Care Design 2016

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#8 Purposefully focus on the design and improvement of the system

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Our eighth proposed redesign principle is to purposefully focus on the design and improvement of the system e.g.

  • Remove unnecessary complexity
  • Drive out waste and eliminate unwarranted variation
  • Redesign activities, connections and pathways
  • Focus on continuous improvement and develop skills and leadership to support this
  • Apply improvement science approaches to system design
  • Design for safety and high reliability to be system properties


Now tell us what you think!

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  1. Candy Perry
    46 pts
  2. Hugh MacLeod
    34 pts
  3. Jane Evans
    30 pts
  4. Wendy Lane
    15 pts
  5. Carol Read
    6 pts

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To me the principle statement as written comes across as more of a statement of intent underpinning why we would develop a new model of care. How would this challenge people to think differently about their approach to designing services, as I am sure everyone intends to do this currently? A lot of the aspects to consider are wrapped into the other principles identified, so I think it would be helpful to test what intervention this principle is adding that is different to the earlier ones.

Wendy Lane
by Wendy Lane
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Wendy Lane

Driving out waste, eliminating duplication, unnecessary variation and complexity - it all sounds a bit Lean to me and Lean didn't achieve the kind of system improvement heralds sang about. Why? because while Lean is a systems methodology it like to operate in hard systems not soft people-based systems. How something should work and was designed to work, and how it works officially on paper is one thing, how it's actually working, and the inherent human systems dynamics operating on the...

Candy Perry
by Candy Perry
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Candy Perry

  Patient Safety and Quality Improvement is stalled.   For this redesign principle to take hold (become un-stalled) your comments/views on the following statements will help produce a new narrative.    First , a 2014 quote by Ashish K. Jha, M.D., a professor at the Harvard School of Public Health... "Unsafe care is not on the top priority list for CEOs. It's not what keeps CEOs awake at night. And until we get CEOs losing sleep about unsafe care, we're not going to make a big...

Hugh MacLeod
by Hugh MacLeod
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Hugh MacLeod

This principle is the foundations on which to deliver the other 9 principles. If the health systems (macro, meso and micro) are not capable of improving then we cannot expect to deliver change sustainably. And improvement is a science that needs to be formally taught and then learnt by the system, by organisations and by individuals. All three levels of capability must be in place otherwise any change cannot be effective. Capability for improvement will ensure that improvements is not seen...

Jane Evans
by Jane Evans
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Jane Evans
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