International Forum on Quality and Safety in Healthcare 2017 – Day 2

02 May 2017

This is a follow on from my thoughts on Day 1 at IHI 2017 which was convened back in London this year and which in my view was more about embedding the patient experience and engagement as a way of practice for healthcare workers. A really vital theme, but I personally really enjoyed the creativity of day 2.

The Keynote address with Derek Feely, President and CEO of IHI and Jason Leitch, National Clinical Director Quality and Strategy for Scotland was really good. They shared their thinking on Quality and Safety getting to the Third Curve or stage 3 in the process of grounding quality and safety into the DNA or healthcare organisations. Organisations maturing from:

• Keeping Power – performance management, targets, sanctions, inspections, control, centralisation; to
• Sharing Power – control shift to working together to achieve outcomes, growing stronger quality and safety systems); to
• Ceding Power – partnerships, relationships, mobilising social action, working together for outcomes with patient having power, and
• A Mindset shift to humility, respect and humble enquiry to delivering best services to meet what matters to the patient/client

Curve 111 is characterised by patient-centred, consumer directed models of healthcare. Future healthcare practitioners must be trained to embrace this change and function in the ‘third curve’.

The Keynote address by Sir Ranulf Fiennes was inspirational for me. The man himself and his achievements are inspirational – an English explorer and holder of incredible endurance records. He is also a prolific writer and poet. Sir Ranulf addressed a number of themes from his own life:

• A commitment to big goals – the first person to visit both the North and South Poles by surface means; the first person to cross the Antarctic continent on foot; he circumnavigated the world along its polar axis, a three year and 52,000 mile expedition yet to be matched by anyone; he discovered the legendary lost city of Ubar in the southern Arabian sands which has often been called the “Atlantis of the Sands”
• Thorough preparation – these expeditions took 6-9 years to plan, get funding, establish rigorous protocols and systems for safety, and, pick teams. All with the leadership and support of his wife Ginny, a powerhouse in her own right and a meticulous planner
• Picking teams based on character – “pick your team on character, not skill. You can teach skills; you can’t teach character”

A final quote “There is of course never any point in crying over spilt milk – the key is to learn from failures and then to keep going” – Sir Ranulf Fiennes

I enjoyed Sir Muir Gray’s session and conversations with him where he referenced Manuel Castells who talks of The Network Society to describe a new world in which relationships are more important than entities, a world in which the Internet plays a huge part not only technically but culturally. Castells says that the third revolution is underway and it is not driven by the leaders of industry or politicians but by the interrelated forces citizens, knowledge and the smartphone.

Muir talks in health of paradigms that started with:

• Effectiveness and Evidenced Based paradigm, then
• the Cost Effectiveness paradigm, then
• the Quality and Safety paradigm, and now
• a shift to Value from a population perspective

“A paradigm does not necessarily destroy the preceding paradigms but embraces them.” – Sir Muir Gray