Great innovations of the first and second healthcare revolutions
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Great innovations of the first and second healthcare revolutions • MRI and CT scanning • Anti psychotics • Antibiotics • Genetics • Hip and knee replacement • Chemotherapy • Antidepressants • Randomised controlled trials • Systematic reviews Gower Street - Doll & Hill Broad Street - John Snow
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MRI and CT scanning Anti psychotics Antibiotics Genetics Hip and knee replacement Chemotherapy Antidepressants Randomised controlled trials Systematic reviews. Great innovations of the first and second healthcare revolutions. - PowerPoint PPT Presentation
Transcript of Great innovations of the first and second healthcare revolutions
Great innovations of the first and second healthcare revolutions
• MRI and CT scanning• Anti psychotics• Antibiotics• Genetics• Hip and knee
replacement• Chemotherapy• Antidepressants• Randomised controlled
trials• Systematic reviews
Gower Street - Doll & Hill
Broad Street - John Snow
The First The Second
- BUT the NHS still faces 5 major problems• SAFETY -Errors and mistakes
• QUALITY - sub standard clinical practice and poor patient experience
• FAILURE TO MAXIMISE VALUE– Waste– Overenthusiastic adoption of interventions of low value and failure to get new evidence into practice
• INEQUALITIES • FAILURE TO PREVENT
AND new, additional challenges are developing
• RISING EXPECTATIONS• INCREASING NEED due to
– population aging – obesity due to too much food and too little exercise– new technology
• CLIMATE CHANGE which will create health problems and health emergencies and lead to Carbon constraints
• FINANCIAL CONSTRAINTS
We need to do the right things and, every year, do them•Better,•Safer,•Greener, and•Cheaper
We need to do the right things and, every year, do them•Better,•Safer,•Greener, and•Cheaper
Commissioning
QIPP
High Value
Low Value
The economic meaning in the Shorter English Dictionary is‘that amount of some commodity, medium of exchange, etc. which is considered to be an equivalent for something else’, and it gives as an example of the meaning of the term the use in 1806,‘we could hardly be said to have value for our money’.
Waste
Value
ValueWaste
We hate muda
High High Carbon Value
Low Low Value Carbon
High High Carbon Value
Low Low Value Carbon
Information Knowledge Technology
Citizens
The Drivers of the Third Industrial Revolution (Manuel Castells)
21st C leadership
The management of culture is one of the responsibilities of the leader
If you were to ask all the commissioners to write down the difference between the
meanings of productivity and efficiency what would they write?
If you asked them to describe Donabedian’s theory of optimality
The law of diminishing returns
BVHP The Better Value Healthcare Programme
Benefits
Investment of resources
Harmful effects increase in direct proportion to the resources invested
BVHP The Better Value Healthcare Programme
Harmful orSide effectsOf care
Investment of resources
After a certain level of investment the health gain may
start to decline
BVHP The Better Value Healthcare Programme
Benefits
Investment of resources
Harms
Benefits - harm
At the point of optimality value is maximised
BVHP The Better Value Healthcare Programme
Investment of resources
Benefits - harm
Optimality
BVHP The Better Value Healthcare Programme
cancer
cardiac
mental health
Manage.&IT Prevention
Diagnosis
Complicatedeg Trauma,Very old people
ChronicHealthProblems
Res& Ed
Evidence
The values of the population served
The other needs of the population(opportunity costs)
Choice Decision
DECISION MAKER(OFFICIAL)
11 Total Problems of the Respiratory System 3,539,634
11 A Obstructive Airways Disease 576,008
11 B Asthma 849,076
11 X Problems of the Respiratory System Other 2,114,551
792,000 tonnes of carbon
23 X Other Areas of Spend/Conditions 22,596,181
23 a • General Medical Services/Personal Medical Services 7,256,778
23 b • Strategic Health Authorities (including WDCs) 3,514,197
23 x • Miscellaneous 11,825,209
Evidence
The values of the Patients served
The other needs of that group ofpatients
Choice Decision
BVHP The Better Value Healthcare Programme
cancer
cardiac
mental health
Breast
bowel
lung
The Oxford Healthcare System
Objectives Criteria Standards Performance Minimal Achievable Excellent (Annual Report)
•To diagnose rheumatoid arthritis quickly & accurately•To slow the process of the disease by effective and safe treatment•To help the individual adapt to the challenges•To control symptoms and the effects of disabilities•To involve patients, both individually and collectively, in their care
This is an example of a national service set upas a system
Knowledge System
Patient
Clinician
Ideas and Information
Ideas and Information
Information
HIERARCHY
NETWORK
“A business organisation should have a nonhierarchical, self-organizing structure working in tandem with its hierarchical formal structure…..As business organisations grow in scale and complexity they should simultaneously maximise both corporate level efficiency and local flexibility…the most appropriate name is the ‘hypertext’ organisation” IkujiroNonaka and Hirotaka TakeuchiThe knowledge creating company OUP 1995
21st C leadership
Volunteer to take a lead on a systemShare your work through the Optimising Value BriefingsVolunteer to be the Value Improvement Lead
The PHCN will offer A culture clubTraining on system development
