Design Rules
The final ten design rules are as follows:
- Boundaries
- Agree the explicit objectives within the context of your change.
- Communicate
- Require compliance
- Measure and publish progress
- People
- Understand all your audiences
- Communicate your vision and objectives accordingly
- Outcome
- Develop and agree measurable outcomes that help ensure achievement
- Know what you want
- Don’t choose the ‘quick-fix’ route
- Working with own Model of Large Scale Change
- Agree and adhere to a proven model of Large Scale Change
- Review progress
- Adapt model as necessary
- Don’t just muddle through
- Framing
- Connect with hearts and minds
- ‘How’ of the change
- Drive the change as locally as possible
- Learning/Memory
- Build on the best
- Learn from the worst
- Have systems for organisational memory
- Permission/Risk
- Is it good for patients?
- Is it good for staff?
- Does it achieve our outcomes?
- If yes to all - Just do it!!
- Generate and go with energy
- Create ownership
- Be honest about current state
- Raise awareness of what is possible
- Find testimonies that connect with core values
- Operate with a bias
- Make room for ‘dissidents’ in the tent
- Vision
- A large scale change needs to be described in a statement which is:
- clear
- understandable
- directional
- precise enough to set your compass by
- justified
- couched in terms that excite energy
- A large scale change needs to be described in a statement which is:
These are great, a simple and logical log of all the ingredients for improvement we have been talking about for years! So… that’s what design rules are (light bulb moment!)!!
Posted by Jacqui Fowler | 05 Jul 08 @ 7:56 am
Jacqui,
This looks like a very exciting series of events and I would be glad to offer input and involvement.
I have been researching large scale change in the NHS for the last 8 years, looking at what change really means for people on the ground and what they need to support them in building sustainable, ethical change from the centre of practices in the way that Darzi is advocating. The research was funded by SHA NHS Spread II and supported in the North by a number of Trusts and CSIP. I would be glad to share the findings in the form of blow by blow accounts of change and what happened when we took those accounts and their needs seriously and based a management/ senior clienician support programme around them. It was surprising to find out what our participants said they needed to implement change and it was highly challenging to the dominant mechanical or prescriptive theories of change. Last year Lord Darzi requested a brief on my research and included it as evidence for a change in approach.
Regards,
Dr Mervyn Conroy
Lancaster University and
Quintec Associates
Posted by Dr Mervyn Conroy | 03 Nov 08 @ 10:54 am
I would add that it helps greatly if you can create just enough discomfort with the current state to make people ‘wriggle’ but not so much that they ’squirm’.
Otherwise you are severely up against what Machiavelli said: ‘It should be borne in mind that there is nothing more difficult to handle, more doubtful of success, and more dangerous to carry through than initiating changes in a state’s constitution. The innovator makes enemies of all those who prospered under the old order, and only lukewarm support is forthcoming from those who would prosper under the new. Their support is lukewarm partly from fear of their adversaries, who have the existing laws on their side, and partly because men are generally incredulous, never really trusting new things unless they have tested them by experience.’ (from ‘The Prince’)
I love the Rules - succinct and usable!
Posted by Jon Harvey | 03 Nov 08 @ 9:35 pm