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18 jun cliche or not to cliche….? posted in uncategorized on 18.06.10 by merlyn after a deep, long sigh over a many times cancelled and rearranged cup of coffee, a dear friend from medical school days pronounced ‘the life you get is the result of the decisions you make’. at the time i nodded gravely and filed the thought in the clichés department in my head. it has popped back into my mind several times since – and almost refuses to lie down in the pigeonhole to which i had assigned it. the build goes a little like this: - decisions are driven by the interplay of hard fact and emotions. - hard fact is hard fact, but emotions are driven by relationships and conversations. - the way we make decisions – emotional, contextual, cultural and habitual input triangulating with the facts - is what defines the quality of the decision. - and the quality of decisions, along with the degree to which systems and incentives are aligned (or not) is what makes organisations work – or not. in exploring a new order of doing the business in the nhs, we need to pay real, determined attention to the quality of the decisions that are made – for the very simple reason that poor, shabby decisions cost a good deal more than brilliant one do. but it is a waste of time perfecting quality decisions unless somehow, a fertile, organisationally aligned, culture in which they can thrive is created. high quality decisions are the result of the right conversations between the right people, on the basis of accurate, real time information. yet when we look at the crucial conversations, the crucial relationships that should be happening from the patient’s perspective, we see a strange picture. we see information based on proxy and poor levels of accuracy, of decisions made on habit and convenience – of the wrong conversations, held between the wrong people. now the nhs has a major chance to get some very important pieces of the elusive jigsaw right. but to do so it must focus on getting the conversations right, between the right people, building the right relationships. for my money this would be doctors who understand management in primary care and doctors who understand management in secondary care – all speaking as one with their management colleagues, sharing a single set of values and principles, within a context of the slickest management process. there are some fundamentals – what you get out of an organisation will always be the direct result of the quality of the decisions that are made and the leverage and incentives that are put in place. the real question of course remains – is the strength there to make the changes to the power-bases to allow the relationships and conversations to happen? do we have the guts to change the dynamics, the incentives and the levers? or will we default to the comfort of what we’ve always done before, just with a veneer of the current set of words? jenny no comments » 15 jun choppy waters posted in uncategorized on 15.06.10 by merlyn on an expedition aboard a friend’s boat last thursday, my youngest daughter chided me. i was lounging at the back of the boat, fascinated by the white wake spreading out, leaving a dramatic trail behind us towards the shore beyond. she urged me to the front of the boat, bouncing off the top of ever more boisterous waves, with wind tearing at our hair, spray on our faces, our eyes fixed ahead, on the horizon. i was somewhat fearful that i would find myself in an unladylike sprawl across the deck or worse, tumbling over the railing to land in the sea. how uncool. at 17, melissa has a cutting turn of phrase. ‘what are you doing looking backwards when its so fantastic to have a wide open space ahead? the horizon’s where we should be going’. how much of our thinking and ideas are really based on the way things were ? and how much effort do we put into recreating our familiar comfort zones, the minute they have been disrupted? possibly whilst even labelling the process ‘change’ or ‘improvement’? how do we learn – and help others - to embrace the open space ahead in the context of incredibly busy lives and a complex, highly politicised environment? how do we share the excitement of riding the surf of change and crisis? how do we create a culture of stretching ourselves to discover of new horizons in tightly constrained organisations? my world is the interface between professionals and management infrastructures in complex organisations whose product or service is delivered by highly trained – and expensive professionals. healthcare in particular - a world of constant change – yet combined, ironically, with overwhelmingly powerful organisational homeostasis to keep everything stable, the same. not surprising perhaps when, as in the case of the nhs in the uk, healthcare is a publicly funded service organisation providing all levels of care to an increasingly demanding, increasingly needy population. when a disruptive change comes along – even when the result is improved care or systems for patients – all manner of forces come into play, to ensure that the change doesn’t really happen – or is moderated. the headspace to think creatively and to lead change is a luxury rather than a necessity virginia woolf said that every woman has a sword across the body of her life. on one side of the sword lies the path of compliance, acquiescence and keeping her world stable. on the other side lies risk, change and challenge of the status quo. those that choose to cross the line achieve great things – but inevitably face a more perilous existence. the nhs too struggles with the perils of change, of ridding itself of that which holds it back – whilst being an inherently risk-averse culture. yet it can see - all too clearly – the need to cross the line of the sword to the world of challenge, of difference will the new regime instigate real change or cosmesis? will the people of the service rise to the challenge – or retreat to comfort? it all depends – of course – on how it is done. the financial crisis, undoubtedly creates the choppy waters in which change can thrive. but only if minds are set free and allowed to think the unthinkable. and only if the brightest people who care passionately about the service, who have the freshest and best ideas, are recognised, cherished and nurtured. they are the ones who will take the nhs to a new place. they will need vision, strength and determination. they are there – but will they be spotted and given the space they need? jenny no comments » home register log in categories uncategorized archives june 2010 blogroll tagcloud search © 2008 theme by merlyn

URL analysis for onward.org.uk

http://www.onward.org.uk/2010/06/
http://www.onward.org.uk/wp-login.php
http://www.onward.org.uk/2010/06/cliche-or-not-to-cliche/#respond
http://www.onward.org.uk/2010/06/cliche-or-not-to-cliche/
http://www.onward.org.uk/2010/06/choppy-waters/
http://www.onward.org.uk/category/uncategorized/
http://www.onward.org.uk/2010/06/choppy-waters/#respond
http://www.onward.org.uk/wp-login.php?action=register

Whois Information

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Error for "onward.org.uk".

the WHOIS query quota for 2600:3c03:0000:0000:f03c:91ff:feae:779d has been exceeded
and will be replenished in 79 seconds

WHOIS lookup made at 17:11:08 07-Aug-2017

--
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Copyright Nominet UK 1996 - 2017.

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register. Access may be withdrawn or restricted at any time.

  REFERRER http://www.nominet.org.uk

  REGISTRAR Nominet UK

SERVERS

  SERVER uk.whois-servers.net

  ARGS onward.org.uk

  PORT 43

  TYPE domain

DISCLAIMER
This WHOIS information is provided for free by Nominet UK the central registry
for .uk domain names. This information and the .uk WHOIS are:
Copyright Nominet UK 1996 - 2017.
You may not access the .uk WHOIS or use any data from it except as permitted
by the terms of use available in full at http://www.nominet.uk/whoisterms,
which includes restrictions on: (A) use of the data for advertising, or its
repackaging, recompilation, redistribution or reuse (B) obscuring, removing
or hiding any or all of this notice and (C) exceeding query rate or volume
limits. The data is provided on an 'as-is' basis and may lag behind the
register. Access may be withdrawn or restricted at any time.

  REGISTERED no

DOMAIN

  NAME onward.org.uk

NSERVER

  NS5.XILO.NET 91.230.181.30

  NS6.XILO.NET 95.215.175.30

  NS4.XILO.NET 193.150.34.30

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