1 csc protected / csc sensitive (delete as appropriate) csc’s healthcare group health it and the...
TRANSCRIPT
1 CSC Protected / CSC Sensitive (delete as appropriate)
CSC’s Healthcare Group
Health IT and the Francis Report
Dr Paul Shannon30th April 2014
How IT systems can help
address the key findings of
the Francis report
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Schein’s 3-layers model
• Schein, E.H. (1985) Organizational Culture and Leadership, Jossey-Boss, San Francisco, CA.
Surface manifestationsArtefacts, ceremonies, rituals, heroes, sagas, etc
Values and Beliefs
Basic assumptionse.g. nature of reality, truth, relationships
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Analysis of cultural diversity in a NHS Trust using Schein’s 3 level scheme
(sub)cultureLevel 1Surface
manifestations
Level 2Values, beliefs
Level 3Basic
assumptions
Medical White coats, stethoscopes, ritualised ward
rounds, fellowships of Royal colleges,
eminent personalities
Personal contract between doctor
and patient, clinical freedom,
scientific basis for treatment, member of
profession, not employee of Trust
Hippocratic Oath, patient
confidentiality, sanctity of life,
responsibility to patient
Admin/Managerial
“civilian” clothes, plush offices
remote from patient areas, separate
hierarchy
Loyalty to Trust,Resources limited by
centrally controlled
budgets, Financial prudence,
adherence to central policy
Responsibility to Trust/NHS for public money expenditure, health gain of
population more important than
individuals
Nursing Uniforms, “hands-on” work,
Largely female, local training
Patient advocacy, care more than cure, nurturing, comfort, self-
sacrifice, hygiene
Primacy of the individual,
patient dignity,
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‘...doing the right thing even when no-one is watching’ (C S Lewis)
Key finding: ‘Secrecy’
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Key finding: ‘A lack of openness to criticism’
‘To focus on blame will perpetuate the cycle of defensiveness, concealment, lessons not being identified and further harm.’
(p35, Executive Summary)
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Key finding: ‘Acceptance of poor standards’
Urgent improvement necessary
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Key finding: ‘Misplaced assumptions about the judgements and actions of others’
There should be ‘...no place for favourable assumptions’. (p1678)
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Key finding: ‘Defensiveness’
“We can only be sure to improve what we can actually measure.” (Lord Darzi)
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Key finding: ‘Looking inwards not outwards’
‘[The NHS] is self-referencing. It’s not good at listening’ (Ombudsman, p1363)
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Key finding: ‘A failure to put the patient first in everything’
‘The Trust prioritised its finances and its FT application over its quality of care, and failed to put patients at the centre of its work’. (p45, Executive Summary)
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Conclusion
• Patient stories have high impact!
‘a rich and varied source of information on each patient to help patients avoid or manage chronic disease, deliver truly personalised health care
and proactively monitor safety and quality of care.’ (CSC, 2012)