Sorry, you are inadequately tenacious to change the world. Go to prison. Do not stop at Go. Do not collect…
Incivility from me to you is as bad as my stabbing you with a knife, just less bloody.
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.
If their lack of safety is 10 times greater than your perception of safety, are they safe? Are you?
What became even funnier was the background I occasionally use of a photo I took in the winter of a cob-web.
The slower we move now, the more people will become ill or die.
There is still plenty of bread, flour and beans in the UK.
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.
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’)
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.
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.”
It is hard to be an Outsider.
It is hard to go it alone.
We humans aren’t designed for prolonged battles of isolation;
Would a tiger if given the option have chosen its stripes? Surely;
That is the best way to end-up with an unhappy, mediocre, computer programmer. Not a happy lepidopterist.
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”
I hadn’t laughed so much (about me, A and C’s stupidity) since arriving in Rotherham; this is the secret to significant improvements in health.
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”
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.”
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”
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”
Costa person one, ‘We’d better tell the continuous improvement team about that.’
Ignorance is not bliss.
Who have slipped from, Jean in the corner, retired postmistress from Fife, to bed 12;
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?”
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;”
What is important and where we must return is the individual starfish.
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?”
Quality Improvement is, fun.
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?
She survived. She could have died – I never asked the question.
‘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?’
Thank goodness for those who push the boundaries, who are open and transparent, showing the world that we aren’t infallible, perfect beings. That we are all human.
You are unconscious, the focus for the doctors and nurses is maintaining your physiology with particular attention to your brain and heart.
As modern humans we are the best of the best – most of us are perhaps not as perfect as the Olympians strutting their stuff at Rio, but, pretty damn good.
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.
And so, back to the junior doctors –
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.