SN's Profile

I set up a clinical and governance team for 71 large Medical centres.
This was done by identifying the key leaders through assessments and interviews.
The key was to decide the purpose and outcomes required for the business.
Role modelling, culture of continued learning and innovation, business outcomes, dealing with “People” issues in their departments,and being part of a greater collective decision making at the head office level.
Engaged with 3rd party vendors for some of the functions. ( this I thought was the key to success, use their expertise)
Creating tools and support for clinical leaders.
Off site training in groups of 7-9 clinical leaders with the key management team, re enforcing the values of the organisation, and how that leads to better patient and business outcomes.
On the ground and head office support was given when and as needed.
It took a good part of 2.5 years, resources and effort to get a team of 57 leaders.
Like everything, devil is in the detail and constant grind to get it off the ground and deliver on a day to day basis.
ROI on that was amazing.
Great initiative.

Hi Ivo,

Comments above are extremely interesting and that of support, quality, reflecting , team culture etc.
You have obviously been through a lot to have to come to the board to recommend changes.
Health delivery is a business in its own right.
A large corporate would replace the person and walk them out of the building with a separation cheque and support services. ( further training or mentoring for them to seek another position else where) Why are we different in the health industry.
This sounds drastic and aggressive, but really is the only way,extricate your team from the problem and move on. Do not waste precious time and resources in feel good exercises. We can feel good by providing better services.

“People” as its called now are often the toughest issues to deal with.
I would put this under a broader umbrella of compliance.
Compliance is both Regulatory and Contractual. There is often not much play in regulatory compliance, but business needs are often met within contractual agreements.
Not knowing the Law in Abu Dhabi, I would approach each department head to have conversations with their teams to re negotiate the terms of contracts. The heads would need training from “People” on how to approach the subject, what changes need to be made and how it will help the team and more importantly the individuals contract. ( concept of whats in it for me, i.e. monetary, skill and career not necessarily in that order)
I get the sense sitting on the fence and letting it go, is leading to a catastrophe waiting to happen

We used “Kaizen” to help us map out how doctors were entering data into the software.
Needed to determine 1) Number of clicks required by clinicians for entering specific details into the software. 2) The way the clinicians enter the data using clicks or F keys.
Change management is about showing people,whats in it for them, hold their hands to get to the outcomes and also achieve their personal benefits.
Kaizen was able to show how the doctors by using this specific program with increased clicks were slow, affecting productivity, leading to lower earnings.
They then helped make suggestions on how the software with minor changes would become user friendlier with less clicks,increasing productivity. Each clinic had specific days for training on the new changes to the program, each clinician was showed that over a year how productivity increased their personal income, how patient records were better kept. The changes also meant that we could get better data usage ,not just mining.
Having external consultants, with industry knowledge will bring about innovative changes, usually benefiting the hospital or clinics.

In reality saving lives by Population Health (AKA) Community Medicine is probably a more effective way of achieving better health outcomes in the short term, than developing highly sophisticated models of care.
Innovation in its true sense is making even small changes. Providing potable water to communities preventing water borne diseases.
Having a better system of running clinics in various backward communities for immunisation, education on nutrition, precautions and prevention techniques for insect vector borne diseases will drastically reduce mortality.
Technology, will and must play a part in actively managing the delivery of care and drive data driven healthcare outcomes.
As we get over the line, I have no doubt that 1st class technology should be used in Kenya, as any where in the word.

Consumerism is not necessarily a bad thing.
Affordable and Accessible are two key factors in consumerism.
Pizza now comes to your home and can now even track it to the minute to your door step. Rest of the industries have moved on, why can’t the medical industry adapt to that.
What is important: the payer model, standards and outcomes of the service,be it short term or long term.
Should that be subsidised by the various governments and to what extent and what cost.
The standards of care, clinical governance and compliance should be instituted.
Have regular accredited clinical meetings, regular audits of patient records against say 15 college standards by a lead doctor in the practice.
In my experience people in a fee for service model,use different primary physicians for different problems. They will get a physician who is quick for colds and flus and repeat scripts and for complex issues they tend to see their “own GP”.
Linking these practices with local area health bodies and not alienating them to begin with, is important in preventing fracturing care.