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There are few healthcare systems that can show evidence of working together collaboratively on anything more than a small scale. In fact, much collaboration is resisted because one party will see that the outcome is detrimental to their own organisation’s income or activity. Whole programmes have been put at risk by the inertia that enters into a system when senior leaders think parochially and lose sight of the bigger picture and the fact that ultimately everyone will be a winner but not everyone can win everytime.

To find out more about how we are working with whole health systems to introduce collaborative transformation contact us today on 0870-446-1002 or visit our website at www.amnis.uk.com.

Is it any wonder that when people have been involved in one service redesign exercise after another that have not led to actual improvements in the way things are done that they lose the desire to get involved in new initiatives? The problem is that the management ‘will’ to follow through normally does not extend beyond the actual ‘brown paper’ exercise itself. This is because implementation is hard and time-consuming and, being frank, less exciting than putting post-it notes onto brown paper but it is only implementation that generates the improvements ultimately.

To find out how we can help you turn brown paper into improvements call us on 0870-446-1002 or visit www.amnis.uk.com.

Some of this is related to the way that our system is set up to encourage organisations not to work together effectively by focusing on the income of individual organisations and not focusing on ‘whole systems’ working and the efficiencies of whole pathways. Even more inefficiency is brought about by the inherentcultural inertia in the system brought about by low levels of trust between teams and between organisations and a desire for individual organisations to implement their own transformation plans in isolation of other organisations, even when most patient pathways span at least two and often more organisations.

Do these behaviours lead to optimum performance? Well, with examples cited by the OECD in the UK of high unneccessary admission rates for things such as COPD and Asthma and other evidence about the actual amount of time spent by clinicians working directly with patients would suggest that a fragmented approach to transformation would be sub-optimal.

To find out how we can help you create an integrated transformation plan contact us today on 0870-446-1002.

Lean isn’t mean, Lean is green and if you want to know more then you can contact us on +44(0) 870-446-1002 or email info(a)amnis.uk.com.

Being clear about the problem you are attempting to solve is as important as how you tackle it. Where you sit in a pathway will affect how you perceive what needs to be done and where you would like to focus. For example, deciding to tackle ‘Urgent Care’ may mean something completely different to a commissioner than it does to a Nurse based in a hospital based assessment unit. These differences may appear slight at the outset when the desire to improve is very high but as time goes on and plans turn into actions if there is a difference of opinion about what the ultimate aim is then the problems about how the ‘wins’ are distributed and who will lose budgets or need to make additional investments can become real barriers to moving forward.

Effectively scoping the problem prior to moving into action is the key to improvements within individual pathways and in Lean Systems this often means using an A3 or Scoping Paper that clearly sets out the compelling need for change, has defined measures of success (with tangible numbers attached) and tackles such things as the project risks (and how to control them), the other projects going on (and how you will link to them) and the fixed points (in terms of things that cannot change). This isn’t the only information you will need but it will go a long way to ensuring your programme sets off in the right direction.

If you work within a healthcare or other public sector organisation or within a manufacturing or other industrial company and would like a template for an A3 please contact us via email to info(a)amnis.uk.com.

Taking an End-to-End view of improvement activities is the key to transformation. Looking at pathways, value streams and processes only within a department or across a single organisation normally leads to minor improvements that are difficult to sustain, and the reason they are difficult to sustain is because such things as the quality of information and peaks/troughs of activity coming into the department or organisation has not been tackled.

Focusing internally can also lead to costs and risks being transferred elsewhere within the overall system. For example, a change of policy on checking for errors in one area can lead to increased errors occurring further downstream.

Having said this, even taking an End-to-End (E2E) focus is not fool proof and sometimes you need to consider the impact of other pathways and processes within a ‘Whole System’. This is where you start considering the overall organisation and reviewing where you really should be applying resources, as well as assessing the risks of ‘knock on’ effects of transformation activities in one pathway affecting others.

To find out more about Whole Systems Analysis contact us on info(a)amnis.uk.com.

One of the most important things to do with your service improvement programme is to link tactical ‘Rapid Improvement Events’ to your organisation’s strategic objectives. This is called Transformation Mapping and is an essential part of any improvement programme. Any activities that are not clearly linked to your strategic objectives are liable to not engage your senior team and could possibly waste a lot of time and money.

Creating a Transformation Map involves six steps, namely:

1. Getting clarity on your high level improvement objectives and understanding exactly what they mean (quoting Jim Easton from the Department of Health – “Some is not a number, soon is not a time.”)

2. Identifying the actions that will enable you to deliver each of your high level objectives

3. Putting the actions into a ‘time sequence’ identifying when each will be undertaken

4. Looking at the risks and issues that might undermine your plan

5. Implementing and managing the plan

6. Updating the plan regularly

 If you link your transformation map to your actual Lean/Service Improvement activities it is much more likely to generate the improvements you are looking for and for those improvements to stay in place rather than just ‘drift away’.

For more information on Transformation Mapping contact us on info(a)amnis.uk.com.

Nothing is more motivating than giving people the skills to improve performance and then enabling them to actually take the time to make the changes. Nothing is more demotivating than bringing in an outside organisation to gather information from your team and then make the changes and claim the credit for ideas generated by frontline staff. Not only is the latter approach more expensive it is also significantly (by an order of magnitude) less likely to actually result in changes that will actually embed themselves in the organisation. Sure, you can force people to do things differently, you can even bully them or bamboozle them into it but the moment there is a problem they will fold their arms and look to you for a solution.

By contrast, empowering people to make change, and that means more than just sending them an email telling them they are somehow ‘empowered’, and then giving them the space and skills to make the changes is more likely to lead to change that ‘sticks’ and to an environment where people are prepared to actually get involved in continuous improvement.

To find out more about empowering and developing your team call us on 0870-446-1002 or email info(a)amnis.uk.com.