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MAPPING INNOVATION IN HEALTH CARE Friso den Hertog MERIT/University Maastricht Publin policy workshop 2 December 2005 Brussels.

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Presentation on theme: "MAPPING INNOVATION IN HEALTH CARE Friso den Hertog MERIT/University Maastricht Publin policy workshop 2 December 2005 Brussels."— Presentation transcript:

1 MAPPING INNOVATION IN HEALTH CARE Friso den Hertog MERIT/University Maastricht Publin policy workshop 2 December 2005 Brussels

2 AGENDA Paradox of health care Patient centered perspective Diffusion & implementation: core problems New map for identifying walls & ceilings Systems perspective Radical change: high & low road Exploration

3 Mapping Wild & Unknown Territory EU network projects: Publin, Innoflex, Saltsa. Action research, Literature survey, In-depth interviews, Act as a sounding board.

4 PARADOX OF HEALTH CARE Despite the impressive progress in the development of technological and professional competencies, commitment and involvement of the professionals: Madness in the system: administrative and managerial powerlessness.

5

6 5 minute INTRODUCTION IN SYSTEM THEORY A SYSTEM IS: Set of elements Interrelations Function (=process) Feed back

7 LEARNING = FEED BACK actie measurement (deviation from the norm) input otput Black box

8 UNCLOSED CYCLE action measurement (deviation from the norm) inputoutput Black box ?

9 OPENING THE BLACK BOX The black box inputoutput

10 EFFECT HERE/ CAUSE OVERTHERE Black box input output CAUSE effect

11 WALLS & CEILINGS Black box inputoutput CAUSE effect

12 HEALTH CARE AS A PROCESS Discipline, function innovation environment system innovation process innovation functional innovation Firms, knowledge centers, advocacy organizations 1e care hospital revalidation homecare

13 NEW WORDS Total quality management (business-) reengineering Continuous (clinical) improvement Clinical pathways Organizational learning Focused factory Case management Care management Value chain management Evidence based medicine

14 MEANING: Total quality management (business-) reengineering Continuous (clinical) improvement Clinical pathways Organizational learning Focused factory Case management Care management Value chain management Evidence based medicine Process Management

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16 Active submission When a dog tucks his ears back and close to his head, hides his tail between his legs and crouches, he is probably in an active submission stance. This is a dog's message to an aggressor that he is not interested in fighting. Courtesy "The Truth About Dogs," by Stephen Budiansky

17 WALLS innovation environment system innovation process innovation functional innovation primary care hospital revalidation homecare Between primary care and hospital care Between disciplines Between services Between in- and outpatient care Discipline, function Firms, knowledge centers, advocacy organizations

18 FEED BACK ON SERVICE LEVEL action measurement (deviation from the norm) input output home care

19 MULTI-SERVICE FEED BACK action measurement input output home care hospital care home care action

20 LEVEL 2 Care functions Regional platforms LEVEL 4 care systems (policy) ECHELONS LEVEL 3 Service mgt. LEVEL 2 Care functions Communities of practice LEVEL 1 Care teams LEVEL 1 Care teams LEVEL 3 Service mgt.

21 LEVEL 2 Care functions Regional platforms LEVEL 4 care systems (policy) CEILINGS LEVEL 3 Service mgt. LEVEL 2 Care functions Communities of practice LEVEL 1 Care teams LEVEL 1 Care teams LEVEL 3 Service mgt. Boardroom ceiling Care unit ceiling Front line ceiling

22 MULTI-LEVEL FEED BACK Or: measuring the impacts of system-level change on health care frontlines & vise versa

23 BETTER PRACTICE Management of processes: radical change Ownership of change Multi-level change: connecting system levels Integrated feed back systems: across levels, across functions (and services)

24 HIGH ROAD Radical reform of the primary process in health care across disciplines and services by continuous change.

25 NO DOUBT: MANAGEMENT OF PROCESSES.


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