Where social media and patient engagement really intersect

This article encapsulates well the significant role of social media in particularly in creating online communities whereby patients can exchange experiences, increase knowledge of their own conditions and share potential solutions. It also flags up areas of concern anyone new to social media as a healthcare professional or engaged patient should bear in mind.

One such online community that has helped me immensely has been the weekly #bpdchat on Twitter. Here’s what the organiser of the chat Carl Dunn Junior told The Edge about the benefit of the chat:

“#BPDChat is one example of what can happen when people come together in mutual support. It is a weekly peer-based, moderated Twitter chat for anyone with Borderline Personality Disorder. Borderline Personality Disorder (BPD) involves problems regulating emotions. BPD has an optimistic prognosis if treated with effective, evidence-based therapy such as Dialectical BehaviorBehaviour Therapy (DBT) or Mentalization-based therapy (MBT). Unfortunately, many mental health professionals are not aware of this and DBT and MBT are is not available or affordable for many people.

#BPDChat is often the first chance people with BPD have ever had to talk to someone else suffering with from BPD and the first time many have heard there’s an effective therapy. For some the chat is a way to overcome isolation. #BPDChat has also been a place where people can share and learn coping skills that are helpful in overcoming BPD.

After more than 3 years #BPDChat is still going strong and is an example of how people use social media to aid their recovery.”

Carl remarks that the concerns expressed in the article about privacy have been outweighed by the clear benefits with people able to maintain their anonymity should they choose.

All in all #BPD chat has become precisely one of the “pods of solidarity” mentioned in the article and has become a major lynchpin of my week.

Powered by Mary Freer

Can you make something fabulous happen with your main resources being passion, determination and relationships? Yes you can. Mary Freer was so inspired by NHS Change day that she gave up her paid job to lead a movement in Australia 1,7012.999 Kilometres (1,0571.387 miles) away. In the last two years Change Day Australia has inspired around 50-60,000 people to make pledges. Some are small, some are huge but all aspire to make a positive difference to health and care systems.

Gandhi said: “Be the change that you wish to see in the world.” Mary has taken that advice and is living proof that you can make it happen.

Change agents: know thy audience

There are five considerations when change agents are preparing to communicate their ideas for change.

Firstly, how does the audience react to change? Knowing whether the audience will be receptive to new ideas or sceptical will govern how the information should be presented.

Secondly, communication should be targeted to the professional focus of the audience. Presenting information in the same way to A&E nurses, specialist doctors and management executives will not work because each person will want different information.

Thirdly, if the audience reports to the change agent then leading by example is essential. People look for actions before believing words.

Fourthly, adapting the message to people’s personal motivators and perspective will allow them to see what benefits they will receive from adopting the changes.

Finally, ensuring that the execution framework is well thought out and will succeed is essential because if changes fail to succeed the likelihood that people will agree to future changes reduces.

Why we cannot learn a damn thing from Semco or Toyota

I’ve chosen this article “Why we cannot learn a damn thing from Semco or Toyota” because I think that an awful lot of failed practice goes on in the NHS and wider health and care system. We think we can take the best practice or good practice of high performing organisations and directly replicate their achievements. This isn’t something that it is possible to do because each local context is unique. There are certain hospitals and other health and care organisations that get continuously quoted as examples of high performing systems. Lots of people visit these organisations and seek to learn from them. Yet the pool of high performing organisations with their own unique style in healthcare never seems to grow. The same, small numbers of organisations continue to be cited. So perhaps the time has come to think about best practice and replication in a different way. Rather than seeking to translate the operating systems of high performing organisations, we might choose to focus on building a local context for change where it can flourish.

Is change management junk?

I have chosen to link two pieces together; “Your Change Management Plan Is Junk” by Geoff Schaadt and “Is it time to bin the idea of change management?” by Stefan Norvell. They are among an increasing number of authors who question the very term “change management” as a mechanistic, top-down approach. It leads to change being experienced by people working at the front line as imposed, rather than change being embraced. The more that we seek to plan large scale change interventions, the more assumptions we make, the less likely the plan will deliver the results we seek.

I have a lot of sympathy for the perspective set out in these two articles. Like these authors, I believe that it is impossible to plan complex change interventions as if they were IT installations or new build projects. I always try to avoid using the terminology “change management”, using terms like “leadership of change” instead.

Ironically, one of the best sources of new articles about the leadership of large scale change is the “Change Management Daily” produced by @innovate via twitter. So even though the term “change management” is questionable, it acts as a magnet for all sorts of interesting content about the future of change.

Caregiver becomes patient: 3 arguments for QI

This short blog piece outlines three arguments to show how quality of care can always be improved. The author writes from the perspective of being a patient who feels vulnerable in care setting and applies a quality improvement lens to a real experience. The three QI arguments come from the patient’s perspective and go a long way to show that there are some basic actions we can take towards improving care. The first argument centres on not being intimidated by hierarchy. The author makes the case that if you put yourself in the shoes of the patient you can change your actions and act as the patient’s voice. The second argument focuses on taking personal responsibility of providing care and not blaming poor care on others. Finally the third argument shows that even a small improvement can have a big impact on a patient’s experience.

These arguments sound obvious when written down, but sometimes we can’t see the wood for the trees.


5 psychology secrets for great interaction design

A huge amount of healthcare work involves communicating with patients, carers and colleagues –providing information on someone’s medical condition, giving information and advice or promoting good health and wellbeing. To communicate well, we have to consider the whole person who we are trying to communicate with: what is their situation when we are trying to communicate with them, what information are we trying to give them, how should we best package this information for them, at the time they are receiving it? What is the best medium? What are the best words to use? For patients and families, this is especially important: Issue 11’s change maker, Leigh Kendall, spoke about the importance of not overwhelming patients and carers with information, but packaging it in a way suitable for the recipient. Essentially, that is what human centred design is about: designing your work for the humans receiving it; putting the patient or the recipient at the heart of your designs, so that it is suitable for them.

In 5 psychology secrets for great interaction design, Jerry Cao takes a look at how to create human centred websites and apps. This article is quite specific for website design, but it also contains lots of practical tips and ideas on how we can adapt our products and services to be better designed around humans.

Jennifer ClemoCommentary by Jennifer Clemo-Halpenny, Communications Officer, Horizons Team, NHS SIT


A former Google exec on how to make tough decisions quickly

If change is to be effective and sustained it must be co-created and co-owned by the team, instead of ‘raining down’ from the top.

Organisational change can be viewed in terms of building a boat and then paddling it together. The co-creation, or building of the boat, ensures that everyone has the same vision and everyone has input. This means that all members of the team are emotionally and intellectually owning the change that they are going to implement.

Co-ownership is where the paddling starts. This stage is about actions and people taking responsibility for implementing the change. If people do not paddle in time, or do not put the same amount of effort in, then the boat will not move forward. Everyone, at every level, needs to do their bit when change is being driven forward. Only by co-creation and co-ownership will fundamental change be achievable.

Within health and care, it is necessary that change is not prescribed from the top and implemented on the ground. Everyone should be able to get involved in decision making because this is how everyone will be believe in the changes to be made.

Are you a 21st century leader?

There is much debate recently about the role of leadership in health and other sectors in the social age. Therefore Ayelet’s mission to distil the essence of 21st-century leadership within a book appears challenging at first. The article provides early insight into the themes uncovered thus far, drawn from numerous meetings and engaging conversations.

Four key trends have been identified for 21st century leaders which will help change agents and patient leaders make a difference in healthcare. First they break down silos, support communities and engage in a wider conversation. Secondly they demystify change and understand that shared purpose will enable co-creation and build communities. Thirdly 21st-century leaders understand the importance of respect, trust and building relationships. Finally, there is the power of vulnerability, providing space for creativity and hiring the best and brightest people to partner with them.

One point that stands out is that 21st-century leaders are not top down hierarchal leaders, they don’t delegate responsibility, they work hard to build communities and shared purpose. Being a leader in the social age is challenging. I look forward to hearing more insights from Ayelet’s work when the book is completed.

We are looking for change agents to feature in The Edge. If you would like to nominate a change agent who you think showcases 21st-century leadership email us today on

The future of management is teal

Surveys, conversations and observations assert companies to be places of dread and drudgery, rather than passion and purpose. Behind a façade of success, many top leaders are tired of the power games; despite their overloaded schedules, they feel a vague sense of emptiness. Pioneering oranisations in a whole range of sectors are operating with new structure of management that show how we can deal with the complexity of our times in new exciting ways, and how work can become a place of personal fulfilment and growth.

Laloux borrows Ken Wilber’s colour spectrum to explore the successive stages of management evolution. Teal organisations are all about self-management (peer relationships, autonomy, distributed power), wholeness (authenticity, passion, creativity), and evolutionary purpose (agile practices that sense, respond and replace the machinery of plans, targets and incentives). The Dutch nursing care provider, Buurtzorg, provides the perfect case study of a teal organisation. Buurtzorg have removed layers of bureaucracy, to end an outcome that was proving distressing to patients and nurses alike. Jos de Blok transformed the company into a self-managing enterprise, with teams of nurses serving well-defined neighbourhoods. Its purpose is not to changes bandages as efficiently as possible, but to help the public live, as much as is possible, a rich and autonomous life

Already, it’s clear that we can create radically more productive, soulful, and purposeful businesses, schools and hospitals. Laloux emphasises ‘we are at an inflection point: a moment in history where it’s time to stop trying to fix the old model and instead make a leap to the next one. It will be better suited to the complexity and challenges of our times, and to the yearning in our hearts.’


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