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Culture Cataclysm in modern medicine: Helen Bevan at DFTB19


Helen Bevan is the Director of Service Transformation for the National Health Service Institute for Innovation and Improvement. The NHS is one of the biggest employers in the world. When it was established in 1948, the average life expectancy for men was 66 and 71 for women. As science has advanced and the population becomes more medically complex so the challenges of meeting increased demand have become more apparent.

As Chief Change Officer. Helen talks about the clash between old and new power and the ability of super-connectors to drive change.

In medicine and healthcare, change isn’t just an option; it’s an imperative. But how do we navigate the treacherous waters of change while preserving the core values and essence of the healthcare system?

Embracing Cataclysmic Change

The term “cataclysm” typically denotes widespread destruction and distress. However, perhaps we should be more optimistic. The current state of medicine presents a cataclysmic moment of sweeping change. This change is not necessarily apocalyptic but rather a transformation that can reshape the healthcare landscape for the better.

Understanding Culture and Mindsets

Bevan articulated the foundational elements of culture as the patterns of shared assumptions, beliefs, and values that shape how individuals relate, work, and exist in their professional spheres. This invisible tapestry of norms often influences our behaviour and responses, guiding our actions in healthcare settings. Coupled with culture are conscious and unconscious mindsets that dictate our understanding of ourselves, our colleagues, and the healthcare landscape at large. This interplay between culture and mindsets forms the crux of the culture cataclysm.

The Tension Between Old and New Power

Bevan posited that the contemporary healthcare environment is experiencing a conflict between old power and new power dynamics. Old power operates like currency—controlled by a select few at the top of the hierarchy and pushed down through formal authority. In contrast, new power functions like a current, fueled by the collective energy of individuals united by a shared purpose. It’s a force of connection, relationship, and network.

From Transactional to Relational

The shift from old power to new power highlights the evolving nature of healthcare leadership and management. The mechanistic structures of old power—characterized by rigid hierarchies and top-down decision-making—are no longer conducive to navigating healthcare’s rapid changes. Instead, new power emphasizes relationships, connections, and trust. Informal influencers—those who build connections and inspire others—play a pivotal role in the new power landscape.

The Rise of Informal Influencers

Informal influencers or “super connectors” are the linchpins of change in modern healthcare. These individuals, often unknown to formal leaders, can drive conversations and instigate change within organizations. They hold the power of trust and are respected for their insights, making them more effective in inspiring action than traditional authority figures.

The Social Leadership Approach

In a world of cultural cataclysm, healthcare professionals need to adopt a social leadership approach. Power and authority are derived from actions, behaviours, and shared values rather than positional influence. Bevan’s plea for “social leaders of the future” urges individuals to engage in authentic, trust-building relationships that drive change beyond formal structures.

Advocating for Widespread Change

Drawing from the insights of fellow presenter Dr Taj Hassan, Bevan emphasized the significance of emergency departments as the canaries in the coal mine, detecting systemic failures within the healthcare system. She suggested that the lessons learned from the challenges faced in emergency medicine should be translated into advocating for change throughout the broader healthcare landscape. Aligning common standards and engaging informal influencers can facilitate this transition.

Helen Bevan’s thought-provoking talk at the DFTB19 conference illuminated the transformative potential of culture cataclysm in modern medicine. Through her exploration of old power versus new power, the role of informal influencers, and the importance of building trust-based relationships, Bevan provides a roadmap for healthcare professionals to embrace change while preserving the core values of the medical field. By adopting a social leadership approach and harnessing the power of informal influencers, healthcare can navigate the cataclysmic changes ahead and emerge stronger than ever.



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