For more years than I care to mention, I've been embroiled in a long term programme of work exploring flows in healthcare. In simple terms, how the work and the patients move around the system. For the past two years it's gone onto the back burner. Actually the instruction from the then Leadershipper was to... Continue Reading →
After a rather marvellous weekend at NHS Hackday Cardiff 2015, I'm knackered. But, equally excited with the potential that emerged in just few hours by interacting some carbon with some silicon. Lindsey (coding witchcraft), Warren (sexy engineering), Michael (social inspiration), Jas (clinical rudder), Gareth (sense checking) and me (noisily interfering) worked on different bits of bringing a... Continue Reading →
Population health has been defined in many ways, of which this opening gambit from Wikipedia is a good example, "the health outcomes of a group of individuals, including the distribution of such outcomes within the group". I think that’s a bit dry! I like to think of population health at the scale of a community; with... Continue Reading →
An absolutely excellent resource for anyone with a penchant for mashing up some systems theory, healthcare and “how to work in a way that is more congruent with the people and communities you are actually a small part of”. That last bit is mine.
I certainly wouldn’t put my own contributions in the same category as those giant shoulders listed in the blog, however, if you’d like to see what some of the ideas look like, when you sneak them into practice in one small corner of the world, take a look here:
We believe the following ten resources to be great systems thinking and complexity in health resources for health professionals in all fields seeking to apply these ideas to their work.
1. No list of systems thinking resources would be complete without includingSystems thinking for Health Systems Strengthening by the Alliance for Health Systems Research and WHO Geneva. This is the third in a series of flagship reports by the Alliance for Health Systems Research and has had a widespread, and increasing influence. This Report provides a realistic understanding of effective approaches to strengthening systems, especially in low-income countries and global health initiatives. The report also outlines simple steps to take when seeking to apply the often-elusive systems thinking. The ten steps it gives to applying systems thinking to a health system are (1) convene stakeholders, (2) collectively brainstorm, (3) conceptualize effects (4) adapt and redesign, (5) determine…
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An interesting project and I’m looking forward to digging into the taxonomy a bit deeper, to see whether they are considering the typical complexity of each person as a predisposition for their eventual route through the system. Age and frailty are not significant attractors; yes, the majority of people are older and many are frail but those characteristics are not accurate determinants for particular outcomes.
Interestingly, when we looked at journeys across acute care for this patient group within NHS Wales (data health warning aside) – across every organisation the distribution of patients being discharged to their usual place of residence changed significantly at about 19 days in hospital. At that tipping point, your chances of going home dropped by up to 50% and the cause was not due to any specific criteria, the effect simply randomised ie the driving characteristic appeared to be luck!
The British Geriatric Society are pleased to announce that our partnership project with the NHS Benchmarking Network is now live for data collection. Care of older people in acute settings is an exciting new project for 2014 which looks at pathways for older people through secondary care.
The project has been developed in conjunction with the BGS, and it will consider the path older people take through secondary care. The project looks at the journey from A&E through to short term assessment units, elderly care wards and supported discharge processes. Links with other sectors including primary care, community services, mental health and social care particularly at the front and back end of hospitals will be of particular interest and are explored in further detail in the project.
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