Intl Cong Poster presentation - Org Cult. JLYS, TD and AG Draft 2
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Collaboration for Leadership in Applied Health Research and Care East of England (CLAHRC EoE) DEPARTMENTS OF PSYCHIATRY & ENGINEERING , DIVS F & C Organisational Management Theory and the UK Patient Safety Movement Not enough time for change Dr Jennifer Spencer Dual CCT MRCPsych, MB, BAO, BCh, BMedSci, BA; Dr Terry Dickerson, PhD; Ms. Amanda Goodger, PhD student; and CLAHRC East of England Background Most industries spend a lot of time and resources thinking about things before making changes. Time to market (TTM) is the length of time it takes from a product being conceived until its being available for sale. The average time to market for a prototype medical product, such as a medical device or a drug, is 5-16 years. A tacit assumption is that TTM and product quality are opposing attributes. Skipping steps of the development process compromises product quality. “Managers are not confronted with problems that are independent of each other, but with dynamic situations that consist of complex systems of changing problems that interact with each other… Managers do not solve problems, they manage messes.” -- Russell Ackoff, Journal of Operational Research Society, 1979 The Sociotechnical system A set of processes that embrace the actions of a number of individuals interacting with relevant technologies Frontline staff were aware of interconnected nodes where communication occurred between different teams. They were aware of safety concerns that were occurring and being addressed within the confines of the frontline staff communication network. Managerial versus Frontline staff perceptions What we learned Managerial versus Frontline Staff Perceptions University of Cambridge Department of Engineering Engineering Design Centre MPhil in Engineering Report A SYSTEMS BASED APPROACH TO TRANSLATE FROM ‘NEED’ TO STARTING POINT 31July 2015 Amanda C Goodger Supervisors: P John Clarkson, Nicholas H M Caldwell, Industrial Supervisor: Adrian Davis h ttp s ://commo n s.wiki me d i a.org RTI Health So l uti on s: Ma rket Acce ss Pl anni n g Across th e Pr oduct Li fe cyc l e www.rti h s .org / s ervi ce s/marke t- a cce ss - a nd -outco me s-strateg y/marke t- a cce ss-h eo r- a nd -pric in g-strate g i es Primary References The Kano Model - Performance needs incrementally improve customer satisfaction. Basic needs must be met to prevent dissatisfaction, but can at best create indifference when met. Delighters are the result of innovation and are the most powerful driver of customer satisfaction. Over time, delighters become performance needs and eventually basic needs. Therefore, the innovation process can never stop. What we agreed to do The concerns managers came up with were compared with service staff concerns to see what the similarities and differences were. Project Setup • Project P rot o co l • QA To o l Des i gn • CPFT Pe rmi ss i o ns • Peer Revi ews • Ethical Re vi ew Ro u ti n e Qua l it y Ind i cato r s Set up | Col ect i on and M oni t or i ng à QA Interventi on Evaluation • Objective 2 PHA Eval. • Ob j ecti ve 1 Project Reporting • For m al • O bj ect i ves 1, 2 and 3 PHA Arm • Consi st s of a m anagem ent wor kshops • Takes pl ace ear l y i n t hi s per i od QA Arm - In te rv e nti on • Cam br i dgeshi re Nort h • Q A I nt ervent i on • O ut - of - Hour s Ser vi ce • CRHT Ser vi ce QA Arm - Contro l • Cam br i dgeshi re Sout h •No I nt er vent i on • O ut - of - Hour s Ser vi ce • CRHT Ser vi ce = M aPSaF Ti mi ngs ar e i ndi cat i ve Bl i ndi ng ( as f ar as pr act i cabl e) Bl i ndi ng ( as f ar as pr act i cabl e) 2011 2012 2013 O ct Nov Dec Jan Feb M ar Apr M ay – O ct Nov Dec Jan Feb M ar Apr M ay Jun Jul y Aug False S tart • I ni ti al at t em pt t o r un t he i nt er vent i on i n Cams Sout h • Changed to Cams Nort h f or t he I nt er vent i on • Revi si t pr oj ect set up act i vi ti es Methodology How do you identify what is missing from a Sociotechnical system? (Sometimes Systems Engineering really is Rocket Science) A Patient-centred care cycle Discussion • Are we making changes to the healthcare system too quickly Is not enough time being spent on the design processes • Is the current healthcare reform process damaging to our desired outcomes? • If we ensured healthcare change was appropriately paced, would outcomes improve? The Hourglass model Defining the need that exists during a time of change
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Transcript of Intl Cong Poster presentation - Org Cult. JLYS, TD and AG Draft 2
Collaboration for Leadership in Applied Health Research and Care East of England (CLAHRC EoE)
DEPARTMENTS OF PSYCHIATRY& ENGINEERING, DIVS F & C
Organisational Management Theory and the UK Patient Safety MovementNot enough time for change
Dr Jennifer Spencer Dual CCT MRCPsych, MB, BAO, BCh, BMedSci, BA; Dr Terry Dickerson, PhD; Ms. Amanda Goodger, PhD student; and CLAHRC East of England
BackgroundMost industries spend a lot of time and resources thinking about things before making changes. Time to market (TTM) is the length of time it takes from a product being conceived until its being available for sale. The average time to market for a prototype medical product, such as a medical device or a drug, is 5-16 years. A tacit assumption is that TTM and product quality are opposing attributes. Skipping steps of the development process compromises product quality.
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Pa ge 57 of 144
Figure 23: The Finalised MM Spreadsheet Model Navigation Interface
“Managers are not confronted with problems that are independent of each other, but with dynamic situations that consist of complex systems of changing problems that interact with each other… Managers do not solve problems, they manage messes.”
-- Russell Ackoff, Journal of Operational Research Society, 1979
The Sociotechnical system
A set of processes that embrace the actions of a number of individuals interacting with relevant technologies
Frontline staff were aware of interconnected nodes wherecommunication occurred between different teams. Theywere aware of safety concerns that were occurring andbeing addressed within the confines of the frontline staffcommunication network.
Managerial versus Frontline staff perceptions
What we learnedManagerial versus Frontline Staff Perceptions
Page 1 of 144
University of Cambridge
Department of Engineering
Engineering Design Centre
MPhil in Engineering Report
A SYSTEMS BASED APPROACH TO TRANSLATE
FROM ‘NEED’ TO STARTING POINT
31st July 2015
Amanda C Goodger
Supervisors: P John Clarkson, Nicholas H M Caldwell,
Industrial Supervisor: Adrian Davis
https ://commons.wikimedia.org
RTI Heal th Solutions: Market Access Planning Across the Product L ifecyc lewww.rtihs .org/s ervices/market-access -and-outcomes-strategy/market-access-heor-and-pric ing-strategies
Primary References
The Kano Model - Performance needs incrementally improve customer satisfaction. Basic needs must be met to prevent dissatisfaction, but can at best create indifference when met. Delighters are the result of innovation and are the most powerful driver of customer satisfaction. Over time, delighters become performance needs and eventually basic needs. Therefore, the innovation process can never stop.
What we agreed to do
The concerns managers came up with were compared with service staff concerns to see what the similarities and differences were.
Projec t Setup• Pro jec t Protocol• QA Tool Des ign
• CPFT Permiss ions• Peer Rev iews
• Eth ic a l Review
Routine Quali ty IndicatorsSet up | Collect ion and
M onit or ing à
QA In
terv
entio
n Ev
alua
tion
•Obj
ectiv
e 2
PHA
Eval
.•
Objec
tive
1
Pro jec t Reporting
• For m al • O bject ives 1,
2 and 3
PHA Arm• Consist s of a m anagem ent
wor kshops• Takes place ear ly in t his per iod
QA Arm -In terv ention• Cam br idgeshir e
Nor t h• Q A I nt er vent ion• O ut - of - Hour s
Ser vice• CRHT Ser vice
QA Arm - Control• Cam br idgeshir e
Sout h• No I nt er vent ion• O ut - of - Hour s
Ser vice• CRHT Ser vice
= M aPSaF
Tim ings ar e
indicat ive
Blinding ( as f ar as
pr act icable)
Blinding ( as f ar as
pr act icable)
2011 2012 2013O ct Nov Dec Jan Feb M ar Apr M ay – O ct Nov Dec Jan Feb M ar Apr M ay Jun July Aug
False Start• I nit ial
at t em pt t o r un t he
int er vent ion in Cam s Sout h
• Changed t o Cam s Nor t h
f or t he I nt er vent ion
• Revisit pr oject set up
act ivit ies
Methodology How do you identify what is missing from a Sociotechnical system?(Sometimes Systems Engineering really is Rocket Science)
A Patient-centred care cycle
Discussion• Are we making changes to the healthcare system too quickly Is
not enough time being spent on the design processes • Is the current healthcare reform process damaging to our
desired outcomes? • If we ensured healthcare change was appropriately paced,
would outcomes improve?
The Hourglass model
Defining the need that exists during a time of change
