Care Design 2016

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#9 Design on a model of living systems, not a machine

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Our ninth proposed redesign principle is to design on a model of living systems, not a machine e.g.

  • Not imposed top-down in the search for ever-increasing cost reductions and operational efficiencies
  • Based on open systems
    - continuous flow
    - non-linear
    - self-generating networks
  • Networks of communication, communities of practice
  • Intrinsic motivation for change

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  1. Andy Bradley
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  2. Jennifer Clemo
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  3. Hugh MacLeod
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  4. Steve Adshead
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  5. Thomas Nolan
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For Care Design 2016 to be successful healthcare institutions need to balance three pillars: 1. Efficient and effective operating system 2. Supportive management infrastructure 3. Deep-rooted learning organization Operating System The operating system is the nuts and bolts of the organization’s processes. During a transformational journey, the operating system is commonly improved by applying “improvements” techniques. Areas of focus include: reducing variation in...

Hugh MacLeod
by Hugh MacLeod
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Hugh MacLeod

In a new system some aspects will best be designed using machine models, perhaps medication delivery in a hospital or care in a severe acute episode. Many more situations will require models closer to living systems. Both may be useful design provocations. If the concept of a machine is off putting maybe using the voluntary and involuntary functions of a living system could be a more acceptable design provocation.

Thomas Nolan
by Thomas Nolan
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Thomas Nolan

Living systems are not about control, but have a focus on flexible infrastructure. They are not about plans, but are understanding of dynamics and flow.  If we compare an organisation to a human body, a self-organising organism where the strengths comes from our muscles whose are flexible and agile (not rigid and controlled), a heart pumping oxygen through the body, the organs who form equal but diverse partners who work interdependently and collaboratively in achieving a healthy...

Heidi De Wolf
by Heidi De Wolf
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Heidi De Wolf

I hear many stories, most with some kind of safe guarding theme, directly from the person experiencing a situation . And I speak to many health and care professionals who feel unable to change the system, and who feel unbearable pressure to protect themselves and be able to demonstrate compliance with rules in case their practice is audited.  Herein lies the dilemma - As a system professional I must do what needs to be done for the person in my care which means using my professional...

Candy Perry
by Candy Perry
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Candy Perry

I travel hallways, cafeterias, meeting rooms and hierarchical power-based ladders. When I listen to the stories and experiences from citizens who have lost loved ones due to preventable system failure, I hear a common theme, "They did not listen to us." When I listen to a coroner, I hear a common theme, "The family was not listened to." When I listen to front-line care providers, I hear things like constantly being over census, short-staffing, casual and constant churn of staff, new...

Hugh MacLeod
by Hugh MacLeod
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Hugh MacLeod

Information technology offers an ideal framework to cater for individual differences. Clinical practice and research has been dominated by one dimensional diagnostic categories and the simple logic of randomised control trails for too long. Living systems do not confirm to the idealised controlled conditions of the physicist's laboratory; they are inter-correlated systems of competing forces bound in a dynamic flux of power and control. Thesis, antithesis and synthesis. If the NHS wants to...

Steve Adshead
by Steve Adshead
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Steve Adshead
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Care Starts with the Self - attempts to design a model based on living systems that are not aware of this will be incomplete and disembodied and may be experienced as a projection. Health begins at home - in each of us. Activating self care is where the living system comes to life as each of us is part of the whole. If I am broken and not taking ownership of my health and I cannot be part of the whole - the flow and I will experience the system as separate to me. Thinking in this way...

Andy Bradley
by Andy Bradley
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Andy Bradley
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On 24.9.15, Helen Bevan visited AQuA's Leading Transformational Change Programme to lead a masterclass on 'Engagement for Transformation.' Helen asked the delegates to look at the ten draft redesign principles and give their feedback. Here is what they said about this ninth principle ' D esign on a model of living systems, not a machine '... "Value for money needs to be built in" Remove the statement"...in the search for ever-increasing cost reductions and operational efficiencies"...

Care Design 2016
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Care Design 2016
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Care Design 2016 (Admin)

Hi All, Please could you clarify what you mean by a 'model of living system'? Does this refer to the system being a living/changing thing itself, or is it a model to focus on whole life quality? Please help. Confused of Coventry.

Jennifer Clemo
by Jennifer Clemo (Admin)
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