Paul Batalden's idea, "virtually" speaking: A tapestry of lessons and reflections

I am responding to a suggestion presented by Paul Batalden in the recently published Lessons Learned in changing healthcare... and how we learned them. He notes that we are surrounded by leaders who have lessons to share. He states that we too could engage in a process much like they did and learn together. Below you will find a slightly modified version of an email invitation I sent to some colleagues. It's self-explanatory so I will move to my point. I hope you will reach out to those in your network. Please feel free to take my invitation and modify it for your own use or write your own. Additionally, I hope you will engage in this virtual test. Please feel free to join in and comment or send something you would be willing to share.

Here is the email invitation I sent:

I am writing you today because each one of you has inspired me. Your support and the lessons you have shared with me have made a difference to me and in my life’s work, to serve those most vulnerable and to stand up for what I believe in - to never settle. I have turned to you when I needed guidance and I have tried to offer the same in return. It is in this spirit that I reach to you now. While reading Lessons Learned in changing healthcare... and how we learned them 2010: 9-12 edited by Paul Batalden I was moved to action. In his Introduction: Moving Forward Together through Reflection and Sharing, Batalden addresses the pressures we all face in the ever changing environments in which we work. I don’t need to list them out to you as I know you are all too familiar. He notes that there are people all around us leading change and learning lessons. It’s a relatively quick and highly relevant read which I have linked here.

I loved reading the lessons from the amazing leaders that Paul brings together so brilliantly. Presented are succinct stories that present practical lessons that we can all apply in our work environments.

Here is an excerpt from his Introduction:

"When all the authors had submitted their chapters, we collated the learnings across the speakers and recognized that, together, they form a "tapestry" of lessons. We kept probing for the underlying threads that seem to weave themselves through the presentations, and we explore some of the most prominent in the last chapter.

.... step back from these presenters and their lessons and realize that in your own community, in your own network, a process similar to this one could be undertaken, allowing you and your colleagues to inquire of each other about the lessons that have been helpful to you. Explore how your particular setting contributes to the way change is learned and how it happens.

… Through introspection, we can recognize that each change leader has had to create a personal frame of understanding to make sense of what he or she faces as the processes of building knowledge, taking action and reviewing and reflecting become real. Naming the lessons and reflecting on how they were learned is an exercise in contemplation and self-discovery. Sharing these thoughts in conversation with others allows them to be examined, refined and further developed. The opportunity for learning about leading change in today's healthcare is all around us.

The collected lessons and how they were realized offer significant counsel for these times of change. But of potentially equal value is insight into the process of eliciting them. What we did in our local setting, you can do in yours. Everywhere that leader are at work, there is the potential for a "learning laboratory" to help others develop their own leadership knowledge and skills. This is a book about leading from within the frames of personal experience and, through conversation and interaction, across them.

Whom should you invite? We asked physicians who are active as leaders; you could ask nurses, administrators, laboratorians, therapists, social workers, nutritionists, pharmacists – any healthcare professionals working as leaders. The key is the process of reflecting on the experiences: naming the lessons and exploring the means by which they were learned. Sharing them publicly enables others to see the real journeys involved in becoming a leader and, through conversation and interaction, to form communities of individuals engaged in that practice. Watching the process allows us to see that we are all immersed in the phenomenon of leadership development."

As I read the insights presented I thought of you. I recall your stories and your words of wisdom. Some of you used theory to teach me, while others offered a story about your experience. In every case you offered a genuine and thoughtful lesson in the spirit of sharing what you have learned along your journey in the hopes it would be of help to me. I know I may not have always gotten back to you, but I want you to know you did help me and you made a difference.

Here is the real purpose of my email:

I would like to extend an invitation to you to share a lesson with me and others about something you have learned while leading change in your setting. I would also like to do as Paul Batalden suggests and share it publicly. In the past, I have had guest authors on my blog “Doing Common Things Uncommonly Well” and I received positive feedback from both the guest authors and readers.

My specific ask: Please consider writing a one (preferable) or two pages (shorter seems to go over better in the blog world and I know how busy you all are) about a reflection or something you have learned on your journey. It could be something you have already written or something new. I will then post your entry on my blog, with you as the author (or, for those who wish, I can open the blog and you can self-post). Of course I hope you would consider placing the shared lessons and reflections on your blog, Facebook page, Linkedin site, Ning, etc… as well. The aim is to allow others to share in the privilege that I have had, to learn from you. Most importantly, we can learn together!

I end my invitation with a one final quote from Batalden, “There is no claim of a magic five realizations – only the recognition of the truth that emerges from reflecting, listening, having conversations and connecting to the experiences of others within our own lives.”

Please join me. I will start by sharing a reflection I once wrote. You can find it below.

With my deepest respect and gratitude for your support, friendship and all you have taught me.

Anna

Shifting from “having more” to “being more.”
Presented by Anna Roth
CEO, Contra Costa Regional Medical Center and Health Centers

In a call to action, Tim Brown, CEO of the Global Design and Innovation Consultancy IDEO, asks if we could shift our thinking from having more to being more*. A curious question don't you think? He further asks if this question only has relevance to those who "already have lots?"

We don’t have to look far to see possible applications of this thinking all around us. Rather than look for more resources, what if we could get more productivity out of the resources we already have? This is very much aligned with Lean thinking and supports engagement in process redesign. The principle of accomplishing more with the same amount of resources or inputs (simpler still, be of more value with less), or thinking leaner, has been well accepted. Yet if it's such an easy concept, why is change so slow and so difficult? Why do we have experts - whole departments in some cases - dedicated to leading change? The answer may be a bit more personal than we like. What if we are part of the problem? Could this be why W. Edwards Deming and Taiichi Ohno (大野 耐) stressed that in order to make real change we must first change ourselves? They said - and they are well supported by many others - that all change begins with the individual. More explicitly, all change starts with me/you.

I once gave a talk with my esteemed colleagues Dr. Jason Leitch and Dr. Peter Lachman on transformation. We presented a common theory, The Model for Improvement. We then provided three distinct examples of the application of our theory in transformation efforts taking place on very different scales: a hospital, a county, and a country. The take-home message was that all change, no matter how big or small, occurs at the point of the individual experience. In short, no matter how many policies or change events you engage in, if it doesn't result in a change at the point of the actual experience you are trying to alter (in this case at the point of care), it isn't change, it's simply activity. In order to determine if the change you are making is in fact an improvement, you must have a measurement method (measurement is a topic for another post altogether.) My point is that the examples we presented support the idea that all change, whether on a single unit or spanning a nation, begins with changing ourselves.

Let's think about the idea that we as individuals are the target of change. In your setting, who is it that is most likely to NOT let go of what they have? Looking at it another way, who is deriving power or authority in your environment/context from institutional inertia - commonly known as the status quo? Whose identity is coupled with mastery of the current state? Are they likely to give it up? I'm not targeting any particular person or group. I'm simply asking. Who do you think is open to change and who is least likely to really change (the haves or have-nots)? This can get particularly tricky if one can siphon off the new and exciting parts of an innovation/new thing AND keep what they already have. It's a tough question, but I do try and ask myself, where do I fall? Perhaps it's easier to draw on someone else to think this through?

Marshall Ganz...
I saw him speak at the IHI National Forum year before last (my favorite event of the year) and he was downright moving. I found his plenary address so much more than a speech. Were you there? Did you hear it? He speaks not of having more, but of being more.

On the uncertainty of change and the pull of the status quo - the safety and comfort of what we know - he writes the following:
"When we face uncertainty, we often feel conflicting emotions. On the one hand, we may be fearful - things will go wrong, we will fail, others will see. We then retract, metaphorically at least, to protect ourselves from danger. On the other hand, we may be curious - the unexpected can be exciting, bring new opportunities and new growth. So faced with the challenge of learning to act in new ways, we may retreat into the security what we know, or, at least, what will reduce our anxiety; or we may risk leaning into the uncertain. We may learn best when we can do both: secure ourselves in enough certainty that we have the courage to risk exploration. Learning to balance security and risk is not only key to our own learning, but to the learning of those with whom we work, for whom security may be more elusive and the risks greater."

I understand and believe that change is scary. Many will retreat. Our perception of ourselves, whom we believe others approve of and depend on, is often that which we spend most of our time being. But what about our dreams? I know this sounds like a bit of starry-eyed-babble, but what if we try and see ourselves as what or who we really want to be? Better yet, what if we could be that which we are capable of? Do we even know what that is? What if everything we think we are supposed to be were washed away? Dr. Robert Schuller asks, "What would you attempt to do if you knew you would not fail?" What would I do? I'll admit I don't have the answer. I have many questions. Is what I do based on being something or having something? Do I seek knowledge or mastery of the current state in order to understand how to change it fundamentally for the better? Or do I seek understanding of the current state in order to better know how I can achieve rewards from it? Aren't these awful questions? Is it possible I choose superficial success, such as having more because it's too scary to try and be more? Is it possible that the barriers I impose on myself serve a very important purpose: protection from the risk of failing or experiencing pain?

For today that's enough of what Tim Brown describes as "head-hurting thinking." If the answer is to come, it will only be through synthesis of all those divergent ideas and belief systems surrounding what it means to move beyond "having more" to actually "being more." Who knows, maybe having a little fun is part of it? I already confessed I had no answers. I only have starry eyes filled with hope.-