Transparency

Original image: The Blue Window, Philippe Sainte-Laudy

HSJ: The NHS and fundamental change ...

 ... governments typically try to will the end but not the means: they try to shift the habits of the NHS while protecting buildings and people; or in Lord Darzi's pithy phrase, they change "the anatomy of the NHS rather than its physiology". p.16.

Finding the pith in Hodges' model (and the problem of refactoring - where would you like to start?):

INTERPERSONAL : SCIENCES

SOCIOLOGY : POLITICAL

individual

PURPOSE cognitive geography (the 'physiology' of mindsets)	Anatomy & Physiology PROCESS  structure, buildings,geography time, events, space
(habituated - ) PRACTICE (collective purposes) team integration	the NHS (organisation) POLICY workforce, funding  local, regional, national, global

group - population

Seddon, N. (2013) Opinion: Learning from international innovators, HSJ, 12 April. 123: 6346; 16-17.

Personalised care and gravitas (literally)

The Einstein Cross Gravitational Lens
Original Image Credit & Copyright: 
  J. Rhoads (Arizona State U.) et al.

Today's Astronomy Picture of the Day is described as follows:

Most galaxies have a single nucleus -- does this galaxy have four? The strange answer leads astronomers to conclude that the nucleus of the surrounding galaxy is not even visible in this image. The central cloverleaf is rather light emitted from a background quasar. The gravitational field of the visible foreground galaxy breaks light from this distant quasar into four distinct images. The quasar must be properly aligned behind the center of a massive galaxy for a mirage like this to be evident. The general effect is known as gravitational lensing, and this specific case is known as the Einstein Cross. ...

Health care problems can weigh very heavy on the individual affected by them and their loved ones. To deliver personalised care we first need to resolve the four care domains (five including the spiritual). If personalised care is to be realised (aligned and integrated) in practice and not just two words in policy (political lensing), then we need to remember personalised care can be an illusion in itself.

Additional post:
Person centred care, wormholes, pesterers, care domains (iii)

Reflections on: Designing for Self-Care - the home-clinic difference

As much as I might like to I will not be able to attend Copenhagen and the workshop details of which I posted yesterday. Reading the call for papers prompted the following reflections - many of which may not be relevant to the actual workshop content, but hopefully help illustrate Hodges' model:

INTERPERSONAL : SCIENCES

SOCIOLOGY : POLITICAL

literacy - health literacy, cognitive access, insight, memory, education, communication, attitudes, motivation*, beliefs, BEFORE-AFTER holistic measures, mental health, mood, context, therapeutic modalities, self-recording, person-al purposes - process reconciliation, coding / classification, self data capture, expectations, general health perception, sleep, leisure, independence level (self-efficacy), individual 'clinic' need / attendance, rating of existing clinical relationships, DOO - (presence of) differences of opinion*

physical interface modalities: touch, gesture, eye movement, video interviews; clinical diagnoses (primary), observations, assessment-measures, data capture, medications, lab tests, pain, 'distances' (several not just home-clinic); treatment/drugs - training, mobility (room count, vistas), info prescription, other media - learning materials, self-care tasks (granularity, number, complexity, ...), clinic-al purposes - process reconciliation, evidenced interventions, coding / classification, home adaptations?, experience of telecare? mobile apps? home IT / comms, chronological:pathological age definitions: long term- / chronic

life story, narrative medicine, quality of life, care history - duration / exposure to care systems, domestic relationships, primary care / nursing (multidisciplinary care) relationships, perceived integration of care, social network, access to day care / respite care, definitions - shared vocabulary, self-care folksonomy? (virtual) community creation (outcomes)? affordances, meaning of 'clinic' attendance, 'CKO-X' Carer's Knowledge of

autonomy, power in the home: My space?, service interfaces, available specialist services, responsiveness, support, best interests, privacy, budgets (self), protocol - referrals, political emphasis: physical-mental health? predefined benefits, economic impacts, savings, policy reach, implications for commissioning

As the workshop concerns home - clinic difference and designing for self-care this prompted me to a more detailed consideration of the 'distances' involved. Not just in the physical geographical sense of home-clinic travel (car, walking, public transport, disabled transport) but when last the citizen (patient) visited various locations.

There are many other dimensions of course ... the final context reduces the above to something manageable.

Carer's Rights Day ('Care' a concept going global)

I do wish I had time to update the intro pages which can be accessed on the h2cm homepage. I've assigned the SOCIOLOGY care (knowledge) domains intro to the public and this includes carers.

Today is Carers Rights Day.

In Hodges' model the carer is closer to the policy maker than the 'patient', 'client' - person they care for. This does not make protecting carer's rights any easier. This conceptual proximity to the powers-that-be does not reduce the need for an amplified voice. The focus for tomorrow is Money Matters.

The significant realization many years ago was that carer's actually span all ages. What I have learned over the past two years in my role is that even when a family member goes into residential care, the worry, the caring does not stop.

This past July I heard last minute (dinner time) about Disability Awareness Day which was held locally in Warrington, Cheshire. It was a great day and for people in the NW - and beyond - make a date for 2012 15th July.

As to 'care' going global more to follow ...