1. How does a system think and act as one? Leading Large Scale Change Susan Shaw Chiquita Hansen April 10 2014 @drsusanshaw @hansenchiquita

2. @drsusanshaw Conflicts of Interest None to declare #d2

3. @drsusanshaw Why are you here? Patients deserve safe, harm-free care that meets their needs System needs to be sustainable:  Value: the relationship between quality and cost #d2

4. @drsusanshaw Why are we here? Chiquita: RN from New Zealand with a focus on primary care transformation Susan: ICU doctor from Canada who works to generate system change #d2

5. @drsusanshaw

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8. @drsusanshaw Shared purpose #d2

9. @drsusanshaw Leading large scale change

10. @drsusanshaw Engagement for Mobilization Energy for Change #d2

11. @drsusanshaw Energy for Change #d2

12. @drsusanshaw Leadership Transformational leaders  a different way of working requires a different set of skills, behaviours and attitudes #d2

13. @drsusanshaw Leadership - Clinical governance - Clinical networks - Productives - Collaborative clinical pathways - Transformational Leadership Programme The Bridge of Aspiration

14. @drsusanshaw Transformational Leadership Programme (For Us By Us) - 11 programmes over 4 years - 220 participants across sector/levels/professions - 3 two-day modules (You/Teams/Improvement) - Adaptive challenge - 4 coaching sessions - Participant satisfaction  95% content  98% working in groups #d2

15. @drsusanshaw Success! 6 months ago #d2

16. @drsusanshaw Success! Here is a referral from Dr xx which I think should have been dealt with in primary care. I have now arranged for the poor pt with suspected DVT to be scanned at Broadway this afternoon. Dr xx is a repeat offender with this. I have tried to phone and speak to her but they are closed for lunch (!!!!!) nice life Please can you pass on the message? The community pathway is sooooooooooooooooooooooooooo much better for the patient than coming to ED it should be a no-brainer ED Director and Consultant MidCentral Health Palmerston North

17. @drsusanshaw Success! #d2

19. The Why and The How Ki mai ki ahau, he aha te mea nui o tenei ao Maaku e ki atu He tangata, he tangata, he tangata If you ask me what is the most important thing in the world, my reply is this, It is people, it is people, it is people. #d2

21. @drsusanshaw