Poetry Month: celebrating poetry in the workplace

Graphic from grammar.dictionary.com

April is Poetry month.  For many, the last time they read a poem was in school, and even after class discussion they didn't really understand it.  I went off-piste on my academic learning a couple of years ago and completed a Masters in Creative Writing at Oxford Brookes University. It was a great course, notable for being practical - the academic-speak and theory was kept to a minimum. The aim was to turn out writers - and better readers.

Poetry is not "my thing" when it comes to creative writing. I have recently had returned to me the book of poetry I wrote as a teenager in 1979. Sheesh - the angst!  I do occasionally get my thoughts around a poem, but like may others who scribble their thoughts in verse, it feels too personal to share.

It's this same intimacy that draws us, as readers, to a poem. There's that feeling of instant connection when you read a poem and absolutely identify with the line you've just read. It's as though someone has said what you've been feeling - not what you've been thinking. Poetry has the ability to shine a light on those feelings we didn't realise we had.

Is it appropriate to bring poetry into the workplace? I don't see why not, and there is a whole discipline on this topic. And there are poets who specialise in this - David Whyte being my poet-hero.

Throughout April, I'll be blogging about poetry in the workplace, and sharing some of the poems that have meaning to me.

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.

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

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

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.

Paper: Three Collaborative models for scaling up evidence-based practices

In "101 ways to improve your collaborative" I described a number of ways to spread / scale up innovations using the collaborative model in different formats.  In this paper

Adm Policy Ment Health. 2012 Jul;39(4):278-90.
Three collaborative models for scaling up evidence-based practices.
Chamberlain P, Roberts R, Jones H, Marsenich L, Sosna T, Price JM.

... the authors explore the merits and demerits of the Rolling Cohort, The Cascading Dissemination Model, and the Community Development Team.

Readiness for change diagnostics: Some evidence

I'm ambivalent about the concept of "evidence" for much of the change and improvement work we do in healthcare because so many of the concepts and processes are contested.  However, that doesn't stop me checking for evidence and testing my own prejudices.


There are a number of papers  and publications which touch on the topic of readiness for change.  



Review: Conceptualization and Measurement of Organizational Readiness for ChangeA Review of the Literature in Health Services Research and Other Fields
Weimer, Amick & Lee
All literature reviews need to be considered as a service to humanity. This one covers the concept of readiness for change in healthcare and reviews 43 instruments in use.




Assessing organisational readiness for change: use of diagnostic analysis prior to the implementation of a multidisciplinary assessment for acute stroke care

Sharon Hamilton, Susan McLaren and Anne Mulhall

This team conducted a comprehensive review and evaluation using multiple strategies which I like. They also used the Team Climate Inventory.

^{Monograph: Assessing & enhancing readiness for change; implications for technology transfer.}

^{Backer, David & Soucy}

^{Not a peer-reviewed paper as such, but it has some excellent perspectives on what readiness for change means - and doesn't mean.}

Systems Antecedents for Dissemination and Implementation; A Review and Analysis of Measures
Emmons, Weiner, Fernandez, TuThe conclusion in this paper seems ot be there is no common ground for the use of measures or consistency in the way in which they are applied, hence leading to difficulties in figuring out what might be the best strategy.


There are many more papers - if you find any, please leave notes in the comments box.

Focusing on High Impact changes in the NHS may be damaging. Try MIME instead.

Identifying the "top 10" or the "top 5" high impact changes that NHS organisations can implement - then pushing them to do so, has consequences.

1. Unless the identified high impact change is shown to be generalisable (that is it has been tested in different contexts and a similar result has been achieved), then there is a significant probability that the change may not be high impact at all.  When we take one result from one place, then roll up the possible benefits across all organisations we are making a fundamental mathematical, and change process, error.   If we do want to do large scale mathematics then we need to know the baseline at each potential organisation, the match in context to the originating result, and then do a weighted calculation across the system.

2. Not all high impact changes are equal - in the amount of effort and resource (read ££££) they take to implement. A great result may sound good, but if it takes so much resource to implement that the payback time is 10, 15 or even 20 years, then yes it is high impact - but not in the way intended.  The challenge is to find a way to get the impact - but with less cost associated in the process of doing so.


MIME = Maximum Impact, Minimum Effort.


(and of course, LIME, low impact, maximum effort, should always be avoided)

Do your "high impact" exhortations meet the MIME challenge?

Where are the negative studies?

I've written about his before, but I am still concerned about the lack of will to share what doesn't work in quality improvement initiatives. I worry that improvement leaders are so concerned about telling their sponsors that the work is doing very well, that they can't face the less than successful projects. We all know we learn from mistakes - in fact one of the basic tents of quality improvement is the importance of testing and learning (from the good and the bad).

I keep threatening to start the Journal for Quality and Safety Initiative Learning/Mistakes/Failures/Messes.  When I figure the title I'll get it going.  Any suggestions?

Sustainability - how about 52 years?

After 52 years, the Marshall and Fraser Racing MAY be letting down the tyres and packing away their tools. I say MAY, because, if I know them, they might just, possibly, pop out for a few more races next year...

Many of you will have met this team virtually as I have used them as an example of sustainability. I'll leave you with the question I always leave an audience - how will you sustain the results of your work for 50+ years?  I mean results of course. The car looks very different than it did 50 years ago, but their focus is on the outcome.

Congratulations to the team, who, 52 years later, are still on top.

Class Winners of the Championship in 2011.

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.

Back to Writing

Today is the end of my 4 month experiment... From mi July to mid-October 2011 I reduced my writing significantly. For years I have written blogs, papers, articles, short stories etc on an almost daily basis.  I often wondered what it would be like if I stopped. Would I forget how to write? Would my creativity go away? Would I forget about all those interesting things I'd like to write about?

No.

I've learnt a few things:

• creativity doesn't always need to be captured and I think I've got better at remembering because I have made less notes. However, there have been some things I'd wish I'd written down - but I knwo they will come back to me
• the break has allowed me to mull over some ideas in more depth. I've performed some "what if's" in my head and thought through scenarios, ideas, theories, plots and characters
• I love to write. Boy, am I desperate to get back to writing!

So here we go again...

Why do we forget good practice?

I spent a lovely English Spring day visiting the Roman Villa of Chedworth. I came away marvelled by the way in which they had underfloor heating and an hygienic toilet system fifteen hundred (and more) years ago. When the Romans left our small island, those who remained ignored / forgot about (not sure which) these and many other useful inventions.  Why did they do this?

And what other well evidenced business related techniques and products have we forgotten about and are ignoring?

Three Collaborative Models for Scaling Up Evidence-Based Practices

A new paper is out is Adm Policy Mental Health (See abstract below). Two of the models are those I've presented on and published about - the rolling cohort and the cascading dissemination model. There are also subsets of these methods - see my book 101 ways to improve your collaborative. 


Three Collaborative Models for Scaling Up Evidence-Based Practices

Chamberlain P, Roberts R, Jones H, Marsenich L, Sosna T, Price JM.

Source

Abstract

The current paper describes three models of research-practice collaboration to scale-up evidence-based practices (EBP): (1) the Rolling Cohort model in England, (2) the Cascading Dissemination model in San Diego County, and (3) the Community Development Team model in 53 California and Ohio counties. Multidimensional Treatment Foster Care (MTFC) and KEEP are the focal evidence-based practices that are designed to improve outcomes for children and families in the child welfare, juvenile justice, and mental health systems. The three scale-up models each originated from collaboration between community partners and researchers with the shared goal of wide-spread implementation and sustainability of MTFC/KEEP. The three models were implemented in a variety of contexts; Rolling Cohort was implemented nationally, Cascading Dissemination was implemented within one county, and Community Development Team was targeted at the state level. The current paper presents an overview of the development of each model, the policy frameworks in which they are embedded, system challenges encountered during scale-up, and lessons learned. Common elements of successful scale-up efforts, barriers to success, factors relating to enduring practice relationships, and future research directions are discussed.

Difficult Conversations 1: The DED Technique

Dealing with the difficult situation is difficult - usually because emotions are running high and emtoional responses tend to send all good planning straight out the window. One technique I've found useful is simple enough to remember when the flak hits the fan and tends to work well - the DED technique.

D = Describe 

E = Example

D - Discussion

Describe the behaviour you're finding difficult, how it makes you feel and explain the wider impacts of the behaviour. Without any description the other person probably has no idea why you are upset.

Then provide an example of what it is you've just described. Without an example the other person may think you're making it up and may not be able to ground the descriptions in reality.

Discussion - or I prefer the term dialogue as that presumes it is a two-way thing - is the obvious important and final step. If the first D and the E have gone well then the discussion should be fairly straightforward - though posisbly still emotive.

Do you have a favourite technique you'd like to share?

Design a 50 minutes lecture that works

Tired of the person who stands up and delivers a repeat of their presentation (they are as bored as you)? Tired to the point of not being able to concentrate for more than the first few minutes of a presentation? Tired of making it through to someone's lecture to discover afterwards you have no idea what you learnt?

John Medina is a scientist who researches ways to avoid problems like these. He also has some very practical advice. I like his Brain Rules website, with videos (nice to see him practising what he preaches), tips and links to a new book. Each of his 12 rules are available with illustrations and videos.

Advice for a 50 minute presentation? Break it down into 10 minute segments. At the end of every segment add a hook / statement that will generate an emotional response in the listener. I'll be trying that for my next presentation.

Leadership notes from a pilot who saved the passengers

Staying with the leadership theme of the previous posts, Capt Peter Burchil has some interesting reflection of the incident where the BA777 from China, in January 2008, landed short of the runway, due to a technical issue. There was no warning and it was skill, maybe a bit of luck, and a cool head that resulted in no loss of life.

One of his taglines was "plan for the expected and prepare for the unexpected" which I think is an excellent mantra for anyone at work - especially during times of great change.

He summed up his talk by explaining how he was taught in the controlled environment of the simulator to "Aviate, Navigate, Communicate". What an excellent three words those are for any manager or director! For "aviate", substitute the verb that best describes what your job requires you to do (the tick here is to remember to keep doing what you're supposed to be doing and not get distracted.). Navigate - similar to aviate, though I think all Executives should keep navigate in their list of three words. Communicate is obvious.

What are your three words that ensure you remain leading in a crisis?

Leadership thoughts from an astronaut

When I heard Tom Henricks speak at a conference, I was inspired in many ways. A few of the notes I captured all seemed to relate to leadership on the very edge of what is important; there is room for mistakes on a Shuttle.

He spent time talking about how leadership is also about teamwork; how you cannot be a leader unless you have a team. But this also means the leader needs to be an excellent team player. You cannot separate leadership from teamwork. I don't think this has been so clearly set out for me before. It is obvious when you think about it, but less obvious in action in the workplace.

He didn't equate leadership with a consensus, soft approach. He quite clearly explained how the buck did stop with him. On launch, he was the person who said the word"Go". His was the final decision. (mmm, now that is taking responsibility!)

Leadership lessons from rugby

A few more wise words from Brendan Venter than I picked up:

When it comes to leaderships, he believes:

• walk the talk
• never be neutral (learn to have a point of view)
• be able to build relationships (learn to like each other)
• stay in the core
• communicate effectively with colleagues

Again, standard stuff, but so hard to do, consistently and predictably.

Most popular posts on the Spread Good Practice blog

Here is the list of the most popular posts on this blog for the last 6 months.  If I'd had to guess I'd not have guessed these - nothing like a good bit of measurement to separate fact from opinion!

Model 2: data, information, knowledge, wisdom 22 Dec 2010, 1 comment 640 Pageviews

The quickest way to spread scale up change 21 Jul 2010 484 Pageviews

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