This is useful and powerful, as it helps us identify what's missing in largescale complex change efforts, sometimes by working backwards from the outcome (eg if your current organisation's situation is 'confusion', looking back through the horizontal line from that outcome may help you identify the cause - lack of vision or a vision that is poorly communicated or not shared or bought into). There is a downloadable version, below (click on the 'attachment' title) if you need it.

Hello. I run a project called Star Wards, working with mental health trusts to improve inpatients' daily experiences and treatment outcomes. I set up Star Wards following a stint as a detained inpatient in my local hospital. Although I was very well (and incredibly tolerantly!) looked after, it was striking that there was nothing for patients to do all day long and the only treatment was psychopharmacological. Our website (www.starwards.org.uk) has lots of information about the project and, in particular, amazing examples of great acute care.

Hub member Marion Janner forwarded the attached document to me and has said I can post it here to share with other Hub members. It's a mini version of her change agenda and framework for acute mental health wards, to improve the quality of life for patients and job satisfaction for staff.