life (we avoid them) /

If a key role of the person who group is trying to influence others to change their behaviour then it might be useful to reflect on the relationship between the "spreader/pusher" and the "adopter/puller".

There are some people I avoid (4) and I am unlikely to even receive the messages they are pushing out, let alone act on them. In a similar vein, those I tolerate (2) I will probably put them low on my priority list and will be fairly sceptical about what they put out. Whether I adopt anything they are pushing will be a matter of personal judgement.

On the other hand, those whose company I enjoy (1) I will probably get to hear a lot about what they are saying, thinking about and pushing in my direction. I will take their information in quite quickly, though may still toss the ideas about before making any changes to my behaviour.

Those I value I will probably not wait for them to send me information. I will be finding ways to connect, listen out carefully and will most likely shift my behaviour quite quickly when they send out behaviour related messages.

So which types of relationships are you creating and endorsing?

Transformation versus Metamorphosis in Systems & Organisations

Gone are the days where the method of reducing variation and improving quality was focused on the incremental spread of good practice, using mostly communication methodology from the 1960's. The current mantra is "transformation". I am proposing an alternative, "metamorphosis", which may be a more relevant meaning-making metaphor in some circumstances.

We recognise when an organisation has transformed because we perceive a difference. This difference is usually one to stay. Slipping backwards to the old way is not an option. Transformation is something we recognise after the event. Thousands of books and papers have been published describing the experience of others and their own summary, meaning making and production of frameworks and models. However, underlying all the noise of methodology lies the premise that all transformation requires a behavioural change of significance. In addition, to transform usually requires a high degree of emotional commitment, trauma, distress and joy. Transformation is touted by "those at the top" as a process and outcome that is positive. However, for some it is necessarily an unpleasant process.

An alternative concept is "metamorphosis". This focuses on the striking change in appearance, in form and function, of an organisation or system. Individual may transform their behaviour, organisations and structures may morph into new, innovative and maybe even shocking forms. Morphing can happen slowly, the result of an incremental drip by drip process. Then we look back and see it now looks totally different. The changes around Mental Health Care in England from the 1970's to date are an example. Experience a deep depression in the 1970's and you would find yourself in an open ward of a Victorian building, treated (in a rough sense of the word) as a curious, complex and perhaps untreatable patient. Nowadays, you'd be cared for in the home by multi-disciplinary teams who recognise you as an individual with a family and personal set of circumstances. While drugs may be used, talking therapies also abound.

So what is it you are wanting from your quality improvement work? Are you requiring the sorcery of personal transformation or the magic of metamorphosis? Is the aim a behavioural one or a structural version? Of course both overlap and are dependent on each other, though a focus on form is different to a focus on individual behaviour. The resulting process and consequential outcomes will also differ.

One way to use these concepts is to think of transformation as a bottom up behavioural approach and metamorphosis as a top down structural and form based strategy. The two are related, differently.

Stories and Examples are different

We know that stories engage hearts and minds more than bullet points on a PowerPoint or a three page proposal. I believe there is a very important difference between stories and examples.

Stories are personal. I know a story when the person telling it comes alive with the emotions attached to the story. I can feel their passion, enthusiasm, sadness, delight - whatever. I am drawn into their personal experience. It is stories like this that engage me.

When someone stands on a stage and tells someone else's story - then for me that is an example. No matter how much we resonate with the other person's story their passion, enthusiasm, sadness, delight - whatever - is unlikely to be captured by the example-teller. Examples are helpful, though I suggest they are no different from the paragraphs in papers. They are second-hand and no longer associated with the context and emotions that go with them.

I am sometimes asked if a story I have used can be used by someone else. I usually recommend they find a way of developing their own reservoir of stories. This is sometimes difficult. Those who develop and advance theories may find their work disconnected from the reality of practice. The best way to both test the theories and develop your own stories is to test them out on a small scale. Not only will this provide self-confidence, it will also demonstrate the practicalities of your theory or suggestion and increase your personal credibility as you have a personal story to tell.

In the event you are unable to experience your own story, then I suggest capturing someone else's using a short video. Then allow their story to be told as they wish.

In the next week, try to focus on gathering, maintaining, treasuring your own stories. If you find yourself giving an example - telling someone else's story - then take a breather and see how you might do something differently to get the outcomes you desire from your listeners.

Photo from www.freephoto.com

Using Twitter as a social movement strategy

It was Stephen Fry, on Twitter http://www.twitter.com/stephenfry, who, in response to a criticism that eReaders would be the death of books, that said:
"I collect books. Have done for years. I will no more throw out "real" books cos I have a Kindle than I'll jettison pens cos I have a Mac" (11.03.09 8:55)
[responses]
"This is the point. One technology doesn't replace another, it complements. Books are no more threatened by Kindle than stairs by elevators" (11.03.09 9:07)
[responses]
"I've thousands of books and will continue buying them till I die. Smell and feel, yes. Maybe. But that was true of horses" (11.03.09 9:10)

As Stephen Fry so eloquently pointed out, there is room for a both / and when it comes to integrating new technology with older methods and habits. This post covers only Twitter and my own view. I know there are other methods for enabling social movements.

Much of what we know about social movements is from evaluations and post-hoc descriptive research. This is a good way to find analyse and identify some of the key features of a social movement, with the intent thereafter of trying to replicate some of these so as to accelerate the implementation of organisation and system change. For me the jury is out as to how much a social movement can be engineered, though this doesn't detract from some very important components which seem to work well when implemented.

So where does Twitter fit in to the concept of a social movement?
I feel it is a complementary communication method and perhaps one which can accelerate the process. However, it will probably never take away from the more traditional methods of face-to-face (F2F) influencing. It is a both / and.

1. Tweetups: Twitter can be used to facilitate the gatehring of people both virtually and F2F; called a tweetup! For an example of how viral Twitter can be in organising action then go to http://uk.techcrunch.com/2009/01/25/twitter-meetup-spawns-global-charity-event
for an example. The charity event, Twestival, took only 24 hours to get 40 cities involved and after that a further 60 joined up.

2. Getting the word out; hierarchical, planned and controlled media (if that's not an oxymoron...) tends to attract the attention of a "target" audience. Twitter works through its transparency, openness and democracy where anyone can follow anyone. There are no rules about who gets what information. Of course, the Twitter system uses its group wisdom to weed out individuals and organisations who behave badly - they get "unfollowed" and "blocked" and then wither on the digital vine. You know your message is hitting the right note when it starts to be retweeted (others copy and send to their own networks). This is energy for a social movement.

3. Jumping networks; targetted communication campaigns are limited in their effectiveness usually because they are just that - targetted. Twitter enables the jumping of an idea from one person's network to another which may seem unrelated though could potentially be the breakthrough in attracting the attention of peopel who really care about the topic. The jump can be from one group of people to another or from one techology to another, for instance when a tweet gets posted onto Facebook http://www.facebook.com/

4. Social movement becomes social and has movement; Twitter is informal, casual and to the unitiated often chaotic. When an idea takes off, it flows rapidly through the system. Getting it to this point is difficult, however, and requires patience and practice. In true social movement style, you cannnot make a message viral. It becomes viral when followers deem it of value. They drive it, not you who wishes it to spread. A point to remember is that the enegry comes from the social interaction combined with the power of the idea.

Twitter is one part of what is becoming known as mobile social movement enablers. One of the difficulties of assessing its value is it is developing fast, changing over time in terms of both technology and use, that it is difficult to evaluate. This reminds me of what a social movement is like. Namely something we can analyse after it has happened but durign the process it is all a bit messy, unclear, possibly exciting and almost impossible to evaluate.

http://www.twitter.com/sarahfraser follow me there
If you're interested in patient safety then follow http://www.twitter.com/patientsafety
or if large scale change is your thing then http://www.twitter.com/largescale

Spread and large scale change are a battle about perception

So often we focus on the "what" needs to be spread and "who" needs to change their behaviour. My recent experience is that success is more about perception. It is more about understanding the current views of others and then working to enable perceptions that relate more closely to the desired result.

For instance, in patient safety, many healthcare staff have the perception that they are dealing with harm (a sick patient) and that death is a natural consequence, often regardless of their actions. (I knwo that is a generalisation, however, I have a point to make...) In this context where the view is one of inevitability of harm, then it is mightly difficult to implement changes aimed at reducing morbidity and mortality.

Instead, think about an organisation, or clinical team, which has the world view that it is possible to have a hospital with patients where hospital acquired infections don't happen. "Not on my watch" says the Senior Nurse. Here, their curiosity is about how to maintain a good performance, and even how to obtain it. There is a gap between their perception and their reality and they want to fix it.

So I'm wondering whether we would be better off helping with the perception change rather than asking people and teams to carry out projects designed to spread good practice and to implement large scale change. How do we "market" what we need so as to help create new world views?

Visualising data to engage others

So I feel like I just died and went to heaven. The data nerdy part of me likes to find ways to capture and then show information in a way that makes sense and meaning. Too often I see the basic excel chart (not even bothering to change the colours) which does little to inspire me. We know from evidence and experience that capturing the imagination and interest of those we are influencing to change is key.

I clicked on a button and found Google's Visualization API gallery. These are the applications written by Google or 3rd parties. So if you want to put your values on a map, create annotated time series graphs, generate bar graphs with humour, trnslate a table of data into something visual, create an interactive map, show several indicators over time - I could go on. Seeing is believing. There are sections on maps, google, charts, fun, tables, analytics, project, text and other - enough to keep you amused for hours.

http://code.google.com/apis/visualization/documentation/gallery.html Go here only if you have at least an hour to spare to play and be inspired...

Learning communication techniques is important for spread and safety

I'm freshly back from a fabulous 2 day masterclass with a group who actively particiapted in developing their own communication skills. This was more than ideas on how to develop a technical communication plan. This was a group of individuals who spend time in front of video cameras and then assessed their own performance - with the aim of giving each other feedback and consequently improving their skills.

So often when communication is mentioned in the context of spreading good practice we default to "how to develop a communication plan". Yet I know from working with this groups, as with other groups I encounter, that it is only when we get to the finer details of communication and behaviour does anything really change.

Communication itself is an important topic. There is oodles of research about which demonstrates the link between communication and performance, communication and financial outcomes, communication and patient outcomes. In the current copy of International Journal for quality in Healthcare there is another excellent research report demonstrating how communication is linked to medical disputes.

My feeling is we can get further in the goal of spreading good practice when we pay attention to the details, like how individuals communicate with one another and resist the temptation to focus only on technical planning.

I also suggest we can stop researching the link between communication and outcomes and focus on making the desired communication changes.

No time to chat? How will you influence others?

The irony of middle and senior managers sitting alone in their offices and quietly developing communication plans on how messages and information was going to be spread around their organisation was not lost on me when I visited an organisation recently. It seemed everyone worked in isolation and apart from a few meetings where no-one really listened to each other and true dialogue was missing, the organisation appeared to have a dearth of conversation.

Yes, there was a lot of open plan office space, yet this was lunch time and most people sat at their desks, on their own, eating their sandwiches while pressing keys and watching screens. It was very quiet. The kitchens where you can make a coffee are stand around places with no seats, nowhere for sitting down and talking over a coffee. This is an organisation where chat, conversation and informal discussions seem not to happen very much. So I'm not really that hopeful about their "spread" plans. We know from the evidence in researching the impact of planning methods versus informal conversatioons and we know that the informal conversations and peer to peer discussions have a high degree of influence over another's behaviour.

In contrast, I have a client in the Netherlnads that when they redesigned their offices and moved from the rabbit hutch corridors of offices to open plan did so with conversation in mind. Their kitchen areas have seating arrangements and tables around them to encourage eating and talking together. They report that this works well and keeps the flow of information informally moving around the various teams in the organisation.

Design can play a large part but so can culture. If your office is a "no-speak-lunchtime" one, then try sharing your lunchtime with someone else in the coming week. You may even like the break it gives you.