Appreciative Inquiry in the NHS – teambuilding

Following on from the Appreciative Inquiry teambuilding session we did for the Occupational Health team at Mid-Essex Hospital Trust, we’ve received a nice write-up in their Stafffocus magazine (14 October 2009) by Denise Mortimer who commissioned the event.

Introduction to Positive Deviance

Positive Deviance in action: Maternal and newborn care project in Vietnam

A recent article in the Guardian by Jane Dudman gives a good introduction to the Positive Deviance model, a method of solving ‘intractable’ social and organisational problems through the principle that:

…in every community or organisation, there are some people who do better than others, even though everyone has the same resources. By finding how what works well, the whole community or organisation can implement improved practices.

A second article homes in on one example of how the Positive Deviance approach is being used to reduce antisocial behaviour in Gosport, Hampshire, by finding families where children behave well, discovering what they are doing differently, and how this can be copied by local parents.

The approach has some obvious similarities with Appreciative Inquiry – the focus on what is working rather than problems, looking for examples of positive exceptions, and the need to involve everyone so that they own the solutions.

The Positive Deviance Initiative has produced some accessible guides and tools downloadable from their web site, which are well worth a look for Appreciative Inquiry practitioners (NB if you found that the link to this site in the first Guardian article doesn’t work,  you can use the one above). It also has case studies from many Positive Deviance projects around the world, such as the Maternal and Newborn Care project in Vietnam.

I particularly liked this quote from the Basic Guide to the Positive Deviance (PD) Approach:

“Act your way into a new way of thinking instead of thinking your way into a new way of acting”

Appreciative Inquiry for teambuilding

Appreciative Inquiry (AI) makes an excellent format for teambuilding. It can be very rewarding for a team to work through the 4-D cycle, each stage building on the one before. A day (or slightly less than a day) gives enough time to really go into some depth, reaffirm bonds within the team, and build morale and confidence.

For the day to run smoothly it’s important to choose carefully the affirmative topic for the inquiry. Often some variation of “How do we work together more effectively?” will work well.

In the Discovery stage, having team members interview each other to unearth stories of when they have experienced or participated in exceptionally good examples of the topic can help to remind interviewees of their own worth, and that there are times – often forgotten in the hurly-burly of day-to-day work – when the team can work exceptionally well together. The interviewers often also feel inspired as they hear stories that resonate with their own experience and values.

To get the maximum value from the Discovery stage, have people who don’t normally work closely together interview each other. Interviewing across different responsibilities or levels of management can build understanding and appreciation of the contribution and viewpoints of people in different roles.

In the Dream stage, team members co-construct a vision of their desired future as a team. This can be a opportunity for people to loosen up and have fun as they create a presentation of their vision using words, collage, or even on occasion poetry, ‘living sculpture’, or song.

For the Design stage we now favour taking specific aspects of the Dream – whichever elements the team feels most motivated to work on – and letting the team use a adapted fishbone diagrams and ’swimming lanes’ to identify tasks, structures and relationships that need to be in place to translate into an action plan.

Finally, for the Delivery stage team members can make requests, offer to help other team members with their needs, and make commitments to take specific actions or take responsibility for ensuring that something happens.

These photos come from a recent teambuilding day we facilitated for the Occuptional Health team at Mid-Essex Hospital Trust. Denise Mortimer, a project manager at the Trust who commissioned us, wrote the day up for the Trust’s internal magazine:

On 16th September the Occupational Health Department embarked on a team building event with inspiring results! The team were introduced to ‘Appreciative Inquiry’ which is a process that works by acknowledging and building on what is good and what works well, instead of focusing on the negative.  Often we focus on what our problems are and as a result we tend to magnify those problems, which only contribute to a downward spiral of feeling helpless and hopeless.  With Appreciative Inquiry we get to reconnect with what we love about work and when we are at our best, resulting in people feeling inspired to take action and creating more positivity in the workplace.

By the end of the session the group were left feeling inspired with realistic actions that were genuinely created and owned by them. With a lot of laughter and a lot of no-nonsense talk about what needs to happen, the group now have to build on the momentum of the day and they certainly seemed ready to!

We were pleased to help Denise, a graduate of our Practical Appreciative Inquiry facilitator training, to co-facilitate the day. She is now being asked to run other Appreciative Inquiry events within the NHS.

The next Practical Appreciative Inquiry facilitator training runs in Manchester on 21-22 October – there are still some spaces available but you need to get your booking in fast!

Appreciative Inquiry: better ways of doing the Design stage

Read almost any textbook on Appreciative Inquiry and you will find a frustrating vagueness about what to actually do in the Design stage. This stage, which follows on from the Discovery of what is already working well, and the Dream about how the organisation could be at its best, is generally agreed to be about designing the “organisational architecture” – the new systems, groupings and information flows which will make it possible to have more ‘peak experiences’.

But how to go about it? The advice is generally to keep the Dream in mind, think about what systems etc will be needed, and then devise one or more “Provocative Propositions” – inspirational, stretching, present-tense statements which describe the organisation at its best, and give people something to live up to.

Actually doing this in practice, especially in a whole-organisation “AI summit” where there is limited time and most of the participants are not trained AI practitioners, is challenging. Particularly as if taken literally, the textbooks would have you come down one or two levels of detail from the big-picture vision described in the Dream stage to the nuts and bolts of systems design – and then soar up again to the realms of metaphor to craft your provocative proposition!

Here’s an alternative that we have been playing with – I expect there are other AI practitioners that do something similar already, but you wouldn’t know it from the published books on AI that I’m aware of. I’m talking specifically about how to set up the Design stage in the AI summit format – whether this is for a Positive Engagement event for the whole of an organisation and its stakeholders, or for a small teambuilding away day.

1. Possibility Statements

After the creative expression of the Dream (as a collage, presentation, living sculpture or whatever – people can get very creative), ask the participants to craft a “possibility statement” (an alternative and I think more user-friendly name for “provocative proposition” – you can call it whatever will best convey what it’s for and will best fit the organisational culture). Here are the criteria that we used for a recent event for the fine social enterprise and recruitment consultancy Vedas in Burnley, UK:

To me, it makes sense to craft Provocative Propositions right after the Dream – people are still inspired, and the Propositions are at a similar big-picture level of abstraction to the Dream vision. The Propositions can then act as a bridge into the more detailed work of the Design stage, as participants collaborate in designing what has to be in place to make the various elements of the Dream actually happen.

2. Using “Fishbone Analysis” in the Design stage

Usually, fishbone analysis or “Ishikawa diagrams” are used to find the root cause of problems – as in this illustration from Wikipedia.org:

Please restrain your horror at the use of the word “problem”, because we are going to use it for pretty much the opposite – an inclusive process to find the route to the Dream.

For each table of 4-8 people in the AI summit, we give them a blank fishbone diagram on a sheet of flipchart paper. In the ‘head’ of the diagram, they write the part of the Dream that they want to bring into reality.

In the boxes at the end of each ’spine’ of the fishbone, they write an area for which action needs to be taken to make the Dream happen. You can leave this up to the participants, or you can give them preprinted ‘classic’ Fishbone categories like: Equipment, Process, People, Materials, Environment, and Management.

Along each spine of the fishbone, participants place post-it notes with the actions that have to be taken, or the things that have to be in place, to make that area support the Dream goal. Our tip is to use a different colour post-it for each area, and use small notes so there’s enough room for them on the diagram. The process will go faster if smaller groups of participants take an area or two each – but make sure everyone gets to see the end results for each area, to make sure nothing is missed.

The beauty of this process is that it’s inclusive – everyone gets to contribute – and it’s fast. A team can rough out what’s needed in a very short time.

3. Turning the fishbone into an action plan

At this point the design elements have been identified, but dependencies have not, and the elements will probably not be in time order. To turn the fishbones into plans, we stick several sheets of flipchart paper to a wall, and establish a series of horizontal lines – one for each area on the ’spines’ of the fishbone.

Participants can then transfer the sticky note for each element they have identified onto a timeline, in the order dictated by any dependencies that they identify between the design elements. When the timeline for each Dream component is laid out, it’s easy for participants to see dependencies between the different timelines too, and adjust the placing of the individual actions accordingly.

Timescales and milestones can be added later, probably by a smaller team with responsibility making the goals happen.

I hope that’s given you some ideas – if you use them, or something similar, please share your experiences by leaving a comment.

How to live more appreciatively

Here are three quick and easy things you can do to start living more appreciatively. Like anything else, it will take time to become a habit, but the small changes you make will combine and build up more quickly than you expect.

1. Keep a daily ‘gratitude journal’ in which you record things that you are grateful for (no matter how small) – this will have a positive effect on your well-being. Positive psychology researcher Dr Robert Emmons has found that keeping a gratitude journal for as little as three weeks significantly improves happiness levels. When you keep it up for longer, there are also positive effects on health, sleep time and social connectedness – see http://psychology.ucdavis.edu/labs/emmons.
2. Treat problems as challenges – look for what you are grateful about in bad things as well as good. This in itself can be a challenge at first, but every problem is also an opportunity to learn.
3. Ask yourself ‘What do I need to learn from this?’ whenever anything bad happens. Asking yourself this question, and creating some space to allow the answer to emerge, will increase your self-awareness and help you to correct anything that you may be doing unwittingly to contribute to the problem.

The Benefits of Living An Appreciative Life – Part 2

2. Your luck will improve

Psychologist Richard Wiseman studied the attitudes and behaviour of people who considered themselves exceptionally lucky or unlucky. His book ‘The Luck Factor‘ documents his findings that the ‘lucky’ group actually made themselves lucky by creating and noticing chance opportunities, listening to their intuition, and creating self-fulfilling positive expectations.

Of course random events will still happen, but on average, people who live life in an appreciative way will be luckier, because they have created the conditions that allow luck to enter their lives.

3. You will feel better – and your abilities will improve as a result

When you look at events with an appreciative eye, you feel better about whatever happens. Feeling good is pleasant in itself, and it turns out that it has many benefits to your personal effectiveness.

Psychologist Barbara Fredrickson’s research into the value of positive emotions shows that people who feel positive are able to think more strategically, they are more compassionate, more creative, more socially connected, more resilient, they make better decisions, and have better health. She has summarised some of her findings in this readable article: The Value of Positive Emotions

4. Easier goal-setting and knowing what you want

The positive reference experiences that we discover when we look at what is working well in our lives make it easier to clarify our vision of the future, and give a firmer, more realistic grounding to our goals.

Steve Andreas’ excellent book ‘Transform Your Self‘ shows how important positive reference experiences are in forming our expectations and even our sense of self. As you uncover and build on more of your own ‘positive core’, you will enable the self-fulfilling effect of positive expectations, and create still more reference experiences to build on.

Next – how to live more appreciatively…

The Benefits Of Living An Appreciative Life – Part 1

It’s often said within the Appreciative Inquiry community that AI is a way of seeing and being in the world, rather than just another toolkit. If you view AI solely as a toolkit, you are missing the point. So what can you expect when you start applying Appreciative Inquiry to your own life, and viewing the world in an appreciative way?

1. People around you will live up to your positive expectations

In their famous ‘Pygmalion in the Classroom’ experiment in the 1960s, Robert Rosenthal and Leonore Jacobson led elementary school teachers to believe that some of their pupils had unusual intellectual potential and to expect a ‘blooming’ in their academic performance. Sure enough, at the end of the year, their test results had significantly increased, compared to the children who had not been singled out. But in fact, the ‘bright’ students had been randomly selected.

This experiment has been replicated many times, in management settings as well as education. See http://en.wikipedia.org/wiki/Pygmalion_effect

The only difference between the ‘bright’ and the ‘average’ students was that teachers expected them to do better. This expectation would communicate itself in subtle ways: in the questions the teachers asked, which students they called on in class, and the way they marked different students’ papers. Even the non-verbal aspects of their communication with students such as facial expression and voice tone would be subtly different.

In the same way, your expectations of your friends, work colleagues, people you deal with, and even yourself, will influence the responses and behaviour you get. Looking for the good in other people, and yourself, makes it more likely that you will find it.

New Appreciative Inquiry facilitator training dates

We have a new date for the two-day Practical Appreciative Inquiry facilitator training:

Manchester 21-22 October 2009

Details here if you want to book a place: Appreciative Inquiry facilitator training

We’ve had rave reviews both from the public courses and when we’ve run it in-house – you know you’re doing something right when someone who has attended your course sends her boss on the next one!

If you have 4 people or more that you want to send on the course, think about running it in-house for extra cost-effectiveness.

Appreciative Inquiry on Twitter

Microblogging phenomenon Twitter.com has upwards of a million active users posting 140-character ‘tweets’ about what they are doing – some of them must be involved in Appreciative Inquiry, right?

Now you can be notified of every Twitter message that mentions “appreciative inquiry” and have a daily digest sent to your email inbox. It’s an easy way to see what other people are doing with AI.

Just sign up to tweetlater.com’s ‘keyword alert’ service (it’s free) and set their ‘keyword alert’ service to track the phrase “appreciative inquiry”. Simple as that!

If you want, you can follow me (Andy Smith) on Twitter – if my colleagues at AI Consulting start Twittering I’ll add their details too!

Seth Godin on the value of Dreams

Marketing guru Seth Godin (well worth a look if you haven’t heard of him) has just posted a blog entry which is obviously relevant to the Dream stage in the AI cycle:

If your business is a dream come true for customers, you win. Game over.

Check out the entry here: Like a dream come true