Making Things Even Better Learning From the Experience of Others New Horizons: Liberating Surgical T

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Making Things Even BetterLearning From
theExperience of OthersNew Horizons
Liberating Surgical TeamsTorbay, England12-13
November 2007
Paul E. Plsek Roswell, Georgia, USA
PaulPlsek_at_DirectedCreativity.com DirectedCreativit
y Creative Thinking for Serious People.
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Change requires
Source Institute for Healthcare Improvement,
Boston, USA
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Concept of a Change Concept

• Change concept a general idea with sound
  foundation that can stimulate specific ideas
  for change that lead to improvement
• Process change a specific, physical realization
  of the idea

Whose idea would you rather implementyour own,
or someone elses?Capturing change concepts
allows forlocal adaptation and re-invention.
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Tool Change Concepts

• Starting with the specific change ask
• Whats the main idea here?
• What is the key point behind what made this work?
• What did we really do when you get right down to
  it?
• Seek a more general statement of the essence of
  the change

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Generalizable Change Conceptversus Specific
Change

• Specific change AE flow improved by bringing
  patient back immediately registration clerk uses
  computer terminals that are in all AE rooms to
  register patient in the room as care proceeds
• They say, Too expensive, we dont have terminals
  in all our AE rooms!
• Change concept Mobile registration (let the
  patient flow into the care system and we will
  catch up later with registration)
• We say, What are various ways to implement
  mobile registration while the patient continues
  to flow?

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Tool Concept Fan
General Change Concept
Specific Ideas

• Computer terminals in all ER rooms
• One computer on rolling cart
• One laptop
• Could plug into phone jack, have wireless
  network, or just hook up back at desk
• Paper registration form on a clipboard
• and so on

• Computer terminals in all AE rooms

Source Edward de Bono
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Making Things Even Better Listening for Change
Concepts

• As you listen to what others have done, ask
• What are the main ideas behind what they did,
  expressed in plain language? What did they really
  do, in general terms?
• How might I engage others in adapting those
  change concepts to our local context?

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Making Things Even Better Listening for Creative
Ideas

• As you listen to what others have done, ask
• What old rules and mental models have they
  challenges and what have they left unchallenged?
• What ideas can I come up with thatchallenge
  these old ways of working even further?

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Making Things Even Better Listening for the
Human Side

• As you listen to what others have done, ask
• How did they handle the humanand social aspects
  of change?
• What human systems issues will come up in my
  context if I take this idea back, and what can I
  do about that?

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Tackling the Issues Workshops

• Pre-operative assessment clinical evaluation
  (PACE)
• Scheduling admissions process
• Consent
• In the operating theatre
• Safety efficiency Briefing debriefing
• Equipment HSDU

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Making Things Even Better

• Every system is perfectly designed to get the
  results it gets
• Different results requires change
• Change requires will, ideas and execution

How will you find and take away really new ideas
and approaches from this conference?