Thomas John Rose's activity
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Thomas John Rose posted an update in the group Philosophy and ethics for health care improvement 4 months, 1 week ago
My reflections on yesterday’s excellent webinar discussion:
Not only the relationship between technical vs relational in the QI process important; the same relationship in ‘work in healthcare’ and the state of both in the healthcare system are also important and need consideration. So far we have:
· The QI process,
· Work in healthcare, and
· The healthcare system.
What about the relationship between technical vs relational in what we are trying to improve?
A recent cyber attach on a healthcare IT infrastructure, technical, brought Trusts to a standstill were as a period of doctor’s strikes, relational, have resulted in a number of cancelled appointments and ‘work’ not significantly disrupted.
With the advent of EPRs and increasing reliance on AI the ‘technical’ aspects of work in healthcare is becoming more prevalent.
Key to this relationship in today’s healthcare work environment is the effectiveness of your ‘technical’ infrastructure. Within this infrastructure I do regard work processes as a key element. If the technical infrastructure is not effective, as in most parts of the NHS and if processes are not designed and managed then human error, relational, is endemic and the relationship between technical vs relational becomes skewed and meaningless.
The current practice of QI in the NHS, never mind the relationship between technical vs relational, will never resolve this situation. In terms of what I would like to see – 100% relational – but that would require 100% technical effectiveness.
Have a look at this: https://skybrary.aero/sites/default/files/bookshelf/32620.pdf
Hi Tom
Interesting points. My organisation recently experienced technical issues resulting in moving to a new server, most of our work is recovered BUT we are locked out of our old email, this causes major issues in getting back into some systems as they insist on sending verification emails to an address you cannot access. Now with a 2 step verification process this can be overcome, but on other systems where its email alone, this becomes time consuming to resolve.
Perhaps in the discussions of relationships its worth exploring our relationship with IT and AI as there can be a tendency to take for granted it is there and will do as we expect, even though we know the risks. Not so mush an issue where there are IT departments keep on top of this, but not everyone has those, but most of us are becoming more reliant on the technical to maintain standards and our connections and collaborations with others. Perhaps an interesting future conversation exploring the team mate that is IT and how we make sure we stay in sync too
Just a thought
Hilda 🙂
Also, even more important now, DATA and DATA COLLECTION. Now we have 4!
Hi Tom, Data yes but the right methodologies used when analysing data to help make sense of the process capability must come hand in hand, we need to understand what is variation in a complex adaptive system, what is “normal” variation and “not normal” is essential to support good decision making. I wonder what is our experience with how data are collected, processed, cleaned and presented? Lots to think about.
Hi Isabel. SPC is a bit of an art. It is normal (but not in the NHS) to collect data from a single process. That process MUST be standardised throughout the data collection period otherwise any variation source cannot be identified. You are right – lots to think about – but – the first step is to understand and define process and processes.
Juran, in his Handbook, has a good section on SPC.
Hi Tom, think BI is something we need to learn to support the relational piece https://www.ihi.org/insights/how-behavioral-insights-could-support-quality-improvement?utm_campaign=tw&utm_medium=email&_hsenc=p2ANqtz-8Ow2OdbDrOLIBoRB4p6_5t6Yd7Qilwif_TyRfSRRmcHnYvtv8dM7DVIs6XWU3W6XrPnQyDdu-hIl3PFR4xjLZzBEnELQ&_hsmi=329082317&utm_content=328699973&utm_source=hs_email
A very interesting tool and certainly of value in a QI project. I think though that it may be too much for FLS to understand and implement in addition to their day job. FLS should be left to concentrate on CI rather than QI. QI should be the domain of a better trained and dedicated MDT design team. Of course in order for this to work first some process management would be required, the CI bit that is. This would facilitate the sort of data collection requirements touched upon in your post below. The FLS could then do the data collection.
See: https://www.iso.org/healthcare/data-analytics?utm_source=ActiveCampaign&utm_medium=email&utm_content=Unlock+the+future+of+healthcare+with+data+analytics&utm_campaign=health-auto2+data+analytics&vgo_ee=Xke7L44VOZEGgz12UpMNA6xmJ%2BZ1eOvgVqWSsp2bo5JtgTg%3D%3AJTESmQ9%2B75e0JSa90OlJARbWDEC3Y79T