Day 2
Programme for Senior Managers and Leaders
Gareth Evans, Senior Organisational Development Officer
Pamela Roberts, Senior Organisational Development Officer
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Aims & Objectives – Day 2
Aim:
 To provide you with a set of techniques, tools, models and frameworks for
influencing behaviour, team working, mental models, productivity, staff morale
and well-being, team culture and ‘whole systems’ working
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Objectives:
Review between-session tasks on Self Awareness & Staffing Issues
Practice applying additional tools and techniques to yesterday’s case studies
and to your own practice examples and issues
Introduce the 7 Steps in Systems Thinking Framework (Extended Iceberg
Model) for in-depth analysis, planning and implementation of change and
practice using them on an extended case study
Introduce Systems Archetypes – typical patterns that occur in services
Explore the principles of effective team working and practice creating a
‘Community Map’ for your team to understand inter-connections that impact
on you
Use Tools and Techniques to illustrate the course content and explore your
team issues and challenges
Get agreement to review course use-ability with you 3 months post completion
(invite you along to a focus group to explore your use of the tools back in work)
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Review and Reflect
 What was your experience of completing the between-session task?
 How did what we learnt yesterday influence your responses (and how
might these have been different to what you might have thought
previously)?
 Is the link between personal mental models, systemic structures, team
trends and patterns and day to day events becoming clearer?
 Is anyone prepared to share any insights from the task?
https://www.youtube.com/watch?v=kUAf1w_x6y4
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Applying Additional Tools 1
 In this next section we are going to introduce you to something called
‘Systems Diagrams’
 Thinking and talking about the ways in which things interconnect and join
up to influence each other can get complicated and abstract quite quickly
 To get around this Systems Thinkers use a number of visual aids to help
map out these complexities in ways that are easier to understand
 We have already explored two simple examples yesterday – the ‘systems
map’ and how it became an ‘influence diagram’ once we started tracking
how different parts inside and outside the family influenced each other
 This next exercise introduces you to another diagramming tool – the ‘Doom
Loop’
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Applying Additional Tools 1 cont
 First take some time to read through the first two pages of your handout –
‘Guidelines for drawing a Doom Loop’ and then ‘Constructing a Doom
Loop’
 Now in your groups work through the case examples you explored
yesterday (Patient Flow & Silo
Working) and use the Doom Loop
provided to map out the Issue,
Causes, Consequences and
possible Links
 When you have completed this
exercise feedback your thoughts
and reflections to the wider
group
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7 Steps to Systems Thinking (AAT 2)
6
Case Scenario
 Take some time to read through the following case scenario on your own at
first
 Using the ‘7 Steps to Systems Thinking’ handout scan through the case
scenario and make some initial notes on the different elements within the
case and how they map onto the Iceberg
 Get together in your groups and share your initial thoughts and observations
 How would you go about influencing change in this situation?
 Agree an action plan, based on your use of the Iceberg Model, to resolve the
issues you have identified
 What might be some unintended consequences of the changes you make?
7
Case Scenario Review
 Feedback to the whole group on your thoughts about taking things forward
 What did you make of the 7 Steps Framework?
 We would suggest that the 7 Steps Framework could be used in team
meetings as a structure for hosting helpful discussions when you need to
adopt new practices, initiatives, etc
 What do you think?
 Any other suggestions for where the 7 Steps Framework could be used?
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System Archetypes (AAT 3)
 System Archetypes are ‘common patterns’ that systems often cycle through –
they are the ‘deja vu’ experience we often get in our teams and services
(Haven’t we been here before???)
 All the tools of systems thinking are designed to help us recognise these
archetypes and be able to respond creatively (systemically) to them – to help
us get off the merry-go-round and do something different
 There are 8 common archetypes that have been identified which you can
study in your own time with the following handout
 To help us see the value in working with these common patterns we will
explore two that tend to happen in the NHS on a frequent basis – see if you
recognise them in your own work area...
 The first is known as ‘Limits to Growth’ (Why do things go back to how they were?)
 And the second is ‘Shifting the Burden’ (Quick-fixing the ‘symptom’ not the cause)
V4 Draft Document Only – 19/03/15
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Limits to Growth
 Let’s take a look at this archetype
using the example of ‘increasing
PADR compliance’
 The learning with this archetype is that ‘something always pushes back’ – limits will
eventually make themselves known and subsequently we will see diminishing levels of
growth from our efforts over time
 When this happens the typical solution is to ‘do more of the same’ as previously, i.e. Keep
pushing the growth action just harder and with more effort (and over time become
increasingly frustrated as change does not happen as expected)
 Learning into Action:
 We need to explore our systems ahead of time for potential limiting factors and
look at how we plan for, address, work around, reduce, offset, etc ,any limits to
growth
 Look at external issues like limits to resources, political/strategic pressures, impacts of other
systems (partners with competing priorities)
 Look at internal issues like systemic structures, mental models, engrained habits of practice,
potential threats to established hierarchies, norms of power and control
V4 Draft Document Only – 19/03/15
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Shifting the Burden
 Let’s take a look at this archetype using the
example of ‘workload stress’
 The learning with this archetype is that in the face
of challenge we tend to react without pausing to
think – we respond to the symptom and not the
cause
 We then apply symptomatic solutions as this is
what is expected, is easier to implement, helps us
avoid addressing fundamental problems that are
difficult to deal with, etc
 Learning into Action:
 As leaders we need to ask ourselves questions of the types of solution we apply to
problems and the potential side-effects (unintended consequences) of these over time:
 Are we attempting a quick fix, or doing something to alter fundamental structures?
 Remember: Quick fixes tend to produce initial gains (and thereby reduce the sense of urgency
to look at more fundamental problems and solutions); the side effect of this is that we lose
opportunities to think ahead of time and respond, design or transform –we become trapped in
cycles of event – react – event – react, etc
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Principles of Effective Teams (AAT 4)
‘Real Teams’ demonstrate 3 very basic characteristics. These are the very
minimum dimensions of effective team working:
 Team has clear objectives
 Team works together interdependently to achieve these objectives
 Team meets regularly to review objectives and the ways in which the team
is working to achieve them
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Benefits of Effective Team Working
NHS research (www.astonod.com)
 Reduced hospitalisation and costs
 Increased effectiveness and innovation
 Increased well-being of team members
 Multi-disciplinary teams deliver high quality patient care and implement
more innovations
 Lower patient mortality
 Reduced error rates
 Reduced turnover and sickness absence
7 Key Principles of Effective Teams
1.
Team Identity
2.
Team Objectives
3.
Role Clarity
4.
Team Decision Making
5.
Team Communication
6.
Constructive Debate
7.
Inter-Team Working
Aston Organisation Development Ltd 2014
Teams & Community Maps (AAT 5)
OT
Portering
Trust Board
Ward
Management
Team
I
T
Regulatory
Board
Bereavement
Counselling
HR
CQC
Radiology
Physio
Care
Homes
Local
Authority
Social
Workers
Business
Devt
Group
Estates
Theatres
CCG
G.P.s
Aston Organisation
Development Ltd 2014
Patient
Forum
Carer
Networ
k
Teams & Community Maps cont
 Take some time individually to draw a community map for your service area
and the teams you have to work with to achieve your purpose and goals:
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Use arrows to indicate important relationships within the community
Use different thicknesses of arrows to indicate those relationships that have the most
influence on you achieving your purpose (as with Influence Diagrams)
 Consider the impact of the following systemic structures on these
relationships:
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Communication and information sharing
Typical working practices & policies
Issues related to finance and funding
Geography, location and the buildings which you and others work in
 What might the unintended consequences be of not paying attention to those
relationships that have the most influence on your team?
 What impact Mental Models (Yours, your team’s, other teams) might be having
on the relationships within your community (e.g. Power, control, status, ideas
about who needs to know what vs. who doesn’t need to know, etc)?
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Synthesising Task
 In your groups take some time to discuss the tools, frameworks, models
and techniques, etc that you already use in your role as a Senior Leader
 E.g. Process Mapping, Root Cause Analysis, IQT, PESTLE, SWOT, 5 Whys, 6
Thinking Hats, Force-Field Analysis, Fishbone Diagrams, etc (available in a
Resources Link on Pinnacle)
 Think about how you could utilise these (as appropriate) within the 7 Steps
in Systems Thinking Framework, Iceberg Model or Team-based Working
 We would suggest that Step 5 is one useful place, alongside asking the ‘Going
Deeper’ Questions (or as part of using the questions)
 What else do you already know, do and utilise that can be usefully
synthesised with the tools and techniques of systems thinking and the
principles of effective team working?
 Share your ideas, thoughts and suggestions with the whole group
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Summary of Main Learning Points
 Defined and explored Organisational Development, Systems Thinking &
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Principles of Effective Team Working
Understood how stepping back and seeing the bigger picture helps us ‘map
the system’ and see patterns and deeper influences that shape day to day
events
Used a number of frameworks and tools that give us ability to leverage
change at a number of levels within teams and service areas
Understood the connection between mental models, systemic structures
and culture
Understood how exploring for the system’s implicit purpose reveals ways in
which we can influence work place culture to improve dialogue, trust,
confidence and openness to learning
Made the link between the various factors in effective team working and
improved morale, productivity, staff engagement, staff capability and
effective use of resources
Understood that systemic change needs time, has consequences, and that
taking time to think helps us respond, design and transform (and not just
react)
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 https://www.youtube.com/watch?v=rDxOyJxgJeA
V4 Draft Document Only – 19/03/15
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Feedback, Reflections, Next Steps
 Feedback
 Please take some time to complete the evaluation form provided and make
suggestions for how to improve the workshop for future groups
 Reflection and observations about Day 2, and the Wider Programme
 What has been the most useful aspects of the programme?
 What do you think you can do to continue your learning back in the workplace?
 How do you think you can apply some of the tools and techniques back in the
workplace?
 Next Steps
 We are planning a series of CPD ‘master classes’ that build on topics we have
discussed and explore related ones such as workforce modernisation, succession
planning, talent management, etc – let us know if you are interested in attending any
of these
 Would anyone be interested in being part of a ‘systems thinking’ practice group with
the aim of practicing using systems thinking to develop skills, explore workplace
issues and consider possible systemic interventions?
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Diolch Yn Fawr
Thank You
V4 Draft Document Only – 19/03/15
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