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In group: Liberating Structures in healthcare

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  • Matthew Mezey posted an update in the group Liberating Structures in healthcare 4 years, 3 months ago

    Great Liberating Structures query on Twitter just now, from @lizzie12s @liztwelves :
    “Anyone out there using participatory meeting processes e.g. Liberating Structures to run your more ‘formal’ meetings, like your Board meetings or committees?”

    Can anyone help?

    (PS How did you manage to end up on the Q site twice LIz – we’ll need to rationalise that!)

    • In my previous role (at a national regulator) I did run a board session using a technique called Kaleidoscope, which I’ve since used in my current role to run a Senior Leadership Team meeting. I don’t know that Kaleidoscope is a Liberating Structures technique but it is definitely in the spirit as it asks participants to step outside of their own viewpoint (e.g. board member) and into that of someone else (e.g. a carer), and to pose questions rather than give opinions. Both worked really well in enabling a wider range of perspectives as well as supporting colleagues to feel a sense of ownership of the work we were discussing.

      • Hi Kate,
        Interesting to hear about ‘Kaleidoscope’. (Is there a guidance page for it online somewhere?)
        Funnily enough, there’s arguably an interesting – but uncommon – step beyond that to something called ”(‘Systemic’ or) Organisational Constellations’.
        This will typically invite individuals to stand up to create a ‘living map’ of the issue in the space of the room – embodying the different perspectives.
        People somehow intuitively access information and perspectives (eg from patients?) in a way that can feel almost spookily powerful at times. It can be quite an emotional experience. Not just the usual thinking and planning…

        I suspect Constellations are pretty different to most (all?) the usual QI tools.

        Similar to Kaleidoscope at all?

        Though I have come across at least one Q member who’s recently trained in Constellations and happy to share something about it with the community.
        Perhaps one day…

      • Wow. How did that go? How did people respond? Sounds like a brave step to take! Was it for a particular element of the meeting or for the whole of the agenda?

    • Thanks Matthew, I’ll have to take a look at Constellations. It does sound similar to Kaleidoscope. I don’t know if there is a written guide to the latter – I shamelessly plagiarised it by a fellow Q member and QI enthusiast, Jo Vigor (who I can’t seem to @ tag for some reason). I’ll have a go at explaining briefly…

      It works really well for work that has been developed to some extent but there is still further work to do before final decisions can be made.

      The person leading the work spends a few minutes updating colleagues about it’s purpose/objectives, what work has been done so far, the current thinking about where to take the work next, and perhaps flagging any key / difficult questions that will need to be considered to make progress over the next period.

      Meanwhile, each person in the conversation has been given a role to play. These roles could be quite broad (e.g. ‘regulator’) or more specific (e.g. Chief Inspector of X). )So, for example, you might have someone step into the role of CCG Commissioner, another as a Registered Manager of a home care provider, another as person who uses services, another as a senior nurse in a hospital, another as a carer etc etc.

      Then, colleagues can ask questions of the person who is leading the work – but they are asking these questions in the role they have been given. They don’t give opinions or make decisions – their role is to pose questions. This can create a really constructive dynamic as the person leading the work isn’t put in the position of having to defend their work or challenge opinions/decisions – it creates space for them to listen and to feel challenged, but in a supportive and appreciative way rather than a critical or adversarial way.

      The person leading the work then shares their immediate responses to the questions they’ve heard – whether those are high-level reflections (e.g. this has reassured me we’re broadly heading in the right direction) or more specific ones (e.g. I had previously considered x but I hadn’t thought about how it linked to y). And, crucially, then they set out what they will do next to use the input to shape the next phase of the work (and, if relevant, how they will feed back to the group) to make sure participants feel they had been truly heard and their input has been valued.

      • Maybe ‘Kaleidoscope’ is the Liberating Structures-ified version of ‘Constellations’….?

        Though I suspect all the moving around in space, repositioning, the deep relational questions asked etc might make it a more somatic, visceral experience than a Kaleidoscope role-play.

        I don’t really know where to recommend re further info on Constellations – though there is lots out there. (Some will be ‘Family Constellations’, that it grew out of).
        John Whittington’s book ‘Systemic Coaching & Constellations’ is good – even if this approach, more than most, demands experiential learning.

    • Thanks for posting this here Matthew. I’m particularly if people have redesigned their whole way of doing meeting business. I feel sure there is a better way. Imagine though asking a Board to work in a very different way. I sense that power is a big part of what gets done and how in very senior contexts.

    • @liztwelves It was definitely a very different way of working! It was quite uncomfortable for some colleagues – though in a way that’s the point, if it helps us step outside of our comfort zones and look at tricky issues in a different way. In both cases I used it for a specific item on the agenda, and created space for feedback afterwards, to assess how people found the exercise.