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Trying to innovate in the NEW NHS

Trying to innovate in the NEW NHS. Challenges we face. Financial Increasing demand Bureaucracy Institutional inertia GP engagement as well as other stakeholders Barriers to change Amongst others:. Innovation in the NHS. Tribalism. Looking back instead of forward.

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Trying to innovate in the NEW NHS

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  1. Trying to innovate in the NEW NHS WAM GCC

  2. Challenges we face • Financial • Increasing demand • Bureaucracy • Institutional inertia • GP engagement as well as other stakeholders • Barriers to change • Amongst others: WAM GCC

  3. Innovation in the NHS WAM GCC

  4. Tribalism WAM GCC

  5. Looking back instead of forward WAM GCC

  6. Single loop learning NHS • Incremental improvements in current practice • Corrects only one error • No long lasting changes WAM GCC

  7. Case Example (Davie) • Obstetric department of Hospital A examines care of patients through clinical audit. • Gaps are identified between current practice and established standards (ie. Guidelines) • Meetings are held to discuss guidelines, with changes made to working practice. And reporting and feedback on practice • Changes made increase the proportion of patients receiving good care for that area. WAM GCC

  8. Double loop learning • When organisations try to rethink their basic goals, norms and paradigms WAM GCC

  9. Case Example (Davie) • Obstetric department of hospital B. • In examining its quality of care decides to interview some patients. • It emerges that the issues which are bothering women are to do with continuity of care, communication skills, access to information. • Obstetric care is reconfigured but the guidelines are not abandoned but woven into the new pattern of interaction and values. WAM GCC

  10. Meta learning • Learning to learn • Increasing our capacity for learning WAM GCC

  11. Case Example (Davie) • Obstetric care at hospital B was a useful experience. • The experience itself was analysed • Through its structure and culture the organisation encourages the transfer of these valuable lessons. • Other hospital services share the lessons about learning to reconfigure WAM GCC

  12. Senge learning organisation • Systems thinking • Improving individual capabilities • Team learning • Mental Models • Shared Vision WAM GCC

  13. Our answers • Learning organisation • Curriculum planning • Outcomes based and situational analysis • Appraisal • Skill shares • Communicate, communicate, communicate! WAM GCC

  14. How will it work • Communicate and engage at early stages • Ownership by all involved – including managers • Develop outcomes that look into the future • Ways of evaluating and reviewing process as it occurs feeding in to the change WAM GCC

  15. What does this mean practically • Initial stages • Masterclass • Newsletters and surveys • Structure with forums to involve all including managers • Learning organisation • Induction process • Appraisal processes • Review of outcomes and changes in delivery of service accordingly • Moodle • System of working and process related to our outcomes WAM GCC

  16. References • Doctors, managers and the battle for quality • Managing Change in Primary Care The chains of education, experience, and culture David Metcalfe • Spencer J (2001)Educational outcomes and leadership to meet the needs of modern health care Qual Health Care 2001;10:ii38-ii45 doi:10.1136/qhc.0100038 • Future of primary healthcare education: current problems and potential solutions J Lord Postgrad Med J 2003;79:553–560 • Developing learning organisations in the new NHS Davieet al BMJ 320 : 998 doi: 10.1136/bmj.320.7240.998 WAM GCC

  17. Questions WAM GCC

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