Join the Revolution: For the Lady in the Corner (c/o ST4Health)

ST4Health

INTERPERSONAL : SCIENCES
SOCIOLOGY : POLITICAL

individual

Lady situated assumptions personal experience	one disease - malaria, smallpox, leprosy, TB,  emergency treatment, hospitals, Africa, systems, capacity
people, society, community, village gender, interactions, humanitarian works,	policy, organisations, population health improvement, global health, poverty, economics, outcomes

group - population
BIG PICTURE (above)

My source:  HIFA2015 list

BBC Horizon II: Processes - step this way ... safely

Following the BBC TV Horizon programme last night "How to Avoid Mistakes in Surgery" I came across the following list concerned with processes:

Sequential steps. Where one step follows another.

Alternative steps. Where conditional logic specifies which of several paths should be traversed.

Iterative steps. Where a single step is repeated multiple times.

Composite steps. Where steps are nested within other steps.

Optional steps. Where any one of a set of steps may be traversed, depending on the results of a boolean operation.

Checklist. Where all of a number of steps must be traversed, but in any order. p.126.

The list is related to software development and manufacturing as per the reference source below. Within informatics and project management I've noticed and written here about the emphasis placed on processes. Process, process and yet more - in one form or other. As A&E doctor Kevin Fong revealed people can get lost in a process (intubation), especially experts within organisational hierarchies - complex teams in urgent circumstances. In information system projects the need for a socio-technical perspective is essential, and is synonymous with due consideration of human factors. Processes are an essential ingredient to understanding the world and there's a huge literature on events, co-ordination, timing, logistics, value ... but as the Horizon programme pointed out there's also a need for reflection, stepping back, taking in or trying to grasp the big picture. Maintaining situation awareness is vital to assure safety and as the program showed in a crisis hindsight makes a blind spot visible. This is why process is one of four P's in Hodges model (the others - purpose, practice and policy). Processes count, but they are only part of the bigger picture.

The steps above are intended for software developers, but the descriptions throw up some points when subject to a more literal - human - interpretation (which might be a problem?).

The 'alternative' steps: could that mean skipping one in turn as in 'alternate'?

And crucially for the checklist are there any risks associated with its being completed in any order?

There is a world of difference between programming methods and logic on the one hand; and human language and dialogue on the other.

Fayad, M.E., Johnson, R.E. (Editors). (2000). Domain-Specific Application Frameworks: Frameworks Experience by Industry. Wiley. p.126.

"How to Avoid Mistakes in Surgery" BBC TV Horizon 21/03/2013 2100 UT

On 03/18/13 9:45 AM, Martin Bromiley wrote:
--------------------
About two years ago I approached Dr Kevin Fong with an idea for a BBC scientific programme, and at last it’s happened. Since September I’ve been working with Kevin and the BBC Horizon team to pull together a programme about human factors in healthcare. It looks at how learning about the human in the system and the system itself can bring about enormous improvements in safety and outcomes that technology and medical science can only aspire to.

Kevin and the Horizon team have produced something inspirational yet scientific, and - just as importantly - is by a clinician, for clinicians. It's written in a way that will appeal to both those in healthcare and the public. It uses a tragic death to highlight human factors that all of us are prone to, and looks at how we can learn from others both in and outside healthcare to make a real difference in the future.

Although the BBC Management chose a surgery based title for the programme to gain mass public appeal the lessons of this programme are for everyone in healthcare.

It would wonderful if you could pass on details of the programme to anyone you know who works in healthcare. My goal is that by the end of this week, every one of the 1 million or so people who work in healthcare in the UK will be able to watch it (whether on Thursday or on iPlayer). BBC 2 Thursday 21 March 2100 UK

Cheers

Martin Bromiley

My source: Joy Whitlock via LinkedIn

New: NHS Change Model

The NHS has a new model to help deliver change, a critical objective over the months and years as new commissioning arrangements are also implemented. The introduction below is from the website, from where the components of the model are also explained following registration and this is a chat forum:

Welcome to the NHS Change Model

The model has been created to support the NHS to adopt a shared approach to leading change and transformation.  We hope to build this website further and add practical information, tools and support over the coming months.  Please tell us what you think to help us shape this model and the ongoing future work using the chat room facility.

Why do we need a change model?
Building on what we collectively know about successful change the ‘NHS Change Model’ has been developed with hundreds of our senior leaders, clinicians, commissioners, providers and improvement activists who want to get involved in building the energy for change across the NHS by adopting a systematic and sustainable approach to improving quality of care.  

What does the model do?

The model brings together collective improvement knowledge and experience from across the NHS into eight key components. Through applying all eight components change can happen. This means no matter whom or wherever you are in the NHS you can use the approach to fit your own context as a way of making sense at every level of the ‘how and why’ for delivering improvement, to consistently make a bigger difference.

NHS Change Model

Social Impact Bonds (SIBs) in Health

The following text is from the report:

Social Impact Bonds
A new way to invest in better healthcare

PURPOSE

This report is about the potential applicability of Social Impact Bonds
(SIBs) in the health field. The SIB is a financial mechanism where 
investor returns are aligned with social outcomes. The SIB is based on a
contract with government in which the government commits to pay for
an improvement in social outcomes for a defined population. Investors
fund a range of preventative interventions with the goal of improving
the contracted outcomes. If and as the outcomes improve, investors
receive payments from government.

To widespread interest, the first SIB was launched in September 2010. 
Its aim is to reduce reoffending among short sentence male prisoners
leaving Peterborough prison.

Social Finance believes that the reach of the Social Impact Bond 
model is wider than Criminal Justice. We asked Professor Paul Corrigan, 
a leading health adviser, to assess the suitability of the SIB model for 
the NHS. This report presents his thoughts. We hope that his report 
provokes a thoughtful debate on how, or alternatively if, financial
mechanisms such as Social Impact Bonds, might fund new 
interventions, improve people’s well-being and ultimately lead to 
a real change in the health system.

http://www.socialfinance.org.uk/resources/guide/new-way-invest-better-healthcare

Additional link:
Paul Corrigan - blog

My original source: HSJ