Tag Archives: Quality Improvement

Photographic evidence. A long, convoluted road.

Sorry, you are inadequately tenacious to change the world. Go to prison. Do not stop at Go. Do not collect…

If I told you I’m good, you would probably say I’m boasting & Teamworking

We want to be associated with the best – the best team, country, organisation.

Others don’t really care.

Some see the whole of the moon.

Others Brigadoon.

Covid – My blog is calling (Week one, through a doctor/dad/outsider’s lens)

Fear of doing the wrong thing is a fundamental of quality improvement. If you are afraid to act because people might call you out or think you stupid, you won’t do anything, and the quality won’t improve. It won’t necessarily deteriorate either, yet, in times of radical change, that is worse.

Broken sleep & Coronavirus (Bruce Lee, the philosophy of time and space and this week)

Getting rid of the routine allows people to focus on what is important. (Bruce Lee said this in the 60’s – ‘Hack away the un-essential’)

My Job

Mostly, my approach is to consider that we, that is the community services (those outside the acute hospital) can and do support a far broader range of patients than people realise and, when working well together, can care for a significant proportion of the people who otherwise arrive at the door of A&E.

Flow; best left to plumbers.

It perhaps has something to do with my internet settings or preferences, I don’t know; you see, I get a number of emails from different national and international health organisations informing me of conferences and award ceremonies taking place in the realm of Quality Improvement. This is the science of doing things better in healthContinue reading “Flow; best left to plumbers.”

Change, standing still and evolution

I watch the ripples change their size But never leave the stream Of warm impermanence So, wrote David Bowie in 1972. Whenever I think of change these lyrics play in my mind. Let’s take a position on change – it is essential; critical to the survival of our species – we grow, learn, adapt andContinue reading “Change, standing still and evolution”

Dying man

I thought I had aleady blogged about my patient and his dog.   I hadn’t.   He was breathless And now, I realise At the time, things were too raw too proximate to translate into 500-odd words of text.   The man was dying.   Heart failure, COPD, Frailty – The mechanism is not whatContinue reading “Dying man”

Fail fast then try again.

Try, fail fast then try again; repeat. try a little different. like cooking frying boiling, basting. add some salt A little pepper, change this move that, over here there, and fail Fail fast don’t take pride in your attempts to change or improve Just stick with what works and lose no sleep with the failure,Continue reading “Fail fast then try again.”

Standardisation

Let’s face it, us humans are not that adaptable*. Sure, we can survive extremes, cope with trauma and insult, but, when it comes down to it, on a day to day basis we seek consistency, regularity. How much of our world is designed to assist with habit? With doing the same thing the same wayContinue reading “Standardisation”

Stuck

I am stuck. I don’t know if this is because I am in a work-limbo; in the transition between the end of a decade working in Doncaster and a shift to Rotherham, or whether there is something deeper, perhaps more sinister going on. What, if I have run out of ideas? Many years ago, aContinue reading “Stuck”

Dad, did you get the job?

No. It didn’t work-out again. I only had to wait three days to learn that the appointment was not mine. I am sure I could have been made to hang-on longer. But no; Monday until, today (Weds). And, The other guy got the job. Did better in the interview; Maintained his calm under fire. UnlikeContinue reading “Dad, did you get the job?”

York – somewhere else;

I spent a few hours in York yesterday. I travelled up to present some of the work we have done in Doncaster in relation to Quality Improvement, dementia and delirium (signing, dancing, dog-visits – that sort of thing). Recently, I have been talking about the perpetual Narnia which the government has foisted on the NHS;Continue reading “York – somewhere else;”

Twin-peaks?

I have just been reading Matthew Syed’s Black Box Thinking. Much of it was a revision of the work around patient safety and quality improvement that I have been reading for the past couple of years. One thing that stood-out for me was the relationship between incremental improvement and innovation. Matthew explains this using theContinue reading “Twin-peaks?”

Person-centred

Could you Facetime your doctor when you are on holiday in Greece rather than having to wade through the complexities of health insurance (yes, Brexiters) and a foreign health system?

Stop!  

She survived. She could have died – I never asked the question.

1328 and some

‘Did my dad die because someone didn’t follow policy, didn’t pay attention or, was the outcome inevitable?’ ‘Might my mum have survived the operation if she had a different surgeon or she was at a different hospital?’

Unnatural selection

You are unconscious, the focus for the doctors and nurses is maintaining your physiology with particular attention to your brain and heart.

The Interceptors

The point, as is often the case, is my aversion to patients. Or rather, the existential construct that relates to the ‘patient state’ = they who suffer; with the principal goal of my life being to obviate suffering, my objective is to really stop people turning into patients.

And that is the role of the interceptors.

Complex Adaptive Systems, Steppenwolf & Siddhartha

The essence of this is not to not do nothing, but, when we act, whether that act is big – going to war, or small, deciding to smile, there is a likelihood that the effects will reverberate far into time and space.