Sunday 5 April 2009

Clinical quality vs profit

They say another key difference between clinicians and managers is that managers are only interested in what will make money, whereas clinicians are only interested in delivering the highest quality.
I don't know if you've studied Lean methodology in any detail? It's a series of techniques for improving the delivery of services and products, and
NHS Institute for Innovation and Improvement has released a number of guides of its Productive series, Productive Ward, etc.
This is about getting people to question the way we do things round here, to see if there's a better way.

Community Engagement

It's about getting staff engaged locally, down to their own individual teams, and some of the techniques including management by walking around and process mapping involve everyone working together - sponsors (typically executive directors), senior doctors, consultants, nurses and AHPs, hospital staff or primary care health care staff (staff nurses, staff medical, etc) - to map out how the patient journey is done now and where are the things we do that don't add any value.
For example, the patient waiting in the waiting room doesn't add any value. The patient going home and coming back for another appointment doesn't add any value. Writing labels on blood samples going for diagnosis adds value, but is there a better way (adds more value or takes less effort). Recording the number of patients waiting only adds value if you do something with the results.

Staff Evaluation

Staff themselves are involved. We work together. We learn from each other, understand why a particular action or a particular step is necessary, and jointly evaluate and agree what isn't necessary. The service is better quality, because there's less waste. The service is lower cost/ uses less resource, because there is less waste.

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