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14 NOVEMBER 2014

NHS Innovation Diffusion: digital tools and social movements

"There is innovation inside the NHS. But innovations tend to stay local, failing to be adopted by other healthcare organisations or diffusing very slowly. This challenge is well recognised. But what's the problem? Given the assembled talents and good intentions of NHS staff, how can the systemic sum of innovation be so much less than its parts?

The NHS is sometimes described in terms of it's hierarchical structure. For my purposes it's useful to describe the current NHS using the language of philosopher–activists Deleuze & Guattari. In their terms, the NHS is a striated space marked by linear boundaries, restricted to a particular plane of activity in the space of all possible potentials[1]. For Deleuze & Guattari, like Foucault before them, power does not simply operate as a pyramid but in myriad multifaceted directions and relationships. Foucault said 'One doesn't have a power which is only in the hands of one person who exercises it alone... it is a machine in which everyone is caught, those who exercise power as much as those over whom it is exercised.. it becomes a machinery that noone owns'[2]. The overall effect is an institutional environment that acts to tame energies it is a social machine that produces conformity. As Deleuze & Guattari would say, the NHS is highly codified, where a code is a pattern of repeated acts. Of course, there are many situations where this is desirable–an ICU emergency needs a practiced response. But it doesn't make for a system that diffuses innovation.

Anyone who's returned from an innovation workshop and tried to applied new ideas in their NHS workplace has experienced this striation. It's the overlap in particular experience of all the dynamics that limit change: lack of autonomy in a hierarchical structure, the expectations of colleagues, the time it takes to deliver your daily targets, the lack of incentive, the lack of peer support, lack of sense of entitlement to change the way things are done all of which can combine to deliver an experiential straitjacket which is an impersonal affect, a pattern across the system and one that stifles diffusion as effectively as individual innovation.

The alternative is a system marked by flows, connections and zones of intensity. In the abstract terminology of Deleuze & Guattari, an innovative system would include smooth as well as striated spaces. Smooth space is occupied by intensities and events, by the continuous variation of free action. The characteristic experience of smooth space is short term, up close, with no fixed points of reference. I will try to show how the combination of social movements and digital technologies could blend smooth space with the more rigid boundaries and caste structures of the NHS in a way that aids the spread of innovation."

(Dan McQuillan, 2011)

[1] Deleuze, Gilles and Félix Guattari (1980). A Thousand Plateaus. Trans. Brian Massumi. London and New York:Continuum, 2004.
[2] Foucault, Michel (1975). Discipline and Punish: the Birth of the Prison, New York: Random House.

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2011 • a practiced response • an impersonal affect • change the way things are done • codified • conformityconnections • continuous variation • Dan McQuillan • diffusion • digital movements • digital technologiesevents • expectations of colleagues • experiential straitjacket • Felix Guattariflows • free action • Gilles Deleuze • healthcare organisations • hierarchical structure • ICU emergency • individual innovation • innovation diffusion • innovation workshop • innovative system • institutional environment • intensities • lack of autonomy • lack of incentive • limiting change • linear boundaries • local innovation • machinery • Michel Foucault • myriad multifaceted directions • myriad multifaceted relationships • NHS • no fixed points of reference • ownership • particular plane of activity • peer support • philosopher-activists • power • pyramid structure • sense of entitlement • short term • smooth spacesocial computing • social machine • social movements • spread innovation • striated space • striation • up close • zones of intensity

CONTRIBUTOR

Simon Perkins
12 AUGUST 2013

Human communities depend upon a diversity of talent

"One of the real challenges is to innovate fundamentally in education. Innovation is hard because it means doing something that people don't find very easy, for the most part. It means challenging what we take for granted, things that we think are obvious. The great problem for reform or transformation is the tyranny of common sense; things that people think, 'Well, it can't be done any other way because that's the way it's done.'"

(Ken Robinson, February 2010)

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2010 • ability • Abraham Lincoln • Al Gorebatching people • broken model • common sense • conception of abilityconformitydigitised world • disenthrall • diversity of talent • dogma • education dislocates • education innovationeducation reform • education revolution • education system • Eric Clapton • fast food model • having original ideas that have value • human communities • human development • human flourishing • human resourcesindustrial model of educationintelligence • Jamie Oliver • Jeremy BenthamKen Robinson • kindergarten • learning revolutionlinearity • live for the weekend • manufacturing model • Maud Gonne • mechanical process • Natalie Merchant • natural talents • order of things • organic process • our talents • pre-digital culture • previous centuries • quiet past • rise with the occasion • single function device • standardisation • stormy present • take for granted • talentTED TalksteenagerWilliam Butler Yeats • wristwatch • Zagat

CONTRIBUTOR

Simon Perkins
29 JULY 2012

Fahrenheit 451: passive consumption through audience participation

"When the 'Family' (the television with its 'cousin' announcers and actors) presents an interactive play in which Linda believes she has a role, an actor (Donald Pickering) wearing glasses with thick, black rectangular frames, turns to the camera as it zooms in on him and says, 'What do you think, Linda?'"

(Tom Whalen, Gale Student Resources In Context)

Whalen, Tom. "The Consequences of Passivity: Re–evaluating Truffaut's Fahrenheit 451," in Literature–Film Quarterly, Vol. 35, No. 3, July, 2007, pp. 181(10).

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1966Alphaville • anti-intellectualism • audience participation • banbannedBernard Herrmannbig brotherbook • book burning • book-people • booksburning • Clarisse (character) • comic bookconformityconsolettecontroldisplay walldomestic futuresdystopiadystopian futureFahrenheit 451fire • fire department • firefighter • fireman • Francois Truffaut • Furia • futuristic societyGattacahousewifehumourindividualisminteractive dramainteractive experience • interactive teledrama • interactive television • It Happened Here (film) • Julie ChristieLinda (character)literature • Machiavelli • mahogany veneer • massificationmedia consumerMetropolis (1927)Montag (character)new forms of television • Nicolas Roeg • Nineteen Eighty-Four (1949)Oskar Werner • parlor wall • parlour • participation dramaparticipative media • passive consumer • passive consumptionpicture newspaper • pro-literature underground • Ray Bradburyreadingreality televisionscience fictionself-reflexivity • sensory deprivation • speculative fictionsubversion • telecast • televisiontelevision screenThe Family (television) • The Handmaids Tale • The Martian Chronicles • The Prince (book) • THX 1138 • totalitarianism • TV parlor • TV story • TV wall • video wall • visual joke • wall TV • wall-sized screen • what do you think • written languagewritten word

CONTRIBUTOR

Simon Perkins
15 APRIL 2012

Ken Robinson: human ability and talent is highly diverse

"Yes you know there's this view that only special people are creative and it's not me. It's not it's not anybody I really know. It's a very isolated sort of genius you know to be really creative. And you know people doubt their own strengths and their own capacities. So I meet all kind of people who don't really get much fulfilment from the work they do. You know they just get through it and wait for the weekend. But I also meet people who love what they do. And couldn't imagine doing anything else. You know if you set and don't this anymore they wouldn't' know what you were talking about because this is who they are. You know I mean like I don't know what else I would do. They are so to speak in their element. And so the book is about that. It's about the journeys people took to discover their own talents and what difference it made in their lives. And I talk to all kinds of people. It's not just interviews. But the book is seasoned as you know with interviews with people in science in business in the arts in sports in technology all kinds of different fields and what's interesting to me is of course it's different for everybody and this is really a key point you know that human ability and talent is highly diverse. You know what turns somebody on might totally turn somebody else off. What excites some propel does not excite other people and I know when I am signing the book these days I always ask people what they do. And when they tell me I ask them if they like it. And I always think it's great when people say I love it. Because you just never [inaudible].'"

(Ken Robinson, Conversations from Penn State)

Fig.1 Conversations from Penn State Episode 207: Sir Ken Robinson, Uploaded by WPSU TV/FM/Online on 6 Nov 2010, YouTube.

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2010 • all kinds of different fields • American schools • auditory learning • being really creative • career journeycareer narrativeconformity • Conversations from Penn State • creative capacity • creative capacity developmentcreativityeducation innovationeducation reformeducation systemgeniusgenius of the individualget a jobhuman resourcesisolated sort of geniusKen Robinson • kinaesthetic learning • kinesthetic learninglearning styleslone genius • no child left behind • only special people are creative • pathologized • Patty Satalia • PBSpedagogic codepedagogy • Penn State • PennState • Pennsylvania • psychologically abnormal • school systemsschoolingSingaporesocial construction of knowledgestandardisationstandardised testingstatistics can tell you most thingsSTEMstudenttailored curriculumtailoring curriculumtalent • talent is highly diverse • teaching to the test • three types of learners • University of Warwickvisual learning • WPSU

CONTRIBUTOR

Simon Perkins
29 DECEMBER 2003

Urban Theory: the disintegration of social relationships into anomie

"Durkheim, writing towards the end of the nineteenth century, feared the disintegration of social relationships into 'anomie'. This constituted a situation where the norms and expectations surrounding behaviour were no longer known. The onset of industrialisation would create normlessness and social breakdown. He identified, as a key feature, the shift from a community based upon mechanical solidarity to one based upon organic solidarity. Mechanical solidarity was where the moral ideas and values of a society were shared by all members, collective authority was absolute and. deviants were not allowed. Conformity to the rules was expected of all the population and was enforced by strong sanctions. The basis of this form of solidarity was the homogeneity of moral beliefs across the population. In contrast, organic solidarity was based upon social differentiation and a key integrating role was played by the division of labour. The new form of solidarity was thus based upon the interdependence of specialised parts. Norms, rules and laws were organised, not around repression, but through contracts between individuals and groups which were legally binding and enforceable via the judiciary and court system. Stability and integration would be rebuilt on the basis of necessity. None of us could survive in the new industrialised urban world on our own; we all depended upon the activities of each other. The newsolidarity that Durkheim saw emerging came out of our diversity rather than being imposed by our homogeneity as it had been under 'mechanical solidarity'. He thus termed this new form of solidarity 'organic solidarity'."

(David C. Thorns, 2002, p. 23)

David C. Thorns (2002). "The Transformation of Cities", Palgrave Macmillan.

Durkheim, Émile. 1960. "The Division of Labour in Society". New York: Macmillian.

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