1. Developing Effective Call to Actions and Exploring Your Challenge Marlies van Dijk January 30 & 31, 2013

2. Fiasco From the Field

10. They get designed using the same mindset, belief and rules as have been used before ….

11. Social Movements “A voluntary collective of individuals committed to promoting or resisting change through coordinated activity.” - Produce a lasting and self-generating effect - Create a sense of shared identity Bibby et al, 2009

13. Characteristics of Social Movements Energy Mass Passion Commitment Pace and momentum Spread Longevity

14. Change is about releasing energy and is largely self-directing (top-led, bottom up) ‘Moving’ people Focus on what is the right thing to do, even if there are personal implications for me Insists change needs opposition - it is the friend not enemy of change People change themselves and each other - peer to peer A planned programme of change with goals and milestones (led from the top) ‘Motivating’ people Change is driven by an appeal to the ‘what’s in it for me’ Talks about ‘overcoming resistance’ Change is done ‘to’ people or ‘with’ them - leaders and followers “Planned” or “Programme” view of change “Movement” view of change vs.. Not “either/or” but “both/and”

15. Frame to connect with hearts and minds

16. Question for Reflection “When have you felt most energize and passionate about the work you have been involved in?” 1.What were its features? 2.How would you describe it?

17. Different thinking for different results 5 principles for radical change: Frame to connect with hearts and minds Energise and mobilise for action Organise to drive change forward Make change a personal mission Hold the gains and sustain momentum

18. Framing Framing is the key to turning an opportunity into action Frames: are like picture frames, what is in it you see, what is outside you do not provide shape and structure for organising ideas and arguments are ‘hooks’ for pulling people in are ‘springboards’ for mobilising support Frames need to be authentic and connect with an individual’s reality

19. Target audience Doctors Nurses Administration The Public Bad framing? The ministry has asked us to seriously improve efficiency of cases. The doctors would like to start on time and operate on more patients. The ministry has mandated we increase efficiency. This is an important aspect of patient access. We can’t control everything – surgery is complex and we can’t promise wait times or guarantee of surgery on that day. Good framing? Starting on time will hopefully result in completing all cases slated for the day. How can we have a better run operating room theatre? This way we also don’t have to tell patients they have been cancelled that day. If we have more efficient operating rooms we will be able to do more cases and control or reduce the wait lists Help us, help you Framing: Operation Room - Efficiency

20. Picture frames – what is in it, you see; what is outside you do not Provide shape and structure for organizing ideas and arguments “Hooks” for pulling people in (frame in one way and I pull you in; frame in another, and it goes over your head) “Springboards for mobilizing support” Relies on authenticity and a connection with an individual’s reality Must be credible! – Resonate with mainstream beliefs and experiences – In terms of claims they make – Delivered by credible people Frame to Connect with Hearts & Minds

21. Approaches for Effective Framing Hooking People In – Need to build mass; therefore appeal to a range of stakeholders – Think about the different people you need in order to achieve goals  Consider based upon readiness to act … “believers, sympathizers, ambivalents, antagonists, etc…” – Frame differently for each target group Connect with Hearts and Minds – Emotional heart tug – Intrinsic motivation and values – Imagine if …  mental health is understood by all  No one loses their dignity  hospital admissions are rare

22. Bridging and Linking Diverse Groups – Outward looking and inclusive – Movements that are exclusive and inward looking become sects and elites Use a Range of Strategies – Words, stories, anecdotes – Visual images – Humor and irony – Performance and spectacle

23. Our aspiration is to have a healthcare system with: no needless death or disease no needless pain no unwanted delay no feelings of helplessness (for patients or staff) no waste and no inequality in service delivery (adapted from: Don Berwick by Pursuing Perfection )

26. Key approaches to framing Clearly articulate your cause: – not too broad, not too narrow – worthy and worthwhile – ambitious and lofty, yet achievable – make more friends than enemies Frame to connect with people’s emotions Frame to connect with people’s minds logic/rational thinking Bridge and link diverse groups Employ a range of strategies appropriately

27. Framing the leadership role “Leadership is the art of mobilising others to want to struggle for shared aspirations.” (Kouzes and Posner)

28. Exercise Framing for critical stakeholders

29. A good frame … Increases the readiness to act Is credible, specifically: – involve empirically credible claims – is delivered by a credible individual Is salient, specifically: – compatible with life experience of the audience – resonates with values and sentiments Is compelling and optimistic Aligns with the desired direction Has the right scope Remains fresh

30. Call to Action To enable others to achieve a common purpose through shared values and commitment and by doing this, create 'contagious commitment' to deliver results in challenging times. http://www.institute.nhs.uk/qipp/calls_to_action/Dementia_and_antipsycho tic_drugs.html

31. What is it?

32. Hope… We have a choice

35. 35 Six-stage staff engagement cycle Asking 1 Listening 2 Understanding 3 Acting 4 Measuring 5 Spreading 6 Framing questions for staff around what we do and how we do it ‘Breakthrough conversations’ with critical mass of the right people who will jointly own the problem and the solution Hearing what’s been said, re-framing local priorities so they connect and working out what to focus on together Mobilising and energising the right mix of people to take ownership of the improvement opportunities Coordinating delivery and tracking improvements around patients, staff and performance Using the powerful stories of the outcomes delivered to inspire others and ‘fuel’ further spread

36. Fuelling a ‘groundswell’ around engagement of staff and patients in owning and delivering priority outcomes better and faster for the benefit of our patients Building connections with our staff by listening to them, understanding what we hear and using this to drive joint action Linking staff insight with what matters to our patients and public to build a powerful picture to inform what we do and how we do it ‘Powering up’ leaders at all levels by giving them the know-how and confidence to engage the right people in owning and addressing priority issues in a joined up way In parallel and continuously:

37. Interested in further reading?