Create Micro-moves for Organizational Change
Summary
TLDRIn this talk, Jane Dutton introduces Karen Golden, a prominent researcher in organizational change and identity, who discusses the concept of 'micro moves' as a tool for positive leadership. Golden emphasizes the power of small, often unnoticed actions to foster meaningful change within organizations, using examples from education and healthcare to illustrate her points. She highlights the importance of being outward-facing and forward-looking to discover new possibilities for transformation and the role of these subtle actions in generating collective enthusiasm and momentum for change.
Takeaways
- 🌟 The importance of positive leadership and its impact on organizations was emphasized, with the session focusing on how to be a positive leader.
- 📚 The session was based on a book about positive leadership and aimed to build on the knowledge shared in previous sessions.
- 🙌 Attendees were encouraged to express gratitude and support for each other, highlighting the community aspect of positive leadership.
- 🎥 The use of live-streaming allowed for a wider audience to participate, showcasing the accessibility of positive leadership education.
- 🤝 Participants were invited to build high-quality connections with others they didn't know, fostering a sense of unity and collaboration.
- 🏢 The Center for Positive Organizational Scholarship was introduced as a hub for researchers, leaders, and students to engage in generative dialogue and knowledge creation.
- 🎓 Karen Golden Middle, a renowned researcher and professor, was introduced as the speaker, bringing her expertise in organizational change and identity.
- 📈 The high failure rate of change initiatives was discussed, emphasizing the need for new approaches to organizational change.
- 🔍 Micro moves were introduced as subtle, less disruptive actions that can lead to significant change within organizations.
- 🌐 The concept of facing outward and being forward-looking was highlighted as a key aspect of micro moves, encouraging leaders to explore new possibilities for change.
- 📚 The session concluded with a call to appreciate the power of micro moves to create macro impact and lasting change for the benefit of all stakeholders.
Q & A
What is the main focus of the Center for Positive Organizational Scholarship?
-The Center for Positive Organizational Scholarship focuses on promoting positive leadership and creating a vibrant, dynamic community at the intersection of researchers, leaders, and students. It serves as an engine for transformative knowledge creation and a reservoir of grounded hope, inspiration, and practical ideas for positive change in work and organizations.
How does the speaker, Jane Dutton, describe the concept of 'micro moves' in the context of organizational change?
-Micro moves are small, often barely noticeable patterns of action and interaction that engage people meaningfully and respectfully for change. They are consequential in generating collective enthusiasm, energy, and momentum, building palpable hope, and fostering transformation within organizations.
What is the significance of the 'high-quality connection' exercise during the session?
-The 'high-quality connection' exercise is designed to build meaningful relationships in a short period of time, demonstrating the impact of positive interactions and emphasizing the importance of human connection in creating a positive organizational environment.
What are some examples of micro moves in action mentioned in the transcript?
-Examples of micro moves include first-grade students at Oakhurst Elementary School researching and recommending changes to make their community more accessible, and healthcare clinicians and administrators walking with patients to experience firsthand the difficulties of the care system, leading to the development of a collaborative care model.
How does the speaker, Karen Golden Biddle, connect her research and experience to the concept of micro moves?
-Karen Golden Biddle's research and experience as a qualitative researcher and a Dean in a major university have led her to understand the significance of subtle and less disruptive actions in creating change. Her work emphasizes the importance of micro moves in fostering positive change within organizations, especially in dynamic and challenging environments.
What is the role of leaders in facilitating micro moves within an organization?
-Leaders play a crucial role in facilitating micro moves by encouraging and supporting small actions and interactions that foster change. They should create an environment that promotes meaningful engagement, respect, and collaboration among members, and they should also be open to experimenting with new ideas and approaches to drive positive transformation.
How does the concept of 'discovery' relate to micro moves in organizational change?
-Discovery in the context of micro moves is about generating new and meaningful possibilities for change. It involves being open to learning, exploring, and understanding the experiences and needs of others, which can lead to insights and actions that drive positive change within the organization.
What are the benefits of focusing on micro moves in organizational change?
-Focusing on micro moves in organizational change can lead to more sustainable and positive transformations. It engages individuals meaningfully, respects their contributions, and builds collective enthusiasm and energy. This approach can also lead to a more adaptable and resilient organization that is better equipped to manage change effectively.
How does the example of the first-grade students' project at Oakhurst Elementary School illustrate the impact of micro moves?
-The first-grade students' project illustrates the impact of micro moves by showing how a small group of individuals can make a significant difference in their community. Through their research, engagement with local experts, and firsthand experience, the students were able to identify areas for improvement and recommend changes that could make their community more accessible and inclusive.
What is the role of 'collaboration' in the context of micro moves and organizational change?
-Collaboration is a key aspect of micro moves in organizational change. It involves working together across differences to transform possibilities for change into reality. By fostering a collaborative environment, organizations can leverage the diverse perspectives and skills of their members to drive positive change more effectively.
How can the experiences and insights gained from micro moves be adapted to other organizational contexts?
-The experiences and insights gained from micro moves can be adapted to other organizational contexts by identifying the core elements that made the micro move effective, such as meaningful engagement, respect, and collaboration. These elements can then be applied to different situations, modified as needed, and used to foster positive change in new environments.
Outlines
🎤 Introduction and Gratitude
The speaker, Jane Dutton, introduces herself as a co-founder of the Center for Positive Organizational Scholarship and the organizer of the series on positive leadership. She expresses gratitude to the Joneses for their support, which has enabled the session to be live-streamed and has helped the center dream bigger. Jane also welcomes virtual attendees and encourages in-person networking among participants. She briefly describes the center's mission, emphasizing its role as an engine for transformative knowledge creation and a source of inspiration for positive change in organizations.
🌟 The Joy of Collaboration
Jane shares her experience working with Karen Golden Biddle on a book about using a positive lens to explore social change in organizations. She highlights the joy and creativity of collaborating with diverse researchers and appreciates the productive partnership. Jane praises Karen's contributions as a researcher, teacher, and qualitative researcher, and introduces her as the speaker for the session.
🚀 The Power of Micro Moves
Karen Golden Biddle discusses the concept of 'micro moves,' which are subtle and less disruptive actions that can lead to significant change within organizations. She emphasizes the importance of these actions in generating collective enthusiasm and energy for change. Karen shares her research and experiences, particularly from her time as a senior associate dean, to illustrate how these small actions can create positive impacts. She introduces the idea of micro moves in the context of discovery, collaboration, and sustainability, focusing on the first aspect in the session.
💡 Fostering Discovery Through Micro Moves
Karen delves deeper into the concept of micro moves of discovery, challenging traditional models of organizational change. She argues that these small, often unnoticed actions can engage people meaningfully and respectfully, leading to change. Karen invites participants to share their experiences of change at their tables, focusing on small actions that fostered engagement. She outlines the process of examining these micro moves, understanding their components, and exploring how they can be adapted for use in different organizations.
📚 Inspiring Education through Micro Moves
Karen shares an inspiring example of micro moves from an elementary school in Decatur, Georgia, where first-grade students embarked on a project to understand what one little person can do to create positive change. The students researched historical figures, identified differences in their community, and engaged with local experts. They then ventured into the community to see firsthand the accessibility issues and presented their findings to the city commission. This project exemplifies how micro moves can lead to tangible changes and fosters a sense of agency and hope among students.
🏥 Healthcare Transformation through Micro Moves
Karen presents another example of micro moves from the healthcare sector, where clinicians and administrators at a hospital system in Wisconsin walked with patients to experience the care system firsthand. By leaving behind their professional roles and directly accessing patient experiences, they discovered the difficulties faced by patients and identified the need for a new model of care delivery. This led to the development of a collaborative care model that significantly improved patient and staff outcomes and received international recognition.
🌈 The Impact of Micro Moves
Karen concludes her talk by emphasizing the effectiveness of micro moves in fostering discovery and leading to organizational change. She outlines the design elements that make micro moves impactful, such as having a clear purpose, directly accessing experiences, and stepping out of familiar roles. Karen highlights the positive outcomes of these micro moves, including a shift in clinical care focus, the cultivation of insider's belief in their ability to make a difference, and the facilitation of insider-led change. She encourages leaders to view micro moves as tentative experiments that can lead to macro impacts and lasting change.
🎉 Closing Remarks and Q&A
After Karen's talk, the session concludes with a Q&A where participants ask questions about the impact and measurement of micro moves. Karen emphasizes the importance of trying micro moves to see their potential impact and using them as a way to tentatively test ideas. She also addresses the concern about the sufficiency of micro moves, arguing that they are a necessary starting point for achieving macro impacts. The session ends with a formal thank you to Karen for her insightful presentation and contributions to the field of positive leadership.
Mindmap
Keywords
💡Positive Leadership
💡Micro Moves
💡Organizational Change
💡Grounded Hope
💡Qualitative Research
💡Collaboration
💡Transformational Knowledge Creation
💡Positive Lens
💡Community Engagement
💡Innovation
Highlights
Jane Dutton introduces the concept of positive leadership and the Center for Positive Organizational Scholarship.
Karyn Golden Biddle is introduced as a guest speaker, an expert in organizational change and identity.
The importance of high-quality connections in 45 seconds to someone new is emphasized.
The Center for Positive Organizations is described as a triangle with researchers, leaders, and students at its hubs.
Chris White's image of the Center as an engine for transformative knowledge creation is shared.
Karen Golden Biddle's work on micro moves and their role in organizational change is discussed.
The traditional models of organizational change are criticized for overemphasizing top-down, disruptive strategies.
The significance of small, subtle actions in creating and sustaining positive change is highlighted.
A study estimates that 70% of change initiatives fail, pointing to the need for new approaches.
The concept of micro moves in discovery, collaboration, and sustainability for change is introduced.
An example of first graders in Decatur, Georgia, initiating change in their community is shared.
The impact of micro moves is discussed, including generating collective enthusiasm and hope.
The story of Satya Nadella at Microsoft challenging the organization to become better at innovation is presented.
The example of healthcare providers at SATA Care in Wisconsin experiencing the patient care path is shared.
The design elements of micro moves that make them effective are explored.
Three positive outcomes from the micro moves at SATA Care are discussed, including a new model of patient care.
Karen Golden Biddle emphasizes that micro moves, when tried, can lead to macro impact and lasting change.
The Q&A session begins with a discussion on the impact and measurement of micro moves.
Transcripts
good afternoon and welcome
I Jane Dutton and one of the cofounders
of the Center for positive
organizational scholarship and I'm also
the organizer of this series on how to
be a positive leader for those of you
who haven't been to some of the earlier
sessions this session is a one of
several it's actually the second to last
in the series that we've been running
all year sort of built on this book
about how to be a positive leader and
I'm really excited that Karyn golden
Biddle is here I'm going to introduce
her in a minute but I just want to do a
couple of other sort of warm up things
one of the first things again is to
express gratitude to the Joneses who
raise your hand Diane pomme what
everybody knows to really for many
mirrors have supported positive links
and have allowed us to dream much bigger
about what this session can look like
and I want to welcome those of you who
are listening to this from we're
live-streaming this this is again one of
the things that the Joneses funding has
allowed us to do and we appreciate your
presence for those who are here
virtually I also want to before I say
one thing about the center I want to
give you as is tradition and a one
minute connection opportunity so as is
tradition I'm going to ask you to turn
to people or get up and stand and go
build a connection to someone you don't
know and the thing is that my charge is
to not just build any old connection my
charge is for you to build a
high-quality connection in 45 seconds to
someone that you don't know and it's
going to be chaotic and that is great
because it's four o'clock and the energy
needs to come up so 45 seconds go
connect high quality go
please stop connecting
thank you I'm always feel bad inviting
you and then disconnecting you but
hopefully there is enough of a
connection that you'll want to follow up
and have a conversation with someone
when we have our healthy snacks after
this session just a word about the
center of positive organization so we've
been trying lots of different ways to
talk about it and I am completely
enamored with Chris White's
sort of one of his images of what the
center is so I'm just going to preview
and try it out here but the way Chris
talks about the center is in terms of a
triangle kind of with three hubs where
you have researchers leaders and
students and you have this this very
vibrant dynamic community that's at the
intersection of these these three
stakeholders and the way I like to think
about it the way Chris has helped me
imagine it therefore is in this triangle
there's a lot of generative dialogue in
this triangle it's a type of engine for
transformative knowledge creation
traditional things like articles and
books but some things that are less
traditional like blogs or other new
forms of social media types outcomes so
but beyond being a site for generative
dialogue an engine for transformative
knowledge creation we also envision in
this triangle that it's a deep reservoir
of grounded hope inspiration and
practical ideas for positive change
around work and organizations so that's
my my latest sort of communication about
another way to think about what the what
the center is but now it's my
opportunity this is my favorite part to
introduce our speaker karen golden
middle is a longtime researcher and
friend she comes to us from boston my
hometown she's the quest on professor of
management at Boston University and it's
particularly exciting right now because
she's just stepping down from a very
demanding Dean job associate dean job
you're Dean of research of a major
university that's a big job you're
basically managing all the faculty which
we know is a complicated job and she's
just about to be set loose which means
she's going to come back to being a
full-time researcher and teacher she's a
prolific scholar particularly in the
area of organizational change and
identity she's also a well known
qualitative researcher and I just have
to pitch this for those of you any of
you who are doing qualitative research
this is probably one of her best-known
books called composing qualitative
research any doctoral student in any
field that's doing qualitative research
will read this book but the way I got to
dance with Karen most recently as we put
together a book called using a positive
lens to explore social change in
organizations and you know you have some
of those projects that are you you sort
of look at they're kind of drudgery and
then you have those joyful projects
doing this project with Karen which
brought together really diverse
researchers who are studying social
change in very different ways and
invited them to kind of reinvent or
rethink their work in terms of a
positive lens wasn't incredibly I
thought creative and fun and I think
productive collaboration and never would
have been done without care and she's
just a wonderful colleague and I think
in that in doing that work I got a
little bit of a wisp of her evolving
perspective on the micro on microbes and
their importance in how we understand
how change is accomplished or how change
gets gets done in organizations so it's
my total pleasure to introduce my
wonderful colleague here in golden
middle
[Applause]
well I think Jane gives the best
introduction actually that book
conference that led to that book was one
of the highlights of my professional
career as well great great college ship
so it is wonderful to be here I've had
an incredible day already
what energy in the Center for positive
organizations amazing and I think I've
known it since 97 98 amazing the number
of people both here presently as well as
stream tuning in online it's great and I
had an especially inspiring lunch with a
group of the center's students known as
A+ lab are any of you here a few of you
might be here yes very cool right and so
please ask them what plus gram means
it's wonderful also thanks to Diane and
Paul very much had a great conversation
in advance that fueled my thinking on on
micro boobs and I think Diane and I
coined a new phrase I'm a micro mover so
we're gonna we're gonna kind of look at
that alright we're going to today look
at micro moves and we're going to share
a couple of examples around that and
work those examples at the table of
micro moves in discovery that did work
and we're going to kind of look at those
to see how can they work and how did
they work and how might we take those
into our own organizations to adapt and
to try them out I'll start on the other
side studies estimate that 70% of all
change initiative failed our traditional
academic models of organizational change
have offered few if any viable solutions
to improve these statistics focusing on
big strategies and particular sequences
of actions
they really overemphasize the origin of
change as being by necessity exogenous
externally driven and highly disruptive
disrupting people's lives disrupting
people's work highly disruptive and they
portray the process of changing
organizations as linear implemented
through top-down direction and very
prescribed steps as a result our
traditional models do not do justice to
the critical human component of change
and they provide little I might add
little precious little guidance for
positive leaders wishing to create
change there are some exceptions the
early work of Elinor Ostrom and her
colleagues demonstrates how can and do
achieve very stable self-governing
entities that sustain ecological systems
such as water basins and the work of
some organizational behavior scholars
many of whom are here at the Ross School
whose work in leadership issues selling
and positive organizational scholarship
draws important attention to how leaders
small actions have large and positive
impact my work enthusiastically joins
this latter group consultant and seeks
to enrich our understanding about how
people inside organizations work
together leaders front line across the
levels to create and sustain changes
that benefit patients students customers
clients and our larger communities in
particular it asks in part because I'm
just rotating off of a Dean's role how
is this positive change achieved
especially in organisations such as
healthcare or universities when their
external environments are in significant
flux today and their internal
environments consist of very
long-standing and often rigid
subcultures of expertise
my research analyses and my recent
experiences in creating change as a
senior associate dean really point to
the significance and our conversations
every conversation with practitioners of
change and thoughtful leaders of change
point to the significance of these more
subtle and less disruptive actions
enacted and I call these micro moves so
what are micro moves micro moves and
think as we're talking about this about
a time when you either enacted a micro
move or that you had some really good
mike remove examples in change and we'll
get to that in just a minute and ask you
to generate it at your table micro moves
are those small and often barely
noticeable patterns of action and
interaction in fact when people engage
in them they're often invisible and they
go unheralded but they are they barely
noticeable patterns of action and
interactions that engage people
meaningfully and respectfully for change
and they are consequential in generating
collective enthusiasm and energy that
builds palpable hope you can sense it
when you walk into an organization you
know you can feel it palpable hope and
momentum and now in the spirit of James
introduction with you when you created a
high quality connection in a short
period of time I'm going to ask you
right now at your at your table to
consider an experience of change in
which you felt meaningfully engaged and
to think about one or two small actions
that helped foster that engagement for
you and share that with your neighbors
we're going to take two minutes for this
45 seconds or so a minute for each
person alright so think about a time and
change and maybe one or two small
actions that really brought you in to
that change go so lots of different
kinds of conversations going on as I
wandered around it's really the warm up
to thinking about micro moves is what
this is if we think about
micro modes and we're going to start to
now delve into them analyses from my
studies and others that are grounded in
P end researchers who studied
organizations through direct
observations they go into study and they
look and they watch the action really
disclose what I'm calling three
different groupings of micro moves that
are oriented to the central work of
achieving change we can think about
micro moves in many other ways this is
that for the goal of achieving change
achieving desired change through
insiders in an organization discovery is
one grouping collaboration is a second
grouping and sustainability is the third
grouping so discovery is about
generating new and meaningful
possibilities for change so new
possibilities new lines of sight then
we've thought about this before that's
what we're going to work today
there's also a second grouping and there
is some interdependence obviously
collaboration collaboration is not
opposed to competition but collaboration
is more about collective about being
able to work together across our
differences whatever those differences
may be to transform possibilities for
change into reality and then third
sustainability is about opening up
institutional practices and systems to
accommodate the change so the notion is
opening up not merely adapting what
we're doing to the to the existing
institutional practices so how do we
make room for the new possibilities and
the change today as I said we'll focus
on the micro moves of discovery which
are critical for seeding transformation
and so we're going to work a couple of
these examples of discovery moves as I
mentioned very closely we're going to do
a couple things we're going to exam
examine them at the tables so I'll share
the stories and then we're going to
examine them by asking what are they
made up of what are the pieces that
together come together that make these
patterns of action work and what do they
generate right what what happens as a
result of them and second is to really
explore how they could be adapted to
foster change in our own organizations
so micro moves let's move to micro moves
of discovery
they challenge us to objectively see so
outside of us
they challenge us to objectively see and
then prepare to let go of our
traditional practices our ways of
interacting and definitions of how we
should go about our work this is not
easy to do yet letting go is central and
there's an example from Microsoft CEO
Satya Nadella who is challenging that
organization to become better at
innovation in an early interview just
after he was named CEO last year he
commented so how do you create that
self-organizing capability to drive
innovation and be focused culturally he
said I think we've operated in Microsoft
as if we had the formula figured out and
it was all about optimizing that formula
and its various constituent parts now
however he added it's about discovering
the new formula microscope discovery
Michael Lewis also asked us to become
outward-facing to others to our students
to our patients experience to our
consumers to the community and forward
looking to new possibilities so facing
outward for example involves listening
to our stakeholders and learning about
their perspectives and experiences
accessing their experiences and then
importantly using their input to prompt
us to see more clearly
needs to be changed in our organizations
so facing outward in this respect
provokes us it challenges us when we
start this external outward facing to
stop taking for granted how we do our
work as in the case of Microsoft to stop
acting as if they had the formula
already figured out then forward-looking
involves venturing forth beyond our
comfort zones
sometimes it's not comfortable and
notably venturing forth beyond our
territorial fences to actively pursue
new possibilities for changing
transforming how we deliver patient care
redefining the model for innovation in
business and industry and redesigning
our practices perspectives and vehicles
of teaching and learning in universities
so our first example that I'm going to
share is a fun example and it takes
place and so it's the first example of
the micro move of discovery and so I'd
like you to listen and as I share this
example there are some wonderful
colorful notes note pages on the on the
table and I'd like you to jot down notes
about two things about to it so I'd like
you to listen for two two areas and then
we're going to talk about those also at
the table what piques your interest what
resonates for you in this is in this
example what do you find interesting in
the example so generally it's all about
what resonates for you that's the first
one and then second is what clues do we
get about what makes this micromo move
effective in fostering discovery for
change so helping people see new
possibilities seeming lines of sight
right what makes this micro move
effective for discovery so what
interests us totally up to you and then
also what what clues do we get about
what makes this micro move effective in
fostering discovery and again there are
micro gestures there are small
actions we're looking for the pattern
what what comprises what goes into
making up this mic remove so this first
example takes place in a school
Elementary School in Oakhurst not
Illinois but a small village part of the
city Decatur Georgia at Oakhurst
elementary school first grade classes
undertook the project all first grade
classes undertook the project titled
what can one little person do I love
that title that when I read started
reading about that I'm like I got to
know more about this there's human
agency five six years old ahead of it
they first as part of this project
resource research historical figures in
America paying attention to the
contributions these people made to our
country following on that research they
then asked the question that was going
to guide the rest of their work what
contributions can i as an individual
student and can we as the first grade
class make to create and I'm not kidding
you a positive change in our community
stunning think about the transformative
possibilities in this project when
defined this way to explore this they
research differences of people in the
community of Decatur including vision
hearing mobility and learning
differences they invited experts into
their classrooms to share their
knowledge and experience about
accommodations that people with
differences might need in order to live
and thrive in their community then the
students ventured forth with their
teachers into the community guided by a
recommended longtime resident and
community volunteer who uses a
wheelchair to get around
they saw firsthand what had been done
and what needs yet
be changed to accommodate all residents
and visitors in their community as Nadia
one of the students commented we've been
going on field trips to look for things
in our community that we can change to
make things better for people who have
differences then in January of this year
they presented their findings and
recommendations for change to the
Decatur City Commission local changes
that would make their community more
accessible for all members there's a
Facebook page they have a video I would
have loved to have shown it with more
time and each one of them is laughing
jumping and noting their own differences
as as classes the class members at this
presentation during her time at the
podium a student named watts reflected
on the project we have been learning
about differences she said and what one
little person can do we're fixing stuff
in downtown ochres for people with
differences there are no ramps so people
with wheelchairs won't be able to get up
on the sidewalk it would really be
difficult for them to live here if we
don't make these changes that was the
closing statement stunning and
inspirational at your tables I'd like
you to work this story and work it
around what resonates for you and then
also what are the elements what did they
do what small actions what may be the
teachers do to help make this happen
this is all one big micro move for
discovery that is fueling the changes
they're recommending we're going four or
five minutes to have a conversation at
our tables I'll be circulating just
ignore me I'm going to be listening
okay go thank you so pleasing to the
years
thank you all for and gave her some very
interesting pieces all the way from how
did the teachers design this and the
teachers had to work together as well as
the City Council had to agree to here
the students right all the way along so
they're pieces to this that are
coordinated elements that fit together
and so if we think about this and then
what happened was it asks the students
and teachers in the most general way to
become outward-facing and
forward-looking the teachers needed to
entertain the idea that they wouldn't
stay in the classrooms only right and
they would venture forth so they heard
others experiences and their
difficulties and used it to prompt an
exploration of what needed to be changed
right at the most general level and they
ventured forth obviously they could have
stayed in their classroom they could
have read research on what do
communities need to accommodate people
with differences right and what was
happening in the most innovative they
went out to experience firsthand our
second example comes from health care
who in the room is in the health care
area okay so a fair number at each table
this is great as I share this example
I'm going to ask you now to jot down
those again similar to this one is what
piques your interest and also what makes
this story this example as a micro move
for discovery effective in fostering
discovery in enabling discovery to
happen and this time I'd like you to
also imagine in the what if way possible
how you might adapt it for use in your
organization are there pieces of it
could you assemble aspects of it that
would fit with some other things for
discovery whether you're in health care
or not
okay transformation began at SATA care
SATA care is a hospital system in
Wisconsin not too far from here when
clinicians and administrators walked
with real patients to experience
firsthand the difficulties created by
their system to prepare these clinicians
and administrators generated open-ended
questions to ask patients when they
accompanied them what would illuminate
their experiences they actually had an
OD consultant come in to do that to help
them questions such as would you share
with me what being a patient here is
like what was it like for you just now
when X happened a lot as they were
following them could you describe some
other experiences you've had here as a
patient in addition to those questions
they decided to leave behind their
medical frocks and suit jackets in order
to slip out of their expert roles as
they walked with patients the team was
surprised to discover how very difficult
the route through their care system was
for many patients and how truly arduous
it was for the elderly and the very ill
they had no idea they also discovered
many other burdens patients faced such
as having to return at a later time to
complete diagnostic tests who hasn't
been asked to do that or having to
repeatedly answer the same question as
different providers came into the room
these clinicians and administrators
realize that all it although individual
services and units may work well their
whole system of care for the patient and
the patient experience did not a
clinical leader commented
we became acutely aware at a deeper
level that the old process was oriented
to justifying patience stay in the
hospital we needed a different process
one focused on optimal recovery and
helping patients get well the result was
a forward-thinking innovative model of
patient care delivery named
collaborative care that led to
exceptional patient and staff outcomes
and international recognition you can
also read about it in Health Affairs
special issue today the physicians the
nurses work together across any
territorial fences and there's aftercare
as well and I'm glad to talk with anyone
about this particular example for us
right now it's the early stages of this
and the discovery micro move I'm going
to ask you again to take three to four
minutes or so at your table to share the
pieces like what really resonates with
you with this very short example that
I've shared in a healthcare system as
they were trying to improve the delivery
of their system they gather together to
improve the delivery of their system and
had no idea it would lead to seeing the
whole system needing transformed so what
piques your interest
what makes this micro move effective in
fostering discovery for change and how
might it be adapted for use in your
organization so these questions are up
on the slide for your reference
Wow some of the very interesting about
ways that you're trying to adapt this
for use in your own organization and I
do want to there were a couple questions
did they decide to do that themselves
you know were they how how authentic
were they in this process the group came
together first they are senior leaders
administrators and senior clinicians so
they're over units some of the
clinicians but they don't get to the
frontline often what they did initially
was walk the care path as if they were
patients and then realized there's some
stuff that didn't quite fit
something was niggling a little bit like
they needed to see more and they made
the decision to walk the care path with
patients and numbers so great
conversations I look forward as we
continue this and also afterward for a
conversation with you if we think about
this and I'm going to link to some of
the conversations I've heard there are
some design elements that come forward
with a micro move of discovery that
makes it effective first of all it's not
existing out of context there's a
purpose that gives it meaning I mean you
could walk with patients and not get a
thing out of it right that's not what
they did so there's a purpose it's
enveloped in a purpose of improving care
delivery and they change that purpose to
transforming care delivery as they went
through this process there's also the
importance of accessing patient
experience directly in order to really
understand the experiences whether it's
community members with differences
whether it's patients in the healthcare
system whether it's students and their
learning paths to add it it's there is
an importance of accessing their
experience not putting our experience or
expectations onto that experie
so they got out of their familiar roles
and they spent time with the questions
many of you talked about this left their
medical uniforms and suits behind and
then really did go to walk the Kerr path
with patients so we're starting to see
some design elements of micro moves that
then have major impact right so this is
the discovery pieces many more kinds of
things that went on in order for the
collaborative care model to be developed
obviously the CEO was right in the room
with the clinicians and administrators
they clear congruence so walking the
care path with patients conveys the
discovery micro move that enables groups
to gain insight into previously
invisible problems and foster momentum
for change the difficulty there's one
piece left in this case the team's
decision to walk patients paths led to
at least three positive individual and
organizational outcomes and let me share
those first it generated a new line of
sight for clinical care it moved it away
from justifying as the clinician talked
about justifying patient stay which is a
normal way of going about delivery why
they have to stay and why they can keep
getting insurance to helping patients
get well major shift in line of sight
for them that really affected the design
of the care system itself as they went
forward and they had teams together
physicians nurses social workers and
aftercare
that huddled after every before they saw
a patient second it cultivated insider's
beliefs that their efforts could make a
positive difference in improving care
they had hope that if they took action
it would matter
and it did matter so that whole notion
of hope that my action will matter and
that generated momentum to design the
new care system and it took a lot of
work to design the care system that
momentum helped energize it and finally
it did enable insider led organizational
change these insiders designed and
executed needed change in 2004/2005 long
before government changes in legislation
that stretched and they did it by
stretching that organizational culture
through the infusion of new ideas they a
lot they moved it culture became more
malleable that allowed them to and then
they infused these new ideas so I think
I'm going to end on this piece of it and
look forward to conversations and say I
hope today from today's session that all
of us can gain an appreciation that Mike
removes our critical resources for
positive leaders in change in both
examples of the discovery Mike removes
people are meaningfully and respectfully
engaged in what might be called
expeditions of inquiry whether it's into
the community or in with patients in the
care system into how to make a positive
difference they venture forth to see new
possibilities for change they see touch
and hear right sidewalks they themselves
stepped up to see they weren't
accessible they experienced the
difficulties of care paths for change
than the benefits patients communities
and society so on that notion I would
say micro moves
do add up to macro impact lasting change
that knits together the best of the past
with a desired alternative future that
benefits all of us
thank you we were hoping that for
questions five minutes for questions
four minutes I'll watch CJ back there
yeah all right question-it stop it if I
know it I've seen look this is so
wonderful one of you had a micro
movement generated the impact for
everybody else with it so would you like
to start yeah
yeah yeah what's mike remove is very
much that's a really great question
they have macro impact for sure and what
happens is as we take micro moves we
might even think about it as
experimenting all right can you imagine
the teachers together saying we want to
do a project where our students will
understand about agency right and then
go out in the community and actually
have the experience of creating change
so you can imagine the teachers huddling
together even thinking that is a micro
move right rather than we're not able to
do anything in this system right around
that now notably there is support for
this kind of learning that really is
catalyzing right so there's a there's
another group that are talking about
expeditionary learning here in Michigan
and elsewhere that's only in the
elementary and maybe up to k12 maximum
right that's kind of tapping in and
helping give resources and resource
these kinds of efforts right but getting
the City Commission to meet those kinds
of things right but you know a small
move would be to ask the City Commission
to meet all right great question I had
that a couple times as we went around
the tables great question so we can
think of these as as micro moves that
are kind of mini experiments to see
whether there's traction right we don't
know unless we try other other questions
yes
so I can't did you come you hear my
question please repeat it again okay
sure so did you found on measuring the
impact from unclear more difficult so I
look forward to many many more people
measuring the impact of micro moves
where I measure it right now the metric
I'm using is the palpable hope the
enthusiasm the energy and then the
students are getting those projects
implemented it is a new model of care
right and the interesting thing when you
start looking for positive change
examples if there are a lot of them
right there just under the surface and
they may not be large scale all of them
right I chose some better more large
scale on purpose to show that it can
have that kind of macro impact yeah but
definitely look forward to other kinds
of and broadening our metrics right
about what matters in terms of how do we
measure that
there I can tell you nurses are talking
in this about since graduation they
haven't been able to take hold of their
profession as strongly as they're
enabled to now right that's a metric
right so these are really helping staff
as well as patients and communities yeah
yeah
so as leaders we presumably have a range
of micro and macro moves that we could
take in any given situation how would
you counter an argument that says as a
leader a micro move is just not enough
when you know something needs to happen
and how would you make that decision as
a leader if we don't start with Mike
removes we're not going to get to the
macro impact yeah I think probably the
micro moves we don't know if it's not
going to be enough until we try it right
what we can do is we can really now that
there's a sense about micro moves try it
and see has energy been generated is
there momentum or others starting to
talk about it what what reactions do I
get right so that's kind of this mini
experiment under the radar to see who
picks it up now there are some micro
moves and things we may not pursue after
that right but others that just kind of
get moving that's why I think the plus
gram from the from the plus lab is such
a great example that went into the Ross
School it's just wonderful it moves it
you could just tell it's time was here
right and they did a lot to make that
happen right behind that so we think
about it as tentative testings right
tentative ways because otherwise we
won't know right so that's a helpful way
tentative waves moving forward okay I
have to stop you don't you stay there so
I I'm sure you're all feeling like I do
I'm going to formally thank Karen and
we'll all do so applause and then I have
two announcements I'd like tonight so
first as you know we love artifacts yes
I know everything simple you can take my
ruler if you really know business that I
know oh okay it's not it's not a blogger
but I think I'm gonna get one oh there
you are
yeah I'm gonna get my own okay I'll move
to me this has a positive spiral that's
the image that
but thank you so much for coming in
she's spending a couple of days here so
if anyone wants to follow up with their
discussion please join me in thanking
Karen for coming
[Applause]
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