The Health Foundation - Inspiring improvement - Study tour to Sweden, Jönköping-Stockholm, 25-28 ...
1. Notes
1.1. Introducing hosts of the meeting
2. Participants
2.1. Doc Manchester
2.2. PR health foundation, London
2.3. Bristol, Acute Medicine
2.4. Oxford, General Practice, work for health authority
2.5. London, MD
2.6. Manchester, Gastro Enterology, clinical leadership / healthservice management
2.7. 2nd year MD, London
2.8. Bristol, Management consultant / family physician, hospital CEO
2.9. Junior doc, surgery, Birmingham childrens hospital, clinical strategy
2.10. General manager, Wimbledon
2.11. Final year med student, Cambridge
2.12. London,
2.13. Junior doc, London, respiratory medicine
2.14. London, final year med student
2.15. first year junior doc, Brighton, acute medicine
2.16. trainee obstetrics and gynaecology, taken one year out to work for Health foundation
2.17. Pediatrics registratr
2.18. London, psychiatrist
2.19. final year medical student Manchester
3. Programme kick off
3.1. Anette Nilsson talk
3.1.1. Who are we here for?
3.1.1.1. Shared values
3.1.1.1.1. it's all about values
3.1.1.2. Patient focus
3.1.1.3. population focus
3.1.1.4. Create a sense of coherence in a complex system
3.1.1.4.1. understandability
3.1.1.4.2. manageability
3.1.1.4.3. meaningfulness
3.1.1.5. experts vs guides
3.1.1.5.1. who will guide?
3.1.1.5.2. Who is expert?
3.1.1.6. Seven questions showing the way
3.1.1.6.1. Henriks, Nilsson, bojestig,edvinsson, berger
3.1.1.6.2. for the microsystemteam on their journey to the best possible results
3.1.1.7. A leader must ask for results and make result visible in the daily work
3.1.1.7.1. What are you proud of today?
3.1.1.7.2. Understand the outomce / results
3.1.1.8. Important
3.1.1.8.1. will
3.1.1.8.2. ideas
3.1.1.8.3. execution
3.2. Göran Henriks talk
3.2.1. A journey of learning from others
3.2.1.1. Dartmouth
3.2.1.1.1. value compass
3.2.1.2. Balanced score card
3.2.1.2.1. Using Balanced Score card by Norton et al. - 4 lenses to evaluate systems
3.2.2. no connection
3.2.2.1. Process
3.2.2.2. outcomes
3.2.2.3. leadership
3.2.3. Whole is different than the pieces
3.2.3.1. improvement comes in small steps
3.2.4. Build a culture of continuous improvement
3.2.5. Shortcomings in the system
3.2.5.1. capability
3.2.5.1.1. drive by professionals (bottom up)
3.2.5.2. capacity
3.2.5.2.1. decided (top down)
3.2.6. Top down AND bottom up approach results
3.2.6.1. results are made bottom up
3.2.6.2. no progress is made without a strong strategy (top down)
3.2.7. 50% of workforce is engaged in in quality improvement working on processes
3.2.8. Attempts to integrate micro systems into macro systems
3.2.9. It's a dynamic interaction between politics and healthcare workforce
3.3. Boel Andersson Gäre talk
3.3.1. Linking knowledge-research-learning-improvement in practice - for better patient/population health
3.3.2. Trust is core
3.3.3. Shares a personal story of engagement in learning and quality: continuously looking for feedback
3.3.4. Physicians are leaders all the time
3.3.5. Jönköping system learning
3.3.5.1. not all parts in system were connected well
3.3.5.2. improving clinical and patient perceived results and improving improvement
3.3.5.2.1. improvement science; leadership, learning, informatics
3.3.5.3. Futurum
3.3.5.3.1. clinical research
3.3.5.3.2. epidemiology
3.3.5.3.3. outcomes research
3.3.5.4. Qulturum
3.3.5.4.1. systems theory
3.3.5.4.2. variation
3.3.5.4.3. psychology of change
3.3.5.4.4. theory and action
3.3.5.4.5. leadership
3.3.5.5. clinical practice
3.3.5.5.1. care which is safe, effective, equal etc., increased value
3.3.5.6. "Gulbenkian-meeting" final statement
3.3.5.6.1. What we need is: not structural changes with new boxes but instead a wider and more open organization for the intellectual capital
3.3.5.6.2. groups around and about specific interests and themes
3.3.5.6.3. focus on questions around themes
3.3.5.6.4. transparance, openness, capability and sustainability
3.3.5.7. "Engaged scholarship"
3.3.5.7.1. Van de Ven 2008 (ref)
3.3.5.7.2. see the gap between theory and practice as a knowledge production problem rather than a transfer problem
3.3.5.7.3. "a participative form of research"
3.3.5.8. Batalden & davidoff, 2007
3.3.5.8.1. it takes many knowledge systems
3.4. Johan Thor - talk
3.4.1. Swedish vs UK healthcare system
3.4.1.1. Comparing w UK
3.4.1.1.1. Malmö 300.000 inhabitants
3.4.1.1.2. 15% of Swedish residents is born outside of Sweden
3.4.1.1.3. Values / culture
3.4.1.1.4. Aging population
3.4.1.1.5. UK
3.4.1.2. How is universal access to healthcare achieved?
3.4.1.2.1. Sweden
3.4.1.2.2. UK
3.4.1.3. How is healthcare paid for?
3.4.1.3.1. UK
3.4.1.3.2. Sweden
3.4.1.4. What does the healthcare system do to accomplish high quality, safety and value?
3.4.1.4.1. Laws and regulations
3.4.1.4.2. Soft regulations
3.4.1.4.3. Healthcare Quality actors
3.4.1.5. Improvement in our heart
3.4.1.5.1. how do we catch the spirit where all employees can contribute for the systems peak performance
3.4.1.5.2. from theory to praxis and back again
3.4.1.5.3. to develop a change culture
3.4.1.5.4. We have two jobs
3.4.1.5.5. References
3.4.1.6. New node
3.4.2. Jönköping academy
3.4.2.1. mission statement
3.4.2.2. A collaborative initiative
3.4.2.2.1. Jönköping county council
3.4.2.2.2. 13 municipalities
3.4.2.2.3. Jönköping university
3.4.2.3. faculty of all different schools of Jönköping university in the programme
3.4.2.4. "bridging the gaps" project wsa starting point
3.4.2.5. Master program on Quality improvement and leadership in Health and Welfare Services
3.4.2.5.1. model after Dartmouth programme
3.4.2.5.2. collaboration w Paul Batalden
3.4.2.6. Trying to learn iteratively
3.4.2.6.1. 8 steps approach
3.4.2.6.2. students: usually mid career
3.4.3. QUASER project
3.5. Paul Batalden
3.5.1. started in medical school 1963
3.5.2. career: studying knowledge necessary for quality improvement in healthcare
3.5.2.1. generalisable science
3.5.2.2. particular context
3.5.2.2.1. or particular patient
3.5.2.3. measurable performance / outcome
3.5.3. if it doesn't make sense in the front lines of care, it will not be adopted
3.5.4. Value compass
3.5.4.1. how do you know a change is an improvement?
4. Reflections on Social Media during the tour, #HFSweden
4.1. Twitter Transcript
4.2. Twitter analytics
4.3. Recommanded reading/viewing (link to storified reading list)
4.3.1. Corporate culture survival guide
4.3.2. Appreciative inquiry
4.3.3. Dan Pink on motivation (RS Animate)
4.3.4. From god to Guide - TEDxMaastricht, Bas Bloem
4.3.5. The story behind Patients Like Me (TED, Jamie Heywood)
4.3.6. Experience based co-design
4.3.7. Jönköping quest for high performance
4.3.8. Balanced Score card, Norton et al
4.4. Websites
4.4.1. www.patientslikeme.com
4.4.2. www.myhealthstory.me
4.5. Themes (link to storify)
4.5.1. What we can learn from the corporate world
4.5.2. Value of Simulation
4.5.3. Patient participation
4.5.4. Open access
4.5.5. Potential of Intelligence of the masses/crowd
4.5.5.1. informing patients
4.5.5.2. informing doctors
4.5.6. Working on Quality improvement
4.5.6.1. How do you embed this in a culture?
4.5.6.2. What can we learn from Sweden?
4.5.7. Leadership
4.5.7.1. High turn over of leadership vs long lasting leadership
4.5.7.2. Competence
4.5.7.2.1. Social
4.5.7.2.2. medical
4.5.7.3. Synergy in combining different fields of competence
4.5.7.4. Focus on what you CAN change!
4.5.7.5. Importance of Consistency of leadership + consistency of dialogue
4.5.7.6. "We built our network together" - there was no need for experts
4.5.7.7. Professional development is key
4.5.7.7.1. to better outcomes
4.5.7.7.2. to system improvement
4.5.7.7.3. "A day without problems is a day without learning"
4.5.7.8. Results in healthcare are made Bottom up!
4.5.7.9. Top Down leadership: Build supportive (infra)structures
4.5.8. TQM and ISO certification
4.5.9. Balanced Score card
4.5.10. What we love about NHS (link to storify)
4.6. Storifies per day, chronological order
4.6.1. Day 1
4.6.2. /dat 2