{"id":2287,"date":"2013-04-29T11:00:05","date_gmt":"2013-04-29T10:00:05","guid":{"rendered":"http:\/\/www.idenk.co.uk\/blog\/?p=2287"},"modified":"2013-04-20T18:02:29","modified_gmt":"2013-04-20T17:02:29","slug":"getting-rid-of-the-mess","status":"publish","type":"post","link":"http:\/\/www.idenk.com\/blog\/getting-rid-of-the-mess\/","title":{"rendered":"Getting rid of the mess"},"content":{"rendered":"

The impact of the Francis inquiry in health care in the UK continues to reverberate. We like the very practical things (speak \u2013 act \u2013 lead) that individual doctors are being encouraged to do by a bunch of their peers<\/a>.<\/p>\n

And in a recent blog <\/a>we posed the question of what can be done\u2013 and offered a teaser of an example to learn from\u2026<\/p>\n

We think the improvements that have led to a reduced nuisance of dog fouling is due to a number of \u2018nudges\u2019 that make it easy for people to do the right thing, every time.<\/p>\n

Looked at through one of our favourite frameworks \u2013 SPP<\/a>– there are a number of things that have helped sustain progress in cleaner streets\u00a0and parks\u00a0over the last few decades:<\/p>\n

There was change in three dimensions:<\/p>\n

1) STRUCTURE change \u2013 by laws to regulate some action, set a path and direction \u2013 with prosecution of (human) offenders<\/p>\n

2) PROCESS change \u2013 town planners listened to local people and put in dog poop bins and systems to empty them+++<\/p>\n

3) BEHAVIOURAL pressure for personal responsibly \u2013 from other dog walkers to do something pretty unpleasant with a plastic bag (even when no one is watching)<\/p>\n

So, how does this help in thinking about getting rid of the mess in health care? For example, on improving compassion in health care, I think there are things to do at all three levels:<\/p>\n

a) STRUCTURE: Promoting leaders for their values (plus thorough regulation of professions too)<\/p>\n

b) PROCESS: Investing in the capacity for bottom up staff and patient led improvements \u2013 leaders listening and helping<\/p>\n

c) PATTERN: Building a cultural campaign amongst staff for calling unproductive behaviour by peers on the wards, etc. This is something that is pretty hard for many to do \u2013 and not for just when others are watching. But it is essential to get beyond the sort of verbal \u2018window dressing\u2019 (\u201cwe are here for the patients\u201d) that can happen in \u2018noble purpose organisations\u2019<\/a>.<\/p>\n

I walked over a verge in the dark the other night and realised I no longer worry about what I might stand in like I did when a lad delivering papers during early winter evenings. It reminded me again of this inspiration for health service improvement post Francis. An example based on 3 levels of \u2018nudging\u2019 \u2013 structure, process and pattern of behaviour. A model on what has helped eradicate dogs mess on the streets.<\/p>\n

(btw, I think the process improvements of the bereavement system (with the one stop shop approach to cancelling passports, driving licences, etc) is another example of a study of success change\/improvement with the SPP framework in mind: new integrated IT system, more time for registrars and a willingness of staff from hospitals to town hall to help make it work for relatives\u2026.but maybe that is another blog\u2026)<\/p>\n","protected":false},"excerpt":{"rendered":"

The impact of the Francis inquiry in health care in the UK continues to reverberate. We like the very practical things (speak \u2013 act \u2013 lead) that individual doctors are being encouraged to do by a bunch of their peers. And in a recent blog we posed the question of what can be done\u2013 and […]<\/p>\n","protected":false},"author":5,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[154],"tags":[97,157],"_links":{"self":[{"href":"http:\/\/www.idenk.com\/blog\/wp-json\/wp\/v2\/posts\/2287"}],"collection":[{"href":"http:\/\/www.idenk.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/www.idenk.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/www.idenk.com\/blog\/wp-json\/wp\/v2\/users\/5"}],"replies":[{"embeddable":true,"href":"http:\/\/www.idenk.com\/blog\/wp-json\/wp\/v2\/comments?post=2287"}],"version-history":[{"count":3,"href":"http:\/\/www.idenk.com\/blog\/wp-json\/wp\/v2\/posts\/2287\/revisions"}],"predecessor-version":[{"id":2299,"href":"http:\/\/www.idenk.com\/blog\/wp-json\/wp\/v2\/posts\/2287\/revisions\/2299"}],"wp:attachment":[{"href":"http:\/\/www.idenk.com\/blog\/wp-json\/wp\/v2\/media?parent=2287"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/www.idenk.com\/blog\/wp-json\/wp\/v2\/categories?post=2287"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/www.idenk.com\/blog\/wp-json\/wp\/v2\/tags?post=2287"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}