Feb 252014

Marc Franklin reflects on the Institute for Healthcare Improvement’s National Forum in Florida, and thinks about some of the lessons he left with.

Joshua Kovoor, Dr Andy Carson-Stevens, Marc Franklin, Don Berwick, Gney Mehta, Amy Butlin, Hope Ward, and Beth McIldowie at the IHI Open School Congress

Above: Joshua Kovoor, Dr Andy Carson-Stevens, Marc Franklin, Don Berwick, Gney Mehta, Amy Butlin, Hope Ward, and Beth McIldowie at the IHI Open School Congress

Just before Christmas, along with  five other members of the 1000 Lives Student and Educator Community and the Cardiff Medics Student-Patient Chapter, I headed for Orlando, Florida to attend the Institute for Healthcare Improvement’s 25th Annual National Forum on Quality Improvement in Healthcare. We boarded the plane excited to join over 5000 other delegates, and join the discussion on patient safety and quality improvement.

We began by attending the Institute for Healthcare Improvement (IHI) Open School Chapter Congress, along with many of the Forum’s other student delegates from universities around the world. Don Berwick (President Emeritus and Senior Fellow at the IHI), who led the Congress, emphasised the importance of students approaching healthcare systems with “fresh eyes”, and the significance of students’ position as the future of healthcare.

We were then set the modest task of saving the NHS £1 billion! We worked together to put forward a suggestion for quality improvement – our idea was  moving away from the use of non-essential sterile swabs when cannulating a patient, toward the use of cheaper, non-sterile swabs. This was an idea which had the potential to make real savings, and it shows that a small change has the possibility of making a big impact. Continue reading »

Feb 202014
Paul Gimson

Paul Gimson

Imagine what a primary care service might look like if we gave the patients the money and asked them to design it themselves. This was the story I heard recently at a presentation given by the Southcentral Foundation, a citizen-owned health-service provider based in Anchorage, Alaska.

The presentation was at a recent event in Cardiff looking at Southcentral Foundation’s Nuka system of primary care. It’s ‘A customer-owner driven overhaul of a bureaucratic system centrally controlled, to one in which the local people are in control.’ It is the use of this term customer-owner which is one of the most striking features of the Nuka system.

The idea of a patient as a customer might feel wrong in the context of the NHS, but in this case the term represented a shift from a service designed around a medical model to one where the patient’s needs were put first. The provocative question for us is, if we considered patients as customers would that improve the experience of being a patient in NHS Wales? Continue reading »

Apr 042013
Paul Gimson

Paul Gimson

We have seen the problems caused by a wrong culture within the banking industry (LIBOR fixing) and within the media industry (phone hacking). We have also recently had a powerful reminder that the wrong culture in healthcare can lead to a drastic reduction in patient safety and quality of care.

The Francis report has shone a spotlight on the attitudes and actions of staff in one small part of the NHS. The report makes for uncomfortable reading for all of us. The accounts of appalling lack of care are so shocking and difficult to equate with our core principles as health professionals, that it is easy to feel a sense of distance from them. Continue reading »

Feb 222013
Chris Hancock

Chris Hancock

When I worked in a Neonatal Intensive Care Unit (NICU), a full term baby was admitted because of rapid deterioration in his condition due to sepsis. As we prepared to resuscitate the little boy the consultant, attempting to encourage us, cried: “Come on, we won’t lose this one.” 

He was wrong. In a matter of minutes this newborn baby, who had only a few hours before been thriving, was dead. I was struck then by how quickly sepsis kills and also the futility of leaving treatment too late. Continue reading »