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Creating a culture for innovation – grand round and patient co-design workshop with Dr Lynne Maher

We  are thrilled to annouce that Dr Lynne Maher, Director for Innovation and Design at NHS Institute for Innovation and Improvement, will run a grand round here at CMDHB on Friday 18 May 12.30-1.30pm at the Innovation Lab at Ko Awatea. Preceding the grand round, Dr Maher will run a workshop on patient co-design from 10.30-11.45am, …

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Video: Professor Sir Mansel Aylward discussing population health key challenges

4 May 2012 On Thursday 26 April Sir Aylward Mansel spent an enjoyable session talking to staff about the work he is doing at Ko Awatea and the key population challenges currently facing our organisation and other healthcare organisations around the world. These include rising demand, ageing population, technology advances, and increased pharmaceutical products coming …

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Carew Hatherley

Ko Awatea Visitors – Carew Hatherley on leadership

30 April 2012 In late March I was privileged to interview Carew Hatherley who was attending the Executive Quality Academy (EQA)* at Ko Awatea. Carew has had an illustrious career, including 17 years in the British Army with 2 years as the team leader for the Chief of the General Staff and 3 years as …

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Father and baby photo

‘Leadership is a foul weather job’

23 April 2012 Post 2 | The Transformation Essentials Series Prof Jonathon Gray, Director, Ko Awatea In this blog series we are exploring the essentials of system transformation. I am pretty confident that few would argue with the critical role of leadership, however we define the word! There are disparate definitions which I have tried to capture …

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Professor Sir Mansel Aylward

Mansel’s Musings – Part 3

24 April < Previous blog I have been out and about in the last couple of weeks, mostly in Wellington, so I have neglected my blog. In my last blog I mentioned that I would be visiting a Marae as part of my Tikanga training. What a memorable, informative and enjoyable experience that proved to …

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Creating a culture for innovation – grand round and patient co-design workshop with Dr Lynne MaherVideo: Professor Sir Mansel Aylward discussing population health key challengesKo Awatea Visitors – Carew Hatherley on leadership‘Leadership is a foul weather job’Mansel’s Musings – Part 3

May 15

Creating a culture for innovation – grand round and patient co-design workshop with Dr Lynne Maher

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We  are thrilled to annouce that Dr Lynne Maher, Director for Innovation and Design at NHS Institute for Innovation and Improvement, will run a grand round here at CMDHB on Friday 18 May 12.30-1.30pm at the Innovation Lab at Ko Awatea.

Preceding the grand round, Dr Maher will run a workshop on patient co-design from 10.30-11.45am, also at the Innovation Lab. The workshop will include how to involve patients and families in improvement work.

Lynne Maher leads work innovation focusing on the design and redesign of health services to improve quality and efficiency within the NHS. She has a particular focus in translating learning from service design and other industries to inspire in the NHS. This resulted in the development of experience-based design, a ground-breaking method of co-designing health services with patients based upon their actual experience of the service provided.

This is a tremendous opportunity to tap into Dr Maher’s expertise. All are welcome to attend.

 

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May 04

Video: Professor Sir Mansel Aylward discussing population health key challenges

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4 May 2012

On Thursday 26 April Sir Aylward Mansel spent an enjoyable session talking to staff about the work he is doing at Ko Awatea and the key population challenges currently facing our organisation and other healthcare organisations around the world. These include rising demand, ageing population, technology advances, and increased pharmaceutical products coming onto the market.

Sir Mansel is helping us to make sense of and address some of these key challenges, and to explore the steps we need to bring about sustainable and effective change. He offers a valuable insight into the importance of engagement, not only for getting people to believe in your vision but to take it further and make it a reality.

Joining in the discussion is Pam Muth, who has over 30 years experience in population health in the United States. Pam is assisting Sir Mansel with his quest at Counties Manukau DHB.

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Apr 30

Ko Awatea Visitors – Carew Hatherley on leadership

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30 April 2012

In late March I was privileged to interview Carew Hatherley who was attending the Executive Quality Academy (EQA)* at Ko Awatea.

Carew has had an illustrious career, including 17 years in the British Army with 2 years as the team leader for the Chief of the General Staff and 3 years as the commander of a busy infantry battle group. He is a Fellow of the British Institute of Leadership and Management.

Carew Hatherley

Carew Hatherley

To Carew, leadership is a personal thing and there is no template for the perfect leader. However, he believes there are common leadership traits and throughout his career, which began as a young 17-year-old soldier, Carew has purposefully tried to learn from the leaders around him, and from their successes and failures.

While there are many types of leader, Carew leads by example and has a ‘do as I do’ approach.   It is this leadership style, along with his ability to energise his teams, that has earned him the respect and admiration of many who have served with him.

“If you want people to follow you, you need to earn their respect and take them on the journey with you,” says Carew.  “People need to believe in you as a person and what you are trying to achieve.  They also need to see some relevance of how they fit in.  That’s why courses such as the EQA are so important as it gets leaders thinking about how can we work together and motivate people to bring about sustainable and effective change.

“I have to say that from my brief time at Ko Awatea you seem to have a culture where everybody works together for a common goal -that is, the patient.  It’s been great to hear about all the wonderful work that is taking place at Counties DHB and how everybody from the CEO to the people on the ground has a role to play.  That ‘can do spirit’, strong belief and energy needs to filter through to all levels of the organisation – get that right and people will go that extra mile.

“As for being a leader, it’s not an easy road and I’m sure there are times when even the great leaders among us have had doubts or question what they are doing.  There is a great Bill Bryson book called Mother Tongue that talks about a word called velleity – which is the will to do something but it’s just not strong enough to make you actually do it.  We all have moments of velleity every day.  Part of good leadership is getting people to just get over that tipping point.”

*The EQA is run by the Institute for Healthcare Improvement and brings leaders together to discuss ways of implementing sustainable and effective change.

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Apr 25

‘Leadership is a foul weather job’

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23 April 2012

Post 2 | The Transformation Essentials Series
Prof Jonathon Gray, Director, Ko Awatea

In this blog series we are exploring the essentials of system transformation. I am pretty confident that few would argue with the critical role of leadership, however we define the word! There are disparate definitions which I have tried to capture in these 10 quotations, and Muir Gray talks about leadership in this podcast.

What do I think about leadership? Well, at a recent school event I feel I witnessed true leadership in my children’s headmaster – and the transformation possible, and the tangible culture that such leadership can instil. I witnessed what Muir explains in his podcast is the intimate entwining of culture and leadership. Edgar H Schein suggests culture and leadership are two sides of the same coin and I agree. From that, some suggest a good leader shapes and defines the culture (and perhaps a manager works within that culture?) and good leaders (along with good managers) together mobilise people to tackle tough problems.

So what is the ‘foul weather’ reference in the title of this blog and how does it come to mind here in Counties Manukau? The quote comes from Managing the Non-Profit Organization by Peter Drucker. Drucker suggests that the most important task of an organisation leader is to anticipate a crisis. A leader has to make the organization capable of weathering – and, indeed, being ahead of – a storm. The challenge for us is to build an organization that is battle ready, with high morale, an organization that knows how to behave in a challenge, trusts itself, and its people trust each other.

That’s why we are trying to confront and articulate the major problems that face our organization. That’s why we need to communicate the essence of these problems and gather ideas and support for confronting them.

Reading Drucker again, after too long a break from his teaching, I was interested in his suggestion of the ‘four competencies of a leader’. He describes:

  • Listening – and that listening is not a skill, but a discipline anyone can choose
  • Communicating – requiring infinite patience
  • ‘Not to alibi’ – acknowledging that something isn’t working and openly reengineering it
  • ‘Subordinate to the task’ – putting the task ahead of the particular person performing it

Are these the core competencies we want in our leaders, or in ourselves as we lead?

I think we need to build a leadership academy to support our young (and not so young) aspiring leaders – I may well be wrong – but I wonder what we could learn from and about the more formalised leadership frameworks that exist inside and outside healthcare?

We will keep revisiting leadership and reflecting on your thoughts and feedback.

There is a storm approaching … are we ready for it?

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Apr 25

Mansel’s Musings – Part 3

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24 April

< Previous blog

I have been out and about in the last couple of weeks, mostly in Wellington, so I have neglected my blog. In my last blog I mentioned that I would be visiting a Marae as part of my Tikanga training. What a memorable, informative and enjoyable experience that proved to be. My wife (Angela), a visiting friend from Canada (Mary), Jonathon Gray and the colleagues whom I had met at the Mau Takitahi about two weeks previously, spent a whole day of Marua at the Pukaki Marae in Mangere. This was facilitated in a most generous, expert and enthralling way by Te Aroha Teriaki and Eric Nathan, as was the earlier Tikanga Best Practice Training (Mau Takitahi) held at Ko Awatea.

Professor Sir Mansel Aylward

Professor Sir Mansel Aylward

We started with a powhiri at 9.00am where we received an outstanding welcome and felt privileged to be part of this hallowed ceremony. The hospitality was tangible. I now know how to introduce myself in Maori language and, more importantly, how family, ancestors, connections with the land, heritage and belonging are so very precious in Maori core values and culture, as indeed they should be to us all.

As I am Welsh, I felt it important to say a few words in my native language and I even regaled everyone with my raucous rendering of Mae Hen Wlad Fy Naddau (our National Anthem) which may be familiar to those of you who have heard of the game, rugby. Moreover, not only was I pleased to say grace before each meal in Welsh (and to thank the cooks afterwards) but Angela, Mary and I now know the karakia for blessing food before a meal – and very much more too.

I learned much from the case studies which were discussed in the afternoon, the critical relevance of Maori Quality Standards and how these should be applied and exploited fully in our day-to-day professional practice. It was a day of joyous learning, at times solemnity and veneration, a moving experience and strong camaraderie. I wouldn’t have missed it for anything. I recommend this experience, knowledge and training to all staff at Counties Manukau District Health Board who have not yet availed themselves of it.

The experience and knowledge I gained helped me very considerably when I was more recently invited to speak to the Maori General Practice Faculty of the RNZCGP, which I also greatly enjoyed.

Furthermore, I now possess a valued certificate for completion of Tikanga Best Practice Training, which I can now put on the wall.

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Apr 24

Professor Sir Mansel Aylward speaking about key population health challenges

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20 April 2012

An informal talk by Ko Awatea ‘thinker in residence’ Professor Sir Mansel Aylward on identifying and addressing key population health challenges

Thursday 26 April 2012, 11am-midday, the Innovation Lab, Ko Awatea

As a centre for innovation, Ko Awatea aspires to be at the forefront of a healthcare revolution that begins in the community and is firmly focused on innovation that will be recognised as good as or better than that found elsewhere in comparable health systems internationally. Ko Awatea aims to develop solutions to improve efficiency, to achieve effective application of high quality healthcare, to secure maximum patient safety, to promote a shift from acute care to prevention and early intervention, and to realise a step change in the health of its constituent communities.

To this end, Professor Sir Mansel Aylward is at Ko Awatea as a ‘thinker in residence’ to progress several issues related to identifying and addressing key population health challenges faced by CMDHB, potential solutions to the issues, and ways to measure success in the three domains of the Triple Aim (population health, service cost and productivity, and quality of patient experience). Sir Mansel is assisted by Pam Muth from KPMG, who has been seconded to Ko Awatea three days per week for three months.

 

Professor Sir Mansel Aylward

Sir Mansel

Professor Sir Mansel Aylward CB is widely recognised as an expert in the area of healthcare innovation, including those that address integrated system approaches, patient safety and health inequities. He chaired the Bevan Commission – an independent advisory body to critically assess the alignment of the NHS Wales to the principles and delivery of health services as articulated by Aneurin Bevan, the architect of the NHS. The Commission tabled its report in May 2011 and has been successful in influencing thinking and development within NHS Wales. Sir Mansel is the first-ever Chair of Public Health Wales – a new unified NHS Trust responsible for the delivery of public health services at national, local and community level in Wales. He previously served as Chair of the Wales Centre for Health, established to be the ‘hub of connected organisations’ and to communicate better health messages to the people of Wales. He is also Director of the Centre for Psychosocial and Disability Research at Cardiff University. Sir Mansel was knighted in the Queen’s New Year’s Honours 2010 for services to health and healthcare.

Pam Muth

Pam Muth

Pam Muth has over 30 years experience in population health in the USA, Australia and New Zealand. She has held roles as clinician, health facility manager/administrator, Government executive and consultant. Pam is currently the head of the health and community services practice at KPMG where she specialises in health and community service policy development and implementation, program/policy evaluation and review, and monitoring outcomes/using evidence to drive policy and programming.

 

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Apr 10

Quotations about leadership

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I cannot give you the formula for success, but I can give you the formula for failure – which is to try to please everybody.

Herbert B Swope, editor and journalist (1882-1958)

The high sentiments always win in the end. The leaders who offer blood, toil, tears and sweat always get more out of their followers than those who offer safety and a good time. When it comes to the pinch, human beings are heroic.
George Orwell, novelist and essayist (1903-1950)

The key to successful leadership today is influence, not authority.
Kenneth Blanchard, author of ‘The One Minute Manager’

Leadership is the ability to strongly influence a group of people towards a common goal.
Professor Sir Mansel Aylward

Our chief want is someone who will inspire us to be what we know we could be.
Ralph Waldo Emerson, essayist and poet (1803-1882)

The very essence of leadership is that you have to have vision. You can’t blow an uncertain trumpet.
Theodore M Hesburgh

I think leadership comes from integrity – that you do whatever you ask others to do. I think there are [subtle] ways to lead. Just by providing a good example as a parent, a friend, a neighbor makes it possible for other people to see better ways to do things. Leadership does not need to be a dramatic, fist in the air and trumpets blaring, activity.
Scott Berkun

The leaders who work most effectively, it seems to me, never say “I.” And that’s not because they have trained themselves not to say “I.” They don’t think “I.” They think “we”; they think “team.” They understand their job to be to make the team function. They accept responsibility and don’t sidestep it, but “we” gets the credit… . This is what creates trust, what enables you to get the task done.
Peter Drucker, social ecologist (1909-2005)

Innovation distinguishes between a leader and a follower.
Steve Jobs

As we look ahead into the next century, leaders will be those who empower others.
Bill Gates

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Apr 05

Mansel’s Musings – Part 2

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5 April 2012

< Previous blog

I am the blogophobe some of you might have read last week. I am the first Ko Awatea Visiting Professor who arrived here a few weeks ago from Cardiff, Wales. It is a great honour and privilege for me to be the first to occupy this Chair, in what undoubtedly will be a long line of more distinguished professors than I.

Professor Sir Mansel Aylward

Professor Sir Mansel Aylward

I am here to learn about this remarkable and innovative concept that Ko Awatea represents, now that it has achieved reality.

I am impressed by the buzz about the place, which is the first thing that struck me. Equally, it is also a privilege to work with so many colleagues at Middlemore who are so evidently devoted to ensuring and improving patient safety, highly committed to delivering high quality healthcare services, and to exploiting to the full innovative thinking, practices and learning from others in the international arena. Not least, I have been met by a great welcome and hospitality from all the people I have met.

I hope that I shall bring some added value to the time I shall be with you. Wales is not that different to New Zealand: we have a smaller population than you by around 1.5 million but have the same number of sheep, we play rugby and now have the best team in the Northern Hemisphere after stunningly beating Ireland, Scotland, England (especially) and France (revengefully!); so watch out All Blacks. Like you we have a big neighbour – though England is a little nearer to us than your neighbour.

Most importantly in regard to my visit here, Wales faces the same sort of challenges to our healthcare services that the Counties Manukau District Health Board has to tackle. So we can share our learning and experiences to work together to deliver health services that will be as good as, or better than, those in comparable systems anywhere else in the world.

A little bit about me: I am chair of Public Health Wales which is a part of NHS Wales that delivers a unified population health service at the local, community and national level. We also are involved in health policy development and strategy in Wales, working closely with Civil Servant colleagues in the Welsh Government, provide national screening services, a national public health observatory and are a health research and development resource working closely with academia. I also have another job as Professor of Public Health Education and Director of the Centre for Psychosocial and Disability Research at Cardiff University. In a previous incarnation I was Chief Medical Officer and Chief Scientist at the UK’s Department for Work and Pensions in Whitehall. That’s enough about me for the present.

Incidentally, I have also done day one of Tikanga training and I am off with my wife to Pukaki Marae later this week. My apologies if I am not using the right Maori words as yet. I shall soon learn. I shall tell you about my further training in my next blog.

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Apr 03

Ko Awatea Visitors – Sir Mansel Aylward

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3 April 2012

Counties Manukau DHB and Ko Awatea are delighted to host Professor Sir Mansel Aylward, who flew in from Wales just in time to open the Innovation Lab with Auckland Mayor, Len Brown.

Prof Sir Mansel Aylward (centre) with Prof Gregor Coster (left) and Prof Jonathon Gray (right)

Prof Sir Mansel Aylward (centre) with Prof Gregor Coster (left) and Prof Jonathon Gray (right)

Sir Mansel joined health professionals, sponsors and other guests to celebrate the opening of a facility that will provide people from around the country with a space to think, plan, create, and execute great ideas and initiatives. Initiatives that will help improve the way healthcare is delivered now and into the future.

The opening of the Innovation Lab was Sir Mansel’s first event in New Zealand and his first look at Ko Awatea – a place he has been following with interest since it opened its doors in June 2011.  He is delighted to see the dream become a reality and fully supports the work the various teams are doing.

At the opening Sir Mansel shared some valuable insights (see below) into the healthcare challenges we are all facing –food for thought as we develop our own culture of change and improvement.

The major dilemmas of ill health, such as poverty and disadvantage, lie outside the health service and you can’t improve the health system if you ignore them. How do we do this? It all comes down to changing behaviours, expectations and beliefs.

  • A belief is something that someone holds to be true.
  • We need to stop our citizens from falling into the river of ill-health, rather than being so focussed on fishing them out. We need to work much harder at keeping people well in our communities.
  • What is leadership?
    - The ability to strongly influence a group of people towards a common goal.
    - Leadership is like happiness. When you’ve got it, you don’t know it. And if you pursue it, you won’t attain it.
    - Bosses and leaders are not necessarily the same. Bosses have power and authority; leaders have influence and pull others along with them.
  • If you have the passion to make things better, pick up the baton and run with it.  If no-one asks you to stop – keep going!
  • Biggest cultural challenges:
    - Fear of fear itself
    - Fear of change
    - Fear of failure
    - Fear of political change
    - Fear of demographic change

Sir Mansel will be with us until June, meeting with health system stakeholders within CMDHB and across New Zealand, holding workshops for staff and students, and contributing to publications and academic papers.

Professor Sir Mansel Aylward CB was appointed as Chair of Public Health Wales in 2009.

He is physician and specialist in rheumatology, rehabilitation, therapeutics and clinical pharmacology. 

He played a key role in the development of the UK’s medical assessment for incapacity (the All Work Test), the Personal Capability Assessment and the Pathways to Work initiative for vocational rehabilitation.

– Public Health Wales

For more information click here to view his biography.

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Apr 02

Transformation starts here

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2 April 2012

Post 1 | The Transformation Essentials Series
Prof Jonathon Gray, Director, Ko Awatea

Welcome to the first blog of our new ‘Transformation Essentials’ series.

In this series you’ll be hearing from me, and others, about essential topics relating to the transformation of healthcare systems, starting with our own.

What is the aim? Well, I am really clear about that. Ko Awatea will help Counties-Manukau to become the best health system in the world, and as we do that we will share our learning widely.

What is the strategy? Ko Awatea will encourage, support, and provide the necessary ‘will, ideas and execution’ to achieve our aim.

This web site and all our communications will help to build will, bring people together to share ideas, knowledge and expertise, and will help to highlight the execution (the doing) that we achieve together.

But first – let’s be clear – I know we all have very limited time so I will try to provide you with the “essentials” – either directly or via links. Let me give you back some of that time you spend surfing the web – looking for the latest interesting idea or book or podcast. I will also provide you with thought-provoking  words and quotes. Thinking deeply and innovatively is our key skill so I hope these ‘thoughtbeats’ will help to stimulate your thinking and ideas.

Why have I chosen ‘Transformation Essentials’ for the title of this series?

The fact is, transformation of healthcare systems is not an optional or part-time goal, it is a common challenge that everyone who works in healthcare must face and overcome. As our CEO, Geraint Martin wrote in his recent Sustainability and Excellence blog, ‘demand on the health system is both growing and changing. The reality is that if we don’t change the way we work, Middlemore will eventually seize up and we’ll simply run out of beds.’

So how should we respond? Should we just work harder? Learn more, research more, improve more? That won’t be enough – and it will wear us down. Our thinking must change. Our system must change. But where do we start in addressing this? What are the steps on a journey to best achieve the balance of patient experience, population health, and value for money?

Thinking deeply and differently to uncover pathways to a truly excellent and sustainable health system is our responsibility and opportunity.

This is why our Board has supported the establishment of Ko Awatea.

This is why healthcare improvement centres like the Institute for Healthcare Improvement and the Oxford Centre for Healthcare Transformation exist and are our partners.

This is why we have generous, forward-looking sponsors.

This is why eminent healthcare leaders like Professor Sir Muir Gray and Lord Darzi have visited us, and why Professor Sir Mansel Aylward is with us now.

This is why campaigns like 20,000 Days are so important.

This is why we will host the Asia Pacific Health Improvement Conference in September.

This is why our joint venture education partners – Auckland University, AUT, and MIT – have joined us here at Ko Awatea, becoming part of the solution as career pathway agents and as fellow innovators, helping us to think our way through this most complex of challenges.

And thinking is the key.

What will a transformed system look like? I don’t know, but I am happy to defer to Muir Gray on some of the key steps we will explore en route to that transformation. He describes 20th century healthcare as being based on bureaucracies, whereas 21st century healthcare will be based on ‘knowledge-based systems of care’ and will have five quite different dimensions.

  • Knowledge-based healthcare
  • Citizen-centred healthcare
  • Web-enabled care
  • Better value healthcare
  • Sustainable healthcare

You can learn more about Muir’s views on the components of transformation in his podcast What is a win-win health service?.

So, through this blog we will look at these and other important – ‘essential’ – steps towards a transformed health system, because our people deserve no less.

What do you think will be the features of a sustainable health system? Please comment with your thoughts and ideas.

And come back next week when I will blog about the first of the ‘essential’ steps that I think is needed to kick-start transformation.

Thanks for your time. After a blog-free summer (that wasn’t much of a summer, to be fair), it’s good to be back.

Jonathon

This series complements a forthcoming ‘Management’ series, led by our General Manager, Tanya Maloney, and ‘Voices’ series, which is for internal and external commentary.

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