Are you working at full STEAM?

I've just been reading through the Welsh Government Report of the Independent Review in Neonatal Services at Prince Charles Hospital in Cwm Taf Morgannwg University Health Board. Much of it was sadly familiar, as I wrote an internal review of women and child health services in that region about 15 years ago. A few things... Continue Reading →

Lean, with Joy and Mary…

I prefer to comment on a blog, on the blog itself. It helps to convert them from monologue to dialogue: which all bloggers appreciate. On this occasion, however, I have got too much to say and it would distract from the excellent blog on Lean, published by Joy Furnival. A few weeks ago, while Joy... Continue Reading →

See One, Do One, Teach One.

One of the important things to consider when being a general curmudgeonly old goat, especially on social media, is that you have to be willing to openly accept two inevitable consequences. Firstly, be ready to humbly apologise. You'll occasionally bleat at a touch of blather that got your goat up, only to discover that the... Continue Reading →

Inconvenientis and the Rise of the Shiny

I love this cartoon! It so clearly articulates what I consider to be one of the most virulent barriers to transforming organisations. This disease seems to have taken hold in many industries, but disconcertingly over the years, I've spotted some of the symptoms glistening across the sweaty brow of Healthcare. Having invented the concept of... Continue Reading →

The Mystical Acronomicon

I recently tweeted out this image and it got some attention, so I went off trying to remember why I had created it. Several lovely clicks and reminiscences later, I found one of my typical curmudgeonly responses to a name drop, in a stimulating blog by @whatsthepont from a couple of years ago. So I... Continue Reading →

Fads, Acronyms & Healthcare Improvement

Complex Systems are driven by the quality of the interactions between the parts, not the quality of the parts. Working on discrete parts or processes can properly bugger up the performance at a system level. Never fiddle with a part unless it also improves the system.

Innovation, shiny toasters and the pedlars of bull!

I'm fed up of all the bull being peddled about innovation. There's a particular type of proselytism that has emerged from the open collared, soft shoed, jacket juxtaposing, ikea-esque, media trained, expensive lack of haircut, i-everything, shiny-grinned consultancy brigade. These Innovatists pepperpot their well coiffured zoomy presentation thingy, with phrases like "socio-technical" and "prefix-leaderism" and an... Continue Reading →

Thinking about population health …

Population health has been defined in many ways, of which this opening gambit from Wikipedia is a good example, "the health outcomes of a group of individuals, including the distribution of such outcomes within the group".[1] I think that’s a bit dry! I like to think of population health at the scale of a community; with... Continue Reading →

Alaskan Déjà vu

The first time I saw a presentation about The Nuka System of Care, I was sat at the back of a big lecture theatre, next to an old fella who was chuckling his way through the whole thing. The presentation was full of the typical marketing malarkey used by people flogging a story that they... Continue Reading →

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